2,270 Children a Year End Up in the ER Because of Bottles, Pacifiers, and Sippy Cups

The short version: Every four hours, a child under the age of three is treated in a U.S. emergency department for an injury involving a baby bottle, pacifier, or sippy cup. That was the finding of a study released in May 2012 — and the cause was almost embarrassingly preventable: children falling while walking or running with the product in their mouths.

What the study found

Researchers at Nationwide Children's Hospital in Columbus, Ohio, analyzed twenty years of emergency department data (1991–2010) and estimated that 45,398 children younger than three were treated for injuries related to these three products — an average of 2,270 injuries per year. The study was released online on May 14, 2012, and published in the June print issue of Pediatrics.

The breakdown: baby bottles accounted for about 66% of injuries, followed by pacifiers at 20% and sippy cups at 14%. The mouth was the most commonly injured body region (71%), followed by the head, face, or neck (20%). Most injured children — nearly 99% — were not hospitalized, but mouth and dental injuries can be painful, frightening, and expensive.

Why it happens

Falls caused 86% of the injuries, which tells the story: children were walking or running with the product in their mouths when they fell. Two-thirds of the injured children were one-year-olds — kids just learning to walk and, as co-author Sarah Keim put it, "more prone to falls."

Her recommendation was simple: "Having children sit down while drinking from baby bottles or sippy cups can help reduce the occurrences of these injuries."

What pediatricians advise

Both the American Academy of Pediatrics and the American Academy of Pediatric Dentistry recommend transitioning children to regular, lidless cups at 12 months of age. The AAP also suggests limiting pacifier use after six months, since continued use past that age may increase the risk of ear infections.

The study's message was never that bottles or pacifiers are dangerous products. It was that toddlers in motion are, essentially, small people carrying hard objects in their mouths while mastering balance — and that the fix costs nothing: sit them down to drink.