Button Batteries: Tiny But Dangerous For Kids

There was something obviously wrong with Cole. The three-year old told his parents that he put a coin in his mouth, and now he was standing in front of his parents coughing, gagging, drooling, and saying, “My heart hurts” while pointing to his chest. They quickly took Cole to the ER, where an X-ray revealed a disc-shaped object lodged in his esophagus (the tube leading from the mouth to the stomach) that was consistent with a 21 mm button battery. Cole’s dad then remembered that he found a broken light-up fidget spinner with a missing battery at home.1

Cole was then immediately transported to the regional children’s hospital, 36 miles away. The battery was removed 7 hours after ingestion by inserting a scope into his esophagus with pincers to grab the battery and pull it out.

Despite the quick action, the battery’s electric current caused damage to Cole’s esophagus, which required him to be tube fed for awhile. In addition, the damage and swelling to the esophagus caused some local inflammation to the aorta, the main blood vessel leading away from the heart. This required careful monitoring with multiple MRIs over the next few weeks to make sure the aorta didn’t rupture or develop an aneurysm.

Finally, Cole was able to eat normally, the inflammation around the aorta resolved, and he went home after 20 days in the hospital. This is a typical example of how a tiny, common household object, if swallowed, can cause serious damage. And Cole was lucky: many times, the damage can be permanent.

The Dangers of Button Batteries

Button batteries are small, round batteries found in small electronics like remote controls, calculators, cameras, hearing aids, toys, and games. There has been a rise in button battery ingestions over the past several years, partly due to the increased use of these electronics. And the batteries have gotten larger over the years and more powerful, which makes them more dangerous. Batteries larger than 20 mm in diameter with 3 volts of power, as opposed to 1.5 volts in smaller batteries, are associated with more complications.2

Ingestion of button batteries can result in esophageal perforations (a hole in the esophagus), tracheoesophageal fistulas (a tube-like connection between the esophagus and the trachea, or breathing tube), esophageal narrowing due to scarring, dysphagia (difficulty swallowing), vocal cord paralysis, aortoenteric fistulas (a tube-like connection between the aorta and the bowel leading to severe, life-threatening bleeding), mediastinitis (a dangerous infection of the chest), and death.1

And unlike Cole, many patients experience chronic or even life-long complications after the button battery has been removed. One study demonstrated that even 4 years after the ingestion, only 1 in 5 children were able to eat a regular diet.2

When placed in the nose, the battery can cause damage to the lining of the nose, resulting in scarring and septal deviation. It can also lead to periorbital cellulitis, a severe infection of the tissue around the eye. If a child puts the button battery in his ear, it may cause hearing loss, ruptured eardrum, or facial nerve paralysis.3

And remember: button batteries can cause all of these problems after as little as 2 hours in the esophagus, nose, or ear.3

Signs of Button Battery Ingestion/Impaction

Often, there are not signs or symptoms that a child has placed a button battery in their body. And when there are signs, they can be non-specific, such as fever or cough, which mimic common illnesses like a cold.2,3

Other signs of button battery ingestion or impaction in the ear or nose include drooling, noisy breathing, wheezing, trouble swallowing, pain in the throat or chest, refusal to eat, bleeding from the mouth, and pain or bleeding in the nose or ear.2

What To Do If Your Child Puts A Button Battery In His Body

If you see your child ingest a button battery or put one in his mouth or ear, take him immediately to the emergency room, even if there are no symptoms. The battery needs to be removed as soon as possible to avoid long-term damage or death. If you even suspect that this is what happened but didn’t see it, take him to the ER.

Of course, prevention is the best treatment. Follow these tips to keep your child from harm:3

  • Don’t assume that all battery-powered devices in the home are safe for children. Many of these items, when dropped on the floor, can expose or expel the battery, making it easier to ingest.
  • Tape shut the battery compartments of all devices.
  • Keep all loose batteries out of reach of children, ideally in a locked container.
  • A button battery stops powering a device before it runs out of charge, so even “dead” batteries can be harmful. Safely dispose of all “dead” batteries immediately after removing them from the device–don’t keep them in the home.

For more information about button batteries, watch this video from the American Academy of Pediatrics.

References:

  1. Khalaf RT, et al. Button battery powered fidget spinners: a potentially deadly new ingestion hazard for children. J Pediatr Gastroenterol Nutr. 2018 Apr;66(4):595-597.
  2. Bolton SM, Saker M, Bass LM. Button battery and magnet ingestions in the pediatric patient. Curr Opin Pediatr. 2018 Oct;30(5):653-659.
  3. American Academy of Pediatrics. Button battery injuries:  a growing risk.
Ruben Rucoba
Dr. Rucoba has over 25 years of experience as a primary care pediatrician after completing medical school at the University of California, San Francisco. His clinical areas of expertise include caring for children with special health care needs and assisting families with international adoption. He has been a freelance medical writer since 2010, writing for health websites, continuing medical education providers, and various print outlets. He currently works at Wheaton Pediatrics in the suburbs of Chicago, where he lives with his wife and four daughters, including a set of twins.

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