Beware the Button Battery: Tiny Discs can Lead to Big-Time Health Scare
By Sam Smith, MD, Surgeon in Chief, Arkansas Children's Hospital
Parents sometimes dismiss the occasional swallowed item as a rite of "passage" in young kids. They often assume that the ingested object will, indeed, pass through their bodies quickly, and they'll see it again at a diaper change. While this may be true with older babies and some items like coins, there is a swallowing hazard that parents need to know about and stay on top of: the button battery.
You know these kinds of batteries from basic items around the house. The little flat, disc-like batteries power everything from bathroom scales and car remote key chains to children's books and toys. They look like coins, but when swallowed they are much, much more dangerous.
The reason we are so concerned about these batteries is because they can severely damage the respiratory and digestive systems. When these larger disc batteries get stuck in a child's throat, they mix with the saliva and essentially conduct electricity inside the child's body or leak their caustic contents. The result is a severe chemical reaction that causes extreme burns to the esophagus with erosion into other structures including the breathing tube in a very short span of time. Major damage can occur in as little as two hours, and can continue even after the battery is removed during surgery.
According to The Battery Controlled, a partnership between Safe Kids Worldwide and Energizer®, the number of cases in which children swallowed button batteries and sustained either critical injuries or even died quadrupled between 2006 and 2010. They estimate that poison control centers nationwide receive 3,500 reports of these cases each year.
What's even scarier is that the initial symptoms of these injuries can be similar to a host of other childhood ailments. Kids may cough, drool and show general signs of discomfort. They may also have trouble breathing. It's important to take a child to his physician if these symptoms are present and the family did not witness the child swallowing any kind of non-food item.
If the parents or caregiver did see the child put a button or coin-sized battery in her mouth, they need to head to an emergency care provider immediately and let the physician or nurse know what happened. If they can bring the packaging for the battery with them, it will be helpful to the care team. They'll be looking for an ID number to tell exactly which kind of battery was swallowed.
Parents should not give their children anything to eat or drink when they head to emergency care, and they should not try to induce vomiting if a baby has swallowed a button battery.
The child will receive X-rays to locate the button battery and will likely need immediate surgery to remove the item if it's stuck in the esophagus or other part of the child's respiratory or gastrointestinal tracts.
The best thing we can do for these cases is to prevent them from ever happening. Families must keep lithium button batteries – and items that use them – far out of the reach of young children. Consider them poison and store them high up in cabinets secured with child safety locks. Do not allow your kids to play with toys that use these batteries unless the compartments are tightly secured with screws.
Of course, button batteries aren't the only shiny things little ones put in their mouths. The Surgery division at Arkansas Children's Hospital removes at least 50 coins a year from the breathing tubes of children. It's almost always a penny and almost always a toddler who swallowed it. The U.S. penny, it seems, is just the wrong size and usually hangs in the tube and blocks breathing.
Teens sometimes end up with quarters stuck in their throats after tossing them in the air and trying to catch them in their mouths or even by trying out magic tricks that aren't exactly magical. Coins can usually be removed with a scope in the OR, and anesthesia will be required.
While I have removed far more coins from children's breathing tubes, the button batteries I've had to take out have caused much more serious damage. Some children will need their entire esophagus replaced, a process that takes many months and several invasive surgeries.
We are similarly concerned about toys that include super magnets – like the miniature balls that stick together and were recalled by several retailers a few years ago. When children would swallow a few of those little magnets separately, they could link up in the digestive system and weld the intestines together. At ACH, we removed three sets of those toys from children's intestines, and each time it was a harrowing experience for everyone involved.
Kids will always gravitate to shiny items and once they have them in their hands, they'll always satisfy their curiosity by popping them in their mouths. It's up to us to make sure that button batteries never have the chance to make it near a child's lips.
This is one rite of passage that we can prevent with a little diligence and determination.
Sam Smith, MD, is surgeon in chief at Arkansas Children's Hospital and a professor of Surgery at the University of Arkansas for Medical Sciences. He writes a column each week covering a variety of kids' medical concerns. If you have a topic you'd like him to consider addressing, email firstname.lastname@example.org.