Two-year-old Jasmine was fascinated by the bright red buttons on her teddy bear’s suit.

They were coming loose. As she tugged at them, two fell off. They looked like sweets. She popped one into her mouth. It tasted funny, so she took it out and put it up her nose. Her mother, who was in the same room, was engrossed working on the computer. Jasmine ran to her crying and pointing to her nose.

Seeing the ragged teddy bear and the other button on the floor, Jasmine’s mother realised what had happened and frantically rushed the toddler to hospital. Doctors managed to remove the button from Jasmine’s nose, but only after holding her down and wrapping her in a blanket to keep her still, because she was crying and refusing to cooperate.

Jasmine’s story is a composite profile of children under five who have been hurt while playing with age-inappropriate toys. This case involved a teddy bear with buttons that could come off. However, if a child swallows a button battery and it is found to be in the oesophagus, he will have to go under general anaesthesia to have it removed.

Toy-related injuries in children in Singapore

In 2013, more than 500 children were treated at the KK Women’s and Children’s Hospital (KKH), a member of the SingHealth group, for toy-related injuries. Most cases are minor, but serious ones include bruises, fractures needing surgery, wounds needing stitches, or buttons, coins and pen lids painfully lodged in mouths, noses or ears.

Last year, the hospital saw a 15 per cent increase in the incidence of toy-related injuries in a nine-month period, compared to a similar period the previous year. Most of the children were under five years old. Half were under three.

Dr Chong Shu-Ling, Senior Staff Registrar, Department of Emergency Medicine, KKH, said, “It may be a true increase in the number of toy-related injuries, or it may be that caregivers are more aware of these injuries and more likely to take their children to the emergency department for treatment.”

Study on parental knowledge of toy safety and practices in Singapore

The increase prompted the hospital to study parental knowledge of toy safety and practices in Singapore. It surveyed 93 parents and caregivers at its children’s emergency department from February to April 2012.

Results showed that 81.7 per cent ensured their children’s toys were age-appropriate, 72 per cent checked labels for age recommendations, and 63.4 per cent read safety labels and followed the instructions. However, 92.5 per cent still bought toys not appropriate for their child’s use.

Survey respondents said they made this decision because they believed that the toy had an educational benefit, or believed that their child had met the appropriate developmental milestone and was able to play with the toy safely.

Age recommendations on toys are labelled based on each toy’s safety aspects, the physical and cognitive abilities of children, and children’s level of interest.

Common mistakes include buying toys with small parts for children under three, or putting small children on overly large riding toys from which they can fall, resulting in wounds or fractures.

About 87 per cent of the participants had experienced at least one toy-related incident. About 44 per cent said it was due to the child using the toy wrongly, and 37.6 percent blamed this on lack of supervision by the caregiver.

Young children playing with potentially dangerous toys should always be supervised, said Dr Chong. “Preschoolers have a strong exploratory nature, but are not fully aware of the dangers that their acts may cause.”

Ref: R14