title: Injuries associated with bottles, pacifiers, and sippy cups in the United States, 1991-2010.
abstract: OBJECTIVE
  To describe the epidemiology of injuries related to bottles, pacifiers, and sippy cups among young children in the United States.
  
  
  METHODS
  A retrospective analysis was conducted by using data from the National Electronic Injury Surveillance System for children <3 years of age treated in emergency departments (1991-2010) for an injury associated with a bottle, pacifier, or sippy cup.
  
  
  RESULTS
  An estimated 45398 (95% confidence interval: 38 770-52 026) children aged <3 years were treated in emergency departments for injuries related to these products during the study period, an average of 2270 cases per year. Most injuries involved bottles (65.8%), followed by pacifiers (19.9%) and sippy cups (14.3%). The most common mechanism was a fall while using the product (86.1% of injuries). Lacerations comprised the most common diagnosis (70.4%), and the most frequently injured body region was the mouth (71.0%). One-year-old children were injured most often. Children who were aged 1 or 2 years were nearly 2.99 times (95% confidence interval: 2.07-4.33) more likely to sustain a laceration compared with any other diagnosis. Product malfunctions were relatively uncommon (4.4% of cases).
  
  
  CONCLUSIONS
  This study is the first to use a nationally representative sample to examine injuries associated with these products. Given the number of injuries, particularly those associated with falls while using the product, greater efforts are needed to promote proper usage, ensure safety in product design, and increase awareness of American Academy of Pediatrics' recommendations for transitioning to a cup and discontinuing pacifier use.
authors.affiliation: Center for Biobehavioral Health, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio 43205, USA. sarah.keim@nationwidechildrens.org
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Keim
authors.forename: Erica N
authors.initials: EN
authors.lastname: Fletcher
authors.forename: Megan R W
authors.initials: MR
authors.lastname: TePoel
authors.forename: Lara B
authors.initials: LB
authors.lastname: McKenzie
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000059:Accidents / Q000706:statistics & numerical data / Q000639:trends*; D001903:Bottle Feeding / Q000009:adverse effects* / Q000592:standards / Q000639:trends*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D022125:Lacerations / Q000453:epidemiology / Q000209:etiology; D008297:Male; D041361:Pacifiers / Q000009:adverse effects* / Q000639:trends*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology