Small Batteries: A Health Hazard for Babies
Every year, approximately 7,000 children are rushed to the emergency room for one reason: swallowing small batteries.
These button-cell batteries power electronics found all over our homes, including garage door openers, remote controls, key fobs, cameras, calculators, wireless doorbells, and toys. Industry taskforces are trying to childproof the packaging and modify battery casings to make them less dangerous to small children. But, parents need to take the lead to prevent and effectively react to these life-threatening choking emergencies and accidents.
“I’ve been a pediatric emergency medicine physician since 1994. Over the years, I’ve evaluated and treated quite a few children who have put foreign bodies, including batteries, in their mouths, ears, and noses. The most common age group for ingesting objects is approximately six months (the developmental age when some infants become able to sit up, reach, and pick things up) to around five years of age,” says Valerie Thompson, M.D., an expert in pediatric emergency medicine with the University of Miami Health System.
“Young children are curious. They often explore the world with their mouths and don’t distinguish between edible and non-edible items before putting them in their mouths,” Dr. Thompson says.
Even the most watchful parents can’t possibly keep an eye on an active toddler 24/7. That’s why many of these dangerous ingestions go unwitnessed.
If you don’t see your child put something like a battery in their mouth, how can you determine if it’s an emergency?
Parents and caretakers should respond to any of these distress signs with urgency:
- unusual fussiness
- change in the level of activity
- refusal to swallow
- refusal to eat foods they typically enjoy
- poor feeding
- refusal to drink
- choking or gagging
- respiratory distress
- pointing to the throat area
- making unusual or high-pitched breathing sounds (called stridor)
- suddenly not breathing
“If you suspect a child has swallowed something, and the child is choking, losing consciousness, has stopped breathing, or is turning blue, you should call 9-1-1. If you’ve been trained in choking/CPR management, call for help and initiate emergency first aid for choking or CPR immediately,” Dr. Thompson says.
“If you suspect a child has inhaled or ingested a foreign body, even if the child is alert, conscious, and breathing adequately, you should still take them to the nearest emergency room.
“As pediatricians, we’d rather see them and ultimately tell parents ‘there’s nothing here to worry about based on our diagnostic evaluation than for families to stay home and worry or for the child to experience harm related to a delay in medical attention.”
What about those anti-choking devices designed for toddlers?
“If you’re not trained to use one of these devices, or if you’re not comfortable using one, you could potentially cause harm from improper use. Plus, once a child swallows something, it may no longer be accessible using such devices, which is hard for parents to determine,” says Dr. Thompson.
“The time lost trying to figure out how to use such tools may delay medical care. If the child is in immediate respiratory distress, decompensating, and losing consciousness, I would rather you not belabor those efforts and bring the child in for care,” she says.
“If the child is breathing, alert, and awake but showing classic signs of possible ingestion or inhalation of an object (such as drooling or gagging), we will expeditiously evaluate them when they arrive in the ER.”
All of these situations are time-sensitive.Dr. Valerie Thompson
Button or coin batteries can damage the esophagus of a child within a few hours. Medical treatment may prevent or reverse some of this damage, but many children who have sucked on or swallowed or even put a battery in their mouth could suffer lifelong disability or premature death.
Corrosion and erosion of the esophagus and other vital structures in the chest (including the lungs, windpipe, and heart lining) can leave children unable to swallow or eat normally for long periods or even permanently.
Battery contents that touch the mouth, throat, esophagus, or windpipe can scar and narrow tissue and leak toxic contents into the chest cavity, which can lead to the death of a child.
The moist skin inside your nose is similarly vulnerable to the tissues in the mouth and digestive tract.
“Batteries in the nose can corrode and erode the septum (the divider of the nostrils) and down through the maxillary sinuses and the lower bones of the eye socket,” Dr. Thompson says.
Because of this risk, a battery in a child’s nose isn’t trivial and should also be immediately evaluated.
The potential chemical reaction from a battery inserted in the ear is also harmful, and the battery needs to be removed from the ear canal. “Because this situation typically isn’t immediately life-threatening, you may not need to call 9-1-1,” she says.
“But, the child should be urgently evaluated. If the battery is visible and accessible in the ear, your general pediatrician may be equipped to remove it. If it’s not feasible in the pediatrician’s office, an ER physician can attempt to remove the battery, which occasionally requires sedation.
“If we are unable to remove an object from the nose or ears in the emergency room, we consult an ENT (ear, nose, and throat) specialist. After an ENT evaluation, we determine if the removal is possible in the ER or if we need to move the child to the operating room or a procedural suite.”
Many doctors in urgent care clinics are also trained in pediatric emergency medicine.
“However, even if they take an x-ray for battery insertion or ingestion, and one is found, an urgent care doctor will likely need to send your child to the ER for further care,” Dr. Thompson says. “If you know your child swallowed a battery, even if they are stable, I would recommend that you forgo the urgent care evaluation and go straight to the ER to avoid delay.”
How to prevent this emergency in your home
When a toy or object is purchased or gifted to you, observe the type and location of its batteries. Regularly check these items, especially the ones your children can access. Look for looseness, breakage, and missing batteries. Ensure that the battery-cage door is closed and the battery is still in there.
Practice safe storage.
Make it a habit in your home to keep batteries in secure containers and out of reach of children. Keep batteries in their original tamper-resistant/childproof packaging until you need them.
Dispose of batteries properly.
Avoid thoughtlessly placing used batteries in your pockets or on a nearby counter or coffee table.
When replacing or removing batteries from a device, immediately dispose of them in a safe spot in your home. Don’t toss them in a junk drawer with coins and buttons). Batteries shouldn’t be thrown in the trash, as dangerous chemicals can leak into soil and water. Contact your local household hazardous waste facility to learn about battery recycling and safe disposal options.
Lower your threshold for emergency care.
If your child may have ingested a battery (or swallowed something inedible), call 9-1-1 or take them to an emergency room immediately.
Dana Kantrowitz is a regular contributor to UHealth’s news service.