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Say Aah!

Your child just swallowed something they shouldn’t…don’t panic!

Dr Sharryn Gardener

Most kids do it at some point. Some even do it more than once!

Usually it’s young inquisitive toddlers (six months to three years) However, occasionally older children will do this for seemingly no obvious reason. Children who have learning or development challenges may swallow foreign objects more commonly.

First up it’s important to try and figure out whether it was swallowed or perhaps inhaled. Most children who inhale a foreign body will have coughed, but not all. The hardest thing is even remembering to think that they might have swallowed or inhaled something – they often won’t volunteer the information.

Often the object in question will be something small, like parts of toys, coins, little plastic gems, sequins, erasers, blu-tac, loose teeth, or large pieces of food. Most of these will pass through and out into the poo uneventfully. 

There are two specific objects require immediate referral and possibly immediate surgery.

BUTTON BATTERIES – Those nice round flat batteries you find in all sorts of normal household battery-powered items like watches, remote controls, hearing aids (elderly grandparents may not appreciate the risk).

It’s not leaking that causes the issue but the reaction with fluids in the body to create a circuit. This produces a really strong alkali which burns through the tissue it is in contact with. The most dangerous is the gullet or oesophagus as it may get stuck there and the prolonged contact allows the reaction to happen. Further down past the stomach the risk is less but still urgent to assess.

SUPER STRONG RARE-EARTH MAGNETS – These look like tiny balls which are highly magnetic and found in toys mostly. There has been a craze to play with these with one ball on the top of the tongue and one underneath to look like a pierced tongue. Although they are strong magnets they can still be easily swallowed. 

Any more than one can cause a problem, or one plus something made of metal that the magnet can stick to.

If they stick together they will pass through uneventfully. The risk is that they don’t stick together and can be attracted to each other from two different parts of the bowel causing problems. 

Other risky ones needing quick assessment are very big or awkwardly shaped items or sharp items.

Most other things will just pass normally and they don’t need you to check the poo to make sure! 

Your doctor may use a metal detector or Xray to find an item that contains metal or glass and so will show up on Xray. So long as the item passes through the thicker muscle at the bottom of the stomach it should pass fine. As long as your child doesn’t get tummy pain or vomiting you can just forget about it.

So honestly, take a breath, don’t panic.

If it is in that risk list get emergency help.

Here is an interesting study where some (slightly silly) Paediatricians swallowed lego and watched to see if it came out and to help reassure parents: https://www.theguardian.com/lifeandstyle/2018/nov/27/shit-a-brick-doctors-swallow-lego-to-allay-parents-fears

Here is a resource aimed at doctors on these so-called foreign bodies. It’s reasonably easy to read: https://dontforgetthebubbles.com/ingested-foreign-bodies/