Why Are Button Batteries So Dangerous for Children?

Batteries of all shapes and sizes contain caustic chemicals and should be kept safely out of reach of kids. However, the small flat, coin-shaped variety – known as button batteries – are particularly dangerous to babies and young children. Frequently used to power singing greeting cards, hearing aids, remote controls, toys and small electronics like calculators, button batteries are especially dangerous for two reasons:

• Their small size makes them a choking hazard – if a child puts one in their mouth, it can easily become lodged in the throat and block breathing.
• When a button battery comes in contact with saliva, it sets off a chemical reaction that can erode or burn through soft tissue. When lodged in the throat, the resulting burn can cause perforation of the esophagus in as little as two hours and extend through to major blood vessels, causing internal bleeding and other serious complications.

Without prompt treatment, a button battery lodged in a child’s throat can lead to permanent damage, long-term complications and even death.

Symptoms of Battery Ingestion

“Most of the time, a parent or caregiver will not see the child put the battery in his or her mouth and may misinterpret the symptoms, which can mimic other conditions and illnesses,” says pediatric emergency medicine specialist, Sarah Margolius, MD.

Symptoms will appear suddenly and may include:

• Coughing, gagging or wheezing
• Difficulty breathing and swallowing
• Drooling
• Chest pain
• Nausea and/or vomiting

If your child displays any of these symptoms and you believe there is a chance that they may have swallowed a button battery (or anything else), go to the nearest emergency room or call 9-1-1 immediately. Never attempt to induce vomiting or give the child anything to eat or drink.

Diagnosis and Treatment in the ER

When you get to the emergency room, immediately tell the staff what you suspect is wrong. Prompt diagnosis and treatment is essential to minimize damage to the child’s esophagus, trachea and vocal cords.

Battery ingestion will be confirmed or ruled out with X-rays of the child’s neck and abdomen. If the battery is lodged in the esophagus, an ear, nose and throat specialist (otolaryngologist) will remove it using an endoscope – a thin, flexible tube with a camera and a light on the end. If, for any reason, endoscopic removal is not possible, the battery will be removed surgically.

If the battery has passed through the esophagus and shows up in the stomach, a gastrointestinal (GI) specialist will be called for a consultation. Usually, endoscopic or surgical removal will be recommended; however, in some cases the doctor may decide that the best course of action is to allow the battery to be eliminated naturally through the digestive tract. In that situation, your child’s stool will be monitored for any signs of active bleeding until the battery passes.

“The decision to remove the battery from the stomach or allow it to pass on its own will be based on factors such as the child’s age, time since ingestion, size of the battery and the severity of symptoms, if any,” adds Dr. Margolius.

Follow-Up Care after Battery Removal

During endoscopic or surgical removal of the battery, the doctor will determine the extent of any damage to the esophagus, including tissue burns and/or perforation. If there is a tear/hole in the esophagus from the battery chemicals, your child will be admitted to the hospital for additional treatment, which may include one or more surgeries. Complications of a perforated esophagus may include:

• An abnormal opening (fistula) between the windpipe (trachea) and the esophagus. This can lead to aspiration pneumonia if saliva passes through the opening and into the trachea and lungs.
• Large blood vessel tears and internal bleeding
• Infection/inflammation of the area between the lungs (mediastinitis) which can lead to sepsis
• Esophageal stricture – narrowing of the esophagus due to scarring (a long-term complication that may require one or more dilation procedures)

If the child is discharged after removal, follow up imaging tests will be required along with close observation and esophageal rest.

Take Steps Today to Protect Your Child

Babies and young children explore everything with their mouth. Therefore, it is essential that your home be carefully checked for all kinds of choking hazards, including button batteries. Take the following steps to keep your child safe:

• Get down on all fours (your child’s level) and look for choking hazards. Anything golf ball size or smaller should be removed and stored safely away from children.
• Identify every battery-powered device in your home. Ensure the battery is only accessible with a screwdriver and that the screws are tight and secure.
• Keep all loose batteries out of reach, ideally in a locked cabinet or drawer.
• Always supervise young children when they are playing with battery-powered toys.
• Share this life-saving information with all family members, babysitters and other caregivers.

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In the event of any life-threatening emergency, including battery ingestion, it is important to immediately call 9-1-1 or go to the nearest emergency room. University Hospitals has a wide network of general and pediatric emergency departments across Northeast Ohio - know which one is closest to you and how to get there quickly.