Children age 1 to 3 are most like to swallow or breathe in a foreign object, such as a coin, marble, pencil eraser, buttons, beads, or other small items or foods.
Young children can easily inhale certain foods (such as nuts, seeds, and popcorn) and small objects (such as buttons and beads). Such objects may cause either partial or total airway blockage.
Coins, small toys, marbles, pins, screws, rocks, and anything else small enough for infants or toddlers to put in their mouths can be swallowed. If the object passes through the esophagus and into the stomach without getting stuck, it will probably pass through the entire GI tract.
However, in some cases, only minor symptoms are seen at first, and the object may be forgotten until later symptoms (inflammation, infection) develop.
FOR INHALED OBJECT
Any child who may have inhaled an object should be seen by a doctor. Children with obvious breathing trouble may have a total airway blockage that requires emergency medical attention.
If choking or coughing goes away, and the child does not have any other symptoms, he or she should be watched for signs and symptoms of infection or irritation. X-rays may be needed.
Bronchoscopy may be necessary to make a definitive diagnosis and to remove the object. Antibiotics and respiratory therapy techniques may be used if infection develops.
FOR SWALLOWED OBJECT
Any child who is believed to have swallowed a foreign object should be watched for pain, fever, vomiting, or local tenderness. Stools (bowel movements) should be checked to see if the object exited the body. This may sometimes cause rectal or anal bleeding.
Even sharp objects (such as pins and screws) usually pass through the GI tract without complications. X-rays are sometimes needed, especially if the child has pain or the object does not pass within 4 to 5 days.
DO NOT "force feed" infants who are crying or breathing rapidly.
Call immediately for emergency medical assistance if
Call a health care provider or local emergency number (such as 911) if you think a child has inhaled or swallowed a foreign object.
Cut food into appropriate sizes for small children, and teach them how to chew well.
Discourage talking, laughing, or playing while food is in the mouth.
Do not give potentially dangerous foods such as hot dogs, whole grapes, nuts, popcorn, or hard candy to children under age 3.
Keep small objects out of the reach of young children.
Thomas SH, White BA. Foreign bodies. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 57.
Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.