All toys which are small, or consist of small parts which can be
taken off or fall off, come with a warning that they are not suitable
for children under 36 months. This relates mainly to the danger of
small parts being put into the mouth, inhaled into the lungs and
blocking the main windpipe (trachea), potentially causing death. You
may have noticed that many of the caps of biros now have the tops cut
off , to allow air to pass through should they end up in the trachea.
Foreign bodies in the lungs are clearly the most dangerous as death can
occur rapidly. However small objects including peanuts can lodge in the
peripheral parts of the lungs blocking off smaller airways. This
initially does not cause a problem and may not have been noticed by the
parents. However eventually the blocked airways become infected and the
child develops pneumonia. This will show up on a chest X-ray but if
no-one knows of the possibility of a foreign body being the cause, it
may take a little time before this is realized unless the object itself
can be seen on the chest X-ray, for example if it is metal.
When it is diagnosed treatment is to remove the foreign body from the lungs via a tube passed into the lungs
Children older than 36 months are capable of doing exactly the same
thing, as well as being able to introduce foreign bodies into their
ears, nose, vagina or swallowing something that gets stuck.
Young children explore objects partly by using the mouth and so
putting the objects into the mouth. These objects can be inhaled into
the lungs or they can also be swallowed. If the object is relatively
small it will pass down through the gullet into the stomach and
eventually out. However the gullet is quite narrow and objects such as
coins, pieces of toys, safety pins etc. can end up stuck in the upper
part of the gullet. This is not usually painful but the child may have
the sensation of food being stuck. This may cause some children to
refuse to eat as this sensation gets worse but they will still drink.
Again it may take some time to sort this out if no-one had noticed the
child swallow the object and chest X-ray will only show something up if
it is metallic. Treatment is again by removing the object via a tube
into the gullet
Foreign bodies such as small rubbers, pieces of paper, pieces of
toys, pieces of sponge can be introduced into the ear, nose or vagina.
In the ear or nose the object may be visible but too far in to be taken
out. On the other hand there may be nothing to see. Eventually the
area around the foreign body will become infected and this usually
produces a foul smelling discharge which should alert your doctor to the
possibility of a foreign body. If the foreign body is far up the nose
however then the discharge may trickle down the back of the nose so the
only clue is an unpleasant smell from the child.
Treatment again is by removal. In the ear it may be possible without
sedation but anaesthetic is normally needed for a foreign body up the
A similar problem happens in the vagina. A vaginal discharge apart
from an odourless white or creamy discharge is uncommon in prepubertal
girls. The infection caused by the foreign body will eventually cause a
foul smelling discharge and anaesthetic will be needed to examine the
vagina carefully and remove any foreign body.
Small objects are hazardous for young children and their orifices. It is best to keep the two apart.