Gifting and Playing With Toys Safely During the Holidays

Gifting and receiving gifts are an exciting part of the holiday season. But it is critical to remember the importance of safety, especially when it comes to young children.

The United States Consumer Product Safety Commission estimates that about 155,000 children age 12 years or younger were treated in emergency rooms for toy-related injuries in 2023. How can you make sure that your loved ones are playing with safe, age-appropriate toys? Kara Meister, MD, FAAP, pediatric otolaryngologist at Stanford Medicine Children’s Health, answers common questions about the dangers of small toys and what other safety measures you should think about for the holidays.

What tips do you have for parents when choosing a safe toy for kids?

Safety goes hand in hand with a child’s development. For babies and young children less than 4, we think about anything larger than 4 centimeters as probably safe. Four centimeters is about the diameter of a carboard tube in a toilet paper roll. So, if a toy can fit in that, it’s not a great choice for babies and toddlers because it presents a choking hazard.

In older kids, we think more about big risks. You want to make sure they’re using the toy or equipment properly. For instance, if they’re gifted a bike, ensure that they have a helmet and properly wear it when riding. Also, don’t forget about siblings. Your youngest child is your common denominator. If you have a 5-year-old and a 2-year-old, be cognizant of introducing those small parts that they could choke on inadvertently.

Are there any parts of a toy that parents should be aware of?

The other thing that we worry about is any toy with a button battery. A button battery can look like a coin and can be very enticing for children to put in their mouth. They can be found in many toys for kids of all ages, remote controls, hearing aids, and even singing greeting cards. Every year, thousands of kids are treated in emergency rooms after swallowing button batteries, and some have died from those injuries. That number unfortunately has been increasing because a lot of toys and new technologies are using button batteries more and more.

Button batteries are not only a choking hazard, but if they also get stuck in the body, that can create severe burns. For example, if they get stuck in the throat, they can erode into other organs or blood vessels and be life-threatening injuries. I’ve also seen them be placed in the nose, where they can create a burn leading to brain infections or other complications. These injuries can happen in as little as two hours. It’s very important to know if there are button batteries in the house, and if there are, keep them in a safe place away from your children.

How do I know if a child has swallowed a button battery, and what should I do?

The first sign you’ll notice if your child swallows a button battery is they may start drooling because they don’t want to swallow their own spit, or they’ll refuse eating or drinking. Several hours later, they may develop a fever, fast heart rate, or difficulty breathing. If you suspect a button battery has been swallowed, take the child to the closest emergency room immediately or call 911, as time is of the essence.

The number one thing to do is to give honey every few minutes while on the way to the emergency room. If your child is less than 12 months old, give them jam or jelly. That helps coat the injury.

Some manufacturers have coated the battery in a bitter taste in hopes that a child will spit it out. A more recent introduction has been applying dye to the battery. So, if a child does put a button battery in their mouth, the dye will mix with the moisture and turn the mouth bright blue. If you see that, give the child honey or jam and take the child to the emergency room for further checks.

Are there any other choking hazards during the holiday season?

Toys are an obvious answer, but this time of year is filled with many other choking hazards. A lot of holiday foods are filled with nuts or popcorn, which are not appropriate for little children to eat. Think about the ornaments on your tree or around the home. If you have any that are small enough to fit through a toilet paper roll, make sure they are out of reach, as well as Christmas lights or the hooks of your ornaments. Anything can be a choking hazard for kids—not just toys.