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"Our center removes about 200 foreign objects every year," says Dr. Kramer, one of the nation's foremost experts on foreign body ingestion. "We also field a lot of phone calls about foreign bodies that we can manage with guidance and observation."
The vast majority of those kids, he says, will be fine. The swallowed object will drop into their stomach, wind through their intestine and (ahem) "pass" a few days later without incident.
But some cases are more serious, and some can be deadly. Dr. Kramer has devoted his career to studying these cases and how to prevent them. Here's his advice on what objects to look out for — and what to do if your child swallows one.
The delayed danger of swallowed button batteries
Even when they're seemingly spent, batteries can still carry a small electrical charge — and when a button battery is stuck in the esophagus, that charge essentially causes a chemical burn, which can erode a hole in the tissue.
"If the area of the burn is close to a large vessel like the aorta, that can and has been a fatal event," says Dr. Kramer. "Even when we remove the battery itself, there's a structural weakness in the esophageal wall, so a fatal bleeding event can occur up to three weeks after."
Kids often get button batteries out of household objects parents might not think to suspect: remote controls, toys (light-up Fidget Spinners are among the latest offenders, says Dr. Kramer) and even greeting cards that play music.
What to do if you suspect your child has swallowed a button battery:
If you're not sure, call the National Battery Ingestion Hotline. If you know your child has swallowed a button battery, go immediately to the emergency department or call 911.
How swallowed detergent pods and household cleaners cause burns
Like batteries, detergents and household cleaners can cause chemical burns to the esophagus — and the scarring can cause sometimes permanent narrowing. "I have patients with caustic esophageal injuries who I see sometimes once a month, to physically dilate their esophagus," Dr. Kramer says, "sometimes for years."
To prevent injury, keep cleaning products locked up or out of reach of children, especially detergent pods, whose bright swirling colors make them look like candy to toddlers.
What to do if you suspect your child has ingested detergent pods or cleaners
Call Poison Control, which can help you figure out if it's something to worry about — and send emergency help if it is. "Any parent of a toddler should have the number for poison control available at all times," says Dr. Kramer.
A big share of the foreign object ingestions Dr. Kramer sees are coins. "Most that make it to the stomach are not emergencies, and if it leaves the stomach it's going to pass through without a problem," says Dr. Kramer. "But if it's stuck in the esophagus, because of the veins and arteries nearby and the propensity for scarring, we want to remove it within 24 hours."
What to do if your child swallows a coin
If your child seems to be having any trouble breathing, call 911 right away. If not, urgent care can X-ray to see if the object has made it to the stomach — although if it's stuck in the esophagus, you'll need to go to an emergency department to have it taken out. So if there's a reason to believe it might be stuck (a kiddo drooling, vomiting or refusing food or drink, for example), it's probably best to head straight to emergency.
When to worry about swallowed magnets
Like coins, magnets are not inherently dangerous to swallow. If a kid swallows a single magnet, and it's not stuck, there's probably nothing to worry about. The larger concern is with so-called "rare earth magnets" like Buckyballs, the kind of brightly colored, visually appealing adult fiddle toy you might keep on your desk. "These are literally and figuratively magnets for children," says Dr. Kramer. "They will find them, and they will ingest them." When kids do swallow multiple magnets, they often get stuck in separate folds of the intestine, pulling toward each other so strongly they can bore holes in the intestine wall.
The Consumer Product Safety Commission found these magnets so dangerous to children that they were recalled nationally in 2012, until a 2016 Federal Court case overturned the ban. "Almost immediately we started seeing cases again," Dr. Kramer says. If you have young children, it's probably best not to keep these in the house at all.
What to do if you think your child has swallowed one or more rare earth magnets
Whether your kid swallowed a rock, a toy or a piece of plastic, here's how to determine if it's a true emergency — and a course of action.
If you need to go to the emergency department
"If you know what your child has ingested, and you have another of the same object, bring it to the emergency department with you," Dr. Kramer says. So for example, if your child swallowed a LEGO piece, bring a similar one along. Seeing the object — and knowing if it will show up on an X-ray — will help care providers plan a course of action.