15 Apr Children Swallow Jewelry, Coins, Toys and Button Batteries, Leading to 99 ER Visits a Day
MedicalResearch.com Interview with:
Danielle Orsagh-Yentis, MD
Pediatric GI Motility Fellow
Department of Gastroenterology, Hepatology and Nutrition
Nationwide Children’s Hospital
MedicalResearch.com: What is the background for this study?
Response: Foreign body ingestions are quite common in young children. Much of the literature and advocacy to date has focused on the harms of button battery and magnet ingestions.
We found that foreign body ingestions in children younger than 6 years of age have been increasing over the past 2 decades. This overall increase is mirrored by the rise in coin, toy, and jewelry ingestions, as well as batteries, which, when swallowed, have the potential to cause considerable harm.
MedicalResearch.com: What are the main findings?
Response: Our study demonstrated a dramatic increase in the number of foreign body injuries between 1995 and 2015. The change in the rate of annual ingestions over the study period was statistically significant, increasing 91.5% over the 21 years. In 1995, there were 9.4 cases of foreign body ingestions per 10,000 children less than 6 years of age. By 2015, there were 17.9 cases of foreign body ingestions in the same age group. When we broke the data down a bit further, we found that there was a 4.4% annual increase in the rate of these ingestions over the two decades.
The sheer number of these injuries is cause for concern.
Nearly 800,000 children less than 6 years of age were estimated to have sought care for foreign body ingestions in US emergency departments between 1995 and 2015. This is an average of 99 children each day. This number likely reflects the accessibility of these objects, as coins, jewelry, and toys are readily found around the home. Children in this age group are prone to putting objects in their mouths, as they are enticed by the various colors, shapes, and sizes of the items we investigated in this study. Children aged one to three years accounted for the majority (61.9%) of all ingestions, likely related to their developmental stage and curiosity about their surroundings.
Children younger than six years of age most frequently ingested coins (62%), toys (10%), jewelry (7%), and batteries (7%). While coins were the most frequently swallowed object, batteries are of particular concern because they can do considerable damage when ingested. While all batteries can be harmful when ingested, button batteries, which represented 86% of battery ingestions in this study, can be particularly dangerous. When button batteries become lodged in the esophagus, necrosis, perforation, and strictures can occur. The ingestion of high-powered magnets can also be incredibly harmful. When more than one magnet is ingested, the magnets can attract across intestinal walls, leading to perforation and sepsis.
MedicalResearch.com: What should readers take away from your report?
Response: Children explore the world readily, and they frequently put things in their mouths. We can hopefully decrease the frequency of these ingestions through a few different mechanisms, though.
It’s incumbent on us as physicians to educate families on the dangers inherent in ingesting items such as these. We need to teach families how they can lessen the potential of their child ingesting something. In general, parents can keep their children safe by practicing safe storage. They should keep small items, especially button batteries, high-powered magnets, and loose change up, away, and out of sight of young children. Parents should also check age recommendations on toy packaging to ensure a toy is appropriate for their child’s age. Parents should also read and follow manufacturers’ instructions for toy assembly and use.
Parents can start talking to their children about the risks of putting non-food items in their mouths when the kids are toddlers. Vigilance is still of paramount importance, though, and these items should be kept in secure locations out of their children’s reach.
If you think your child may have swallowed something, first call your pediatrician to ask for advice. If you think your child may have ingested a button battery or high-powered magnet, go to your local emergency department as quickly as possible. Taking a picture of the ingested item or bringing in its packaging can be incredibly helpful to the physician treating your child.
The relative frequency of these ingestions underscores the need for continued advocacy and product regulations. We need to ensure that the youngest among us are kept safe.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Our study underscores the need for further research into ways to lessen these ingestions. Future research should also focus on understanding the various factors that contributed to the dramatic increase in foreign body ingestions over the past two decades.
MedicalResearch.com: Is there anything else you would like to add?
Response: I have no financial relationships or potential conflicts of interest relevant to this article to disclose.
Danielle Orsagh-Yentis, Rebecca J. McAdams, Kristin J. Roberts, Lara B. McKenzie
Pediatrics Apr 2019, e20181988; DOI: 10.1542/peds.2018-1988
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