A peanut got stuck in 3-year-old's windpipe: Why are children prone to swallowing and feeding difficulties?

Indian Express

07-05-2025

When a three-year-old girl was brought into the emergency room of Max Hospital, Shalimar Bagh, Delhi, in a critical condition with high-grade fever, cough, vomitting bouts and severe respiratory distress, her parents thought she had contracted some serious infection. But paediatric pulmonologist Dr Deepak Kumar suspected that something had gone into her windpipe. Tests showed fragments of a peanut she had eaten 10 days ago.
Putting his stethoscope on her heaving chest, he noticed that there was poor air flow on the right side of her chest and a wheezing sound. A chest X-ray confirmed his suspicion of a foreign body trapped in the child's airways. He performed a bronchoscopy in the paediatric intensive care unit as the camera-mounted wire hit the peanut lodged in the right main bronchus (one of the main tubes that carry air to the lungs). He manoeuvred it to remove the nut fragments, restoring the child's ability to breathe normally in four hours and sparing her from potentially life-threatening complications. 'Some tissue had also formed around the peanut due to the body's inflammatory response. With steroids for inhalation, she recovered completely,' says Dr Kumar.
What are common food items that put children at risk?
Dr Sonia Mittal, Director, Paediatrics, who has seen many such cases of foreign objects getting stuck in children's windpipes, says parents should watch over hard solids in their children's diet. 'Peanuts, dry fruits, candies, small toys, beads and marbles are often swallowed by kids. Organic materials like peanuts can cause significant inflammation in the airways if not removed promptly. This can lead to severe complications if not diagnosed early. In this case, timely identification, diagnostics and intervention ensured the child's complete recovery. The peanut was stuck for at least 10 days,' she says.
Why does food get into children's windpipe often?
Food can enter a toddler's windpipe (trachea) during swallowing due to a condition called aspiration. Children under the age of three are still learning how to eat properly. 'In the body, there are two main pipes — the windpipe (trachea) and the esophagus (food pipe). When we swallow food, a flap called the epiglottis partially covers the windpipe to prevent food from entering it, allowing us to breathe safely. However, young children often play or run while eating and if they eat solid food during this time, it can accidentally slip into the windpipe instead of going down the esophagus. This isn't a disease — it's typically an accidental occurrence,' says Dr Kumar.
The only medical conditions where the child can have trouble swallowing are when they have a development disorder like a cleft palate or a problem in the oesophagus, neuromuscular disease, cerebral palsy or Gastroesophageal Reflux Disease (GERD).
What should be the feeding protocol?
Parents should powder and crush nuts and other solid foods to minimise the risk of choking in children under three years of age. Change the thickness of liquids too.