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Foreign object - inhaled or swallowed

If you breathe a foreign object into your nose, mouth, or respiratory tract, it may become stuck and cause breathing problems or choking. It can also lead to inflammation and infection.

If you swallow a foreign object, it can get stuck along the gastrointestinal (GI) tract. This can lead to an infection or blockage or tear in the GI tract.

Considerations

Children age 1 to 3 are most like to swallow or breathe in a foreign object. These items may include a coin, marble, pencil eraser, buttons, beads, or other small items or foods.

Causes

Young children can easily breathe in certain foods (such as nuts, seeds, and popcorn) and small objects (such as buttons and beads). This may cause a partial or total airway blockage.

If the object passes through the esophagus (food pipe) and into the stomach without getting stuck, it will probably pass through the entire GI tract.

Symptoms

Symptoms include:

  • Choking
  • Coughing
  • No breathing or breathing trouble (respiratory distress)
  • Wheezing

Sometimes, only minor symptoms are seen at first. The object may be forgotten until symptoms such as inflammation or infection develop.

First Aid

FOR AN INHALED OBJECT

First aid may be performed on an infant or older child who has inhaled an object. First aid measures include back blows or chest compressions for infants, or abdominal thrusts for older children. Be sure you are trained to perform these first aid measures. 

Any child who may have breathed in (inhaled) an object should be seen by a doctor. A child with a total airway blockage requires emergency medical help.

If choking or coughing goes away, and the child does not have any other symptoms, he or she should be watched for signs and symptoms of infection or irritation. X-rays may be needed.

A procedure called bronchoscopy may be needed to confirm the diagnosis and to remove the object. Antibiotics and breathing therapy may be needed if an infection develops.

FOR A SWALLOWED OBJECT

Any child who is believed to have swallowed a foreign object should be watched for pain, fever, drooling, abnormal breathing, vomiting, or local tenderness. Stools (bowel movements) should be checked to see if the object has passed through the body. This may sometimes cause rectal or anal bleeding.

A procedure called endoscopy may be needed to confirm if the child has swallowed an object and to remove it. Endoscopy will be done if the object is long or sharp, or is a magnet or disk battery. It will also be done if the child has drooling, breathing difficulty, fever, vomiting, or pain.

In severe cases, surgery may be needed to remove the object.

DO NOT

DO NOT force feed infants who are crying or breathing rapidly. This may cause the baby to inhale liquid or solid food into their airway.

When to Contact a Medical Professional

Call a health care provider or local emergency number (such as 911) if you think a child has inhaled or swallowed a foreign object.

Prevention

Preventive measures include:

  • Cut food into appropriate sizes for small children. Teach them how to chew well.
  • Discourage talking, laughing, or playing while food is in the mouth.
  • Do not give potentially dangerous foods such as hot dogs, whole grapes, nuts, popcorn, or hard candy to children under age 3.
  • Keep small objects out of the reach of young children.
  • Teach children to avoid placing foreign objects into their noses and other body openings.

Alternative Names

Obstructed airway; Blocked airway

References

Kelsen JR, Liacouras CA. Foreign bodies and bezoars. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 334.

Schroeder JW, Holinger LD. Foreign bodies in the airway. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 387.

Thomas SH, Goodloe JM. Foreign bodies. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 53.

Review Date 10/16/2017

Updated by: Jesse Borke, MD, FACEP, FAAEM, Attending Physician at FDR Medical Services/Millard Fillmore Suburban Hospital, Buffalo, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.