Two months ago, Jackie Sherrill of Grove City, Ohio, was sitting on her couch when her 20-month-old toddler, Morgan, who was sitting beside her, suddenly reached over. In an instant, Morgan, who had a bottle in her mouth, tumbled off the couch, crashing into an ottoman as she plunged to the floor.
As she wiped away her daughter's tears, Ms. Sherrill noticed that Morgan had a broken tooth and a cut mouth, damage from the hard plastic bottle she had been drinking from. Morgan didn't suffer any long-term harm, but it was then that Ms. Sherrill decided to begin transitioning her daughter from bottles to normal cups.
"I never would have thought that a child could get hurt from a bottle," said Ms. Sherrill. "It's something comforting to them. That's not one of the first things you think about when you're giving a kid a bottle."
Most parents don't think of a child's bottle as a potential hazard. But two new studies in the journal Pediatrics highlight several under-recognized causes of injury in young children: bottles, pacifiers and sippy cups, which cause thousands of injuries to the mouth and teeth every year, often when toddlers topple over while holding them in their mouths, and button batteries, those flat silver discs used in toys, watches, remote control devices and other home electronics that can cause serious harm when swallowed.
The report on injuries involving bottles, pacifiers and sippy cups, the first nationwide look at such injuries, found that in the 20-year period from 1991 through 2010, more than 45,000 children under the age of 3 -- an average of about 2,270 children a year -- were treated in emergency rooms for injuries related to bottles, pacifiers and sippy cups.
"This is the equivalent of about one child every four hours," said Sarah A. Keim, a study author and a researcher at Nationwide Children's Hospital in Columbus, Ohio. She noted that the true number is likely to be much higher, since the study looked only at children who had been taken to emergency rooms. "We expect that less severe injuries were handled by the parents themselves, or that the child was taken to a pediatrician," she said.
“这就等于是说，每四小时就有一个孩子受伤，”本文研究作者、俄亥俄州哥伦布市美国儿童医院(Nationwide Children’s Hospital)研究员莎拉·A·凯姆(Sarah A. Keim)说。她还指出真实的数字可能高得多，因为这项研究只统计了那些被送去急诊的儿童。“我们估计，那些不太重的伤会由孩子家长自行处理，或者交由儿科医生来处置，”她说。
While almost all children use a pacifier or bottle at some point, health authorities have long encouraged parents to wean them off around the time they are learning to walk. The American Academy of Pediatrics, for example, recommends that children stop using pacifiers by about 6 months and transition from bottles to lidless cups by 12 months -- yet most parents ignore these guidelines. Studies show that nearly half of 1- and 2-year-olds continue to use bottles, and more than three quarters of children 1 to 2 drink from sippy cups.
差不多每个幼儿都会在成长的某个阶段使用安抚奶嘴或奶瓶，不过长期以来，卫生部门一直倡导家长在孩子开始学步时，就不再给他们使用这类用品。比方说，美国儿科学会(The American Academy of Pediatrics)推荐家长在孩子满6个月时，让他们戒掉安抚奶嘴，在12个月时从奶瓶过渡到没有盖子的杯子，不过大多数家长都忽视了这些指引。研究显示，有近半数一到两岁的幼儿仍在喝奶瓶，超过四分之三的一到两岁的幼儿在喝吸管杯。
In the new study, a majority of the injuries involved 1-year-olds. Bottles were the most common culprit, accounting for about 66 percent of cases, followed by pacifiers, at 20 percent, and sippy cups, at 14 percent. Injuries tended to occur at home and result in cuts to the mouth and face, usually when children were running or walking.
"We think 1-year-old children are just learning to walk and run and are pretty unsteady on their feet and may be more likely to experience a fall," said Dr. Keim.
She added that in her estimation, if the guidelines for stopping bottle and pacifier use had been followed, "about 80 percent of the children in the study would not have been using the product at the time they were injured."
Dr. Keim said that teaching children to use regular cups was important not because there is anything about the design of a normal cup that makes it safer, but that parents are simply more likely to make their children sit or stay in one spot while drinking from a lidless cup to prevent spills.
"It's the combination of being seated while drinking that I think would reduce the risk of injury," she said.
The second study, warning parents to be on the lookout for button batteries, a concern raised in earlier reports, noted that in the last two decades, about 66,000 children and teenagers were taken to emergency rooms in the United States for battery-related injuries. While none of the cases -- many involving children under 5 -- were fatal, lithium-cell batteries that are swallowed can set off a chemical reaction inside the body that can lead to severe tissue damage in just two hours.
The researchers, also at Nationwide Children's Hospital, found that the number of cases had doubled during the study period. While parents need to be mindful about not leaving button batteries within reach of young children, they said, doctors, too, need to be aware of the growing problem so they can recognize it.
"Because button batteries may be mistaken for a coin, electrocardiogram electrode or other external object on a chest radiograph," the authors wrote, "disc-shaped objects should be carefully examined for features such as diameter and a double rim to prevent delays in diagnosis."