Advances in Pediatrics and Neonatal Care

Article / short communication

"Choking Hazards Made into Toys: Beware of Beads and Babies"

Miriam R. Singer1, Ruiyi Gao1 and Ruth Milanaik1,2*

1Department of Pediatrics, Steven & Alexandra Cohen Children’s Medical Center of New York, New York, USA

2Donald & Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA

*Corresponding author: Ruth Milanaik, Division of Developmental & Behavioral Pediatrics, Steven & Alexandra Cohen Children’s Medical Center of New York, 1983 Marcus Avenue, Suite 130, Lake Success, NY 11042, New York, USA. Tel: +15168026100; Email:

Received Date: 15 August, 2019; Accepted Date: 13 September, 2019; Published Date: 20 September, 2019


Choking Hazards Made into Toys: Beware of Beads and Babies

Choking is one of the leading causes of morbidity and mortality among infants in the United States, with toys as one of the primary causes of choking-related injury and death [1,2]. Certain products marketed towards parents of infants, including modern pacifier clips, pose a heightened choking risk to babies. In this article, we aim to highlight the unique hazard associated with trendy silicone or wood beaded modern pacifier clips, which jeopardize the lives of infants.

Pacifier clips, which are meant to prevent infants from dropping or losing their pacifiers, are increasingly made with wood or silicone beads intended to be chewed on by teething infants. Pacifier clips with wood or silicone beads are often advertised as “unique, modern, and safe” for babies, with materials that are “non-toxic, Phthalate & BPA-Free.” However, these beads pose a serious choking hazard to infants.

The United States Consumer Product Safety Commission has stated that toys or products with small parts present a choking hazard to children under the age of three. A “small part” can be a whole or piece of a toy or article that “fits completely into a specially designed test cylinder 2.25 inches long by 1.25 inches wide that approximates the size of the fully expanded throat of a child under three years old” [3]. The wood or silicone beads on pacifier clips are usually less than 1 inch in diameter, clearly within the dangerous size range. Furthermore, small objects that are round and smooth, like wood or silicone beads, are especially likely to form a plug in the airway and obstruct airflow [1]. Additionally, once they have blocked the airway, the smooth nature of these beads can also make it difficult for medical professionals to retrieve them via forceps in an emergency situation. Once again, is important to note that these beads are marketed as “teething beads” and strung to pacifiers, actively encouraging infants to place them into their mouths.

In 2018, the U.S. Food and Drug Administration recognized the dangers of these beads and issued warnings against beaded jewelry for infants, stating that “choking can happen if the jewelry breaks and a small bead enters the child’s throat or airway” [4]. However, the FDA has not yet issued warnings about pacifier clips with beads, which possess the same parts that can result in adverse outcomes.

Chewbeads New York-based company, was forced to reckon with the dangers of beaded pacifier clips in 2015 when they recalled over 45,000 silicone-beaded pacifier clips due to safety concerns after receiving reports of beads detaching from the products [5]. Yet, despite this precedent, pacifier clips with beads intended to go into babies’ mouths continue to be marketed by companies and purchased frequently by parents of infants. Moreover, many online resources offer parents advice on crafting their own “homemade” pacifier clips with silicone or wood beads. These do-it-yourself imitations are often made using instructions that lack any warning about the potential dangers.

Undoubtedly, parents and other caregivers should be aware of the severe choking hazards that pacifier clips with silicone or wood beads can pose to their infant. Additionally, healthcare providers should warn parents of the risks of beaded pacifier clips. Most importantly, responsible toy manufacturers need to be aware of choking hazard guidelines and actively avoid making products that pose specific risks to infants. For example, manufacturers of beaded pacifier clips could instead use beads that are larger, connected, and/or a less dangerous shape, which would reduce the choking hazards of the product. It is essential that companies do their part to protect infants from preventable injuries and death. After all, it is not only doctors who should be committed to first do no harm.

Citation: Singer MR, Gao R, Milanaik R (2019) Choking Hazards Made into Toys: Beware of Beads and Babies. Adv Pediatr Neonatol care: APNC-102. DOI: 10.29011/APNC-102.100002

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