The beads are sewn on the necklace individually, and they are not big enough to be a choking hazard (none of the ones I've seen anyway). Also, there is not enough space to get them tangled or double looped or hung onto something in a crib.

I've never had a kid come to me with one on, but if someone did, I wouldn't take it off for nap unless mom and dad asked me to do so.