Schneider Children's Medical Center - Recommendations for Purim

Children and parents invest time and energy in preparing mishloach manot, eager to create packages filled with goodies - often including candies or snacks not regularly available to children. But do we give enough consideration to whether the contents are age-appropriate for the child receiving them? How often have you seen mishloach manot containing chocolate with almonds given to preschool-aged children? Or peanuts? Or toys that are too small or contain tiny detachable parts? All of these can pose a serious risk to children under the age of five and even older children in some cases.

Prof. Dario Prais, Director of the Pulmonology Institute, and Dr. Oshrat Weiss Sela, Head of the Speech-Language Pathology Unit at Schneider Children's, explain:

A foreign object inhaled into the airways can have immediate clinical manifestations, such as a choking event. Still, in some cases, the symptoms may appear later, depending on the size of the object, its location in the airway, and other factors. Symptoms may include a persistent cough that began after a suspected incident or even recurrent pneumonia in the same lung area. In all such cases, it is essential to seek medical consultation.

Safety guidelines for mishloach manot:

Take time to plan the contents of the mishloach manot carefully. Do not include small toys or items that contain tiny detachable parts.

For children under five, carefully check the mishloach manot they receive and remove hazardous items such as marshmallows, gum, lollipops, toffee candies, popcorn, Bissli, chocolate with nuts, coated peanuts, and similar treats.

Do not allow play or exposure to seemingly harmless objects that may pose a risk, such as small toy parts, plastic fragments, jewelry, pendants, tiny beads, and stickers. These items should be kept out of reach of infants and young children, both at home and outside.

Children under five should not eat nuts in any form (whether whole, chopped, ground, shelled, or peeled). Avoid eating nuts in households with young children and ensure that nuts and seeds are kept out of their reach.

Do not give young children slippery, round, cylindrical, or sticky foods, such as hard candies, toffee, marshmallows, lollipops, sticky sweets, or gum, as these can pose a choking hazard.

Dr. Ron Berant, Director of the Pediatric Emergency Medicine Department (ER) at Schneider Children's, highlights key safety concerns for Purim:

Caps (exploding noisemakers): Playing with caps is extremely dangerous, as it can cause burns and pose a risk to both the children playing with them and those nearby. Children should be kept away from caps, and their use should be minimized as much as possible. If an injury occurs, the affected area should be rinsed with tap water and bandaged, and medical attention should be sought at the emergency department as soon as possible.

Costumes and makeup: It is crucial to purchase costumes that the Standards Institute has tested and approved to ensure they are fire-resistant and do not contain feathers, paper, cardboard, or cotton wool. Children should be reminded to keep safe from open flames, especially when wearing hats or wigs. Additionally, only makeup products approved by the Ministry of Health should be used. If a skin reaction occurs due to makeup use, the recommended treatment is to rinse the area with water and seek medical advice.

Spray foam and aerosol cans: Spray cans contain chemical substances that can enter the eyes and cause injuries. Therefore, it is advisable to avoid using them altogether. If they are used, care must be taken to avoid spraying them toward the eyes. In case of eye irritation caused by these substances, rinse the eyes with tap water and seek medical attention.

Dafna Busani-Ziv, Head of the Nutrition and Dietary Unit at Schneider Children's, explains:

Mishloach manot, one of the Purim traditions, significantly increases children's exposure to candies and snacks. Beyond monitoring the quantity of sweets, it is equally important to pay attention to their quality - particularly the types of food coloring they contain. Artificial food colorings are not recommended for consumption, and it is advisable to avoid sweets and snacks that contain them. Maintaining a balanced diet is especially important during this festive time. Parents should explain the importance of healthy eating, help children set limits, and guide them in making healthier choices.

A simple way to help children make better choices is to use red and green labels, which are easy for them to understand.