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Ask Dr. Sears: Into the Mouths of Babes

Q. Our 4-year-old has started to put coins, marbles, and other small things in her mouth. What should we do if she swallows one?

A. While choking is certainly a hazard at age 4, if an item is small enough to make it through the esophagus (the tube running from the mouth to the stomach) and the stomach, it will generally pass through the intestines and be eliminated within three days without causing any harm. You can help move it along by giving your child extra water and one cup of a stool-softening drink, such as prune juice or fruit nectar. Check her stool for the next few days for the item to appear. If it doesn't, consult your pediatrician, who can do an x ray to confirm the object's location. In most instances, you can just wait for your child to pass the item, as it likely won't cause lasting damage.

In some cases, though, an object will need to be removed immediately (under anesthesia and with a long, skinny tube called an endoscope). Here's what you should watch out for:

Any object stuck in the esophagus. It can wind up damaging the stomach lining or press on the windpipe and interfere with breathing. Difficulty swallowing, excessive drooling, gagging, pain in the throat, and vomiting blood are common symptoms.

Something trapped in the intestines. It can cause irritation if it stays there for too long. Signs include abdominal pain or blood in the stool.

A swallowed penny. In 1982 the traditional copper penny was replaced with one that contains mostly zinc, which can be digested by stomach acid and corrode the stomach's lining if it gets stuck there for more than a day.

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