What is going into your child's mouth?

Playful, happy toddlers are a treat to watch. However, their intense curiosity and oral exploration of toys and objects can land them in trouble. Mostly, when children are not supervised by caretakers, various kind of accidents happen, either indoor or outdoor. There are two such accidents encountered by a gastroenterologist.

Firstly, ingestion of non-edible, sometimes harmful "foreign body", which can lodge itself in the throat, nose, respiratory pipe (trachea) and food pipe (oesophagus) or stomach. Secondly, corrosive agents such as acid or alkali. Unfortunately, most of the victims are infants and young children, especially under 5 years of age.

Foreign bodies

These bodies in the gastrointestinal tract can lead to range problems based on the nature of the object ingested and the site of impaction. Such complications can result in instances of death despite proper medical attention.

For example, sharp objects can pierce the wall of the oesophagus, stomach, small intestine, and damage nearby structures such as trachea, blood vessels leading to bleeding. These objects can lead to infection if they get impacted and stay for a long time.

We usually encounter children with sharp objects, such as pins, needles, nails, components of jewellery, toy keys, fish bones and even blades, which can be extremely difficult to remove safely.

Parents or guardians should be extremely vigilant when a child is playing with toys or gadgets, remote, watch, etc as all these operate with a button battery. It is another dangerous item ingested by children. Most parents think button batteries are well insulated in the devices. But don't underestimate your child's capacity to engage in enough mechanics to take them out.

Of late, the incidence of button battery ingestion is increasing at an alarming rate. This could be due to the rise in the use of electronic gadgets, toys, remote and lack of supervision by busy parents or guardians.

Recent advances in technology have also enabled us to replace the mercury-based batteries with the more efficient Lithium-ion (Li-ion) batteries, which carry higher voltage in small space. Therefore, a so-called "dead battery" has enough alkali and charged ions to burn and damage the human tissue within a few minutes to a few hours if they get impacted at a site.

Button batteries can lead to very serious complications such as perforation, bleeding, trachea-oesophageal communication, and even death in some instances. Even after removal of these batteries, depending upon the extent of the injury, they can cause stricture of the oesophagus or stomach, leading to difficulty in ingestion of food or vomiting.

Coin ingestion is also extremely common and they should be kept away from children as much as possible. The last thing you want your child to swallow is a sharp object. So, always keep them away from objects like hairpins, jewellery, toy keys, etc which we encounter frequently.

Similarly, multiple magnets can cause ulcers and perforations in the stomach and intestine. Finally, any large blunt object can create problems by blocking the food pipe and ulcerating due to pressure necrosis.

Hence, one should always label such objects properly and keep them out of reach of children. It would be better to not use acid or alkali for toilet or house cleaning. In an unavoidable situation, buy a small quantity of acid or alkali and use them completely, do not store them at all.

Trip to the doctor

Despite your best possible vigilance, sometimes a child may swallow a foreign body. In such cases of accidental ingestion, visit a gastroenterologist as early as possible for better care. Your timely action and caution can avoid serious health hazards in your child.

Any child with chest pain, difficulty in swallowing food or secretions, difficulty in speaking or respiratory distress after foreign body ingestion will require their urgent removal, especially sharp objects and button batteries.

Sometimes you may not know that your child has ingested a foreign body but the above mentioned symptoms or circumstantial evidence should make you head to the doctor in double quick time.

The early intervention of a gastroenterologist will not only help in the safe extraction of these objects but also prevent short-term and long-term complications due to foreign body impaction.

(The writer is Consultant Pediatric Gastroenterology, Columbia Asia Hospital, Hebbal)

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