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Are Your Holiday Decorations Putting Your Toddler in Danger?

Child playing with ornamental bulbs
By Sharon Holland

Forget the 12 days of Christmas. The most important days of Christmas are the seven days before, and seven days after the holiday.
That’s when children aged two and younger are most likely to ingest your twinkling tree lights, Gramma’s ceramic Christmas tree bulbs, your collection of miniature ornaments, button batteries and magnets, and a variety of other seasonal tchotchkes adorning your home, according to scientists from the Uniformed Services University of the Health Sciences in Bethesda, Maryland.
Child pretending to eat an ornamental bulb
The number of injuries and emergency room
visits due to children swallowing foreign
objects spikes seven days before and after
Christmas because of unfettered access
to decorations and other Christmas
objects in the home. 
(Photo by Rachel Donahue)
The study, “Pediatric Ingestions of Christmas Past, Present and Future” published in the journal, Clinical Pediatrics, found that although there are increases in pediatric injuries around most holidays, the number of injuries and emergency room visits due to children swallowing foreign objects spikes between December 20 and January 1 because of unfettered access to decorations and other Christmas objects in the home.
The authors looked at the Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS) data from 1997 to 2015. The NEISS database catalogues emergency room visits in the United States for injuries related to consumer products from urban, suburban, and rural hospitals. They found that there were an estimated 22,224 children who visited the ER for “Christmas Foreign Body Ingestion”, or CFBI – more than 1,200 per year – and of those, 84% were by children aged two years and younger. Boys were more than twice as likely to swallow items than girls were.
Non-electric items like ornaments, bells, candles, and snow globes were among the biggest draws for children, although strangely enough, Christmas trees, tree lights, tree stands/supports, and electric decorations were also common culprits.
The team, Army Capt. (Dr.) Patrick Reeves, Navy Lt. Cmdr. (Dr.) Eric Passman, and Air Force LtCol (Dr.) Cade Nylund, said that all of these items present a risk for perforation or impaction. The electrically enhanced ornaments, Christmas tree lights and other electrical decorations present the unique risk of burn and tissue erosion when swallowed. This risk is compounded by the advent of light-emitting diodes (current conductors) and the use of button batteries as a power source. Their study found that Christmas tree lights alone accounted for nearly 40% of injuries.

Two button batteries
Button batteries, used in many Christmas decorations and toys, can cause serious harm to children if ingested.  (Photo courtesy of Health.mil)
The scientists all cautioned that older, artificial Christmas trees may contain lead, leading to lead toxicity in patients following extended contact with, or ingestion of parts of these trees. In addition, they said that the greatest risk for artificial Christmas tree ingestion happens in the days after Christmas, as families take their trees down.
Child pretending to eat an ornamental bulb
Bulbs, tinsel, Christmas trees, tree lights and stands,
and other holiday decorations can result
in serious injury to toddlers
left unsupervised.  (Photo by Martha Plumlee)
“These ingestion injuries around the winter holiday season can cause serious respiratory and gastrointestinal problems, and in a worst case scenario, even death,” said Reeves, assistant professor of Pediatrics at USU. The authors have advice for ER docs, radiologists, and primary care providers.
“Emergency medicine providers who evaluate children with abdominal pain or other gastrointestinal complaints around the holidays should consider asking questions and using diagnostics to see if Christmas objects or other foreign bodies could have been swallowed,” said Reeves. “Radiologists who employ two-view chest x-rays, multi-detector row CT scans, or providers using handheld metal detectors play an important role in the diagnosis and care of these patients.”
And for parents?
“Christmas decorations are a fun part of Christmas celebration for many families. These brightly colored and interesting decorations are naturally attractive to curious children. I don’t want to sound like the Grinch, but just like the rest of the year, it's important for parents to be mindful and keep small objects out of reach of young children,” said Reeves.

Child holding an ornamental bulb
Foreign body ingestion injuries around the winter holiday season can cause serious respiratory
and gastrointestinal problems, and in a worst case scenario, even death, according to
Uniformed Services University researchers.  (Photo by Judy Caulk)