Swallowed Coins and Other Objects

Hilliard Pediatrics, Inc. - Dr. Tim Teller, MD


Introduction


Children often swallow objects they are not supposed to have in their mouth. Common items include coins, small toy pieces, and other items. Even if you keep your home clean and the house picked up, your child may do this at some point.


Is Your Child Breathing Comfortably?


If they are NOT breathing comfortably after having a coin or other small object in their mouth, it means the object is blocking all or part of the airway. This is a life-threatening medical emergency. Your child may be gagging, choking, coughing, or turning blue around their mouth and face.

  • Do not do blind finger sweeps in order to attempt to remove the object.
  • The Heimlich maneuver (abdominal thrusts) can help remove an object that is blocking the airway.
  • For infants less than 1 year of age, the American Academy of Pediatrics recommends 5 back blows (with an open hand) in the head-down position, then 5 chest thrusts while they are face up. This is instead of the Heimlich maneuver at this age.
  • If someone passes out, turns blue and the object cannot be removed, or the above attempts to remove the object are not working, call 911 immediately.
  • Do not do back blows, abdominal thrusts, or chest thrusts if the child is still breathing and is a healthy pink color. If these are done, the object can become stuck in the airway. A child’s normal coughing and gagging should remove the object. 

Do You Suspect They Swallowed Something but They are Acting Fine?


  • If they may have swallowed a battery, this is a medical emergency. The most common battery to be swallowed are watch batteries. The battery will have its casing dissolved by the stomach acid and the chemicals in the battery can cause terrible damage to the stomach and intestines. We want your child seen right away at Nationwide Children’s Hospital’s Emergency Department if you know or suspect they have swallowed a battery.
  • If it was another object that is not sharp or pointed, such as a coin or small plastic toy (such as a Lego® piece), it is very likely that the object will pass through the stomach, through the intestines, and then out with a bowel movement. It may take as long as a week for it to pass, even longer. Realize many objects that children may swallow do not show-up on an x-ray. Therefore, many times we cannot tell with an x-ray if a child has indeed swallowed something they were not supposed to swallow. If your child continues to be comfortable, having regular bowel movements, and eating normally, we will continue to observe.
  • If the object is sharp or pointed, your child may show no signs of pain or discomfort. If your child continues to be comfortable, having regular bowel movements, and eating normally, we will continue to observe.

Is Your Child Breathing Just Fine, but Feels as if "Something is Stuck?"


Many of us have experienced a time in which swallowing something to eat, such as a potato chip, that left our throat feeling scratched or irritated if we did not chew the item well. That can give the sensation that something is stuck. If something is blocking our ability to swallow, a good gulp of water and something soft like a bite of bread would not be able to go down into the stomach. Therefore, if your child is breathing easy, have them try to take a few drink of water. If that is going well, have your child try eating something soft like a few bites of bread. If they are swallowing it just fine, even if there throat feels irritated, something is very unlikely to truly be “stuck” – it just feels like it is stuck. This irritation should pass in a few days. If the discomfort is significant, trying soothing foods like Jell-o® gelatin and cold yogurt will help. Ibuprofen (Motrin® and Advil®) may also relieve the pain. It would also be fine to try a dose of a liquid antacid, such as Maalox Advanced Regular Strength Liquid or Mylanta® Ultimate Strength Liquid, every 4-6 hours while awake for a few days. Dosing: Up to 25 pounds = ½ teaspoon; 25-49 pounds = 1 teaspoon; over 50 pounds = 2 teaspoons. Ibuprofen and the liquid antacid are fine to give together.

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