Children often swallow small objects such as coins, toys, or jewelry. These nearly always pass through the intestines and are eliminated in 3 to 5 days without causing harm, in fact, I have even seen an open safety pin pass through with no problem. It is only a problem if the object gets stuck somewhere along the way.

If your child swallowed a small object, he may have a brief episode of gagging while it travels down the esophagus (the tube running from the mouth to the stomach). If your child then is not having any signs of the object being stuck in the esophagus then you can simply observe him as directed below.

• Button batteries. Watches or calculators can cause erosion of the esophagus if left too long. This should be taken a little more seriously than other swallowed objects so a call to your doctor is in order. If you know the battery is not in the esophagus, it is okay to let it pass through as discussed below.
• Sharp objects. This should not be a problem but should be discussed with your doctor.

Difficulty swallowing, excessive drooling, gagging, pain in the throat, or just persisting fussiness are all signs that the object may be stuck in the esophagus. This is less serious than an object stuck in the windpipe but still needs immediate medical attention and you should call your doctor or take your child to the emergency room. If x-rays confirm that the object is stuck in the esophagus, it needs to be removed because of the risk of windpipe obstruction. This is usually done in the operating room by a specially trained physician (ENT surgeon or Gastroenterologist) and an anesthesiologist. While this may seem like a lot of fuss over retrieving the lost piece of Lego, it is the safest way to make sure the object does not find it's way into the windpipe, which is a much more serious situation.

If your child is not having any of the above problems, then the object has probably passed into the stomach. If the object is small enough to make it down the esophagus and into the stomach, then it will probably eventually pass all the way through the intestines within 3-5 days. You need to check all the stools carefully for the item in question. You can give extra prune juice to help the object move through. If your child develops vomiting, abdominal pain, cramps, or bloody stools, you should call your doctor. If after 7 days of stool checking you still haven't found the object, you should call your doctor (who may decide to wait a little longer for the object to pass). If a swallowed object is stuck in the intestine too long, it can lead to further problems. An x-ray can confirm the location of the object.

• The object is stuck in the esophagus (see above)
• The object is a battery
• The object is sharp
• If there is vomiting, abdominal pain, cramps, or bloody stools
• No symptoms, but the object has not passed in 7 days