US sees sharp rise in number of kids swallowing small objects

Coins remain the most common item ingested by children under the age of six.

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Children playing marbles in a playground

Toys such as marbles are among the most common items swallowed by children under the six.Credit: Tim Hall/Mood Board/Shutterstock

The number of children in the United States who swallowed coins, toys and other small objects nearly doubled between 1995 and 2015, an analysis shows. Some of these objects can cause serious harm when ingested, and possibly even death.

In 1995, an estimated 22,000 children under the age of six visited hospital emergency departments across the country after swallowing items such as marbles, buttons or rings. In 2015, the number had risen to about 43,000, an average annual increase of 4.4% over the two decades. Researchers published their analysis1 on 12 April in Pediatrics.

“It’s a huge problem,” says Danielle Orsagh-Yentis, a paediatric gastroenterologist at Nationwide Children’s Hospital in Columbus, Ohio, and the study’s lead author. “I was hoping ingestions had kind of lessened over time, but that certainly was not the case.”

Beware of batteries

To measure the extent of the issue, Orsagh-Yentis and her colleagues used data from the National Electronic Injury Surveillance System, which records injuries related to consumer products from 100 hospitals across the country. They then used census data to make nationwide estimates.

Coins were by far the most common type of object swallowed (62%), followed by toys, jewellery and batteries. And between 1995 and 2015, there was a 60-fold increase in the proportion of children ingesting batteries, from 0.14% to 8.4% (see ‘Small objects’). Button batteries — used in watches, remote controls and electronic toys — were the most common type swallowed. These small, flat objects can damage or even puncture the walls of the oesophagus if they become stuck.

The apparent increase in the number of children swallowing foreign objects is puzzling, says Robert Kramer, a paediatric gastroenterologist at Children’s Hospital Colorado in Aurora. Part of the answer, he adds, could be that parents are now more likely to bring their children to the hospital if they swallow something they shouldn’t have.

But Orsagh-Yentis thinks the biggest cause could be that people are using these items more frequently. That means objects such as toys and batteries are “around the home, around the schools, and various places where children might be”, she says. “So when they see something that’s shiny and enticing, they’re ready and willing to grab it and put it in their mouths.”

doi: 10.1038/d41586-019-01202-w


  1. 1.

    Orsagh-Yentis, D., McAdams, R. J., Roberts, K. J. & McKenzie, L. B. Pediatrics 143, e20181988 (2019).

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