For anyone with a small child in the house · 11 minutes
With the worst things a child can swallow, waiting to see whether they get symptoms is the mistake.
Most swallowing scares end with nothing happening. But a handful of ordinary household objects cause serious injury while the child looks completely well — a button battery burning through the oesophagus, two magnets pinching the bowel, paracetamol quietly injuring a liver. For those, the treatment window closes long before the first symptom, so the decision has to be made on what was swallowed, not on how the child seems. This page is a fast way to tell which is which, and it takes eleven minutes to read now instead of at midnight.
2 hoursa lodged button battery can cause serious burns this fast
2 magnetsenough to trap and perforate the bowel from opposite loops
Nevermake a child vomit — it causes harm and helps nothing
The question is not "does my child seem all right?" It is "what exactly was it, and how long ago?" Those two answers, given early, are worth more than anything else you can do.
Find the thing
Tap what was swallowed — or what you think was swallowed. Each answer tells you the tier, why it is or isn't dangerous, and the one thing not to do. If the thing is not here, or you are unsure which it was, treat it as the more serious possibility and call.
Nothing is saved and nothing is sent anywhere. This is a guide, not a diagnosis — the poisons service and the emergency number always outrank it.
Regardless of the item, call the emergency number (112) now if: the child is choking, drooling and unable to swallow, struggling to breathe, making a noisy or whistling sound, vomiting blood, drowsy or difficult to rouse, having a fit, or has burns or blistering around the mouth. Take the packet, bottle or an identical item with you, and write down the time it happened.
The button battery: two hours, and no symptoms
This is the one most parents have never been warned about, and it is the reason this page exists. A coin-shaped lithium battery — the kind in a car key, a remote control, a musical greetings card, a hearing aid, a bathroom scale, an LED tea light or a child's light-up toy — does not have to leak to cause harm. If it lodges in the oesophagus, the moist tissue completes the circuit and the current itself produces a strong alkali at one face of the battery. That burns tissue in the way oven cleaner does.
0–2 hserious burn can already be developing, usually with no symptoms at all
4–6 hthe injury deepens; risk of perforation into the airway or a major blood vessel
days–weekscatastrophic bleeding can happen long after the battery is removed, which is why follow-up matters
If a button battery may have been swallowed, go to an emergency department immediately. Do not wait for symptoms, do not wait for a GP appointment, and do not wait to see whether it "passes". Say the words "possible button battery" when you arrive — it changes the queue. An X-ray finds it in minutes, and if it is in the oesophagus it needs removing straight away.
On the way, if the child is over one year old and can swallow normally: guidance in several countries is to give a teaspoon of honey every ten minutes, up to six doses, because it coats the battery and slows the burn. Do not give honey to a baby under one year, do not give it if the child cannot swallow or is drooling, and never let it delay the journey. Nothing else to eat or drink.
Two more things worth knowing. A battery pushed into a nose or ear is the same emergency for the same reason, and it is often noticed only as a bad-smelling discharge days later. And prevention is boring but effective: look for the coin cells you already own, and treat any compartment that opens without a screwdriver as a hazard — tape it shut, or move the object out of reach.
Magnets: one is a swallowed object, two is surgery
A single small magnet usually passes like a coin. Two or more are a completely different problem: they travel separately, end up in different loops of bowel, and then find each other through the walls. The tissue trapped between them dies, and a perforation follows — often days later, and often after the child has been sent home as "watch and wait".
The usual sources are toys and jewellery: magnet ball sets, magnetic construction toys, fridge letters, fake tongue or nose studs used to imitate a piercing, magnetic slime, and the little clasps on bags and cases.
One magnet plus one piece of metal counts as two. A magnet and a swallowed coin, hair clip or battery can trap tissue between them in exactly the same way.
Go to hospital and say "magnets", plural, if there is any chance of more than one. It needs an X-ray, and often a series of them, because the treatment depends on where they are and whether they have joined.
Do not wait for pain or vomiting. Early symptoms are indistinguishable from ordinary tummy ache, which is exactly why the diagnosis is so often late.
The four instincts that make it worse
Do not make the child vomit. Not with fingers, not with salt water, not with anything. Vomiting brings a corrosive substance back up through the oesophagus for a second burn, risks it going into the lungs, and does not empty a stomach reliably. Syrup of ipecac was abandoned decades ago for exactly this reason.
Do not give milk or large drinks "to dilute it". A few sips of water are reasonable for a burning mouth, but filling a small stomach makes vomiting more likely and can change how a poison is absorbed. Ask the poisons service or the hospital what to give — for some substances the answer is nothing at all.
Do not wait for symptoms with the items on the red list. Button batteries, magnets, adult medicines, paracetamol, iron tablets, nicotine liquid, caustic cleaners and cannabis edibles all have a period where a child looks fine while damage accumulates. Feeling well is not reassuring evidence in the first hours.
Do not spend twenty minutes searching online instead of calling. Call first and read while you wait — the people on the other end have a database of every product and dose, and they will tell you whether you can stay at home. About half the calls to a poisons service end with exactly that answer.
What actually helps, in order: get the substance away from the child; check breathing and consciousness; if the mouth or skin is burning, rinse with running water and remove contaminated clothing; find the packet and read the name off it; note the time and the largest possible amount they could have taken; then call. Take the packaging with you, even if it is empty.
Medicines: the handbag is the dangerous cupboard
Most serious childhood poisonings are medicines, and most of those were not in a medicine cabinet — they were in a coat pocket, a bedside drawer, a weekly pill organiser or a visitor's bag. A few points change how you handle it.
Some adult tablets can seriously harm a toddler at one or two tablets. Blood-pressure medicines of the calcium-channel type, opioid painkillers, certain diabetes tablets, some antidepressants, and iron supplements are all in this group. Assume any adult medicine is a hospital question, not a home one.
Paracetamol is the clearest example of the silent window. A child who has taken too much usually looks and feels completely normal for the first day, while the liver is being injured. Treatment works extremely well when it is started early, and much less well later. This is the one where "he seems fine" causes the most harm.
Weekly pill organisers are the worst-case object: no child-resistant lid, several different medicines mixed, and no packet to read afterwards. Keep them locked away between doses, and photograph the contents so you can tell the hospital what was in it.
Grandparents' visits are a recognised risk point — a handbag on the floor with a blister pack in it is the classic story, and nobody is at fault for not thinking of it. Agree in advance where bags go.
Take the packet, count what is left, and be generous in your estimate. "It could have been up to eight" is more useful than "I think two". Nobody is judging; the number decides the treatment.
Sweet-looking things are the real trap: chewable vitamins, iron tablets like little brown sweets, cannabis gummies and nicotine pouches. A child eats these deliberately, not by accident, so they take a lot more.
Prevention that survives real life
The version of childproofing that works is not "put it up high" — small children climb, and a chair reaches everything. It is the boring locked cupboard and the original packaging.
Worth doing
One locked or latched high cupboard for all medicines and cleaners, including yours
Everything in its original child-resistant container, with the label
Coin-cell compartments taped or screwed shut; spare batteries locked away, and used ones too — a "dead" battery still burns
Vape liquid, nicotine pouches, cannabis products and alcohol treated exactly like medicines
A rule for visitors' bags, and a look under the sofa after a party
The poisons service number in your phone, before you need it
Common mistakes
Decanting anything into a drinks bottle, cup or jam jar — this causes some of the worst caustic injuries
Keeping tablets in a handbag on the floor, or in a bedside drawer "for the night"
Assuming a child-resistant cap is childproof; it buys minutes, not safety
Storing cleaners under the sink behind a door that only looks closed
Calling medicine "sweeties" to get a child to take it
Throwing away the packet before you call
The things that are usually fine
Reassurance is part of the job of a page like this, because most calls are about something harmless and the fear is real. In small amounts, these usually cause nothing worse than an upset stomach: silica gel sachets, crayons and chalk, most toothpaste, pencil lead, blackboard chalk, a lick of hand cream, glow-stick liquid, and the water in a flower vase. A swallowed coin or small smooth plastic toy that is past the oesophagus usually passes on its own within a week.
Two honest caveats. First, this list is for calming down, not for skipping the call when you are unsure what it was — quantity and the exact product both matter. Second, a swallowed object that has stopped in the oesophagus is a different matter, harmless material or not: drooling, refusing food, pain on swallowing, or a child who keeps pointing at their chest needs to be seen the same day.
And it is worth separating two things that get confused. Choking is an object blocking the airway — sudden inability to breathe, cough or speak, and it needs immediate first aid. Swallowing means the object has gone down the food pipe, and the child can breathe and cry. Both need action, but they are different emergencies with different answers.
When nobody saw it happen
A large share of poisonings are never witnessed — the packet is found afterwards, or nothing is found at all and a child is simply not right. That is harder, and there are a few things that should make you think of it.
New drooling, refusing to eat, or pain on swallowing in a child who was fine an hour ago suggests something has stopped in the oesophagus. It does not matter that you did not see it.
Unexplained vomiting with unusual drowsiness, wobbliness, very small or very large pupils, or breathing that is faster or slower than normal.
Burns, blisters or white patches around the mouth, or a chemical smell on the breath or clothes.
A missing tablet, a chewed packet, a bottle out of place, or a pet that has also been sick. Circumstantial evidence is worth acting on — say what you found, not only what you saw.
A behaviour change nobody can explain in a toddler who has been alone with a handbag, a suitcase, a visitor's coat or a hotel room.
Say "I don't know" clearly. An unwitnessed ingestion is a recognised, ordinary situation, and the hospital has a route for it — tests, observation, sometimes an X-ray. Guessing to sound more certain than you are is the only thing that makes it harder, because the plan depends on the range of possibilities, not on a confident story.
What actually happens if you go in
Knowing this makes the decision easier at midnight. For a suspected battery or magnets it is usually an X-ray within minutes, then either reassurance or a removal under anaesthetic. For medicines it is often blood tests at set times — paracetamol has a level measured a few hours after the dose — and observation, with treatment if the numbers call for it. For caustics it may be a look at the throat and, sometimes, an endoscopy. A great many families are sent home the same day, and nobody is treated as a suspect for bringing a child in: this is the most common reason small children attend at all.
One more thing worth learning separately. This page is about swallowing — the object went down the food pipe and the child can breathe, cough and cry. Choking is the airway blocked, and it needs back blows and thrusts within seconds; the hands-only CPR and choking trainer on this site covers that, and it is fifteen minutes well spent before you need it.
The drill: 16 calls
Sixteen ordinary moments — a car key on the floor, a bag of magnet balls, a grandmother's pill organiser, a child who seems perfectly well. Most have an instinctive answer that costs time you cannot get back. Pick your move; every answer explains why.
The card for the cupboard door
Print it and put it where the cleaners are kept — the point is that whoever is home can act without reading this page first.