It’s a frightening scenario. You’ve vigilantly toddler-proofed your home — and yet there’s your two-year-old, swallowing and swallowing again, looking scared… And that ring you left on the countertop while you washed dishes? It’s gone.

Eating the inedible

Babies and young children are notorious for mouthing non-food items. Almost anything they can fit into their mouths can become Today’s Special. “Pebbles, marbles, safety pins, little bits of toys, Lego — they’re all fair game. We also see a lot of those small watch-type batteries that seem to be in everything these days,” says Dr. Michael Dickinson, a Miramichi, N.B., pediatrician and member of the Canadian Paediatric Society’s Public Education Safety Committee.

Curious kidlets can find anything to swallow, as North Carolina dad Nick Morgan, learned after his preschooler swallowed a one-inch nail. “We’d just taken down a series of Thomas the Tank Engine pictures from my son Kendall’s room and left the hangers and nails in the wall. We thought nothing of it at the time,” says Morgan. That is, until Kendall ran up to his parents, confessed he’d swallowed a nail and then recanted upon seeing their terrified expressions.

What to do next

Morgan immediately phoned his son’s pediatrician. Upon the doctor’s advice he and his wife took Kendall to a walk-in clinic, got an X-ray confirming the presence of the metal nail and were told they could safely wait it out.

If your child is pre-verbal you may not benefit from a confession. Although the signs of choking are fairly obvious, signs of “successfully” eating an inedible object are less so. Your tip off may be a missing object (i.e. wedding band), or, later on, intense abdominal pain or vomiting (with or without blood). Toddler stomach aches and vomiting should always be taken seriously: Call your doctor or visit the emergency room right away.

Keep calm, carry on

Fortunately, the vast majority of items pass harmlessly through the digestive tract within days, causing neither pain nor distress. “With smooth, round or small items like a small coin or Lego, there’s no need to panic as long as your child seems well and isn’t drooling, choking, vomiting, or complaining of belly pains. It’s not a bad idea to check his or her stools over the next few days to confirm the object’s been passed. If several days go by and you haven’t seen it pass, seek advice from your child’s primary care physician,” says Dr. Dickinson.

For high-risk items, however, call your doctor ASAP. “Batteries, especially lithium ones, can pose can cause significant tissue damage from chemical burns if they don’t pass quickly. And magnets are an issue because if they stick together, they can cause bowel damage. Anything pointy or sharp like a safety pin has a higher risk for getting stuck or causing damage too, so seek medical advice even if your child seems well,” says Dr.Dickinson.

On rare occasions, surgery is required to remove a lodged or high-risk object. That usually entails passing a scope down the throat (or up the other end) to free an item stuck in the esophagus or digestive tract, under general anesthesia.

You can reduce — though probably never eliminate — the risk of these incidents by being vigilant about keeping small objects out of your toddler’s reach. Anything that can fit through a cardboard bathroom tissue roll is small enough to be a choking or swallowing hazard, including parts of larger toys that could fall off or be removed. Also check that toys and remote controls with small button-type battery compartments can only be accessed with a screwdriver.

As for Kendall? Although he and his dad repeatedly fished his stools with a magnet tied to a stick, “his” nail was never found. A week later, X-rays proved it had bid a secretive and safe exit.

Act fast when your child is choking

Not every battery, coin or grape goes down smoothly. Choking signs include wheezing, turning blue, coughing or difficulty speaking. Pre-verbal children will be unable to cry or make normal gurgling or cooing sounds. Choking victims often hold their hands by their mouth or throat, and/or look wide-eyed panicky.

Your first step, says lifeguard and lifesaving instructor Jessica Peer, of Hamilton, Ont.’s, downtown YMCA, is to assess if your toddler needs help clearing his airway.

• For mild airway obstruction (“In this case, you’ll hear something, whether wheezing or coughing or gurgling, ” says Peer), kneel down to his level and encourage the child to cough up the obstruction.

• For severe airway obstruction (“You won’t hear any sound because the airway is completely blocked,” says Peer), start abdominal thrusts immediately.

Be prepared by taking a first aid class. St. John Ambulance and The Canadian Red Cross offer courses across Canada. “And most community centres and pools offer courses because they have to constantly train their staff, too,” says Peer. Hopefully you’ll never need your training — but you’re covered if you do.