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What to do when baby swallows a small object
Q: I think my 20-month-old swallowed a penny this morning and I don’t know what to do. Do you have any advice?
A: Toddlers are curious, as you know. In a flash they can grab a small object (such as a coin, marble, pill, button, toy part or small battery) and pop it in their mouth. Fortunately, 80 to 90 percent of the time the object passes through the child’s digestive system and into the stool within several days, without any problems.

However, serious dangers can occasionally occur. Instead of swallowing the object, the child might breathe it into his airway and choke on it. The child may swallow the object, but it could get stuck in his esophagus (which could block swallowing or breathing), or his stomach or lower intestine, and may need to be removed surgically. Pennies can be particularly dangerous. Since 1982 they have been made of zinc, and when they come into contact with stomach acid they can become corrosive and cause stomach ulcers.

If your child has swallowed a penny or any small object, call 911 or emergency medical services immediately if you see any of the following emergency signs of choking:

  • Trouble breathing, speaking or crying

  • Wheezing or noisy breathing

  • Persistent coughing

  • Trouble swallowing

  • Drooling or spitting up saliva

  • Loss of consciousness

  • If your child has swallowed a coin but there are no emergency signs, it’s best to contact your doctor. But the general recommendation is that you can wait one to three days to see if he passes it in his stool. If you don’t find the coin in his stool, or your child has abdominal pain or vomits, get medical help immediately.

    To try to prevent this from happening in the future, keep small objects such as a coins, marbles, pills, buttons, toy parts, jewelry, nuts and small batteries out-of-reach for your toddler. Anything that is less than 1-inch deep and 1.25 inches in diameter is small enough for a child to choke on. Here’s a quick test for small objects: If the object can fit through the cardboard tube inside a toilet paper roll, your child could choke on it.

Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician