- Swallows a non-food solid object
- Adult suspects an object was swallowed
- Includes object found in the stool with no history of it being swallowed. Sometimes, a young child swallows an object when no one is around. Finding it in a stool is the first evidence that this has happened.
Types of Objects Swallowed by Children
- Coins are the most common swallowed object. Usually safe except for quarters. Call your child's doctor to be sure.
- Coin diameters are 18 mm (dime), 19 mm (penny), 21 mm (nickel) and 24 mm (quarter). Source: U.S. Mint.
- Small blunt (non-sharp) objects. Toy parts, game parts, small buttons, rings, some earrings, paper clips, teeth. Usually safe if not sharp.
- Button batteries (serious). Needs urgent removal. See below for details.
- Magnets (serious). Needs urgent removal. See below for details.
- Sharp or pointed objects (serious). Include needles, pins, pushpins, tacks, nails, screws, toothpicks, some earrings. Pine needles, bones, bottle caps, aluminum pull tabs are also considered sharp. Most need urgent removal. Sharp objects can become stuck and lead to a puncture in the digestive tract. Small pieces of glass generally pass without any symptoms.
- Food Chunks. Large pieces of meat can get stuck on the way to the stomach. Mainly occurs in adults.
- Button batteries can cause low-voltage burns within 2 hours if stuck in the esophagus. The esophagus is the tube between the mouth and the stomach. A battery burn can lead to a puncture in this tube. Even "dead" batteries can be harmful if swallowed.
- All these children need an urgent x-ray to see where the battery is. If the battery is hung up or stuck, it needs urgent removal.
- Once it makes it to the stomach, it will usually safely pass. This may take a few days. These children need to be followed closely until the battery is passed.
- If you have it at home, honey may be helpful in preventing this kind of injury. Caution: just for children 1 year and older. Dose: 10 mL (2 teaspoons) every 10 minutes until you can get to the ER.
Multiple Magnet Ingestion
- When multiple magnets are swallowed, problems can occur. Magnets at different spots can become attracted to each other across the bowel wall.
- The problems include a bowel puncture or blockage.
- All children who are suspected of swallowing magnets need an urgent X-ray.
When to Worry
- Objects 1 inch (25 mm) or larger often cause problems. Quarters (24 mm) are included. These larger objects can get stuck in the esophagus. The esophagus is the tube between the mouth and the stomach. Symptoms of a blocked esophagus are trouble swallowing and throat or chest pain. Your child may gag, vomit, drool, or spit. Also, your child may not want to eat or drink anything.
- In addition to large objects, batteries, magnets and sharp objects can also cause problems.
- Children younger than 2 years are at increased risk of objects getting stuck.
What Doctors Recommend for Smooth, Small Harmless Objects
- If your child has no symptoms, doctors don't always agree on the best approach. They recommend one of the options below:
- Option 1. Do nothing. No X-ray and no checking the stools. They assume the object is in stomach and will pass unless child develops symptoms. Examples are stomach pain or vomiting.
- Option 2. Check all stools for the object. If object hasn't passed in the stool by 3 days (72 hours), get an x-ray (author's preference and used in this care guide).
- Option 3. Get an x-ray on all patients. This can be done to be sure the object is in the stomach. For harmless objects, the x-ray can be delayed for 24 hours. Reason: object is more likely to reach the stomach after a night's sleep.