An increasing number of little children are eating small lithium batteries, also known as "button" batteries, that power many of our consumer devices, with potentially serious consequences, even death, a new report found.
Despite public information campaigns warning parents about the dangers, visits to emergency rooms as a result of battery poisonings were twice as high from 2010 to 2019 compared with 1990 to 2009, according to the study published Monday in the journal Pediatrics.
That's an average of one battery-related emergency visit every 1.25 hours among children under 18, the report found. Children under 5 were at highest risk, the report noted, especially toddlers between the ages of 1 and 2, who often put things they find into their mouths.
Even after removal from the device they're powering, lithium button batteries still have a strong current. When the batteries get stuck in a child's throat, saliva can interact with the current, which causes "a chemical reaction that can severely burn the esophagus in as little as two hours, creating an esophageal perforation, vocal cord paralysis, or even erosion into the airway (trachea), or major blood vessels," warned the Children's Hospital of Philadelphia.
That's what happened in 2010 to 1-year-old Emmett Rauch, who ate a button battery that had fallen out of a DVD player remote, according to his parents, Karla and Michael Rauch.
"The battery literally burned a hole through his esophagus into his trachea (airway) allowing his stomach bile to reflux into his lungs," the couple shared on Emmett's Fight Foundation, the website of a nonprofit foundation they created to educate other parents on the dangers of button batteries.
The battery also burned the nerves of Emmett's vocal cords, the Raunchs said. To deal with complications from his injuries, Emmett underwent six surgeries in five years, including the replacement of his entire esophagus using a portion of his bowel.
"As a mother I replay the morning we noticed Emmett's illness over and over in my mind. How did I not know? If I only paid attention to the kind of batteries the remote controls required!" Karla Rauch wrote on a blog for Cincinnati Children's Hospital.
Batteries are everywhere
Button batteries are all over modern homes, including some places you might not think about, such as blinking or animated ornaments, clip-on reading lights and singing greeting cards.
Other common items that contain lithium batteries are calculators, digital thermometers, flameless candles, flashing jewelry, handheld games and toys, hearing aids, laser pointers, light up bouncing balls, penlights, mini-remotes, step counters and athletic trackers, talking and singing books, and, of course, car key fobs and smartwatches, according to the National Poison Control Center.
The new study analyzed data from the US Consumer Product Safety Commission's National Electronic Injury Surveillance System, which tracks emergency room visits in over 100 hospitals in the United States.
The analysis found ingesting the battery accounted for the majority (90%) of these battery-related emergency room visits, followed by putting batteries into the nose (5.7%), ears (2.5%) and mouth without swallowing (1.8%).
While not as serious as ingestion, lithium batteries stuck in an ear or nose can cause significant injuries, such as perforation of the nasal septum or the eardrum, hearing loss, or facial nerve paralysis, according to the report.
What should parents do?
Prevention is key. Don't insert or change batteries in front of small children -- shiny objects are enticing. Get rid of expired batteries immediately and safely, and store any replacement batteries well out of reach of children, experts recommend.
"Try to choose products with battery compartments that only open with a screwdriver or special tool, or that have a child-safe closure. At minimum, use strong tape to keep the compartment sealed tight against small hands," advised Connecticut Children's Hospital.
Be especially cautious about batteries that are as big as a penny or larger, the National Poison Control Center recommended.
"The 20 mm diameter lithium cell is one of the most serious problems when swallowed. These problem cells can be recognized by their imprint (engraved numbers and letters) and often have one of these 3 codes: CR2032, CR2025, CR2016. If swallowed and not removed promptly, these larger button batteries can cause death -- or burn a hole through your child's esophagus," the center noted.
Always supervise children who are playing with a toy or device that contains a button battery, and educate older children about the dangers so they can assist.
What if you suspect your child has swallowed a battery -- or put one in their nose or ear?
"Call the National Battery Ingestion Hotline at 800-498-8666 immediately. Prompt action is critical. Don't wait for symptoms to develop," the NPCC advised.
Signs of ingestion can look like the child swallowed a coin, so be wary, experts said. Typical behavior can include wheezing, drooling, coughing, vomiting, chest discomfort, refusal to eat, or gagging when attempting to drink or eat. But for some children, like Emmett Rauch, it can take days before symptoms are severe enough to notice.
"It's also important to know if a magnet was co-ingested with the battery, as this could potentially cause further injury. X-rays of the child's entire neck, esophagus and abdomen are typically necessary," according to Texas Children's Hospital.
If you suspect ingestion, don't make your child vomit, Texas Children's advised.
Don't give your child anything to eat or drink until an X-ray shows the battery has moved beyond the esophagus, the National Poison Control Center noted.
"Batteries stuck in the esophagus must be removed as quickly as possible as severe damage can occur in just 2 hours. Batteries in the nose or ear also must be removed immediately to avoid permanent damage," the center advised.