What are button batteries?
Button batteries (sometimes called disc batteries, watch batteries, or coin batteries) are small, round, flat batteries that are found in a variety of toys and other household items.
Household objects that contain button batteries include:
- Key fobs (car keys)
- Flashing shoes or clothing
- Hearing aids
- Remote controls
- Musical greeting cards
- Thermometers
- Toys, games or talking books
- Flameless candles
- Kitchen and bathroom scales
- Watches
- Decorations and ornaments
- Calculators
- Flashing jewelry
- Cameras
If someone has swallowed ANY battery, you cannot treat them at home. They must be assessed in an emergency department. A swallowed button battery can burn through a child’s esophagus in just 2 hours.
Small batteries inserted in the nose and ears can cause permanent damage. They can cause chemical burns and injuries may be life threatening and altering.
Most battery ingestions are unwitnessed and occur when button batteries are removed from household items. The best treatment is prevention; keep button batteries away from children. Even dead batteries have enough power to cause injury if swallowed.
How do button batteries cause injuries?
Button batteries cause injuries in a number of ways. The most common way is when a battery is swallowed and gets stuck in the esophagus, the tube that leads from the back of the throat into the stomach. The positive and negative sides of the battery cause an electrical circuit that can cause a deep burn or a hole. Chemicals can also leak out of the battery causing burns or holes.
Button batteries can also cause similar damage in the ear, nose and sometimes, but less often, the stomach or intestine.
Why are button battery injuries so severe?
Button battery injuries are so severe because the esophagus is in such an important location in the body. Holes caused by button batteries can damage the aorta, the windpipe (trachea), and even the spine. Burns cause scars in the esophagus that can make it hard to swallow in the future.
If a battery passes through the esophagus without causing damage, it will usually pass through the remaining gastrointestinal (GI) tract successfully, however a small number of patients can have serious complications of the stomach and the small intestine. This risk is increased when a child also ingests a magnet at the same time. This may lead to pinching of the stomach or intestinal wall between the battery and the magnet, causing burns and holes in the stomach and/or small intestine. Batteries that do not pass through the GI tract will need to be removed in a hospital. You should not wait to see if a button battery will pass through the GI tract before going to a hospital.
What are the signs and symptoms of button battery ingestion?
The symptoms of a button battery ingestion are not always obvious. Some children may have no symptoms at all. Sometimes children will have difficulty swallowing, drooling, chest pain, coughing, vomiting or fever.
Symptoms can range from mild irritation in the mouth if the battery was chewed on, to corrosive injury and burns.
Batteries stuck in the nose can be really hard to see and children often have no symptoms. They can cause pain, bleeding, fevers or facial swelling.
Batteries stuck in the ear are also easy to miss. They can cause pain, bleeding, hearing loss and ear swelling.
Batteries in the stomach and intestine do not usually cause symptoms. However, when complications in the stomach or intestine occur, patients can have nausea, vomiting, abdominal pain, fever and/or gastrointestinal bleeding.
What are the risk factors for button battery ingestion?
All button batteries are dangerous, but button batteries that are bigger than 12 mm in diameter are the most likely to get stuck in the esophagus. You can tell how big a battery is by looking at the identification number. For example, a C2032 battery is 20 mm in diameter and 3.2 mm in width. Smaller batteries can also get stuck in the esophagus but are more likely to get stuck in the nose or ear.
The more powerful the button battery (e.g., 3V), the more likely it is to cause injury, but even dead batteries can cause injuries.
Swallowed button batteries can get stuck in the esophagus at any age but are more likely to get stuck in children who are younger than 12 years old. The most severe injuries occur in younger children.
Risk factors for complications in the stomach and intestine wall include ingesting a magnet at the same time, being younger than 5 years of age, battery size 20 mm or larger and how long the battery stays in the body.
How common are button battery injuries?
There has been a 10-fold increase in moderate and severe injuries caused by button battery ingestions in the last 15 years even though the rate of button battery ingestions has been stable. This is because of a change in battery production leading to larger size and higher voltage batteries.
However, there has been a worldwide increase in the number of button battery ingestions along with other ingestions during the COVID-19 pandemic as families spent more time at home.
How are button battery injuries diagnosed?
Button battery ingestion is diagnosed by X-ray. Make sure to tell your doctor, nurse, or the paramedic if you think your child has swallowed a button battery so that they can get an X-ray done right away to minimize delays in treatment.
X-ray findings for a button battery can sometimes look similar to X-rays findings for a swallowed coin. The health care team can use a 2-view X-ray to help distinguish these differences.
Diagnosis of complications of button battery ingestion can be done with endoscopy (cameras) and other imaging tests.
How are burns from button batteries treated?
- If your child has swallowed a button battery, go to the nearest emergency department immediately. Make sure to tell the doctor, nurse or paramedic if you think your child has swallowed a button battery.
- Children who are able to swallow can be given honey at home and while enroute to the hospital. Give 2 teaspoons every 10 minutes for up to 6 doses. Do not give anything else by mouth. Call the Poison Centre for further advice but do not delay going to the hospital.
- Button batteries need to be removed as quickly as possible if in the ear, nose or esophagus.
- Button batteries in the ears or nose can be removed safely by trained health care providers.
- Swallowed button batteries need to be removed in the operating room by a surgeon.
- Stomach and intestinal button batteries may be removed in the operating room in case of risk factors (e.g., co-ingestion with magnets) or if complications develop.
Button battery ingestions cannot be treated at home.
How can button battery injuries be prevented?
- Extra batteries should be locked up and out of sight with all of your other household hazards.
- Keep objects with button batteries that do not have screwed-secured compartments away from children.
- Ensure battery-operated toys and appliances are intact (not damaged).
- Dispose of dead batteries right away. Cover dead batteries with duct tape or packing tape if they cannot be immediately discarded.
What are the complications of button battery ingestion?
The complications of a button battery ingestion will depend on where the button battery is, how long the battery has been there, how large the battery is and how high the battery voltage is.
Nose
- Bleeding
- Pain
- Infections that can spread to the face, eye, and brain
- Septal perforations (holes)
- Scarring in the nostril and nose
Ear
- Pain
- Hearing loss
- Ear canal scarring
- Infections that can spread to the ear and brain
Esophagus
- Scarring that can lead to difficulty swallowing
- Esophageal perforations (holes) causing severe chest infections
- Damage to the windpipe (e.g., connections between the windpipe and the esophagus, scarring) and vocal cord paralysis
- Injury and infections in the spine and spinal cord
- Holes in the aorta or nearby blood vessels that can cause life-threatening bleeding
Stomach and intestines
- Abdominal pain
- Gastrointestinal bleeding
- Perforation (holes) in the wall of the stomach
- Perforation (holes) in the wall of the intestine
- Serious abdominal infection as a result of perforation (holes) of the stomach and/or the intestine wall
Follow up care after a button battery ingestion
If your child has swallowed a button battery, it is important to follow up with the doctor after discharge from the hospital and attend any follow up appointments so your child can be evaluated for complications. Some complications can take time to develop. Scarring in the esophagus that can cause problems with swallowing can take about 4 weeks to develop. If the button battery passed through the esophagus into the GI tract, but you did not find the battery in your child’s stool (poo), then it is extra important that you attend your follow-up appointment as the battery could be stuck somewhere along the GI tract.
Things to look for – Go to the emergency department right away if you notice:
- Difficulty swallowing
- Bleeding from the mouth or bum
- Difficult breathing or speaking
- Chest pain or fevers
- Recurrent vomiting
- Abdominal pain
When should you go to the emergency department?
Go to the emergency department immediately if your child has swallowed or potentially swallowed a button battery or placed a battery in their nose or ear. Tell the doctor or nurse that your child has swallowed a button battery.
Resources
National Capital Poison Center: Safety Tips for Button Batteries
Check your local rules about battery disposal to learn how to discard batteries safely: