Round batteries, as small as buttons and as shiny as coins, are prized for the power they pack for their size. In homes, remote controls, hearing aids, toys, electric tea lights, wrist watches, greeting cards that play music and other familiar items have become commonplace.
But doctors warn that such “button batteries” can disable and kill. Put one in your mouth and swallow it – as thousands of children do every year – and it can quickly cause devastating injuries.
A growing number of medical organizations are pressuring battery manufacturers to stop the threat of making a new product: A button or “money cell” battery that won't lead to catastrophic injuries if swallowed.
“The only real solution to the battery problem is to make the battery itself safer,” said Dr. Toby Litovitz, founder of the National Capital Poison Center.
When button batteries are embedded in the body, their electrical energy breaks down water, rising to dangerous levels like bleach. Muscles can start to melt away. Doctors say serious injuries can occur within two hours, sometimes before the parent even realizes the battery has been swallowed.
As button batteries have become more commonplace, the rate of pediatric emergency visits for battery-related injuries has more than doubled in recent decades, according to a study published in the journal Pediatrics. Some children end up relying on tubes to breathe or bleed profusely, doctors say.
“Unfortunately, these batteries cause such serious injuries very quickly,” some of which are impossible for surgeons, said Dr. Kris Jatana, surgical director of clinical outcomes at Nationwide Children's Hospital in Ohio.
Jatana was horrified by the dangers after caring for a 2-year-old child who ended up needing a tracheostomy to breathe. “It was a moment that motivated me to try to see what we could do to prevent this injury from happening in the first place.”
Battery safety button
Here are recommendations from Nationwide Children's Hospital:
Some battery manufacturers have tried adding a bitter or saliva-activated dye to warn parents.
Reese's Law, a federal law named after a child who died of severe injuries after swallowing a button battery, now requires that the compartments of such batteries in consumer products be difficult to open and mandates child-resistant packaging for button batteries.
But advocates say more needs to be done. For example, Litovitz said that packaging that is difficult to open will not prevent many of the injuries caused when children swallow batteries that are left sitting outside or discarded. Among those pushing to create safer batteries is entrepreneur Bryan Laulicht.
“That's what makes them so good for devices and what makes them so dangerous if you swallow them,” Laulicht said of button batteries. “They are powerful enough to dissociate water … raising the pH to Drano levels in minutes.”
Doctors first warned of the threat decades ago as more children began to suffer serious injuries. One study found that between 1985 and 2009, the percentage of button battery installations that resulted in serious or fatal injuries had increased more than sixfold.
Reese Hamsmith was seriously injured after swallowing a button battery and died less than two months later. His mother, Trista Hamsmith, vowed to do everything she could to prevent other children from suffering the same.
(Trista Hamsmith)
Litovitz and other researchers point to the growing popularity of the 20-millimeter cell lithium battery: Their analysis found that 12.6% of children under the age of 6 who consumed button batteries around that size experienced serious complications or death.
“They are the right size to get stuck in the throat of a small child, especially a child under the age of four,” Litovitz said in an email. “What's more, these lithium cells have twice the voltage of other button cells.”
Doctors may not immediately recognize and diagnose the problem if no one notices that the battery has been swallowed, because the symptoms may look like other childhood illnesses.
The problem has gotten worse over time: From 2010 to 2019, an average of more than 7,000 children and teenagers went to emergency rooms each year because of battery-related injuries, according to a study in Pediatrics. The rate of such emergency visits has doubled compared to the period 1990 to 2009.
Button batteries have been involved in a number of cases where the type of battery was unknown. Researchers have counted more than 70 deaths from ingesting button batteries over time, but Litovitz said the true number could be much higher because that number only includes cases documented in medical research or the media or reported to the National Button Battery Ingestion Hotline, which has since been discontinued. six years ago.
At Children's Hospital Los Angeles, doctors see about one child a month injured by a button battery, said Helen Arbogast, injury prevention program manager in their pediatric general surgery unit. Children are attracted to shiny things and see the attention adults pay to electronics, she said.
“Remote controls are really interesting to them — the buttons, the colors — and part of their motor skills development is learning how to turn things on and off,” Arbogast said.
He emphasized that time is critical. “If a parent suspects that their child has swallowed a button battery, it is important to take them to the hospital immediately.”
In Texas, Reese Hamsmith woke up one morning in 2020 gasping for breath. His mother, Trista Hamsmith, took the child to a pediatrician, who suspected croup. It wasn't until the next day, after the Halloween night that Reese stayed sick, that his mother noticed that the button battery was missing from their remote control.
Reese Hamsmith was seriously injured after swallowing a button battery and died less than two months later.
(Trista Hamsmith)
Reese underwent emergency surgery, but the damage continued even after the battery was removed, burning a hole through his esophagus and trachea, his mother said. In the weeks that followed, she underwent more surgery, surgery and an incision. Less than two months after his injury, Reese died.
He was a year and a half old. After her death, “I held her again, and I promised her that I would do everything I could so that no child would die like this again,” said Trista Hamsmith.
The Lubbock mother started a nonprofit organization, Reese's Purpose, which successfully pushed for federal legislation that imposed new requirements for battery parts, child-resistant packaging and warning labels. Hamsmith was pleased to see those laws go into effect, but was upset that such protections had not been implemented.
“It doesn't have to take what we've been through” to inspire action, she said. “It shouldn't take someone like me to shout to the world.”
The group is also funding research into a medical device that can detect a swallowed battery without exposing a child to radiation, which Hamsmith wants to see used whenever a child shows potential symptoms. It also worked with Energizer on safety features including the telltale blue-turning dye and saliva.
“The missing ingredient here … was the ability to alert the caregiver that something has happened,” said Jeffrey Roth, leader of Energizer's global battery and lighting division. “That's exactly what the 'color alert' does – it gives the carer a warning that the child might be putting something in their mouth that they shouldn't have.”
Litovitz warned, however, that because not all batteries have a green dye, doctors and parents should not assume that a battery has not been swallowed if they do not see that color.
Roth said that in recent years, Energizer has spent tens of millions of dollars on research and other efforts surrounding button battery safety. “We believe that one day we will solve this,” he said. “But it needs new developments.”
Laulicht, co-founder and CEO of Landsdowne Labs, said his company was testing another battery with a different type of casing, which is meant to be sealed inside the body. Tests involving sandwiching a battery between two pieces of ham did not show the kind of damage caused by commercially available button batteries, he said. (Ham is used as a readily available substitute for human stomach tissue, Laulicht explains.)
One of their challenges has been finding the same level of battery performance with those changes, Laulicht said. But as a father of young children, “I prefer a battery that only lasts a year on the shelf … but that didn't kill my child when he swallowed it.”
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