*Disclaimer- after this blog was posted, major retailers including Amazon, Target, and Walmart suspended the sales of water bead products.*
Water beads have many uses and come in a variety of different forms, with the most popular branded toy product for children being Orbeez®. They look like candy, which may cause children to ingest them. They are made of non-toxic materials that were originally used in farming to keep soil moist. Water beads have other uses such as absorbing moisture in items like diapers, items for incontinence (loss of urinary and bowel control), and menstrual pads. Water beads can get several hundred times bigger when they come in contact with a liquid. They can cause physical harm and have the potential of causing a severe, and sometimes deadly, small bowel obstruction (SBO) in children.
Water bead ingestions in children are increasingly being reported to Poison Centers. Most often, these cases are related to toys. Researchers have gathered data from 43 cases of SBOs since 2011, and a review of the reports provides lessons in the danger of water beads.
Risk Factors of Water Beads
Children under the age of 4 are most at risk, and ingesting a dry water bead is more of a risk than ingesting a wet water bead. Remember that dry water beads can grow to at least 1 inch in diameter after being soaked in any liquid! Even a 25 mm (1 inch) water bead can cause an SBO.
Water beads that are ingested while dry are more of a risk due to their ability to pass through the stomach and expand in the small intestine, causing an SBO. A fully hydrated bead would typically be unable to pass out of the stomach into the small intestine, reducing the risk of SBO.
At this time, the number of beads ingested has not yet been determined to be a risk factor. This is due to their inability to bind together and form a large obstruction that could potentially put the patient at higher risk for SBO.
Symptoms of SBO from Water Beads
Research shows that SBOs most often occur in children younger than 4 years. Symptoms of obstruction most often began one day after ingestion. Symptoms that children experienced include:
- Stomach pain
Seizures are possible, but not common. They likely occurred because the SBO caused repeated vomiting, leading to very low levels of sodium in their blood.
It is very important to go to a health care provider immediately if a water bead is swallowed, as SBOs can be fatal.
Removing Water Beads Causing SBO
Water beads causing an SBO were removed by either an endoscopy (insertion of a tube with a camera down the throat) or surgery. A few children required a bowel resection (surgery to remove part of the small and/or large intestine) due to necrosis (death of cells or tissue) from the SBO.
During these medical procedures, most often one water bead was removed that was anywhere from 1-2.5 inches in size. There were two deaths linked to water bead ingestion complications. Both had delays of more than one week before being seen by a health care provider.
Safety Tips for Water Beads
We recommend the following safety tips if you have water beads in your home:
- Supervise children while they are using water beads
- Do not let children under the age of 4 play with, or be around, water beads
- Store dry water beads up, away, and out of sight when not being used
- Read the directions for use before using water beads
- Have a conversation with children who will be using water beads and stress the importance of not eating the water beads
- Encourage older children to tell an adult if a younger child eats a water bead
As always, the Maryland Poison Center is available 24/7. If you think your child has swallowed a water bead, call 1-800-222-1222 right away.
Reid LaPlante, PharmD
PGY2-Pediatric Pharmacy Resident