Button Batteries Can be Dangerous and Deadly to Children

I get a lot of information about pregnancy and breastfeeding from reading message boards online.  Some of these message boards are set up so that women can share information based upon their due date.  When you read these boards, you can share pregnancy experiences with women who are going through the same things you are at the same time.  A nice thing about these boards is that once the baby is born, you can still share your experiences or advice as your children grow up.  I started following one of these boards when I became pregnant with my son over two years ago and have followed and made friends with many of the other mommies on the board.  I still keep in contact with and have even met in person a few of the fellow moms on the board that I follow.  The beauty of these boards is there are moms from all over the US and world.  It is interesting to hear about their opinions and experiences based on their different cultural, economic and social backgrounds.  The topics posted are the inspiration for many of my blog posts.  Unfortunately, not all of the topics that I blog about are based upon happy things.

It was through this board that one mom that I've "known" for nearly two years posted that her baby had "died after a short illness."  It was a shock to many of the other moms on the board and we were wondering what would cause her healthy baby to suddenly pass away.  It turns out her baby had swallowed a "button" battery which caused him to suddenly get sick and die.  After hearing her story, I thought that this had to be an isolated "freak" accident.  Unfortunately, it is not and just doing a quick google search, I found that this tragedy has happened again and again and again.  There were 18 fatal cases listed on the National Capital Poison Control Center website.  Even the U.S. Consumer Product Safety Commission issued a warning about button batteries back in 1983.

A study published in the June 2012 edition of the journal Pediatrics looked at "Pediatric Battery-Related Emergency Department Visits in the United States, 1990–2009."  The study found that "an estimated 65,788 patients <18 years of age presented to US Emergency Departments (EDs) due to a battery-related exposure during the 20-year study period, averaging 3289 battery-related ED visits annually.  The number and rate of visits increased significantly during the study period, with substantial increases during the last 8 study years. The mean age was 3.9 years, and 60.2% of patients were boys. Battery ingestion accounted for 76.6% of ED visits, followed by nasal cavity insertion (10.2%), mouth exposure (7.5%), and ear canal insertion (5.7%). Button batteries were implicated in 83.8% of patient visits caused by a known battery type."

How can a tiny button battery cause so much trouble?  According to the National Capital Poison Control Center, "Most button batteries pass through the body and are eliminated in the stool. However, sometimes batteries get “hung up”, and these are the ones that cause problems. A battery that is stuck in the esophagus is especially likely to cause tissue damage. An electrical current can form around the outside of the battery, generating hydroxide (an alkaline chemical) and causing a tissue burn. When a battery is swallowed, it is impossible to know whether it will pass through or get 'hung up'."  According to safekids.org, "Kids can still breathe with the coin lithium battery in their throats. It may not be obvious at first that something is wrong.  Once burning begins, damage can continue even after the battery is removed."

A study published in the May 2010 edition of the journal Pediatrics looked at the clinical implications of battery ingestion and found that "ingestions of 20- to 25-mm-diameter cells increased from 1% to 18% of ingested button batteries (1990–2008), paralleling the rise in lithium-cell ingestions (1.3% to 24%). Outcomes were significantly worse for large-diameter lithium cells (≥20 mm) and children who were younger than 4 years. The 20-mm lithium cell was implicated in most severe outcomes. Severe burns with sequelae occurred in just 2 to 2.5 hours. Most fatal (92%) or major outcome (56%) ingestions were not witnessed. At least 27% of major outcome and 54% of fatal cases were misdiagnosed, usually because of nonspecific presentations. Injuries extended after removal, with unanticipated and delayed esophageal perforations, tracheoesophageal fistulas, fistulization into major vessels, and massive hemorrhage."

A few of the stories mentioned above, the children died as a result of massive hemorrhage.  In the case of the mother on my message board, the battery caused her child's intestines to erode which caused the contents of the intestines to spill into his abdominal cavity resulting in a massive infection.

What are you to do if you suspect your child has swallowed a battery?  According to the National Capital Poison Control Center which operates a National Battery Ingestion Hotline:

"If anyone ingests a battery, this is what you should do:

1. Immediately call the 24-hour National Battery Ingestion Hotline at 202-625-3333 (call collect if necessary), or call your poison center at 1-800-222-1222
2. If readily available, provide the battery identification number, found on the package or from a matching battery.
3. In most cases, an x-ray must be obtained right away to be sure that the battery has gone through the esophagus into the stomach. (If the battery remains in the esophagus, it must be removed immediately. Most batteries move on to the stomach and can be allowed to pass by themselves.)  Based on the age of the patient and size of the battery, the National Battery Ingestion Hotline specialists can help you determine if an immediate x-ray is required.
4. Don't induce vomiting.  Don't eat or drink until the x-ray shows the battery is beyond the esophagus.
5. Watch for fever, abdominal pain, vomiting, or blood in the stools. Report these symptoms immediately.
6. Check the stools until the battery has passed.
7. Your physician or the emergency room may call the National Button Battery Ingestion Hotline/National Capital Poison Center collect at 202-625-3333 for consultation about button batteries. Expert advice is available 24 hours a day, 7 days a week.

Button batteries may also cause permanent injury when they are placed in the nose or the ears. Young children and elderly people have been particularly involved in this kind of incident. Symptoms to watch for are pain and/or a discharge from the nose or ears. DO NOT use nose or ear drops until the person has been examined by a physician, as these fluids can cause additional injury if a battery is involved."

Button batteries are pretty ubiquitous these days which explains why the incidence of accidental battery ingestion is increasing.  Since they're everywhere, I started looking around the house to make sure the batteries are secure from the prying hands and fingers of my toddler.  Thankfully, many of the batteries today are encased in a compartment which is locked with a screw.  Despite finding many batteries enclosed in a "sealed" compartment, there were a few that could be accessed simply by sliding the cover out of the way.  It is with those electronic devices that I am most concerned about.  I cannot be around my child 24/7 but I am trying my best to make sure the batteries are secured.  In some of the cases that I have read about, the origin of the battery was unknown.  It is the "unknown" sources of batteries that I do not even think about that worry me.  All I can do is hope that most of the batteries are secured and inform my child's caregivers to be aware of the potential dangers of batteries.

Educating people about the hazards are key and families that have experienced first hand the dangers of button battery ingestion are trying to spread the word.  Consumer Reports posted a video showing how a button battery, when left on a piece of ham for three days, burned a hole right through it.  It also showed how singing greeting cards aimed at children, can have easily accessible button batteries.  Energizer batteries also posted a video to educate parents about the hazards of button batteries which included a picture of an x-ray of a child with a button battery lodged in its throat.