Button battery ingestion is a big deal. So much so that The National Battery Ingestion Hotline (NBIH) was created in 1982 to study and advise best practices. They look at all types of batteries but swallowed button batteries account for 94% of batteries ingested.
Until recently the agreed-upon first aid guidelines for a swallowed button battery were to take nothing at all by mouth (no oral intake!) but to get to the ER as soon as possible for timely x-rays to find the position of the battery, before promptly removing the battery with an endoscope.
Who Swallows Button Batteries?
Kids swallow button batteries, particularly kids under 6 years old. The peak age for this is in toddlers 1 to 2 years old, just old enough to toddle into trouble and just young enough not to know better. Typically, they pop it in the mouth as soon as they remove it from the object.
Button batteries are in games and toys and lights and remote controls, garage door openers and key fobs and singing greeting card – powerfully fascinating items to young kids.
(The elderly also swallow button batteries, perhaps mistaking a hearing aid battery for a pill)
What’s the Big Deal?
First the good news: most people who swallow button batteries end up fine. But for a significant minority, the battery nestles into the mucus lining of the esophagus and the electrical discharge begins to cause corrosive injury. Burns are seen within a couple of hours, and serious burns as soon as 8 to 12 hours. If the battery remains in place longer than that, perforation of the esophagus may occur.
Sometimes the battery doesn’t get stuck in the esophagus and makes it all the way in to the acid bath of the stomach. This may not be good news. The stomach acid can open the seal of the battery and release the dangerous chemicals inside.
What about Dead Batteries?
The fresher the battery, the higher the chance of harm – but swallowed dead batteries are still an emergency. They can still generate enough current to burn tissues.
Honey, I Think My Child May Have Swallowed a Button Battery! What Should You Do?
Honey can significantly reduce burn injuries from swallowing button batteries. The latest recommendations are to give 1 to 2 tsp of pure honey, if available, before heading to the ER as long as:
- Your child is at least a year old.
- There is no obvious chest pain or fever.
- The known or suspected swallowing happened within the last two hours.
Do the same if the person who may have swallowed the battery is an adult.
Head to the emergency department for evaluation. If you have the battery identification code from the packaging or similar batteries readily available, bring that with you.
Call the 24-hour National Battery Ingestion Hotline (1-800-498-8666) or a Poison Control Center (800-222-1222) immediately for help along the way. Here are Poison Centres outside the United States.
Also, call the hotline if there may be a battery stuck in the nose or ear. And don’t use nose drops or ear drops. One of my kids stuck 5 peas up the nose. I’m glad they weren’t button batteries.
Not So Fast!
If the battery may have been swallowed more than two hours ago, or if there is obvious chest pain or fever, do not give honey. Do not give anything by mouth. Call a hotline and head straight to the emergency department for evaluation.
Button Battery Ingestions Are on the Rise
Button batteries are a convenient way to power devices that make our lives better in many ways. But they can also be mistaken for a pill or a tempting treat. Be alert for the possibility someone may have swallowed a battery – they may not tell you. And they may not have any symptoms yet. Don’t hesitate to give a spoonful of honey if they fit the guidelines above. This is a simple way to make a big difference for someone you love.
- pH-neutralizing esophageal irrigations as a novel mitigation strategy for button battery injury. Laryngoscope
- Serious complications after button battery ingestion in children. Eur J Pediatr 2018; 177:10
- Button Battery Powered Fidget Spinners: A Potentially Deadly New Ingestion Hazard for Children. J Pediatr Gastroenterol Nutr 2018; 66:595.
- Preventing battery ingestions: an analysis of 8648 cases. Pediatrics 2010; 125:1178.
2 CommentsAdd a Comment
Dr. Greene, Thank you for covering this topic. I have to make one correction to your statement about the indications for the use of honey in the gave of button battery ingestions. The guidelines state that if the battery was ingested within the last TWELVE HOURS (and not limited to only two hour window like you mentioned), then you should administer honey to the child if you have it immediately available and make your way to the hospital.
Dr. Alan Greene
The data behind the new guidelines is still somewhat limited, and our experience and learning will increase quickly because of them.
If it’s been longer than two hours, I recommend talking with a poison control hotline or button battery hotline before giving honey.
Grab the honey (if you have it, don’t go to the store to get it), get in the car, and call.
They may well still recommend giving honey on the way to the hospital, but to me the extra moments to connect are likely worth it.