Friday, June 6, 2014

They put WHAT in their mouth?


A few posts ago I wrote about the fact that kids like to explore. Many times this involves sticking things where they don't belong.
Being fairly oral critters, most of the time the object they are handling gets placed in the mouth. When this happens there are two passages that it might go down.

If it goes into the esophagus it hopefully will make it's way down into the stomach, through the intestines and then get pooped out.

If something was swallowed, here are things to consider: 

Is it stuck?
How does the child look? Are they able to take a sip of water? Can they swallow just fine? Is their breathing relatively normal?

If something has gotten stuck in the esophagus they will look uncomfortable, There will  be frequent coughing and throat clearing going on. You will know that something is amiss. This will necessitate a visit to the ER.

Is it poisonous?

If you have any doubt about that, call the poison control center


Is it a battery?
Any battery can be trouble, but button batteries can be a tremendous hazard because they can be easily swallowed and they seem to be everywhere these days. Last year I got a call from a mom of 15 month old twins. There they were, sitting on the floor with mom's pedometer right in between them. It was open and the battery was gone. Because of the uncertainty involved, we did have to send them to get x-rays.  Indeed there it was that little battery, sitting in the stomach of one of the kids. In this case it passed safely, but if a battery gets stuck anywhere on the way it can cause a dangerous amount of damage. Please know where all the button batteries are in all of your little gadgets and make sure that your kids have no access to them. Keep a strict inventory and perhaps stick a piece of duct tape across any battery compartments.

Other objects that you need to be wary of are magnets. I am not talking about the little letters that you may have on your fridge. The ones that cause concern are the industrial strength magnets that you may find in some "grown up"  toys  like buckyballs  or jewelry.
If more than one of those get swallowed it can wreak havoc on the intestines and be deadly. Keep them away from your kids!

Is it sharp?
If it is something that has a point or sharp edge, keep an extra close eye on your child. Make sure the tummy stays nice and soft. If your child seems to have a rigid painful belly, they will need to be seen right away. Keep an eye on the stools. Any dark, tarry poop or bright red blood would be a reason to get immediate help.
One of the sharpest things that we were keeping an eye out for some years ago was one of a Grandma's one carat diamond stud earrings. That passed through and was retrieved with no harm at all to the swallower (Grandma didn't want it back; it was reunited with the mate and is in a safe deposit box waiting until the little girl is 18.)

Most of the time, it is simply a matter of watching for the whatever it was to pass through. I have seen all sorts of stuff get swallowed and pooped out without incident. I think I have seen enough change to put a kid through college. Most coins smaller than a quarter go through fairly easily.

Let's encourage a quick passage! Increase the amounts of fluids that your child drinks. Perhaps add prunes. If your child is old enough that they are beyond simple pureed food, consider giving some corn kernels  (You won't see that in any textbook). Have you figured it out yet? For those of you who need spelled out, corn kernels are usually fairly recognizable after they have been pooped out. They can act as a marker.

If it goes into the trachea it may block the airway and you have a choking situation on your hands or it could get aspirated into the lungs. Neither is good. Your child will clearly be having breathing difficulties if this has happened. They will likely have a color change is they are fully obstructed. Of course with any emergency you should call 911, but it is my hope that all parents and caregivers are trained to do a choking rescue.

To avoid this happening on your watch, it is SO important to keep little items away from the young kids. Anything that can fit into a toilet paper tube is too small for an infant or young child to be handling. Dr Kaplan advises that a rule of thumb to keep in mind is that the size of your child's airway is about the same diameter of their pinky finger or ear canal. That is pretty small!
All parents should be able to do a choking rescue. 

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