Video with SMH Emergency Toxicologist Dr. Tamas Peredy & ER Clinical Pharmacist Jeremy Lund / Written by SMH Digital Content Editor Ann Key
Thousands of young children swallow lithium button batteries each year in the US. Tragically, many end up with long-term damage to their esophagus or gastrointestinal organs; others don’t survive. Devices that use these batteries are becoming more common in homes, so too are button-battery ingestions.
What is a ‘Button Battery’?
“Button batteries” are small, flat, round and shiny, much like a clothing button. While they come in various sizes, most can easily fit inside the mouth of a curious toddler or young child. However, unlike regular buttons, these lithium batteries cause a chemical reaction that can damage tissue when they get stuck in the esophagus.
Button batteries are found in many household items and electronic devices, including: car remotes/key fobs, flameless candles, fitness trackers, book lights, headlamps, watches, thermometers, lighted jewelry, singing greeting cards, laser lights/pointers, holiday decorations, garage-door openers, bathroom scales, games and toys.
What Happens When a ‘Button Battery’ is Swallowed
Button batteries are not only a choking hazard, but when the coin-size batteries become lodged in the esophagus, they react quickly with saliva. The battery discharges an electrical current that hydrolyzes water and generates hydroxide, creating a caustic (alkaline) injury to the tissue. Serious damage can occur in as little as two hours. The higher the battery voltage, the faster the injury.
After ingestion, a child might vomit, refuse to eat, develop a cough, or become feverish or listless. Unfortunately, these symptoms mirror those of common childhood illnesses and could be misdiagnosed. If a battery ingestion goes unnoticed or untreated, the erosive injury will progress rapidly over several hours and could be fatal.
Other symptoms of swallowing a button battery include: wheezing, if airway is obstructed; drooling; chest discomfort; difficulty swallowing; and choking or gagging while eating or drinking.
I Think My Child Swallowed One. What Now?
Suspected button battery ingestions are true emergencies.
If you think a child swallowed a battery, DO NOT WAIT for symptoms to develop and do not take him/her to an urgent care center or pediatrician. Call 9-1-1, or take the child to the closest hospital emergency room immediately for X-rays and treatment.
If you have honey on hand—and the child is older than 1—feed him/her honey en route to emergency care. The honey will coat the swallowed battery, slowing the chemical reaction and reducing the battery’s potential damage to the esophagus or gastrointestinal tissue.
Feed the child 2 teaspoons of honey every 10 minutes or so, up to six doses.
There’s no need to focus too much on the exact dose or frequency, and don't force the child to swallow a full dose, if he/she is not tolerating it. If you don’t have honey on hand, do not stop to buy some; head straight to the ER, which most likely has a stock of it.
Keep in mind that honey is not recommended for babies younger than 12 months due to the risk of infant botulism.
If you suspect ingestion, do not offer the child anything else to eat or drink besides honey. Also, honey is not a treatment for an ingestion; the child will still require an emergency evaluation.
Prevention is Key
Understanding that these small, shiny batteries are a serious hazard for children is the first step in preventing accidental ingestion. If you have young children, or entertain any in your home, treat button batteries with the same caution you do poisons.
Look around your house and identify the items that use these batteries. Some will have the battery compartments screwed closed. For the others, take measures to ensure small fingers cannot access the batteries.
- Always store spare button batteries in a locked cabinet, out of children’s reach.
- Always recycle or properly dispose of button batteries, even ones you’ve deemed “dead.” Button batteries stop powering devices long before they lose their charge. Even a “dead” battery has enough charge to harm a child should it be ingested or become stuck in an ear or nose.
- Be prepared. Have honey on hand, and save contact info in your smartphone(s) for Poison Control (800-222-1222) and the Battery Ingestion Hotline (800-498-8666). You can text “poison” to 484848 to save Poison Control’s contact info to your phone.
As Sarasota Memorial's digital content editor, Ann Key manages the health care system's Healthe-Matters blog and its Ask An Expert and TopTips video series, as well as other social media and wellness content channels. If you have a health question you need answered or a wellness topic you'd like a local expert to weigh in on, please email Ann at askanexpert@smh.com.