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Dangerous toys: the expanding problem of water-absorbing beads

Water-absorbing beads are made from superabsorbent polymer, and can swell to 400 times their original size when immersed in water. They begin as small pellets (1–15 mm) but expand to as much as 6 cm in diameter (Box 1).1,2 Water beads have been marketed for some time for decorative and horticultural purposes, but have recently been promoted as toys (fairy eggs, dragon eggs, jelly beads, water orbs, hydro orbs, polymer beads, gel beads) and as learning aids for autistic children. Due to their progressive expansion after being immersed in fluids, they present a unique foreign body challenge. While most objects that pass the pylorus will also pass through the rest of the gastrointestinal tract, water-absorbing beads that pass the pylorus can later pose an obstruction risk as they swell. There have been reports of serious bowel obstruction (including one death) in children ingesting water beads.1,3,4

We examined cases reported to the New South Wales Poisons Information Centre (NSWPIC) in which children (0–14 years old) had ingested water beads. The NSWPIC database has been described previously.5 We extracted cases for a 12.5-year period (January…