It is important for parents to supervise young children, and not leave small objects and medications within reach of young children. PHOTO: UNSPLASH

SINGAPORE - A three-year-old who swallowed a button battery from a remote control device later needed an endoscopy to remove it at the KK Women’s and Children’s Hospital (KKH).

Another child, a one-year-old, choked on a bowl of water beads – which may be used as vase fillers – when the mother’s back was turned. The child was admitted to the hospital for monitoring.

A more extreme case involved a seven-year-old child who needed major surgery to remove six magnetic beads stuck in the intestine.

These are all instances of children swallowing foreign objects by mistake in recent years, and the numbers are on the rise.

The trend has prompted the Consumer Product Safety Office (CPSO) – overseen by Enterprise Singapore – to work with trade associations, physical retailers, and e-commerce platforms to step up efforts in the removal of the listings of products unsafe for children sold online.

The e-commerce platforms include Shopee, Qoo10, Amazon, Lazada, Carousell and TikTok.

Since the start of 2023, more than 1,000 non-compliant listings of magnetic balls and water beads marketed as children’s toys have been removed, said CPSO director Beatrice Wong. That is more than three times the 300 listings removed in 2022.

She said: “In particular, magnetic ball toys and water beads are not able to comply with toy standards due to their loose and small parts, as well as high magnetic flux and ability to expand considerably in size.

“Hence, they are not allowed to be marketed as toys for children under 14, as such products can cause harm if accidentally ingested by children.”

She added that small button batteries that are improperly secured in battery compartments – often found in toys, books, and other electronic devices – also pose chemical hazards to children.

Ms Wong said: “These button batteries are small enough to be ingested by young children and can trigger a chemical reaction in a child’s throat and internal organs, potentially causing severe burns.”

Dr Ronald Tan, a consultant at the KKH department of emergency medicine, said likely hazards from children’s toys include swallowing or ingestion of the entire toy or parts of the toy, choking, placing parts of the toy in the ears or nose, and lacerations.

Magnetic beads removed from a child’s intestines. Source: KK Women’s and Children’s Hospital PHOTO: KK WOMEN’S AND CHILDREN’S HOSPITAL

Common causes of injuries seen in the emergency department include magnets – such incidents went up from 26 in 2019 to 38 in 2021.

Button battery incidents went up from 10 in 2019 to 25 in 2021, and water bead incidents went up from one in 2019 to seven in 2021.

Dr Tan, who also chairs the KKH Injury Prevention Workgroup, said magnetic beads are dangerous as the intestines can get trapped between magnets, resulting in damage to the intestinal walls.

Button batteries can corrode and cause perforations in organs such as the stomach, food pipe and nose, while water beads can expand to many times their original size when in contact with water and can cause intestinal obstruction.

Dr Tan said: “Small parts of toys may become detached and swallowed or inhaled and cause choking... which may result in death if the windpipe is completely blocked.

“Other objects which are not toys that are commonly swallowed include coins, which may get stuck in the food pipe, and adults’ medications, which may have severe side effects in children, such as causing them to have low blood pressure and low blood sugar.”

He added that it is important for parents to supervise young children, and not leave small objects and medications within their reach.

Common causes of injuries include magnets, which went up from 26 cases in 2019 to 38 cases in 2021. PHOTO: SCREENGRAB FROM LAZADA.SG

CPSO said it regularly raises awareness among sellers on the regulatory requirements related to the supply and sale of children’s toys and products.

It also works with hospitals, primary schools, and childcare centres to provide them with educational materials that highlight the safety hazards posed by water beads, magnetic balls, button batteries and other products.

Ms Wong said: “We will continue to work with the platforms to identify and remove non-compliant listings.”

The last round of regulatory requirements and advisories to remind and urge physical retailers and online sellers not to sell non-compliant products as children’s toys was sent out in mid-July.

The Straits Times has contacted e-commerce platforms for comment.

CPSO safety tips for caregivers

• Caregivers should pay special attention when purchasing toys, and check that they are age-appropriate. If information on the recommended age and the toy’s product safety is not available, consumers should contact the sellers to request for this information. Do not buy the product if such information is not available.
• Caregivers should not allow children under 14 to play with magnetic ball toys and water beads. Should water beads be used as vase fillers or gardening products at home, caregivers should ensure they are out of reach of children, especially as water beads are often brightly coloured and can be mistaken for candy.
• Button batteries and household electronic items without properly secured battery compartments should be kept out of reach of children. Caregivers are also encouraged to remove the batteries in electronic toys when they are not in use as batteries that are left unused for a long time can leak harmful chemicals.
• Young children should be supervised to ensure they do not access hazardous items at play. Inspect toys and play areas frequently for small objects, loose parts or items that could be accidentally ingested by children.
• Caregivers who encounter any product safety issues for toys and children products are urged to report them to at consumerproductsafety@enterprisesg.gov.sg, so that they can conduct the necessary checks.

How should parents or caregivers respond if they believe their child has ingested a small item?

• Dr Tan from KKH says parents or caregivers should seek medical attention if they suspect that the child has ingested items such as magnets, button batteries, water beads, coins or sharp objects.
• If the child appears to be visibly unwell or has difficulty breathing, call for an ambulance immediately and follow the instructions from the personnel over the phone.
• If the child is choking and can still produce sound, breathe or cough, get the child to clear his or her airway by coughing.
• If the child is choking and is unable to produce sound, breathe or cough, and is still conscious: for infants below one year old, perform five back blows and five chest thrusts until the object is expelled or the infant becomes unconscious; for children above one year old, stand behind the child and perform five abdominal thrusts, also known as the Heimlich manoeuvre, until the object is expelled or the child becomes unconscious.

If the child is unconscious, lie them down on a flat and firm surface. Call 995 for the SCDF ambulance and get an automated external defibrillator (AED) if nearby. Start chest compressions.