You swallowed what?
7/17/2023 by Jessie Wilburn, P.A.-C., M.D.
Anyone who has spent time with small children has noticed they explore their world with all their senses. While this sensory curiosity helps them learn their environment, it also puts them at risk of injury or infection when everyday items end up lodged in dangerous places like mouths, ears and noses.
Think only the children in your life do this? It's such a common practice that a museum at Boston Children's Hospital displays items removed from kids' throats, nostrils and ears dating back to 1918.
Here's a guide for parents to know what to do when kids do weird things with everyday items and how to keep children safe at home:
When kids lodge items in ears and noses
Toddlers and preschoolers sometimes stick household items into their noses or ears when no one is watching. Symptoms of something stuck include nasal discharge from one nostril that may be foul smelling or complaints of ear pain or difficulty hearing.
Don't try to pull the object out yourself. Block the other nostril with your finger and have the child "blow." If the object doesn't come out, the child should be seen by a health care professional. If you suspect the object is a button battery, paired disc magnet or superabsorbent polymer — also called a hydrogel and found in household items like diapers, hot-and-cold packs and watch-it-grow toys — the child should be seen immediately for an examination and removal of the material.
Foreign objects that remain in place for a long time can cause infection or damage to the ear or nose.
When kids swallow, inhale or choke on foreign items
Kids 6 months to 3 years old are most at risk of choking or inhaling foreign objects.
The most dangerous of these items include:
- Button batteries and magnets.
- Long objects, such as toothbrushes or spoons.
- Superabsorbent polymers or hydrogels.
- Lead-containing objects, including fishing sinkers, air rifle pellets and lead-based paint.
- Sharp objects.
The most common items infants inhale are small pieces of food, such as nuts, seeds or popcorn. In older children, the most common are nonfood items, such as jewelry, paperclips, pins and pen caps. At any age, toy balloons and similar objects are the most fatal if inhaled.
Children who inhale or swallow any of these items should be seen by a health care professional who can remove the item and provide treatment if necessary.
Symptoms that kids have swallowed or inhaled a foreign object include trouble swallowing food, pain in the neck or chest, drooling, coughing, breathing trouble or noisy breathing. Children who suddenly begin drooling excessively, have difficulty breathing, are making high-pitched breathing noises, or coughing and wheezing should be taken to the Emergency Department.
When kids chew or lick jewelry or paint
Some jewelry can contain harmful chemicals, such as cadmium and lead. With children under 6, be careful when buying or letting them play with jewelry.
Lead-based paints were banned in residential homes in 1978. In homes built before then, lead-based paint can be found on surfaces, including windows and sills, doors and door frames, stairs, railings, banisters and porches. Children should be discouraged from chewing on or licking these surfaces. If a home has chipping, peeling or cracking lead-based paint, this damage requires immediate attention.
When kids eat dirt or grass
Kids occasionally eat dirt or grass. A small amount in an otherwise healthy child isn't necessarily dangerous. Keep kids away from dirt and grass treated with chemicals or that have come in contact with animal feces.
If your child consistently eats dirt or nonfood items, such as paper, paint or hair, the child should be evaluated by a primary care clinician. This behavior can be a sign of underlying health conditions or nutrient deficiencies.
When kids stick things in electrical outlets
Kids don't just stick weird objects in their mouths, ears and noses. They also like to stick objects into things around the house. The most dangerous are electric outlets, and the most common things stuck into them are metallic objects, including hairpins, keys, paperclips, utensils and small toy parts. Metallic objects inserted into an outlet can shock the child.
If you suspect your child has been electrocuted, seek medical care immediately because not all electric shock injuries are visible.
All homes built or renovated after 2008 should have tamper-resistant receptacles. These outlets contain an internal shutter that blocks foreign objects. However, older homes may not have them. Consider upgrading the outlets in your home. Another option is installing outlet plates or covers that small children can't remove and are large enough so they're not a choking hazard.
How to keep kids safe at home
Keep objects like spare button batteries, jewelry, coins and magnets out of reach of young children. When cleaning the house, do a final search at child level for objects that might have fallen under furniture and evaded the broom or vacuum.
If you've got kids in a range of ages, keep in mind that toys appropriate for older children may contain small parts, such as Legos, board game pieces, action figure or doll accessories, that are a choking hazard to younger ones. Educate older siblings about keeping small toy parts away from young children.
Create cleanup routines that round up these small toy pieces, and supervise young children around choking hazards.
And finally, it's a good idea for anyone in your household caring for the kids to be certified in CPR and choking first aid.
Jessie Wilburn, P.A.-C., M.S., is a physician assistant in Emergency Medicine in Albert Lea, Austin and Red Wing, Minnesota.