When my oldest daughter was 3 and my older son was 18 months old, I once entered the living room to find my daughter feeding my son quarters. She had found them between the cushions of the couch, where they had presumably fallen from my husband's pants pockets. Luckily I intervened before any were swallowed, but it was a close call (after that, my husband had to empty his pockets at the door as soon as he came home).
Children, especially children those under 5 years of age, often put things in their mouths that don't belong there. Part of it is how they explore the world. Putting something in their mouth is as natural as touching or sniffing something — and part of it is simply not knowing what is food and what isn't. In fact, it's estimated that 20% of children between the ages of 1 and 3 swallow a nonfood item at some point.
Researchers from Nationwide Children's Hospital in Ohio looked at data from the National Electronic Injury Surveillance System about "foreign body" ingestions in children between 1995 and 2015, and published their findings in the journal Pediatrics. They found that over the 20-year period, ingestions essentially doubled.
It's important to know what they found, because being aware of the problem, and the objects most commonly swallowed, is the first step toward prevention.
Not surprisingly, 75% of ingestions were in children under 5, with children under 1 making up 21%. The most common objects swallowed were:
- Coins (61.7%), with pennies being the most common. Quarters were the second most common, and since they are bigger, children who swallowed them were more likely to be hospitalized.
- Toys or pieces of toys (10.3%). When the type of toy could be identified, marbles were most common, and to be fair, many do look like candy.
- Jewelry, or pieces of jewelry (7.0%). This was more common in girls than boys.
- Batteries (6.8%), with button batteries being most common.
- Nails, screws, tacks, or bolts (6.0%).
Other common objects included hair products, kitchen gadgets, desk supplies, and Christmas decorations.
Here's what you can do
Most of these things pass through the body without causing trouble, but some can cause real problems. Nails and tacks can scrape as they go along, but the more problematic objects are batteries and magnets. Batteries release an acid that can burn the lining of the gastrointestinal tract; 9.2% of children who swallow them end up hospitalized. Magnets are even more dangerous, if the child swallows more than one (in this study, 13.3% of children who swallowed magnets swallowed more than one), as the magnets can stick to each other, trapping tissue in between. Not surprisingly, 71% of children who swallowed magnets were hospitalized.
As with most things in medicine, the best treatment is prevention. Here is what we can all do:
- Pay attention to the age recommendations on toys. They are there for a reason.
- Don't leave any small objects within reach. I know that this is easier said than done, but get in the habit of doing things like keeping coins in covered containers out of reach, putting thumbtacks high on a bulletin board, and storing batteries, nails, and jewelry safely. All of this should be as much a part of childproofing as keeping medications and cleaning supplies out of reach.
- If there are small children in the house, try not to buy anything with magnets that could be swallowed. There isn't much that's necessary to have.
- If you have both older and younger children, buy a "choking tube tester." These are widely available. Show your older children that anything that fits in the tube could be dangerous for their younger siblings. When we had both older and younger children in the house, we had a rule that if a "choke-able" object was found on the floor or within reach, it was immediately thrown out no matter how favorite or important it was. The older ones caught on quickly.
- If you think your child might have swallowed something, call your doctor immediately. If you think they swallowed a battery or a magnet, take them to your local emergency room.