There’s a big fuss afoot over how long babies should breastfeed. But maybe we also should discuss how long babies should use bottles, sippy cups and pacifiers.
Those babyhood staples may seem benign, but they’re implicated in injuries that send about 2,200 children under age 3 to emergency departments every year.
That’s according to a study published Monday in the journal Pediatrics that tracked the incidence of such injuries from 1991 through 2010. Using data from the National Electronic Injury Surveillance System, researchers led by Sarah Keim at Nationwide Children’s Hospital in Columbus, Ohio found that more than 45,000 young children had sustained injuries serious enough to warrant emergency-room treatment over those 20 years.
Though the average number of injuries per year was 2,270, the incidence of such injuries dropped by almost 30 percent over the period studied, with 2,194 occurring in 2010, down from more than 3,000 in 1991.
Most of the injuries (70.4 percent) were cuts and nearly all (86.1 percent) resulted from falls, the study found. Most injuries (70.1 percent) were to the mouth and most (65.8 percent) involved bottles. Two-thirds of the injuries occurred among one-year-olds, an age when toddlers are mighty wobbly on their feet.
Sippy cups weren’t nearly as big a problem as bottles, accounting for 14.3 percent of all injuries across all ages. But that percentage varied according to age: While sippy-cup-related injuries accounted for only 14 injuries to children under a year (too few to amount to a percentage) and 15.6 percent among one-year-olds, they were involved in more than a quarter (25.9 percent) of all injuries to two-year-olds.
Pacifiers were more consistently involved in injuries across the age groups. They were involved in nearly one-fifth (19.9 percent) of injuries across all ages and more than one-third (33.8 percent) of injuries to children under one year old. That percentage fell to 14.9 among one-year-olds, but rose to 18.1 percent among two-year-olds.
On the whole, the authors note, their findings suggest there’s nothing inherently wrong with these products themselves but rather with the circumstances under which they’re used. In fact, only 4.4 percent of cases in the study were attributed to product malfunctions.
The study notes that guidelines from the American Academy of Pediatrics (AAP) and the American Academy of Pediatric Dentistry call for switching straight from bottles to lidless cups, instead of using sippy cups. (Those recommendations, the study points out, are aimed at preventing cavities, not avoiding injuries such as those described in this study.) The authors further note that while the AAP recommends pacifier use for young infants to protect against sudden infant death, that organization suggests easing away from pacifier use at age 6 months to protect against otitis media (ear infection) and cautions that children age 3 and up who use pacifiers may have problems with their dental occlusion (the way their upper and lower teeth meet).
The authors conclude that even if those recommendations weren’t made with injury prevention in mind, if more parents followed them, fewer of these injuries might occur. Finally, the authors hint, “encouraging children to remain seated while drinking may also reduce injury risk.”