Corwin Warmink, M.D., medical director of Emergency Services at Cook Children’s, said not a day goes by that a child doesn’t visit the ER after ingesting a foreign body.

“The vast majority of swallowed objects pass without incident or treatment,” Dr. Warmink said. “The most common objects that must be removed are large coins (quarter or larger) because they won’t pass through the stomach and then button batteries and magnets due to the risk of intestinal injury when they are ingested.”

Dr. Warmink wasn’t surprised to see findings from a new study in the latest edition of the journal Pediatrics. Researchers from Nationwide Children’s Hospital in Ohio looked at data from the National Electronic Injury Surveillance System about foreign body ingestions in children between 1995 and 2015.

The research found that over the 20-year period, ingestions doubled.

Seventy-five percent of ingestions were under 5 and coins (61.7%) were the most ingested items.

“It’s the same at Cook Children’s. Coins are far and away number one, along with beads, toys, buttons, nails/tacks, batteries and magnets,” Dr. Warmink said.

Button/disc batteries are the extremely dangerous due to the risk of corrosion. High powered small magnets are also a risk due to entrapment and erosion of the intestines. But many of the objects have the potential for harm.

“The initial danger is if the object gets stuck in the upper airway and causes the inability to breath or if it’s inhaled instead of swallowed and trapped in the lung,” Dr. Warmink said. “Once swallowed, an object may get trapped in the esophagus, which would cause the inability to swallow items. Swallowed objects very rarely cause obstruction in the intestines, but that is also a concern.”

Dr. Warmink adds any object that can fit through a toilet paper tube opening is a high risk item for swallowing. Children under school age should be monitored closely and never allowed to play with coins or toys with small pieces. Children from 6 months to 4 years are at most risk.

Warning signs to bring your child to the Emergency Department are wheezing, coughing, drooling, difficulty swallowing or sensation of object in the chest.

But what we didn’t address were the safety issues of the fidget devices that it seems every child in America owns, whether they have ADHD or not.

On Monday, a Texas mom wrote a Facebook post that everyone should read.

Kelly Rose Joniec said she heard her daughter making “an odd retching noise” from the backseat of her car. Her daughter’s face turned red and drool poured out of her mouth. The little girl pointed to her throat and said she swallowed a part from her spinner.

The child was rushed to the hospital where she needed surgery to remove the object.

“From this I wish to offer some word of caution to parents,” Joniec wrote. “Fidget spinners are the current craze so they are widely distributed. Kids of all ages may be getting them, but not all spinners come with age-appropriate warnings. The bushings pop out easily, so if you have young kids (under 8 yr old) keep in mind that these present a potential choking hazard.”

In Franklin, Ga., a grandmother wrote on social media how her 3-year-old grandson’s fidget spinner came apart with him holding it and saw a small battery that could have been a choking hazard.

Each year, more than 2,800 kids are treated in emergency rooms after swallowing button batteries, according to Safe Kids Worldwide. That’s one child every three hours.

If you have older children who can comprehend the dangers of choking, talk to them about not placing a fidget spinner in their mouth.

If you do suspect your child has ingested a battery, go to the hospital immediately. Don’t induce vomiting or have your child eat or drink anything until assessed by a medical professional. Safe Kids advises parents to keep the National Battery Ingestion Hotline (202-625-3333) in your contacts.

Otherwise, keep fidget spinners, and other devices that could be a choking hazard, out of reach of your young children.

If you suspect choking, always get treatment right away.

About the Author

Justin Smith, M.D., is a pediatrician and the Medical Advisor for Digital Health for Cook Children's in Fort Worth, Texas. He has an active community on both Facebook and Twitter as @TheDocSmitty and writes weekly for Cook Children's checkupnewsroom.com. His interest in communications started when he realized that his parents were relying more on the internet for medical information. He believes that strategic use of social media and technology by pediatricians to connect with families can deepen their relationship and provide a new level of convenience for both of their busy lifestyles. Dr. Smith’s innovative pediatric clinic, a pediatric clinic “designed by you,” is set to open in Trophy Club in 2017.

That’s the question many of our staff at Cook Children’s wonders about the beaded necklaces promoted as a natural alternative to ease teething pain, including Corwin Warmink, M.D., medical director of the Emergency Department.

"Some parents swear by them, but there's zero proof that amber necklaces help teething in any way," Dr. Warmink. "They are a choking and strangulation risk, the necklaces as a whole and the individual beads also. No child young enough to need a teething device should be wearing jewelry. Choking and suffocation is one of the leading causes of death in children under 4 years of age.”

Kat Davitt, a Child Life specialist at Cook Children's, noticed more and more children at the medical center wearing the necklaces. Then after seeing her niece posted a picture of her child wearing one on Facebook, Davitt researched the necklaces and read about the choking risks. Now, she wants parents to know about them:

• The Centers for Disease Control and Prevention says that suffocation is the leading cause of death for children under a year old and among the top five causes of death for children between the ages of 1 and 4.
• The American Academy of Pediatrics says infants shouldn’t wear any jewelry.

Justin Smith, M.D., a pediatrician at Cook Children’s, is also concerned about the choking aspects of amber necklaces.

“It’s interesting. People say they aren’t a strangulation hazard because they break. Ok. But then they say they aren’t a choking hazard because the beads are tied individually,” Dr. Smith wrote in a previous blog about amber necklaces. “I say, you can’t have it both ways. If they break, they have to break somewhere and a bead has to get loose. And if you’ve seen the size of these beads … looks like a choking hazard to me.”

Dr. Smith is also against the necklaces as a way to soothe children’s teething pain. Click to read his blog on why he says parents should save their money and avoid amber necklaces.