When Samantha bought an adorable pull-toy for her daughter, Kate, she never thought it would be dangerous. The toy was listed for age 12 months, and Kate was almost 18 months old. She was sitting in the playroom with it when Samantha stepped into the kitchen. When she returned just moments later, Kate was turning blue. She had been able to pull one of the wheels off the toy and had stuck it into her mouth. Luckily, Samantha was able to dislodge the toy from Kate’s throat, and all was well. But the ending could have been much more tragic.

We buy toys for our children to enrich their play and enhance creativity, never thinking that they could pose dangers. In fact, they often do and according to National Safe Kids Campaign, 121,000 children per year are sent to the emergency room for toy-related injuries. Here are the top 8 hazards, and how to avoid them.

1)    Small parts and pieces. Toys for children over three should be clearly marked as possibly containing small pieces. But also watch for small pieces that may break off of the toy. If you have older children, help them be aware to keep their small toys away from baby. One way to test the size of small pieces is to try to fit them through an empty toilet-paper roll. If the toy fits, it’s too small for little ones.

2)    Balloons. Kids love to chew on balloons. Maybe it’s the cool squeaky noise they make against their teeth, or the texture. In any case, balloons are obviously not meant for the mouth. Kids can tear little pieces off the balloon that can get caught in the airway and are very difficult to remove. Never give a small child a balloon – inflated or not.

3)    Loud Noises. Before buying a toy that makes noise, hold it up to your own ear and press the buttons. If it seems too loud to you, it’s much too loud for your child. Some toys, especially imported toys, can exceed noise limits and cause permanent hearing damage.

4)    Strings or cords. Toys with strings or cords longer than 7 inches can strangle a child. New toys should be manufactured with this recommendation in mind, but hand-me-down toys are a different story.

5)    Motorized driving toys. These little kid-sized three wheelers and monster trucks meant to drive on the sidewalk can be very dangerous. Though it seems like they’re going pretty slow, crashing at even 4 miles per hour can cause injury. And, cars backing out of driveways often can’t see these low-profile little vehicles. If you absolutely insist on buying Jr. a mini monster truck, use constant supervision.

6)    Lead-Based Paint. There was much ado earlier this year about toys containing lead, and for good reason. Lead poisoning can cause brain damage, and even death in children. Try to choose toys manufactured in the US to avoid lead.

7)    Battery-operated toys. Keep a close eye on toys requiring batteries. Make sure that the toy doesn’t overheat during use. And periodically check the battery container for leaking battery acid.

8)    Hand-me-down toys. Old toys don’t meet today’s safety standards. Some may contain lead-based paint, have strings that are too long, or parts that are too small. Others may simply be wearing out and pose new dangers. Wooden toys may become cracked and splintered, or screws and bolts may become loose.

Most of all, use your careful judgment when choosing toys for your child. Supervise small children at all times.