Button Batteries Are Sending More Children to the ER—Here's How to Keep Kids Safe

More children are ingesting batteries—specifically lithium or “button” batteries—and winding up in the emergency room (ER), leading pediatric health experts to call for regulations to make the batteries safer.

A report published Monday in the journal Pediatrics outlined what researchers called a rising trend in the United States. Between 2010 and 2019, there were twice as many battery-related ER visits than there were between 1990 and 2009—most of which were in children under 5.

When ingested, batteries become a source of serious injury and even death among young children—but the growing rate of ER visits suggests that not enough is being done to help prevent the issue, in terms of regulatory actions and education.

“Button batteries are used to power an increasing number of devices found in the home, including watches, key fobs, hearing aids, remote controls, flashlights, and even some toys,” lead study author Mark Chandler, senior research associate at Safe Kids Worldwide, told Health. “Parents may not realize that certain products in their home are powered by button batteries and are often unaware of the ingestion risk batteries pose.”

Here, pediatric health experts help not only explain the rising trend, but also why batteries are so dangerous for children, and how to keep the kids in your life safe.

A Significant Rise in Battery-Related ER Visits

Batteries are some of the most common foreign body ingestions (FBIs) that lead to emergency department visits among children. Button batteries—small, round batteries that somewhat resemble coins—are the most common type of battery ingested.

For the new study, researchers from Safe Kids Worldwide, a nonprofit organization dedicated to preventing unintentional injuries in children, and Nationwide Children’s Hospital, set out to describe the epidemiology of battery-related ER visits and compare current rates to previous ones.

Using information from the National Electronic Injury Surveillance System (NEISS), the study recorded the number of ER visits due to batteries between 2010 and 2019, and classified them by age, mode of ingestion, and type of battery.

Chandler and his team found that button batteries were to blame for over 84% of the cases, and 90% of all visits were due to children swallowing batteries, rather than putting it in their ears or noses. Children under the age of 5 saw the highest rates.

Most surprisingly though, there were about 9.5 battery-related ER visits for every 100,000 children between 2010 and 2017. Between 1990 and 2009, that number was 4.6 for every 100,000 children.

Though the study didn't find a cause for this increase in cases, Chandler said he believes that an increase in the number of button batteries in our everyday lives is to blame.

Button batteries are used in very common household and personal items, like watches, keyfobs and hearing aids; even children’s toys and singing greeting cards can contain the coin-like batteries.

In addition to these batteries being more commonly available, the increase could also be related to the fact that these small button batteries are much easier for children to ingest.

“Their physical size—which is like a small piece of candy you would readily swallow, up to about the size of a quarter—they’re just easier to put in your mouth and they’re easier to swallow down your esophagus than say, a AA battery, which is a much more substantial type of thing,” Eric Fleegler, MD, pediatric emergency physician at Boston Children’s Hospital, told Health. “They also look rather innocuous. They’re little pieces of silver typically, they’re shiny to kids, and kids like to put things in their mouth in general, especially young children.”

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Batteries Can Cause Severe Damage in a Short Amount of Time

When batteries are placed in any bodily orifice—ears, nose, mouth—they can cause significant severe damage and can even lead to death.

Although most button battery ingestions can pass through the body without an issue, “the number of debilitating or fatal battery ingestions has dramatically increased,” according to the National Capital Poison Center.

One of the biggest issues with battery ingestion—especially in small children—is the chance that the battery can become lodged in their esophagus.

"Because a child's esophagus is narrower than an adult's, a button battery can become lodged in the esophagus when a child swallows it," said Chandler. "Parents may not realize that something is wrong until serious injury has already occurred. This is why we focus on preventing ingestions."

When a battery gets lodged in a child's esophagus, the damage can be severe and sometimes fatal.

According to Rohit Shenoi, MD, professor of pediatrics at Baylor College of Medicine and attending physician at Texas Children’s Hospital, when a battery comes into contact with human tissue, the battery’s electric charge can circulate and cause cells around it to die.

"[This charge] can corrode through the lining of the esophagus and go into the trachea," Dr. Shenoi told Health. "There's some important blood vessels, which take blood to the head, and even those blood vessels can get corroded. So it's really a dangerous issue."

It only takes a couple hours—within two—for this kind of severe damage to happen, Chandler added.

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Signs and Symptoms of Battery Ingestion

With the rise of battery-related ER visits, it's important that parents are aware of the signs and symptoms of button battery ingestion, though they aren't always so obvious.

Sometimes children who swallow button batteries will start to cough or choke on the device, Dr. Fleegler said, especially if it winds up in their trachea rather than their esophagus. With the larger batteries, children may also complain of chest pain.

But, especially early on, kids that get button batteries caught in their esophaguses may not experience severe symptoms. If a parent doesn't witness the ingestion, damage might start to occur before they even notice anything is wrong.

"Once [the battery] has been there for a while and damage has started to occur, it's likely that the pain is going to increase," Dr. Fleegler said. "You may see the patient is vomiting, kind of ill-appearing, and you should have a higher level of suspicion if there is no other reason for the child to not be feeling well."

Because the damage can happen quickly, parents and caregivers should seek care if they suspect something may be off. The National Capital Poison Center suggests calling the National Battery Ingestion Hotline (800-498-8666) immediately.

You'll be instructed to visit the ER as soon as possible; the Poison Center also suggests giving children two tablespoons of honey every 10 minutes on the way to receive medical attention.

Batteries can be easily detected in an x-ray scan, Dr. Fleegler said, so getting one ordered for your child as soon as possible is the best action to take if you worry they may have ingested a battery.

Both Dr. Fleegler and Dr. Shenoi agree that they haven't necessarily noticed an increase in the number of kids coming into their ERs for battery ingestion, but the cases aren't rare. The fact that the increase has largely gone unnoticed up until now, though, just increases its importance, Dr. Shenoi said.

Keeping Batteries Out of the Reach of Small Children

Because of how dangerous they can be, Chandler hopes that this study will encourage parents, physicians, and policymakers to do what they can to help kids avoid situations where they might accidentally ingest a button battery.

Safe Kids Worldwide, an advocacy organization where Chandler is a senior researcher, has a number of easy steps parents can take to reduce the chance of their child getting sick from a battery:

• Make sure that the button batteries in a device are secure and children aren't able to access battery compartments easily
• All devices powered by button batteries should be kept out of sight and out of reach of children, especially those under the age of 5
• Unused batteries should be stored out of your kids' reach and disposed of correctly when you're done using them

In addition to smaller steps at home, President Biden signed Reese’s Law in August 2021, which requires that manufacturers have child-resistant battery compartments. Some battery manufacturers also self-regulate to make their packaging hard for children to open, Dr. Shenoi added.

Chandler says, though, there's still work to be done.

"Until it is adopted widely by industry, and while older devices are in the home, children will continue to be at risk," he said.

Education is also important, Dr. Shenoi said, so that parents know the dangers associated with batteries and they can protect their kids accordingly. So is disposing batteries properly, and not leaving them lying around the house or in trash cans.

"They're fairly ubiquitous, and they are in locations that we sometimes don't think about," Dr. Fleegler said. "If you have young children around, especially under the age of 5, if you are aware that a particular device uses one, then you may want to be more cautious about the child's access to that device."