Nationwide Children's Hospital

Jackie Sherrill was shocked when her daughter, Morgan, 22 months, fell face-first with her bottle, cutting her lip and chipping a tooth.

Of all the things Jackie Sherrill had to worry about while juggling school, work and two kids, someone breaking a tooth on a baby bottle was least among them.

But that’s exactly what happened earlier this year, when Sherrill’s 20-month-old daughter, Morgan, took a nose-dive off a couch and landed face-first on the edge of an ottoman.

“She had her bottle in her mouth,” recalled Sherrill, 26, from Grove City, Ohio. “She must have hit right at that hard spot.”

The 9-ounce bottle of chocolate milk slammed into Morgan’s face, cutting her lip and chipping one of her baby teeth.

Sherrill, a nursing student, was able to calm her down and take her for treatment, but the incident was shocking: “You just don’t think of that,” she said.

It turns out that Morgan is among thousands of kids -- especially unsteady toddlers -- who get hurt every year while using bottles, pacifiers and sippy cups.  

The seemingly innocuous ba-bas and binkies caused cuts, bruises and other injuries serious enough to send 45,398 children under age 3 to the nation’s emergency rooms between 1991 and 2010, according to the first large-scale analysis of the problem. The findings were published Monday in the journal Pediatrics.

“Baby bottles, pacifiers and sippy cups are extremely popular. Basically every baby uses them at some point,” said Dr. Sarah A. Keim, the principal researcher for the center for behavioral health at Nationwide Children’s Hospital in Columbus, Ohio. “There really hasn’t been much research at all on these products.”

Keim and her colleagues looked at data collected by the National Electronic Injury Surveillance System, or NEISS, and then extrapolated information to the rest of the U.S.

To her surprise, Keim found that there were an average of 2,270 cases each year where child was hurt while using bottles, pacifiers or sippy cups.

Dr. Nancy Snyderman's safety tips for parents with young children

That’s a child treated every four hours, the researchers said.

In most of the cases, 86 percent, the kids were injured when they fell with the object. Bottles were involved in nearly two-thirds of the injuries, while pacifiers accounted for about 20 percent and sippy cups just over 14 percent. About 70 percent of youngsters suffered cuts, and about 70 percent were hurt on or near their mouths, the study found. Others suffered soft tissue or dental injuries.

The trouble wasn’t the kind most parents think of when they ponder harm from the objects, particularly pacifiers and sippy cups. More than 16 million pacifiers and 1 million sippy cups were recalled by federal officials since 1991, but usually it was because they posed risks of choking or poisoning by cup materials.

Instead, Keim noted, the injuries are the kind that occur when a child is moving around the home while drinking from a bottle or cup or sucking on a pacifier.

“They’re convenient, they help quiet a fussy child,” she said.

But, as the injuries indicate, they might also hold potential harm.

Part of the problem may be the widespread use of bottles, pacifiers and sippy cups long past when medical and child development experts advise.

Pacifier use is advised by the American Academy of Pediatrics, for instance, but usually during infancy, up to age 6 months, to help prevent sudden infant death syndrome, or SIDS.

The AAP and the American Academy of Dentistry advise that babies move directly from the bottle to a lidless cup by 12 months to prevent dental decay.

In real life, however, an Arizona study found that about 45 percent of children ages 13 months to 3years still used bottles. A 2011 Canadian study found that 86 percent of children ages 1 to 2 use sippy cups. And a 2008 study in the United Kingdom found that more than 18 percent of toddlers were still using pacifiers at age 3.

Clearly, cutting kids off cold turkey can be tough. But Keim said there are ways to allow children to enjoy their bottles and pacis and prevent injury, too.

“If kids are in the habit of sitting when they’re eating or drinking, it’s the kind of thing parents might want to consider,” she said.

In Jackie Sherrill’s case, Morgan’s accident marked the end of an era.

“She loves drinking out of regular cups anyway,” Sherrill said.

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