Number of Children Swallowing Button Batteries On The Rise

Battery-related emergency room visits have doubled in the last decade compared to the previous 20 years. That's according to a new study conducted by researchers at Nationwide Children’s Hospital and Safe Kids Worldwide. On average, a child visited the hospital every 1.25 hours for a battery-related incident.

Using data from the National Electronic Injury Surveillance System (NEISS), researchers found button batteries caused 85% of the recorded injuries that listed the type of battery involved, though not all reports included this information. The study also revealed that 84% of patients in the last decade were 5 years of age or younger, and they tended to have more severe injuries than older children.

“We’re seeing more and more of these injuries come into our ERs and hospitals around the country,” said Kris Jatana, MD, a professor in the Department of Otolaryngology-Head and Neck Surgery at Wexner Medical Center at Ohio State University and Nationwide Children’s Hospital, leader of the National Button Battery Task Force, and co-author of the study.

He said the more technology has become widely available over the years, the more likely it is that children have access to button batteries in their homes.

“I think the reason we’re seeing more and more visits is because we have more batteries in circulation,” Dr. Jatana said. “With the miniaturization of electronics powered by button batteries, that’s a real concern. This is a hidden hazard in all of our homes; children are at risk of serious injury and death if they ingest one of these button batteries.”

Parents reading those statistics are probably taking a mental inventory of every battery in their home (especially those with young children who explore everything with their mouths). Experts want caregivers to know that ingesting a battery is serious, but it is 100% preventable.

The Danger of Swallowing a Button Battery

Swallowing any foreign object is bad for you, something parents remind their young kids of daily. But because of what they’re designed to do, batteries are especially dangerous when ingested. Button batteries are ingested more often than cylinder batteries, like AA, because of their small size.

“The biggest danger is while it’s in the esophagus,” said Robert Kramer, MD, a pediatric gastroenterologist and co-medical director of the Digestive Health Institute at Children’s Hospital Colorado. “Because of the passage of current from positive to negative pull in the battery, it produces hydroxide radicals, which changes the pH of the tissue, so it creates a chemical burn. It’s like swallowing detergent.”

Dr. Kramer explained that when a child swallows a battery and it reaches the stomach or small intestine, it tends to cause less damage than when it’s lodged in the esophagus, pressed against tissue. In those instances, even after the battery has been removed, the chemical burning can continue.

“Even after you take the battery out, the pH has already been affected and it may take some time before that ongoing damage stops. There have been tragic deaths even days or weeks after the battery has been removed,” he said.

“As the tissue tries to repair itself, there’s a period of time where it’s particularly weak. The esophagus lies right next to the aorta. The most common cause of death after ingestion is the injury erodes a hole in the wall of the esophagus and into the aorta, which can cause a fatal bleeding event.”

Dr. Kramer noted children 4 years old and younger seem most likely to have a severe injury from battery ingestion because of their size. They can manage to swallow the battery, but their esophagus is still very small, making it easy for the batteries to become lodged inside.

What Are the Symptoms of Swallowing a Button Battery?

Once a child swallows a battery, symptoms usually appear quickly, Dr. Kramer said. The Poison Control website says parents should be concerned if their child is:

• Drooling
• Wheezing or having difficulty breathing
• Vomiting
• Experiencing chest pain
• Choking or gagging while eating or drinking, or suddenly refusing to swallow

Older, weaker batteries can cause more subtle symptoms.

“Brand new batteries with stronger current cause injury quicker, but even spent batteries can have enough charge to cause injuries. With these spent batteries, it can be more insidious. We’ve had patients with chronic cough for a few weeks and they get an x-ray, and lo and behold there’s been a battery in there for weeks,” said Dr. Kramer.

Dr. Kramer said if you have a young child who is suddenly refusing to swallow food, avoiding meals altogether, or who has an unexplained cough that won’t go away, it could be a sign they swallowed a button battery.

What Should I Do if my Child Swallowed a Battery?

If you believe your child swallowed a button battery, call 911 or head to your nearest hospital immediately. Dr. Kramer recommends choosing a children’s hospital, which will have the equipment needed to remove the battery on site. It’s vital to get your child medical attention right away.

“Injury to the esophagus in animal models can begin after 15 minutes. We’ve had patients who immediately came in for treatment and in less than two hours their esophagus had been fused entirely shut,” said Dr. Kramer.

A study co-authored by Dr. Jatana found that giving a child honey after ingesting a battery can reduce the severity of the injury it causes. He recommends giving two teaspoons every 10 minutes until the battery is removed. He said honey should not be given to a child under 12 months of age, even in the event of battery ingestion.

“Honey is weakly acidic and helps to neutralize the injuries caused by the battery, and creates a viscous layer between the battery and esophagus. That’s how honey is able to slow that rate of injury,” he said.

How Do I Keep My Child Safe From Battery-Related Injuries?

Both Dr. Kramer and Dr. Jatana recommend being aware of all batteries in your home and checking the compartments on your devices to ensure they’re childproof. Parents should make sure the battery compartments stay secure over time and don’t become loose or broken. Dr. Jatana says the safest battery compartments require a tool to open.

Both doctors agree that keeping button batteries and kids completely separate is the safest way to prevent battery-related injuries.

“Storing all batteries of all types out of reach and out of sight of children is another measure,” said Dr. Jatana. “Also, when parents and caregivers change a button battery, make sure that old battery is properly disposed of so it doesn’t become ingested.”

“Especially with toddlers who explore the environment with their mouth, we need to get button batteries out of that environment so they’re not readily attainable,” said Dr. Kramer. “It’s hard to say you can’t have them at all because they’re so ubiquitous, but you want to be sure anything the child has access to, those compartments are well secured. A good portion comes out of remote controls, and those often have loose battery compartments easy for a small child to open and access.”

What is Reese's Law?

There is a new law to help prevent battery-related injuries. Reese’s Law requires the Consumer Product Safety Commission (CPSC) to ensure all products using button batteries have child-resistant closures on the battery compartment, as well as clear warning labels about the dangers of battery ingestion. The law was signed on August 16, 2022, and is named after Reese Hamsmith, a toddler who died after ingesting a button battery.

“Reese’s Law is going to mandate child-resistant compartments for batteries contained in electronic products, and warning labels about ingestion hazards. It’s a significant step in the right direction of where we need to go to prevent these injuries,” said Dr. Jatana.

However, he added, while the new rules will affect the safety of technology produced going forward, devices that are already in homes will not be any less dangerous. So, parents’ efforts to protect children from button batteries will still make the biggest difference.

“Be aware of how significant of a danger this is,” said Dr. Kramer. “I’ve been in the position of having to tell a parent the child they brought into the hospital is never going home and has passed away from what is a preventable injury. This is a potentially fatal injury and it’s all about prevention.”