What to do if a 6-year-old ingests plastic?

Management of Plastic Ingestion in a 6-Year-Old Child

For a 6-year-old who has ingested plastic, observation and watchful waiting is the recommended approach, as most foreign bodies pass through the gastrointestinal tract spontaneously without complications. 1

Immediate Assessment

Evaluate the child for signs requiring urgent intervention:

• Check for complete obstruction symptoms including inability to swallow, excessive drooling, or respiratory compromise—any of these require emergent intervention 1
• Assess for respiratory distress to rule out aspiration rather than ingestion 2
• Determine the type, size, and shape of plastic ingested if possible, as smooth objects are less likely to cause perforation 1

Management Algorithm

If the child is asymptomatic:

• Provide reassurance and observation at home with clear return precautions 1
• No imaging is required for small, smooth plastic objects in asymptomatic children 3, 4
• Most foreign bodies (>80%) pass spontaneously within 4-6 days without intervention 4

If the child has symptoms (dysphagia, vomiting, drooling):

• Obtain imaging to locate the foreign body if symptoms suggest esophageal impaction 3
• Symptomatic esophageal foreign bodies require emergent endoscopic removal within 2-6 hours 1, 3
• Sharp or large objects in the esophagus or stomach require endoscopic removal regardless of symptoms 3

Parent Instructions for Home Monitoring

Instruct parents to:

• Monitor stools for passage of the plastic object over the next several days 1
• Return immediately if the child develops abdominal pain, fever, vomiting, bloody stools, or signs of intestinal obstruction 1
• Expect spontaneous passage within one week for most smooth plastic objects 4

Important Clinical Considerations

• Children aged 6 months to 3 years are at highest risk for foreign body ingestion, though 6-year-olds remain vulnerable 3
• The smooth nature of most plastic toys makes perforation unlikely compared to sharp objects 1
• Surgical removal is rarely needed—in one series of 663 pediatric ingestions, zero required surgery 4
• All 224 foreign bodies that reached the stomach passed naturally in this same series, with only one delayed passage 4

Common Pitfalls to Avoid

• Do not induce vomiting—this increases risk of aspiration and esophageal injury 2
• Do not give laxatives or attempt to "push" the object through with food or liquids 2
• Do not obtain unnecessary imaging in completely asymptomatic children with small, smooth objects 4
• Do not assume absence of symptoms means no foreign body—22% of children requiring removal from the esophagus were asymptomatic 4

Prevention Counseling

• Keep small objects away from children under 4 years who are at greatest risk 1
• Supervise young children during play with toys containing small parts 1
• Educate children about not putting non-food items in their mouths 1