Management of Foam Ingestion in Infants
For a baby who has swallowed a piece of foam, observation is the primary approach as most ingested foreign bodies pass spontaneously through the gastrointestinal tract without intervention. 1
Immediate Assessment
Evaluate the infant's respiratory status first - if the baby shows any signs of choking, airway obstruction, or respiratory distress, this becomes an airway emergency requiring immediate intervention. 2
- Check for active choking symptoms: difficulty breathing, inability to cry or make sounds, cyanosis, or severe distress 2
- If choking is present, deliver five sharp back blows to the middle of the back with the infant held in a prone position with head lower than chest 2
- Never perform blind finger sweeps of the pharynx as these can impact the foreign body deeper into the airway 2
If No Respiratory Distress
Most soft foreign bodies like foam that reach the stomach will pass spontaneously within days without complications. 1, 3
Observation Protocol
- Monitor for symptoms: abdominal pain, vomiting, feeding difficulties, or respiratory symptoms 1
- Watch stools for passage of the foam piece over the next 48-72 hours 3
- Continue normal feeding unless symptoms develop 1
When to Seek Immediate Medical Attention
Obtain urgent evaluation if the infant develops:
- Difficulty breathing or respiratory distress 2
- Persistent drooling or inability to swallow (suggests esophageal obstruction) 1
- Vomiting or abdominal pain 1
- Refusal to feed 1
Imaging Considerations
Plain radiographs are typically not helpful for foam as it is radiolucent and will not be visible on X-ray. 3 However, if symptoms develop suggesting obstruction, imaging may help identify complications such as bowel obstruction.
Key Clinical Pitfalls
- Do not induce vomiting - this can cause aspiration or further complications 1
- Avoid giving laxatives or attempting to "push" the object through - allow natural passage 1
- Foam is generally soft and compressible, making complete obstruction less likely than with rigid objects, but large pieces can still cause problems 1
- The esophagus is the most concerning location - if the foam is lodged in the esophagus (suggested by drooling, feeding refusal, or respiratory symptoms), endoscopic removal within 24 hours is indicated 1
Follow-up
If the infant remains asymptomatic and the foam passes (or is presumed to have passed) within 3-4 days, no further intervention is needed. 3 Parents should be counseled on choking prevention, as foam toys and materials are common choking hazards in infants under 3 years of age. 2