Asking why children stick objects up their noses is like asking why the chicken crossed the road – there is no good answer. It’s more than likely that a curious child will at some point stick something up their nose and when they do the questions become; what is the object, how far up did it go and can it be retrieved before it does any damage? If you are the parent or grandparent of a child old enough to pick up small objects, here is what you need to know about the nose and small objects.
Todaysparent.com1 asked three medical professionals to name the most common objects children put up their noses:
- Play Dough
- Balls of paper or tissue
- Small game pieces like Legos and Polly Pockets
The horrific danger of button batteries
The most dangerous object that a child can put up their nose is a button battery – the type commonly found in watches, hearing aids, singing greeting cards and numerous household objects. The danger that these tiny batteries pose to children cannot be overstated. If not removed immediately they can cause internal burns and death. They are so dangerous that hospitals2, the National Poison Control Center3, and kidshealth.org4 have dedicated special web pages to educate parents about them. According to the Official Journal of the American Academy of Pediatrics5, the most dangerous ingested button battery is the 20-mm lithium cell.
When a button battery is swallowed it lets off an electrical current that activates tissues and burns the body. Clinical studies6 show that serious injury can occur in just two hours if the battery is not removed. Internal damage can be severe and can include perforations of the esophagus, vocal cord paralysis and internal bleeding, among other things. Thirteen deaths have been reported from ingesting button batteries.
Documented cases of children ingesting batteries show that they usually occur under the age of 6, (62.5%) with the majority of them occurring between the ages of 1 and 3. Children were able to get their hands on the batteries in a variety of ways6 that show how enterprising they can be:
- Directly from a product: 61.8%
- Were loose: 29.8%
- Obtained from battery packaging: 8.2%
- Intended for remote controls: 37.3%
The road from the nose to the stomach
Objects that are ingested aren’t necessarily swallowed – they may start by being placed in the nose. Cavities, airways and the sinuses, located inside the skull run from the nose to the mouth. Any object stuck into the nose has the potential to travel into the mouth, down the esophagus and into the stomach. At any point along the way the object can become stuck and obstruct breathing or swallowing. Swallowed objects can also be inhaled into the lungs where it can obstruct breathing. These are just some of the reasons why if you suspect that your child has inserted something into his or her nose it is important to act quickly.
How to tell if an object is in the nose
Depending upon the age of the child, he or she may not be able to articulate that something is stuck in the nose and causing problems. Older children may not want to tell their parents that something is in the nose for fear of getting into trouble. Therefore, it is important to know the signs that indicate an object is in the nose and that it may be blocking breathing or swallowing. Signs can include:
- A sour or foul smell emanating from one side of the nose
- A high fever
- Discharge from the nose that can be clear, gray, green, or bloody
- Whistling noises when the child breathes through his or her nose
What to do
Although a parent’s first instinct may be to do everything possible to retrieve the object, it’s important to try only once and then call the doctor. Repeatedly trying to get an object may cause it to go deeper into the nasal cavities, causing damage along the way. If the child is in distress, has trouble breathing, is choking as a result of ingesting a button battery, call 911 immediately. If none of those things is occurring, here are some things to do, and not to do, when trying to get the object out of the nose:
Here’s what to do:
- Perform the “Mother’s Kiss”: This technique works about 60 percent of the time to dislodge hard objects like beads and Barbie shoes from a small child’s nose:
- Place your mouth over your child’s mouth
- Cover the nostril that is NOT blocked with your finger and close it
- Leave the blocked nostril open
- Blow short, gentle breaths into your child’s mouth until the object pops out
- Use tweezer to remove larger objects.
- Encourage your child not to sniff in because it may pull the object further in
- Go to the emergency room of physician’s office if you can’t retrieve the object
- Call 911
Here’s what NOT to do:
- Do not use cotton swabs to try to get an object out of the nose
- Do not push your fingers up into your child’s nose
Diagnosis and treatment
If you take your child to the doctor’s office or emergency room, clinicians will try to locate the object using lights and imaging. Hand held bright lights may help the doctor to see the object in the nose and retrieve it with small, narrow tweezers, gentle suction or a narrow hook. If not, imaging such as x-rays, CT scans or a fiberoptic camera may be used to detect the location of the object.
Once you are in an office or hospital setting, ask the doctor to check the entire head and neck area for objects in the ears, nose and throat. Where there is one object there may be several.
If the object has caused irritation of the nasal cavities or bleeding, the physician will treat it topically and may prescribe antibiotics to prevent infection. A follow up appointment with the child’s physician is usually recommended to ensure there are no lasting side effects from the incident.
Curiosity causes children to put objects into their nose and mouth to explore them. It’s a natural process. Even though parents race to keep small objects out of children’s reach it is a challenging battle -young children are lightning fast. The two most important things are to keep button batteries out of reach to prevent the extreme damage that they can cause and to know what to do should an object of any type be lodged in your child’s nose.