EXPOSURE TO TOY SLIME IN PREGNANCY

Slime toys consist of viscous, brightly coloured ‘slime’, usually in a plastic pot. These products often contain borax as a component to maintain their texture. In July 2018 it was widely reported in the media that several brands of toy slime contained higher than EU-permitted levels of boron (300mg/kg) owing to their borax content. Borax reacts with hydrochloric acid (e.g. in the stomach) to form boric acid.

There are no studies specifically investigating the fetal effects of handling toy slime in pregnancy. A single small study found that women exposed topically in early pregnancy to boric acid were not at increased risk of having an infant with a birth defect, although the data are extremely limited. In general, dermal absorption of boron compounds is expected to be minimal as long as skin is intact. Risk of maternal and fetal toxicity following dermal contact with toy slime is therefore likely to be low, and no active management or investigation is advised for pregnant women without symptoms of toxicity. Avoidance of further handling of toy slimes identified as having elevated levels of boron is recommended as a precaution.

A study of women ingesting boron compounds via drinking water found no associations between blood levels and the risks of spontaneous abortion, stillbirth, infant congenital anomaly, preterm birth, low infant birth weight or neonatal death. However, ingestion of excessive amounts of some boron compounds can lead to poisoning associated with diarrhoea, vomiting, and in severe cases, kidney injury, widespread dermatitis and exfoliation, and CNS effects including coma and convulsions. Pregnant women who have ingested toy slime and who experience symptoms suggestive of toxicity should be managed according to the general guidance for non-pregnant patients on Toxbase.org. Maternal toxicity is likely to be the major determinant of risk to the fetus. Contrary to media reports, animal studies have not conclusively demonstrated that ingestion of boric acid is associated with birth defects in the offspring in the absence of maternal toxicity. As there are no human pregnancy data relating to poisoning with boron compounds, review and follow-up by a specialist in fetal medicine is recommended for pregnant women who have experienced boron toxicity. Due to the lack of data, the possibility of adverse fetal effects cannot be completely excluded in the absence of maternal symptoms.

Handling of toy slime at any stage in pregnancy would not usually be regarded as medical grounds for termination of pregnancy. However, other risk factors which may independently increase the risk of adverse pregnancy outcome may be present in individual cases. Clinicians are reminded of the importance of considering of such factors when performing case-specific risk assessments. Where exposure is associated with maternal toxicity, additional fetal monitoring may be advised and will need to be considered on a case-by-case basis.