Foreign body in air passages, nose, ear

In general

A foreign body in a child's respiratory tract can be a life-threatening condition because it can lead to choking, and eventually respiratory arrest.

The symptoms are sudden coughing and difficulty breathing.

This can happen when the child is playing or eating.

When choking on something, the child suddenly looks afraid, gasps, turns blue in the face, and can quickly lose consciousness. You must begin treatment immediately. The treatment will depend on the child's age.

Children may also put small objects up their noses or in the ear, causing irritation and discomfort. 

Examples of such objects include small toys, small stones, peas, nuts, and beads.

Home treatment

In the air passages:

NOTE: If the child is unconscious, or not breathing, call 911 before attempting any maneuvers described below.

• For children over the age of 1 year who have swallowed a foreign object, perform the Heimlich maneuver. Stand behind the child and put your arms around the child's chest. Bend the child slightly forward. Place one clenched fist on the child's abdomen, directly over the navel. Place the other hand over your clenched fist and press your two hands quickly and hard inwards and slightly upwards into the child's belly. Repeat this until the foreign body has been coughed up or forced out. 

• For babies, give back blows and chest thrusts. Support the baby's head with your hand. Hold the baby with his/her belly on your arm or lap, head down and legs in the air. Give five firm blows to the back, between the shoulder blades. Turn the baby over. Again holding baby's head with your hand, give five chest thrusts with two or three fingers on the lower half of the sternum (breastbone). Repeat this until the foreign body comes out.

• If the child does not quickly recover after these actions, you must call for emergency medical services by telephoning 911.

• If the child is losing consciousness, you must start CPR. 

In the nose:

• Ask the child to blow carefully out of the nostril that contains the object while you hold the other nostril shut. If this does not dislodge the foreign body, you should seek medical advice. 
• Get the child to breathe through his/her mouth, and discourage the child from "sniffing", because this could cause the foreign body to end up in the respiratory tract.
• If the child has a foreign body high up in his/her nose, you should not try to remove it using any kind of instrument. This could cause the foreign body to be pushed further up the nose, causing possible bleeding, or other complications.

In the ear:

• If you can clearly see the foreign body and it is in the outer part of the auditory canal, you can try to remove it using a small pair of tweezers. 
• Use gravity to help remove an object. Turn the child's head so the affected side is pointing down, pull on the outer ear and wiggle the earlobe, while the child shakes his/her head gently.
• If the foreign body is an insect, you can try pouring olive oil, mineral oil or baby oil into the ear to kill the insect. In this case, turn the head so that the affected ear is pointing up, then the insect will float upwards. 
• You should not try to remove foreign bodies from inside the ear canal because this usually leads to the item being pushed further into the ear, with a possible risk of damaging the ear drum. In such cases, you should seek medical advice instead.

When to seek medical advice

See the doctor immediately or call 911 if:

• You suspect a foreign body has become lodged in the child's respiratory tract.

Make an appointment with your doctor if:

• You are unable to remove the foreign body yourself from either the child's nose or ear canal. Be careful when attempting to remove any foreign body, as it is easy to push the foreign object further in. If you cannot see the object easily, do not attempt to remove it.