Things Children Swallow And Ways Of Discovery
( Originally Published 1936 )
Pins, peanut shells, paper clips, dimes, nails, pennies, thumb tacks, egg shells, watermelon seeds, buttons, small toys in the form of bicycle riders, jack stones, safety pins, open and shut—these are some of the things that have been found in the windpipes and gullets of children.
How do they get in? Especially one wonders how objects of such size get in. Of course, they get in by being put first in the mouth. Then a sudden deep breath wafts them into the windpipe or they are gulped into the gullet and get stuck there.
The astonishing thing is that they can be sucked past the glottis into the windpipe with no sensation. A doctor friend of mine had this experience: he was tapping his teeth with a pin, when suddenly he found it was gone. He looked on the floor for it, then it occurred to him that he might have inhaled it. An x-ray picture of his chest revealed it in the bronchial tubes, from which it was removed. He felt absolutely no sensation as the pin went into his windpipe—not even enough irritation to cause a cough.
In the case of a young child, then, the accident may occur and the child will not feel enough discomfort to complain about it. How can the mother suspect such an occurrence? Are there any symptoms which indicate a foreign body in the windpipe or gullet?
In the gullet or esophagus a foreign body is more painful than in the windpipe. It causes a sense of pressure and great discomfort on swallowing. Difficulty in swallowing is always a symptom which should be investigated.
In the windpipe, a foreign body, after being lodged there a short time, causes paroxysms of coughing, on any movement or change of position. Asthma is also likely to occur. If left alone lung abscess or pneumonia may occur. The x-ray will confirm the presence of a foreign object in the bronchial tubes.
Modern methods of instrumental removal have been developed to a high degree of perfection.
But prevention is worth several pounds of cure and should be carefully emphasized in the nursery. In fact, not only the nursery, but everywhere. Adults have the experience almost as frequently as children.
Do not hold anything in the mouth while running or playing
Do not hold anything in the mouth while riding in an automobile.
Do not allow a child to put buttons, coins, pins, especially peanut shells (which lead to a very dangerous lung condition if inhaled) in the mouth.
Be careful in the selection and preparation of food. Get all the shell out of the child's egg. There are many cases of inhaled egg shells from disregard of this rule.
No RIGID GROWTH STANDARD CAN BE SET UP FOR CHILDREN
A rigid standard for the growth and development of a child's body cannot be set up. Newborn babies, provided they are healthy, or even reasonably healthy, have proportions and measurements all very much alike. The youngest of the quintuplets weighed less than two pounds, it is true, and some babies weigh as much as ten pounds. The weight of most babies does not vary more than a pound or two—from six to eight pounds.
After the first few weeks, however, standards must be made very flexible if they are to include all normal infants. Development is not uniform in all individuals. Hereditary influences begin to make them-selves felt, and if a child is going to be a small adult, his rate of growth is not the same as if he is destined for large bodily size.
Weight and height are, however, the best general standards of normal growth and development. Other things being equal, a growing child who is 10 per cent below the average weight for his age is abnormal, but, if it shows no disease on physical examination, the difference may be disregarded. This is not a usual situation, however, because such a child almost invariably will be found to have something the matter with it.
Height is a more reliable standard than weight. Height cannot be influenced by diet or exercise, but weight can.
There are seasonal variations in growth. Summer is the time of more increase in height and weight than winter. From June to November the average child leads a freer, more out-of-doors existence, with more activity and consequently less infection and illness, and hence is the period of greatest growth.
Fatigue is an influential factor in growth. It is a curious thing that after a good night's rest both children and adults are slightly taller (1 to 3 centimeters) than after a day of activity.
It is not simple to construct a condensed height and weight table for children. Boys and girls vary slightly. At 3 years different boys may be 35 to 39 inches tall, and weigh from 29 to 35 pounds.
Leaving out too many refinements, we may put down averages as follows:
Years. Inches tall. Pounds.
3 37 32
Years. Inches tall. Pounds.
3 37 31 1/2