In 2003, poison control centers in the United States received 92,166 calls about kids who had swallowed coins, according to the website HealthyKids. It is usually not a problem. According to the website Parents, 80 percent to 90 percent of the time, the coin passes through the digestive system, which is protected by mucus and is very pliable. Usually it is expelled within a day or two. But you should at least contact your pediatrician if your child swallows a coin, even if the child shows no signs of distress. If your child exhibits symptoms of distress, call 911 or go to the emergency room immediately.
Usually the coin will be expelled in the stool within a day or two. You should check your child's stool carefully by collecting the bowel movement in a strainer and running water through it. The website Med Page Today reports that about 40 percent of parents don't see the coin when it is expelled. A recent study compared a group of kids with no distress symptoms who were observed for 16 hours after swallowing a coin. They spontaneously passed the coin, regardless of size, into their stomach in many cases, especially when the child was older. The researchers concluded that it was safe to wait eight to 16 hours before removing the coin by endoscopy. If the coin wasn't passed by then, it probably wouldn't pass on its own.
A swallowed coin can get stuck in the esophagus or in the stomach or the intestines, according to the website Aetna InteliHealth. If it does, it will be removed, often by catheter or endoscopy. Occasionally, surgery will be required. If the coin is stuck, symptoms of distress include drooling, inability to swallow or pain when swallowing, vomiting, and chest and neck pain. If the coin gets stuck in the intestines, it can tear the walls. Symptoms can include abnormal bowel sounds or blood in the stool. If any of these symptoms appear, call 911 or go to the emergency room. Don't panic, don't assume surgery will be necessary, don't try to forcefully remove the coin, and don't force a finger, food, or drink down a child's throat.
Zinc pennies (and button batteries) can be especially hazardous if swallowed. Pennies issued after 1982 contain corrosive zinc, which can damage the esophagus. Button batteries can get stuck in the digestive tract and burn a hole in the lining within hours. If your child has swallowed a penny (or button battery), take her to the emergency room immediately.
If you are not sure whether your child has swallowed a coin, watch for several warning symptoms, according to Parents. If the child is having trouble breathing, swallowing or speaking, perform the Heimlich maneuver and call 911 or go to the emergency room immediately.
If breathing is labored or you observe gagging, vomiting, or excessive drooling, or if your child has a severe stomach ache, call 911 or go to the emergency room immediately.
A fever, cough, excessive mucus in the nose or throat could be signs of a respiratory infection resulting from a swallowed item. Call your pediatrician.
While watchful waiting might be appropriate when your child has swallowed a coin other than a penny and exhibits no symptoms of distress, some doctors, such as pediatric surgeon Charles Howell, recommends a conservative approach: "Take (your child) to your pediatrician or the emergency room right away."
An X-ray can usually determine whether a swallowed coin is stuck in the esophagus, which will require removal, or has traveled safely to the stomach.