“We’ve had two toddlers come into the ED with the beads lodged in their intestines,” Dr. Cribbs said. “Usually the beads pass with no problems, but these two patients required major surgery to remove the beads from their intestines.”

The beads are popular in floral arrangements and spas, but with their squishy texture, they are also sold as a sensory toy for children.

“They start as small and squishy, but when you put them in water, they expand up to 100 times their size,” Dr. Cribbs explained.

As a veteran physician who’s been at Cook Children’s since 1988, Dr. Cribbs said when she saw a picture of the colorful beads, she could see why children would try to eat them.

“They’re very colorful and attractive, and the texture is something you might want to put in your mouth,” Dr. Cribbs explained. “It reminds me a lot of Boba.”

However, her message to parents is to monitor children while they play with the beads or don’t allow children around them at all.

"When they're first swallowed, they aren't dangerous," Dr. Cribbs said. "But as they sit in the intestine, they grow and can cause a blockage."

The beads aren’t toxic, so if swallowed, they aren’t poisonous. However, not all children are lucky enough for the beads to pass through their system.

Dr. Cribbs says to remember, the smaller the child, the larger the bead, the more likely the bead is to get stuck in the child.

“With all small toys, there's a choking risk and parents need to be vigilant,” she said. “Unfortunately, probably half of all ingestions of foreign objects are not witnessed by anyone, and you don't know that it's happened until your child is choking, gagging, vomiting, or having other symptoms.”

In today’s society, social media is a major part of life for all age groups. While some use the platforms to keep up with family and friends, others use the sites for networking and job hunting. For those 18 and younger, social media has changed the way young people communicate with each other, often leading to inappropriate use, and bullying among other things.

As part of Cook Children’s Joy Campaign, which aims to reduce the number of children and teens attempting suicide, we’re looking at the role social media plays in the mental well-being of young people.

Kristen Pyrc, M.D., medical director of Psychiatry Outpatient Services and the Partial Hospitalization Program at Cook Children’s, says the number of her patients dealing with anxiety and depression has significantly increased over the past year. She’s concerned that social media is playing a role, especially during the pandemic when young people are online more than ever.

“I have seen an increase in depression symptoms in teenagers who had not had them before,” Dr.Pyrc said. “So maybe I regularly see them for something like ADHD, and now they are showing symptoms of depression on top of that.”

Dr. Pyrc said she often hears complaints from parents that their children are ‘tied’ to their phones. She believes a major problem with that is a lack of exposure to seeing friends in person, and the opportunity for kids to feel left out when they see peers online having fun without them.

“I think online culture can worsen students’ feelings of loneliness and rejection because they see their friends doing things together without them in real time,” she explained. “Also we tend to post things that highlight what’s going well in our lives, but may not tell the full story of the times that we feel sad or inadequate. When teens are feeling down, seeing everyone else having fun without them can make them feel worse.”

Katie Greer, an internet safety expert, has spent the past 15+ years educating students, parents, law enforcement, and large companies across the country about the importance of online safety.

“I have seen social media used to bring out the best in humanity, but I have also seen it rip families apart in a matter of minutes,” she said.

Greer, who began her work as the director of Internet Safety with the Massachusetts Attorney General’s Office, believes social media has evolved in ways no one was ready for. Not so long ago, bullying was something that happened mostly at school. Now, young people are bullied online, in front of countless people. Even worse, a bully’s comments can be liked and shared by others.

“Kids were already spending a lot of time on their phones and online, then came a global pandemic. Now, they’re attending school online and relying on things like gaming online and social media platforms to connect,” Greer said. “There’s a lot more opportunity for cyberbullying and while it can start with one person, it can be a matter of seconds for others to jump in with a like or a comment and gang up on the victim.”

Situations like this increase a child’s chances of dealing with anxiety, depression, and self-harm.

“We know that developmentally, children’s brains aren’t fully formed,” she said. “When we put something in front of them as complex as social media, it’s almost as if we are asking for trouble.”

Greer also warns parents about the newfound TikTok culture.

“TikTok is a platform that has created unrealistic expectations about everyday life,” she explained.

She said children and teens see their peers or influencers having “perfect” lives and begin to feel as if they’re inadequate, or aren’t enough or worth it.

“Children have a desire to fit in and they want to have as much or more than their friends,” Greer said. “When children see their friends flaunt material things, or lavish experiences, that can make them spiral.”

Another issue putting kids’ mental health in danger is ‘sexting’ or the exchange of nude photos and videos, which has become quite prevalent.

“I recently was made aware of an incident where a girl sent a guy nude photos and he leaked them. Once they were leaked, so many people saw them, the young girl was humiliated,” Greer recalled. “The family reported that this led to the young girl untimely killing herself out of embarrassment and humiliation that her photos were leaked.”

Greer said, in cases like these, it is vital to remember that not only does suicide hurt a family, it also tears apart the people who loved and supported the victim.

Cook Children’s launched the Joy Campaign, which this story is a part of, to bring awareness to the increase in suicides and suicide attempts being seen at the medical center. In 2020, seven Cook Children’s patients died of suicide, making suicide the leading cause of traumatic death for the first time ever. The hospital has also seen record numbers of patients being admitted for suicide attempts month after month, most recently in March when 43 children and teens were treated for injuries. While the increase in suicide attempts cannot directly be tied to the pandemic, Dr. Pyrc said children need certain things to properly function in day-to-day life.

“Kids need in-person interactions. They need sunshine and exercise and all things encompassing,” Dr. Pyrc said. “Whenever your world is mostly virtual, it can hurt both your physical health and mental health.”

What does Greer suggest parents do? Stay alert and ask questions.

“A simple, “How was your day?” or “How are your friends doing?” can go a long way in opening the lines of communication,” she said.

She emphasizes knowing what your child is looking at online and know who they are talking to. If you are concerned about your child’s safety, there are measures you can take.

“While I am typically against this and wouldn’t always recommend it, there are ways parents can use apps that will mirror their children’s phone,” Greer said. “I do believe this could hurt the trust between a parent and a child, and isn’t the best way to go about typical monitoring, and I only recommend phone mirroring for dire situations.”

Before leaving any session, Greer reminds everyone she speaks with about the importance of a trusted adult.

“I tell parents and all adults it is important that children have a trusted adult they know they can come to at all times. Parents have to be okay with the fact that the adult may be someone other than them, it is all about a child feeling safe and opening up,” she said. “I also remind every child that I come in contact with that having an adult you trust is one of the most important things you can do to protect yourself and even help a friend.”

Both Greer and Dr. Pyrc see the issue and know there is a lot of work to be done to ensure we are helping our children with their new reality. Both professionals share their tips to help parents and families better support their children.

1. Take your child’s phone before they go to sleep at night. Disrupted sleep has a negative impact on adolescents.
2. Have an open dialogue with your child without judgment and give them the ability to freely express themselves to you. Given the amount of time kids are online, these conversations should happen every day.
3. Ask about their social media. Talk to your child about what they’re seeing, how it impacts them/makes them feel, and know who they’re communicating with.
4. Ensure your child can identify a trusted adult and make sure they understand that an adult can be their go-to person at all times.
5. Talk to your child about good social media etiquette. Remind them if they see something, say something and describe how that can help save someone’s life.
6. If you believe your child is in danger, there are apps available that can monitor their phone so you can see everything they see and get them the help they need immediately.
7. Reach out for help. Do not wait until your child is in a dire situation to reach out for help and get them the resources that could save their life.

Monitor your child’s social media, and make sure you have their usernames/passwords in case of an emergency situation.

Important to note:

Instagram has an anonymous reporting tool that allows users to report when they believe something could be wrong with a friend. The site sends the person resources depending on what was reported on their behalf. These resources could be vital in saving someone’s life by simply reporting.

Last year, 24 kids died in the U.S. and from 1998 to present, 676 children have died.

“What’s heartbreaking is that this is a serious public health issue that is totally preventable,” said Dana Walraven, Community Health Outreach manager at Cook Children’s and Safe Kids Tarrant County Coordinator. “Every mom and dad out there must realize it can happen to you. Texas leads the nation in child heat-related car deaths.”

Parents may mistakenly think they can safely leave a child in a vehicle for a “quick” errand, but that’s simply not true. Temperatures inside the car can be 20 or more degrees hotter than the temperature outside, rising to dangerous levels in minutes. Unfortunately, it only takes a few minutes for tragedy to occur.

Safe Kids Worldwide says that heatstroke is the leading cause of non-crash, vehicle-related deaths for children.

“Heat is much more dangerous to children than it is to adults,” Walraven said. “When left in a hot vehicle, a young child’s core body temperature may increase 3 to 5 times faster than that of an adult. This could cause permanent injury or death.”

Heatstroke, or hyperthermia, occurs when the body isn’t able to cool itself quickly enough and the body temperature rises to dangerous levels.

Safe Kids recommend the “ACT” method to prevent tragedy to your child or to a child you see left in a car:

• A: Avoid heatstroke-related injury and death by never leaving your child alone in a car, not even for a minute. And make sure to keep your car locked when you’re not in it so kids don’t get in on their own.
• C: Create reminders by putting something in the back of your car next to your child such as a briefcase, a purse or a cell phone that is needed at your final destination. This is especially important if you’re not following your normal routine.
• T: Take action. If you see a child alone in a car, call 911. Emergency personnel want you to call. They are trained to respond to these situations. One call could save a life.

It’s difficult to think that as parents, we could “forget” our children, but it happens each year with no exception to socioeconomic or education level. Often times, a change in routine, a distraction along the way, or the event a child falls quietly asleep, unseen, in the back seat, allows for a parent/caregiver to “forget” and leave a child in the car.

Here are some important tips to help prevent unintentional injury to your child:

1. Dial 911 if you see an unattended child in a car. Sometimes, people don’t want to get involved or just assume the parents are on the way out. But as you read earlier, it doesn’t take long for a child to die in a hot car. If you see a child or children alone in a car without an adult, call 911 immediately.
2. Never leave your child alone in a vehicle, even for 1 minute. Windows left slightly open will not affect rising temperatures in the car.
3. Set safe habits: leave a cell phone, purse, briefcase, etc. in the back seat before driving, forcing you to always check the back seat and see a child is/is not back there.
4. Program your cell phone and/or computer to remind you to drop off your child each day.
5. Have a plan with your daycare provider to contact you within a few minutes of being late or absent. Let your daycare know that you want them to call you if you are late or you have not called in saying your child will not be in that day.
6. Teach children not to play in any vehicle.
7. Lock all car doors, even at home.
8. If a child goes missing, always check the cars and trunks.

Learn more by clicking here. Also, visit noheatstroke.org for the latest on heatstroke deaths of children in vehicles.

For more information

Every year children are rushed to the emergency room to be treated for car related injuries, many don't even involve traffic or another car. Some injuries occur without the car ever leaving the driveway. Click here for some of the top dangers to be aware of and the key things you can do to help make your car safer for your kids.