Choking on small parts is the primary risk for anyone who mouths objects. Understanding what makes something a choking hazard goes beyond simple size – it depends on three critical factors:

Size: Can it fit entirely in the mouth or throat? UK regulations use the Small Parts Cylinder (31.7mm diameter) to test toys for under-3s. You can use a toilet roll tube as a home alternative. However, for older individuals, larger items can also pose risks as their mouth cavity is bigger.

Shape: Does it have a shape that could lodge in the airway? Round, oval, or cylinder shapes are particularly dangerous.

Material: Could it compress, break apart, or degrade into smaller pieces during mouthing?

Items that don't fit through the tube can still be dangerous if they break or compress during mouthing, degrade over time into smaller pieces, or have parts that detach with use.

Remember: materials break down faster with constant mouthing. Saliva, chewing, and temperature changes damage toys. A toy that was safe last week might not be safe today.

High-powered magnets are one of the most dangerous items that can be swallowed. If someone swallows two or more magnets (or a magnet and a metal object), they can attract to each other through the intestinal walls, causing tissue damage, blockages, and potentially fatal complications. Surgery is often required.

Where magnets hide:

• Magnetic building toys

• Magnetic dress-up dolls and accessories

• Fridge magnets

• Magnetic jewellery

• Some fidget toys and sensory items

• Magnetic desk toys

Critical safety steps:

• Do not have magnetic toys accessible if someone mouths objects

• Keep all fridge magnets and magnetic items out of reach

• Check existing toys carefully – some have hidden magnetic parts

• Magnets do not show clear symptoms immediately but can cause serious internal damage

If you suspect magnet swallowing, go to A&E immediately (even if they seem fine). Do not wait.

The Office for Product Safety and Standards (OPSS) has issued warnings about high-powered magnets. Even magnets that comply with toy safety standards can be dangerous if multiple pieces are swallowed.

Button or coin batteries are extremely dangerous if swallowed. They react with saliva to create a strong alkaline substance identical to caustic soda (the chemical used to unblock drains). If swallowed, they can burn through tissue in as little as 2 hours, causing internal bleeding or death.

Where button batteries hide:

• Remote controls

• Musical greeting cards

• Flameless candles

• Flashing shoes and jewellery

• Key fobs

• Games and toys

• Thermometers and bathroom scales

• Hearing aids

Essential precautions:

• Store spare batteries in a locked container, out of reach

• Check that battery compartments are secured with screws (not just clipped on)

• Use strong tape over battery compartments as extra security

• Inspect items monthly – compartments can become loose over time

If someone swallows a button or coin battery, call 999 immediately. Every minute counts.

The OPSS has comprehensive guidance on button battery safety, including which products to check and how to secure battery compartments properly.

Water beads are polymer balls that absorb liquid and expand up to 400 times their original size. When dry, they look like small, colourful sweets. The OPSS issued a safety alert in 2024 warning that water beads pose serious risks, particularly for young children and vulnerable adults.

Why they're dangerous:

• They expand inside the body, absorbing fluids

• They don't show up on X-rays, making diagnosis difficult

• They can block the throat or intestines

• They require surgery to remove

Where water beads appear:

• Sensory toys

• Craft supplies

• Home décor items

• Garden products

Critical guidance:

• Do not have water beads in your home if anyone mouths objects or toys

• Check sensory toy boxes – water beads are sometimes included

• OPSS advises keeping water beads away from children under 5 and only using them with older children or vulnerable adults under close supervision

From 2007–2022 in the USA, water beads contributed to an estimated 8,000 A&E visits among individuals under age 20. Whilst we don't have similar data for the UK, the same products have been linked to serious harm.

If someone has swallowed water beads, go to A&E immediately and tell them specifically what was swallowed.

Not all materials are safe for intensive mouthing. Some plastics contain chemicals that leach out with saliva contact, while others degrade quickly and can harbour bacteria. Understanding which materials are safest helps you make informed purchasing decisions.

Safest materials for mouthing:

• Food-grade silicone: Durable, easy to clean, doesn't harbour bacteria

• Natural (untreated) wood: Solid hardwoods only, properly finished

• Natural rubber: If no latex allergies present

• Hard plastic (BPA-free): Look for EN71-3 certificate confirming chemical safety

Materials to avoid:

• Soft, squishy plastics: Often contain phthalates and degrade quickly

• Foam: Breaks down into pieces, impossible to fully clean

• Slime: Unknown chemical composition, contamination risk

• Unknown materials: If you can't identify it, don't risk it

Warning signs of material degradation:

• Surface becoming sticky or tacky

• Surface peeling or flaking

• Colour changes or fading

• Strange or chemical smell

• Cracks or visible damage

When materials break down, they can release harmful chemicals and create choking hazards as pieces detach. Regular inspection and replacement are essential for items that receive intensive mouthing.

Regular safety checks are essential when someone mouths objects intensively. This video demonstrates practical inspection techniques and shows real examples of toys in various conditions – from safe to definitely unsafe.

Quick safety check routine:

1. Small parts test: Use toilet roll tube or Small Parts Cylinder

2. Physical inspection: Check for cracks, loose parts, sticky surfaces

3. Battery compartments: Ensure batteries are never easily accessible

4. Smell test: Weird smells can indicate bacteria buildup or material degradation

How often to check:

• Daily: Items mouthed intensively throughout the day

• Weekly: Deep clean and inspect all mouthed items

• Immediately: After items are dropped on dirty ground or visibly soiled

• Monthly: Full toy safety audit of all accessible items

Signs a toy is no longer safe:

• Surface is peeling or flaking

• Surface is softer or sticky

• Parts are loose or coming off

• Material has faded or changed colour

• Smells strange or chemical

• Has any cracks or visible damage

• Battery compartment is loose or damaged

Remember: Materials break down faster with constant mouthing. Saliva, chewing, and temperature changes damage toys. A toy that was safe last week might not be safe today.

Do not donate unsafe toys – dispose of them properly to protect other families.

Knowing the difference between gagging and choking can save a life. This video provides clear demonstrations of emergency response techniques and helps you recognise when immediate action is needed.

Gagging vs Choking:

Gagging is the body's natural protective reflex – it means the reflexes are working. Signs include making noise (coughing, crying, retching), skin might go red, tongue pushes forward, eyes watering, and the person can still breathe. Stay close and observe calmly. Allow their reflexes to clear the object. Be ready to act if signs change to choking.

Choking means the airway is blocked and breathing is prevented – this is a life-threatening emergency. Signs include being silent or very quiet (cannot cry, speak, or cough), skin/lips/fingernails turning blue or grey, clutching their throat (universal choking sign), and a look of panic or terror. Begin first aid immediately.

Learning through reading if ok, but to be better prepared, you should consider attending one of the local Mini First Aid courses for families:

https://www.minifirstaid.co.uk/classes

Join your local Mini First Aid course to practise these techniques on training manikins and build muscle memory. Thousands of lives are saved each year by people who learned first aid.