More and more children are swallowing button batteries

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Button batteries are everywhere: remote controls, key chains, greeting cards, kitchen scales, tealights, watches, toys and hearing aids. And, increasingly, they enter children’s bodies, causing discomfort, injury and, in some cases, death.

According to an article published in the September issue of the journal Pediatrics, emergency room visits involving children who swallowed a battery between 2010 and 2019 were more than double the number of visits between 1990 and 2009. batteries, also known as button cells) were involved in 85% of the cases in which the battery was described.

When such batteries lodge in the esophagus, the tube that connects the throat to the stomach, they can cause serious damage in as little as two hours. While larger lithium batteries are of greater concern because they are more likely to be caught in a child’s esophagus, small non-lithium button cells can also cause serious injury, the team said, particularly in children under one year old.

Using data from the Consumer Product Safety Commission’s National Electronic Injury Surveillance System, researchers estimated that there were 70,322 battery-related emergency room visits among children between 2010 and 2019. Ninety percent of visits were to children who had swallowed batteries (other injuries involved insertions in the nose, ear and mouth). Most of the cases were in children 5 and under, with the highest number involving 1-year-olds.

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According to Mark Chandler, senior research associate at Safe Kids Worldwide, who conducted the study in cooperation with Nationwide Children’s Hospital and the Global Injury Research Collaborative, both located in Columbus, Ohio.

“In recent years, particularly over the past decade…devices commonly found in the home continue to get smaller and smaller, which means that the types of products powered by button batteries have become more many,” he said.

Chandler said parents often don’t know how many devices in their homes are powered by button batteries and the significant risk batteries can pose to children. The researchers concluded that existing prevention efforts were not enough to reduce battery-related emergency room visits, and they called for “regulatory efforts and the adoption of safer measures”. [button battery] industry-designed to reduce or eliminate ingestion injuries in children.

On August 16, President Biden signed a bill, Reese’s Law (named after a child who died after ingesting a button cell battery), which will trigger these regulatory efforts. The legislation directs the CPSC to develop new safety standards for button or button cell batteries that will require safer packaging, more prominent warning labels – including on the batteries themselves – and safer compartments on devices that contain batteries, to prevent access by children 6 or younger. The agency has one year to publish the standards.

In the pediatric study, 12% of all cases of battery swallowing resulted in hospitalization; ingestions specifically involving button batteries were twice as likely to result in hospitalization. Data did not include outcomes beyond hospitalization. According to the National Poison Data System, 3,467 ingestions of button cell batteries by children and adults have been reported in 2019; of these, 207 resulted in moderate effects, 51 in major effects and 3 in death. More than half of the cases involved children 6 years of age or younger.

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Varun Vohra, a clinical toxicologist and director of the Michigan Poison & Drug Information Center at Wayne State University School of Medicine, said that until 2017, Michigan had actually seen a decline in cases of button cell battery ingestion. There were 562 reported to the center from 2010 to 2017, compared to 723 from 2002 to 2009. But button batteries “are always a concern because they’re so small and they’re in so many different products,” he said. he declares.

Most cases don’t result in serious harm, Vohra said, and button batteries can pass through a child’s gastrointestinal system. But when a button battery lodges in a child’s esophagus, the consequences can be serious. Moisture in the mucous membranes can trigger an electric current which causes a chemical reaction, injuring adjacent tissues (the current creates hydroxide, which causes alkaline burns).

“This can lead to serious injury, including perforation of the esophagus, which can lead to significant downstream complications,” Vohra said. If X-ray imaging reveals a pile in the esophagus, it will need to be quickly removed, either endoscopically or surgically, as serious damage to the esophagus can occur in as little as two hours. But the injury can progress even after the battery is removed, leading to relatively rare complications such as vocal cord paralysis or a tracheoesophageal fistula, an abnormal connection between the trachea and esophagus.

The latter is what happened to the child for whom Reese’s Law is named. Reese Hamsmith, an 18-month-old from Texas, had difficulty breathing in October 2020 which was initially diagnosed as croup. After the family realized a button battery was missing from a broken remote and Reese had ingested it, she underwent surgery to remove the battery but developed a difficult-to-treat fistula between her esophagus and trachea. . After weeks of hospitalization and complications, she died on December 17, 2020.

Although grateful the bill passed, Trista Hamsmith, Reese’s mother, said true child protection would require more. “We finally need a safer battery,” she said.

Hamsmith, who founded the organization Reese’s Goal to make the case for protecting children from dangers such as button batteries, urges parents ‘to be very diligent and very aware of where they are in their homes – if they choose to have them in their home’ . She and Chandler offered some safety tips for parents.

  • Scan your house; you can find button batteries in surprising places, including some electric toothbrushes for kids. “They’re literally designed to go in our kids’ mouths, and they’re powered by button batteries,” Hamsmith said.
  • Keep all devices powered by button cell batteries and loose batteries out of reach and sight of children.
  • Buy button cell batteries packaged in a way that reduces the risk of a child entering the packaging and ingesting them. For example, Hamsmith said, some battery packs need to be opened. She also noted that Duracell sells button batteries with a bitter coating designed to discourage children from swallowing them.
  • Examine your coin-cell powered devices to make sure the battery compartment is as secure as possible. Devices that secure the lid with a screw are generally considered safer to have around children, Chandler said.

If your child swallows a battery or is near an open electronic device with a missing battery, Vohra offers these tips.

  • Call the Poison Helpline (800-222-2222), which will put you in touch with a local poison control center. They will ask for and document important battery information (including size and imprint code) and may tell you to head to the nearest emergency room for further evaluation. They will also want to know how old your child is, how long it has been since the battery was swallowed, and what symptoms the child is showing, to help make a treatment plan.
  • Do not try to make your child vomit.
  • Note symptoms such as wheezing, drooling, vomiting, bleeding, abdominal pain, difficulty swallowing, chest discomfort, coughing, choking or retching, decreased appetite or refusal to eat, or fever.
  • Do not give your child anything to eat or drink.
  • If a magnet is swallowed together with the battery, it can lead to more serious injuries. Call the poison control center and go to the nearest emergency department.
  • If less than 12 hours have passed since the battery was swallowed and your child is over 12 months old, you can give commercial honey – two teaspoons every 10 minutes for up to six doses – on the way emergencies. This will coat the battery and prevent hydroxide generation, delaying burns to adjacent tissue. However, this is not a substitute for battery removal, as it helps slow down but does not eliminate the risk of tissue damage.
  • In cases where a child has a battery lodged in their nose or ear – which can also damage tissue – look for pain or discharge. Do not administer nose or ear drops until fully examined by a physician; these fluids can potentially aggravate the damage.

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