From the Guidelines
If you suspect your infant has swallowed a button battery, seek emergency medical care immediately by calling 911 or going to the nearest emergency room, as button batteries can cause severe tissue damage within 2 hours by generating an electrical current and releasing hydroxide, which burns through the esophageal tissue 1.
Key Considerations
- Do not wait for symptoms to appear, do not give food or drink, and do not induce vomiting.
- While waiting for medical help, if the ingestion occurred within 12 hours and if available, you may give honey to children over 12 months (not to infants under 1 year due to botulism risk): 10mL (2 teaspoons) every 10 minutes, up to 6 doses, as it may help coat the battery and reduce injury.
- At the hospital, healthcare providers will locate the battery using X-rays and remove it, typically via endoscopy, as emergent flexible endoscopy (preferably within 2 h, at latest within 6 h) is recommended for button/disk battery ingestion due to the risk of pressure necrosis, electrical burns, and chemical injury 1.
Potential Complications
- Button battery ingestion can be life-threatening and may cause esophageal perforation, tracheoesophageal fistulas, vocal cord paralysis, or damage to major blood vessels, so immediate professional medical attention is essential.
- The risk of full-thickness perforation, pressure necrosis, and chemical injury necessitates prompt removal of the battery by a healthcare professional 1.
From the Research
Immediate Action Required
If an infant is suspected to have swallowed a button battery, it is crucial to act quickly to minimize the risk of severe complications.
- The infant should be taken to the emergency department immediately, as delay can lead to increased risk of damage to the esophagus and surrounding tissues 2, 3, 4.
- A chest radiograph should be performed to confirm the presence and location of the battery 2, 3, 5.
Diagnosis and Management
- If the battery is lodged in the esophagus, it should be removed instantly, preferably within 2 hours of ingestion 2.
- In cases where the battery has passed the esophagus, endoscopy may still be necessary to screen for esophageal damage and a CT scan may be required to rule out vascular injury, even in asymptomatic children 2, 5.
- The use of honey and sucralfate may be considered in ingestions ≤12 hours while waiting for endoscopic removal, but should not delay the removal process 2.
Prevention Strategies
- Prevention of button battery ingestion is crucial, and parents and caregivers should be aware of the risks and take steps to prevent access to batteries 2, 4.
- The European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) has developed a position paper on the diagnosis, management, and prevention of button battery ingestion in childhood, which provides guidance on prevention strategies and management algorithms 2.