Number of children swallowing foreign objects has doubled since 1995

Foreign object ingestion, including button batteries has doubled over the past two decades.
Foreign object ingestion, including button batteries has doubled over the past two decades. Photo: SHUTTERSTOCK

The number of children swallowing foreign objects has doubled since 1995 according to an alarming new study, which found that coins, toys, jewellery and batteries were the most commonly ingested items in young children.

As part of the research, published in the journal Pediatrics, a team lead by Dr Danielle Orsagh-Yentis analysed data from the US National Electronic Injury Surveillance System for children (NEISS). They analysed presentations to US emergency departments for children under six between 1995 and 2015, who were treated for foreign object ingestion.

According to Dr Orsagh-Yentis, children younger than six are responsible for 75 per cent of all foreign body ingestions, and 20 per cent of children aged one to three have ingested some kind of foreign body. "While many are relatively harmless and able to pass through the gastrointestinal tract, some can cause a lot of harm," she says.

Dr Orsagh-Yentis and her colleagues found that on average, 99 children per day sought care after swallowing a foreign body during the two decades studied, with an estimated 759,000 children under six evaluated after swallowing a foreign object.

The annual rate of foreign body ingestion per 10,000 kids increased by 91.5 per cent from 1995 - 2015. Additionally the number of cases almost doubled from 22,000 in 1995 to nearly 43,000 in 2015.

Coins were the most frequently ingested item (61.7 per cent), followed by toys (10.3 per cent),  jewellery, (7 per cent) and batteries (6.8 per cent). Battery ingestions increased by 150 fold over the period studied, with button batteries representing 86 per cent of ingestions.

"The dramatic increase in foreign body injuries over the 21-year study period, coupled with the sheer number and profundity of injuries is cause for concern," said Dr Orsagh-Yentis. "Continued advocacy and product regulations are needed to keep children safe, and the data shows that vigilance, advocacy and regulations are effective."

While the study was based on US data, closer to home, over the past few years, foreign object ingestion has claimed a number of young lives. In 2017, three-year-old Tasmanian toddler Alby Davis died after a bouncy ball became lodged in his windpipe. The toy, which was to be a party favour at his upcoming fourth birthday party, was larger than the 50c piece/film canister size recommendation for toys given to young children.

Button batteries also remain a serious risk. Two Australian children have died after swallowing button batteries, while around one child a month suffers a serious injury.

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Writing for The Conversation, Dr Ruth Barker, Director of Queensland's Injury Surveillance Unit, and an advocate for button battery injury prevention, described exactly how dangerous they can be.

"When a button battery has sufficient charge (1.2V or more), is lodged in one place inside the body (commonly ear, nose or oesophagus) and lies against a moist surface, an electrical current is generated," Dr Barker wrote. "The current breaks water molecules, producing hydroxide and hydrogen gas. Hydroxide ions are caustic (the main constituent of oven or drain cleaner) and cause "liquefactive necrosis", which means they eat through body tissue."

Last month consumer advocacy group CHOICE, released safety tests revealing that button batteries in 10 out of 17 common household items, such as TV remotes and kitchen scales, are easily accessible. The issue is compounded by the fact that it can be difficult to determine whether a child has swallowed a battery as symptoms can mimic other illnesses. These include: increasing cough, drooling, vomiting, refusal to feed, bleeding from the gut (red or black vomit or bowel motions), discharge from the eye, ear or nose or a fever.

Based on the findings, the American Academy of Pediatrics and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) recommend: 

  • Safe storage: Store small items, especially button batteries, high-powered magnets, and loose change up, away, and out of sight.
  • Check the age recommendations: Labels on a toy's packaging can tell you if a toy is appropriate for your child's age. Read and follow manufacturer's instructions for assembly and use.
  • If you suspect a child has swallowed a button battery, call an ambulance (000 in Australia) or go to your nearest hospital emergency department immediately.