Sometimes a child swallows a bite of meat, bread, or another solid food and suddenly says it’s stuck — or they cannot swallow afterward. This can be a food bolus impaction (food stuck in the esophagus) or another swallowed object.

This post explains what to do immediately and what evaluation is needed afterward.

Step 1: Emergency signs (call emergency / go now)

Go to the Emergency Department immediately if:

• Your child cannot swallow saliva (drooling, spitting, pooling saliva)
• Repeated gagging or retching and cannot keep liquids down
• Any trouble breathing, noisy breathing, choking, blue color
• Severe chest/neck pain or distress
• Vomiting blood
• Suspected button battery, magnet, sharp object ingestion

If your child is drooling and cannot swallow, this is an emergency because the esophagus may be blocked.

Step 2: What you should NOT do at home

Do not try to “push it down” with:

• big pieces of bread
• bananas
• rice balls
• carbonated drinks
• forcing more food or large drinks

These methods can worsen blockage, increase vomiting, or delay urgent care.

Do not attempt to make your child vomit on purpose.

Step 3: What you CAN do while going for care

If your child is breathing comfortably but cannot swallow:

• Keep them sitting upright
• Avoid food and drink
• Go to emergency for assessment

If your child can swallow liquids and symptoms are mild:

• Avoid solids
• Take small sips of water only
• Arrange urgent medical assessment (same day) if symptoms persist

Step 4: What usually happens in the Emergency Department

Depending on severity:

• Clinical assessment of breathing and ability to handle saliva
• Sometimes X-ray (mainly if a swallowed object is suspected)
• If food is truly stuck, doctors may involve gastroenterology for urgent endoscopy to remove it

Step 5: The most important long-term point: why did this happen?

If a child has a true food bolus impaction (especially more than once), doctors often look for underlying causes such as:

• Eosinophilic esophagitis (EoE) (very common)
• Esophageal narrowing (rings/stricture)
• Severe reflux with inflammation
• Motility disorders (less common)

Clues suggesting an underlying problem:

• Slow eater, chews excessively
• Needs water with each bite
• Avoids meat/bread
• Prior episodes of food “sticking”
• Allergy history (asthma/eczema/food allergies)

This is why many children need follow-up evaluation even after the acute episode is resolved.

Quick summary

• If your child cannot swallow saliva or is drooling after food gets stuck: go to the ER now.
• Do not force bread/bananas/carbonated drinks to “push it down.”
• Repeated food-stuck events strongly suggest EoE or esophageal narrowing and need evaluation.