patient story

patient name: Nora Fraver

age: 3-years-old

condition: battery button ingestion

seen in: emergency department, pediatric surgery

provider: Dr. Anne Mackow

Casey was at home with her three-year-old daughter, Nora, when their evening took an unexpected turn. Nora had been quietly playing with toys, but suddenly turned to her mom and confessed that she had swallowed a coin. Casey waited to see if her daughter was behaving differently or was experiencing any distress from swallowing the coin. Nora complained of a sore throat, which made Casey uneasy. Just before bed, Nora threw up after having a snack.

Growing more worried, Casey called Nora’s pediatrician to see what she should do. Their pediatrician told Casey to line up a series of coins and ask Nora to point to the one she swallowed. She pointed to the quarter.

Knowing that she had swallowed such a large object that it would unlikely pass without assistance, Casey knew she had to get Nora to the hospital. Casey and her husband, Kyle, drove to Dayton Children’s Hospital’s emergency department and Level 1 trauma center.

care from the Level 1 trauma team

Given the urgent nature of Nora’s condition, she was brought back immediately for X-rays. As soon as the scans came through, Casey and Nora were joined by Anne Mackow, MD, pediatric surgeon at Dayton Children’s and trauma surgeon on-call that evening, to review the results. Based on the scans, it appeared that Nora had swallowed a button battery and it was stuck in her esophagus. She would need to have surgery immediately to remove it.

At almost 1 a.m., Nora went back for an-hour long surgery to remove the battery and assess for any damage. During surgery, Dr. Mackow found that the battery had badly burned the lining of the upper part of her esophagus.  Because of this, Nora was admitted to the hospital to recover and for further evaluation.

The next day, Nora was again put under anesthesia to assess her esophagus and airway for damage due to the extent of damage seen on her first endoscopy. The pediatric surgery and ENT teams wanted to make sure there wasn’t any additional damage from the battery.

Finding none, they took Nora for additional imaging to check the vessels around her heart. Luckily, there was no additional damage.

battery button ingestion becoming more common

According to Dr. Mackow, battery button ingestions are not that uncommon during young childhood. “3,300 battery button ingestions occur in the United States each year and almost 7 out of every 10 occur in children less than 6 years old. Ingestions peak in kids who are 1 to 3 years of age,” she says.

Dr. Mackow says that button batteries tend to get lodged in the upper part of the esophagus, because that’s the narrowest part of our gastrointestinal tract.  Because the esophagus collapses around a flat disc like a battery, a closed circuit can be created that allows the battery to discharge and burn of the surrounding tissue.

“The upper part of the esophagus is right next to the airway, as well as the aorta, which is the largest blood vessel in the body.  The longer the battery stays in, the more damage it causes,” says Dr. Mackow.  This damage can lead to the development of a connection between the esophagus and the airway or the esophagus and the aorta, both of which can have significant and life-threatening consequences.

After being discharged from the hospital, Nora later followed up with pediatric surgery to address narrowing of her esophagus that was seen on a follow up study. To help expand her esophagus, she had to have a procedure, done under anesthesia, that used a balloon to help widen the narrowed areas of her throat. She will have ongoing follow up to see if she needs to repeat this procedure in a few months if there hasn’t been sufficient expansion. Beyond that, Dr. Mackow has no major concerns about Nora’s recovery and is thankful that her parents brought her in quickly for evaluation.

“Nora had found a spare battery that came with a new toy she got for her birthday. Thankfully, Nora was a good communicator and let me know that something was wrong,” said Casey. “Those little batteries can do so much damage, so quickly. It can be damage that can end their life or affect them deeply for the rest of their lives.”

If you are concerned that your child might have swallowed a round silver object, like a button battery or coin, visit the emergency department right away so the team can see what it looks like with an X-ray.  If you have any concern that it was a button battery, giving your child honey to swallow, while you’re waiting to be evaluated, can help coat the battery to prevent injury to the esophagus.

tips to prevent ingestions of button batteries and magnets

A situation like Nora's can happen in the blink of an eye. In 2023, Dayton Children's emergency department saw 72 kids after swallowing or possibly swallowing a magnet or button battery. Use these tips from our injury prevention specialists and pediatricians that can help prevent your child from swallowing these dangerous items:

• Avoid buying magnetic toys. The small size and large number of high-powered magnets in certain toy sets can make it nearly impossible to tell whether any magnets are missing.
• Keep button batteries and magnetic items out of a child's reach. Most toys with a battery should have a screw that secures the battery compartment closed. 
• If you can't put away a gadget that you know contains these batteries, then put a piece of duct tape over the battery compartment to keep small children from getting to the battery inside.
• Warn family members, friends and caregivers to keep their gadgets with button batteries out of reach of children as well. 
• Stay vigilant. From being mindful of where you shop to constantly observing children when they are around battery-operated devices, this is one of the biggest deterrents to kids swallowing batteries, magnets and more.

be mindful of where you shop

Beware of items bought from internet ads, third-party sellers and other unreliable online retailers like Wish, Temu or Shein. These online stores do not have to stick to or meet U.S. Safety Standards and they do not follow the same regulations as trusted vendors who have stopped selling other hazardous products like toy magnets and water beads.

However, there are U.S. Safety Standards for toys that retailers like Amazon, Target and Walmart, and the vendors they sell in their stores. For example, some manufacturers like Duracell have made efforts to safeguard their products from children by coating their batteries in a bitter film to encourage kids to spit them out due to the taste. Another example is the Small Parts Ban and Choking Hazard labeling ban passed by the U.S. Consumer Product Safety Commission that restricts toys that present a choking hazard to be approved for kids under three and also requires choking warning labels! So, if you are shopping for toys, safety equipment or product, we encourage you to buy from trusted vendors. 

Learn more about preventing children from ingesting button batteries and magnets in our other blogs available!

beware of button batteries

avoid toys with high-powered magnets