Dramatic rise in number of children ingesting foreign objects, says study

There has been a dramatic rise in the number of young children ingesting coins, toys and other foreign objects, including potentially fatal button batteries, a new study has found.

According to the report, which was published today in the journal Pediatrics, the rate of foreign-body ingestions among children under the age of 6 in the United States nearly doubled between 1995 and 2015, rising by about 92 percent during the 21-year study period — and increasing by about 4 percent annually.

“It is a very upward trajectory,” said Danielle Orsagh-Yentis, the lead author of the study and a pediatric gastroenterology motility fellow at Nationwide Children's Hospital in Columbus, Ohio, calling the trend “jarring.”

The researchers analysed nearly 30,000 cases where children under 6 had ingested foreign objects. They then estimated that more than 759,000 children had been evaluated in United States emergency departments for such ingestions during the two decades studied, and the number of estimated cases grew from more than 22,000 in 1995 to nearly 43,000 in 2015.

It was unclear how much of the increase could be attributed to improvements in case reporting over the years. But Orsagh-Yentis said she thought the rise was partly because of the proliferation of electronics with button batteries, which are found in a multitude of household items including thermometers, remote controls and toys.

As a whole, battery ingestions increased 150-fold during the study period, the researchers reported. Button batteries, which can be fatal if ingested, were found to be the most common type of battery that young children swallowed.
“They’re in everyone’s house, whether they realise it or not,”Orsagh-Yentis said.

When a battery is swallowed, it can trigger a series of chemical reactions that could result in burns, causing “significant tissue injury even within two hours,” according to the American Academy of Pediatrics, and potentially lead to perforation or haemorrhage.

The A.A.P. suggests giving two teaspoons of honey to children older than 1 year who have recently swallowed button batteries. Researchers have found that it can help protect the tissue near the battery and reduce injuries. But doctors warn not to delay medical treatment.

“It’s definitely something you don’t wait on. It should be a trip to the emergency room,” said Dr. Aldo Londino, a pediatric ear, nose and throat surgeon at The Mount Sinai Hospital in New York City. “Early detection is the key to effective treatment.”

Foreign-body ingestions are common “in a general sense” among children under 6, Dr. Orsagh-Yentis said. In 2017, these ingestions were the fourth most common reason for calls to poison control centers in the United States for children in this age group, according to the National Poison Data System, and accounted for nearly 64,000 reports.

At Mount Sinai, Londino said he had noticed a trend where he and other doctors were “getting called more and more for foreign body removal.”

In the last six months, he said, he has removed a marble; the bottom half of a Lego man, “which was a challenge because of the shape”; and a coin — each from the esophagus.

Getting to the doctor quickly is critical for safe and successful extraction, he added, especially given how dangerous some objects can be.

According to the study, the most commonly ingested items were coins, most often pennies. In 2015, coins accounted for more than 58 percent of ingestions, and of all of the patients hospitalised during the two decades studied, nearly 80 percent had ingested coins.

Other types of objects ingested included toys, jewellry, nails, screws, hair products, magnets and Christmas decorations. Most of the ingestions occurred among children ages 1 to 3, the study said. Jewellry and hair products were disproportionately ingested by girls, whereas boys were more likely to ingest screws and nails.
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