My child swallowed…

It happens all the time. Kids put things in their mouth that aren’t supposed to be eaten. Parents often call after their child swallowed a toy piece, a coin, and many other things. Most of the time things will just pass — though I’m not a fan of watching the stools for the swallowed object because it just worries parents if they miss it.

Who swallows non-food things?

my child swallowedThe biggest risk group is children between the ages of 6 months and 6 years, but anyone can be at risk.

I have seen an older school aged child swallow a magnet after putting 2 small strong magnets on either side of their tongue to look like a tongue piercing.

Even adults have been known to swallow things such as needles – sewers put the needle in their mouth if you think about it.

Be prepared

Learn CPR

If you are around kids it is a good idea to know child CPR and refresh your skills every couple years.

Classes are often held at local Red Cross stations, hospitals, or fire departments.

You can also find classes by searching “CPR” and your zip code.

Know warning signs

For great information on signs and symptoms of choking and general treatment of choking, visit this KidsHealth Choking link.

Of course, prevention is key

Store medicines and cleaning products where kids can’t reach them.

Be especially alert when visiting other people’s homes – especially if they don’t have young children.

Watch kids carefully when outside.

Throw away broken toys that could have pieces break off.

Keep young kids away from toys designed for older kids.

When to talk to your pediatrician

If your child seems to put more non-food items in his mouth than other kids, he is at risk of pica.

Pica is when a person compulsively puts non-foods in his mouth. For more see the KidsHealth Pica link.

Poison Control Number – use it!

Poison Control number 1-800-222-1222. For more: http://www.aapcc.org
Poison Control number 1-800-222-1222. For more: http://www.aapcc.org

Always keep the poison control number (1-800-222-1222) stored in all your phones!

If you call me about a potentially toxic substance, chances are I will refer to poison control. They have the best database of substance risks and their treatments.

Don’t delay treatment by calling the doctor!

Things kids swallow and what to do:

Balloons:

Balloons are statistically some of the most inhaled or ingested foreign bodies.

One reason is they are so popular with kids. Young kids often will try to bite them.

They often are found at parties or other large crowds, where toddlers and young children are often less directly supervised.

Balloons can suffocate a child quickly if they are inhaled.

Call 911 if there is any difficulty breathing, drooling, or other signs of distress. This can mean the balloon was inhaled into the lungs, not swallowed.

If swallowed, they will pass on their own.

Prevention

Keep balloons away from young children and supervise school aged kids when around balloons.

Batteries:

If you think your child has swallowed a battery, whether or not he appears distressed, immediately take him to an emergency room.

If there is distress, call 911.

Batteries can cause voltage burns or leak, causing acidic burns as soon as four hours after being swallowed.

X-rays will confirm if the battery is in the chest or abdomen.

Batteries usually need to be removed to prevent serious injury.

Prevention

Be sure to keep all of your batteries, especially the small button batteries, safely stored away from children.

Make sure battery-charged items have the battery securely secured. Most now have covers secured with screws. If the cover is easily removed, your child is at risk!

Bugs:

Most of us has swallowed a bug some time in our life. You might not even know if a small one hides in your soda can and you take a big gulp.

A little extra protein, right?

Unless your child chokes, or if it has a stinger (bee, wasp) there is nothing to worry about.

If he’s choking, follow choking instructions.

If you suspect a bee or wasp was swallowed, especially if your child seems to be reacting to a sting in the mouth, or there’s sudden difficulty breathing, drooling, or choking, call 911. Serious reactions to stings in the mouth can occur.

Prevention

Watch kids closely when outside, especially those under 3 years of age or kids who are known to put things in their mouth.

Buttons:

Buttons are generally harmless unless they get stuck or inhaled rather than swallowed.

Signs of breathing difficulty, choking, drooling, or generalized distress should alert you to bring your child to be evaluated.

Buttons are not easily seen on X-ray, which can make identification of a stuck button a little tricky, but if you suspect an issue, talk to your doctor.

Prevention

Keep unattached buttons (the ones in your sewing kit) stored away from kids.

Monitor your children’s clothing and repair any loose buttons.

Cinnamon

Cinnamon is technically a food, but the cinnamon challenge is leading kids and teens to take a spoonful, which can be very dangerous.

The challenge involves something along the lines of swallowing a tablespoon of cinnamon without water.

Ingestion of the cinnamon powder stimulates the gag reflex followed by inhalation of the powder. This causes excruciating pain due to the chemical properties of cinnamon.

It can also trigger airway narrowing and an asthma attack.

And there’s more.

Cinnamon is powdered bark. The cellulose matrix of tree bark acts like a sustained release medicine, slowly releasing a painful and damaging chemical in the lungs.

The body cannot metabolize cellulose. When it’s eaten, it gets passed into the toilet. But if it’s inhaled, our lungs can’t metabolize it.

Prevention

Talk to your kids about the risks of accepting a challenge. It’s not just the cinnamon challenge. Dr. Irene Tien discusses more Dangerous viral challenges you need to know about.

On the surface many things seem just silly and not really dangerous. But unless they know all the risks and consequences and know it is safe, they shouldn’t do the challenge.

Don’t limit this talk to just cinnamon. Use it as an example, but we never know what the next crazy challenge will be – the next category includes a more recent challenge.

Cleaning products, laundry detergent, and other chemicals:

These are highly dangerous and you should call poison control with any suspicion of ingestion. 1-800-222-1222

Call 911 if there are signs of distress.

Prevention

Cleaning products should always be stored away from children to prevent the possibility of swallowing in the first place.

Even the “green” products are usually not safe with ingestion.

And it’s not just toddlers… for whatever reason teens swallowing laundry pods has become a “thing” – talk to your teens about the risks. See the cinnamon challenge information above.

Coins:

Coins are some of the most frequently swallowed objects.

These usually pass through the body without any problems, but many parents never see it come out the other end.

Since it is so common you would think there would be a consensus as to how to manage it.

There isn’t.

When there’s distress

Of course if there is any distress, drooling, breathing difficulty or coughing, your child should be seen immediately, ideally in an ER so that an immediate surgical consult can be made if necessary.

If it was inhaled into the windpipe instead of swallowed into the esophagus or stuck high in the esophagus causing compression on the wind pipe, it may need to be removed.

When there’s no distress

As for kids who swallow coins and have no symptoms, it isn’t as clear cut what to do.

Some doctors get X-rays for all children who swallow a coin to be sure it isn’t stuck in the esophagus. About a third of those stuck eventually end up passing, but most need to be removed.

Some physicians only obtain an X-ray if there are symptoms.

Some physicians remove the ones in the esophagus immediately, others will wait up to 48 hours if there is no distress.

Generally once it reaches the stomach it will pass.

Prevention

Keep coins out of the hands of kids under 3 years old, and supervise young children closely with them.

Remind kids to never put them in their mouth. Not only for the small choking risk, but eeewww… coins have been handled by many and are full of germs!

Crayons or play doh:

I used to wonder why so many things were labeled “non-toxic” — at least until I had a child of my own.

They put everything in their mouth!

These are generally safe (again, unless they choke), although it is possible that these things contain lead or other contaminants.

Prevention

As with everything, supervise young children when they’re playing.

If your child frequently puts them in the mouth, it’s probably a good idea to not allow your child to play with them unless you’re consistently watching them.

Talk to your doctor about pica if they continue to put non-food items in their mouth after 3 years of age.

Dirt or rocks:

Unless your baby chokes or bites down on a rock and breaks a tooth, dirt and rocks are generally harmless.

Prevention

Supervise young children when playing outside.

If your child seems to crave these and eats dirt compulsively, be sure to talk to your doctor about pica.

Energy drinks:

Energy drinks are a popular choice for many, but they contain caffeine and other stimulants that can make them dangerous for children.

Many adults drink caffeine in various forms, so mistakenly think energy drinks are safe. Learn the risks!

Risks from energy drinks

They can lead to dehydration because caffeine is a diuretic.

Energy drinks also can increase heart rate and blood pressure.

They can increase shakiness, anxiety, insomnia, and headaches.

Routine energy drink consumption has been shown to increase the risk of obesity and Type 2 Diabetes, due to the high sugar content.

People build a tolerance to caffeine, leading to increased consumption over time.

Teens are more likely to take dangerous risks when high on caffeine. This could result in injury or legal trouble.

Ingredients in energy drinks can interact with other medications one is taking.

Call poison control if you suspect problems from energy drinks

Prevention

If you drink energy drinks, keep them away from your children.

Talk to teens about the risks of energy drinks. There are deaths reported in teens who drink energy drinks and then participate in sports or alternate alcohol with energy drinks.

Grass or plants:

Unless the grass was recently chemically treated or if the plant is poisonous, there is little to worry about here.

If you’re unsure about a plant being poisonous, contact poison control.

If there is choking, do CPR and call 911.

Gum:

Contrary to popular belief, the occasional swallowed gum does not stay in your gut for years.

It isn’t digested like other foods, but unless it gets stuck along the way, it finds its way out just like all your other food.

Hand sanitizer

Hand sanitizer in small amounts, such as putting fingers in the mouth after rubbing sanitizer on the hands, is generally safe.

Larger amounts can be dangerous and you should call poison control if you suspect ingestion.

Prevention

Keep hand sanitizer away from young children and talk to school aged kids about risks.

Be alert of the sanitizer hanging from your diaper bag or purse!

Magnets

A single magnet is not a worrisome as multiple magnets, but since it often is not known exactly what a child swallows, it is always recommended to take your child to be evaluated if there is a suspicion of swallowed magnets.

They will need X-rays and if there are multiple magnets, they must be removed to prevent perforation of the gut.

Prevention

Keep all magnets away from young children.

Talk to older kids about the risk of swallowed magnets and be sure they understand that they can never put one near their mouth!

Medicines, vitamins, supplements

If your child swallowed (or potentially swallowed) a medication or supplement, call the poison control number ASAP.

Have the bottle with you so you can answer their questions.

Prevention

Make sure medicines and other pills are kept away from kids.

Talk to Grandma about either removing them from her purse or putting her purse out of reach when she’s visiting.

Share this free online brochure with your kids: Medicine is not candy.

Use this interactive site from Scholastic to help kids learn medication safety.

Nicotine:

Sadly, ingested nicotine has been an increasing problem since e-cigarettes have been on the market, but even regular cigarettes, cigars, and their ashes pose problems.

Effects of nicotine poisoning include vomiting, sweating, lethargy and tremors in mild poisoning and confusion, paralysis, and seizures in severe poisoning.

If you even think your child has eaten a nicotine product, call poison control (or 911 if significant symptoms).

Prevention

Keep all nicotine products away from kids.

Talk to teens about the risks of smoking and vaping.

Pet food:

As disgusting as it smells to me, kids love to eat pet food.

The biggest risk here is choking.

If they choke, use your CPR skills. If you’re not confident with CPR, call 911 and they will walk you through it.

Prevention

Keep pet food away from young children.

Pop-top from a can:

The flip top that opens a soft drink can is usually not a concern unless a child chokes on it.

It generally will pass through the intestines if swallowed, but if there are signs that it was inhaled or is stuck in the intestine, a child should be seen.

These do not show up on X-ray because they are made of aluminum.

Prevention

Kids should drink out of cups, not cans.

Keep cans away from young children.

Poop:

This one is gross, but happens more than any parent wants to know. Many babies stick their hand down their diaper and then the hand goes to his mouth.

While this is really gross, it does not cause any danger to the child. If it is his own poop, he will not be exposed to any new germs.

If your child finds someone else’s poop, usually animal poop, there is a little more concern for infection but still pretty low risk.

Symptoms of nausea, vomiting, diarrhea, and low grade fever usually happen within 30 minutes to 4 hours after the ingestion if they are affected. In this case, treat symptoms as you would any other stomach bug and call your doctor.

For specific information of various types of poop (even raccoon!) check out the Illinois Poison Control blog on poop. 

Salt, saltines, and baking soda:

These common kitchen items do not raise fear in many people, but if either is taken in large amounts, they can cause serious problems.

Salt

One tablespoon of salt in a toddler can cause seizures due to electrolyte imbalances. More can be deadly.

An aside: If your child seems to crave salt, talk to his physician. There are salt-wasting conditions that deserve immediate evaluation.

Another challenge

Kids and teens are challenged to eat several saltines without water.

The salt dries the mouth, allowing the cracker to form a powder that can be inhaled.

The coughing that occurs during the attempt encourages more inhalation.

Baking soda

One tablespoon of baking soda changes a body’s pH and can cause serious injury.

Treatment

If your child swallows significant amounts of salt or baking soda, call poison control immediately.

Prevention

Keep young children away from baking items.

Talk to older kids about using foods properly and not accepting challenges, as discussed above – see the Cinnamon section.

Sharp objects:

Any pointed object such as toothpicks, wire, chicken bones, open safety pins and hair pins can pierce the gut.

If you think or know your child has swallowed one of these, get the child to the emergency room immediately. If there’s distress, call 911.

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Cough until you puke

This is the time of year it seems everyone’s coughing. I’ve heard from more than one worried parent that their child coughs to the point of vomiting. In the medical world, we call this post-tussive emesis.

Post = after, tussive = cough, emesis = vomit

Kids tend to have a very active gag reflex, so they sometimes gag themselves and vomit with cough. This can be good, since it gets the mucus out of the back of the throat. You can try to teach older kids to hack and spit it out, cough and spit it out, gargle with salt water, and rinse mucus out of the nose.

Of course it’s not fun to vomit after coughing because everything in the stomach comes up and makes a huge mess. Sometimes the vomit comes out of the nose, which can burn from the stomach acid. And vomiting can be very scary to kids.

Are there serious concerns when kids vomit from coughing?

Yes.

In medical school I learned that when kids cough to the point of vomiting we should consider whooping cough, pneumonia and asthma.

In reality I find that many kids with regular cough and colds can gag from cough, but I always consider the more serious options.

What should I do if my child vomits from a cough?

First, keep your cool.

If a parent starts to get flustered, it makes the child more worried, which never helps.

Make sure your child’s breathing is okay.

Obviously he is coughing, but between coughs if the breathing rate is too fast or labored, he should be evaluated ASAP.

Rinse.

Rinse out your child’s mouth (and nose if needed- saline drops or rinses work well for this). Vomit is just nasty tasting and can burn in the nose.

Treat the cough.

If your child has asthma, give a breathing treatment or their rescue inhaler.

If your child is over a year of age, you can use honey to help a cough. A teaspoon usually does the trick.

Humidify the air with a vaporizer or humidifier.

For more treatments see Cough Medicine: Which one’s best.

When should my child be seen?

If your infant is under a year of age or your child has not had the whooping cough vaccines (Dtap in infants and young kids and Tdap in tweens), he should be evaluated. Some babies with whooping cough stop breathing so many are hospitalized to monitor for complications.

After a single episode of vomiting if your child’s breathing is comfortable, just continue to manage at home.

If your child develops difficulty breathing or dehydration, he should be seen as soon as possible, ideally at a location that routinely cares for children.

If your child continues to vomit after coughing but is comfortable between episodes and is well hydrated, he should be seen during normal business hours at his regular doctor’s office.

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