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Posted by Dr. Monica Wonnacott | January 26, 2016

Accidental Ingestions: Objects (Not Medications/chemicals)

Thanks A.D. from Massachusetts for your recent topic suggestion on accidental ingestions. (The child had swallowed part of a rubber ball.)

At some point, all children swallow something other than food. The question is whether you need to worry about what was ingested. Here are a few guidelines. (Note: In this article, I am not addressing medications or chemicals, both of which are an entirely different animal – both of which usually require medical intervention.)

When To Worry/Seek Medical Care:

If the object has compromised your child’s ability to breath (big objects can get stuck in the esophagus and push on the trachea). If your child is breathing fast, coughing a lot, or drooling; those can all be worry signs.

If the object could have gone down your child’s airway (not into the stomach). Things that go down “the wrong pipe” (i.e., the trachea and into the lungs), almost always have to be fished out. Objects left in the lungs can cause recurrent pneumonias that will never resolve until the object is taken out.

If the object is:

  • A magnet of any size or type, especially more than one. This is one of the most dangerous objects to ingest. Do not delay getting help. The difference of a few hours in getting it out can be life or death.
  • A battery of any size or type. These are also potentially very dangerous and you should urgently seek medical care.
  • Anything sharp. Things like pins, nails, hooks, etc. should all be monitored by a physician. (I know you’re thinking, who can swallow that, but I have seen a kid swallow each one of those objects). The risk is that the sharp object can get stuck or perforate (make a hole) along the way out.

If your child is having a pain/distress in the GI tract (anywhere along the path: mouth, esophagus, stomach, intestines, to out)

Objects Generally OK To Watch At Home

Most things that kids swallow come out over time without causing problems. Items such as:

  • Pieces of toys (plastic, rubber, fabric, stuffing, metal, etc.)
  • Paper/tissue
  • Bugs
  • Bottle caps (plastic kind)
  • Coins (In my career I’ve seen over $2 in coins ingested. Even kids seem to have an obsession with money. Coins can be tricky, since big ones can get stuck in the esophagus and have to be taken out).
  • Plants (Know which plants, some are poisonous)
  • Dirt/rocks (If your child regularly eats dirt, talk to your doctor. Your child may have low iron).

Should I Induce Vomiting?

The general rule of thumb is NO, do not give your child anything to make him/her throw up. The days of using Ipecac are over (it should not be part of the medicines in your medicine cabinet). If the object makes your child vomit, that’s a different story. Leave your child alone and don’t try to stop the vomiting.

Will X-Rays Help?

The answer is maybe. X-Rays can only detect things that are what we call “radio-opaque.” So you will only see on x-ray things like metal. Objects like plastic, rubber, fabric, stuffing, and paper will not show up on x-ray.

What Do I Do?

If your child has swallowed something that can be managed at home, then you simply wait and watch for it to come out. The way you “watch for it to come out,” is the gross part. You strain/check each stool for the object until you find it. Note that sometimes an object will get delayed at a bend in the intestines, so may take a few weeks to see the object (although a few days is most typical).