What to Do If Your Child Swallows a Button Battery

Tiny Hearts

Last week a mum in our community sent us this message:

"I found my 14 month old playing with a packet of button batteries at her grandparents house (we thought we had tidied them all away, we were wrong!). It was a packet of 8 batteries, the tiny ones, I fished 2 out of her mouth and 2 on the ground. So there was potentially 4 missing! Thankfully, because I've followed tiny hearts for years, I knew to give her honey asap and get straight to the nearest hospital!! When I said I'd already given her honey, the triage nurse said 'you must follow tiny hearts!!'"

She did everything right. And the part that stays with us is the bit in brackets. They thought they had tidied them all away. Most of us would think the same, because button batteries hide in things we never think of as dangerous: the kitchen scales, the car key, the birthday card that sings.

Around 20 little ones a week turn up to an Australian emergency department after swallowing or inserting a button battery. Three Australian children have died. If you ever suspect your little one has swallowed one, or you simply can't find a battery that was there a minute ago, here is exactly what to do, in order.

Why button batteries are different to anything else they might swallow

Most small objects a toddler swallows pass through without any drama. A button battery doesn't behave like a coin or a bead.

If it gets stuck in the oesophagus, the food pipe, saliva completes the circuit. The battery starts generating an electrical current that breaks down the surrounding tissue and creates a strongly alkaline burn, a bit like a drain cleaner burn from the inside. This can begin causing serious injury quickly, and severe damage may develop within as little as two hours.

The ones that cause the most harm are the larger lithium coin batteries, around 20mm across (about the size of a 10 cent coin), because they're the perfect size to lodge in a small child's food pipe. The smaller ones can still burn if they get stuck in a nose or ear.

Where they hide in your home

A good rule of thumb: if it's smaller than your hand and it lights up, makes a sound or moves, it might be powered by a button battery. Check:

Remote controls, garage remotes and car key fobs
Kitchen and bathroom scales
Thermometers, calculators and watches
Musical greeting cards and light-up books
Flameless candles, fairy lights and Christmas decorations
Light-up shoes, flashing toys and novelty jewellery
Hearing aids, cameras and fitness trackers
Handbags, bedside drawers and the bottom of the kitchen bin

Items bought online or from overseas may not meet Australian safety standards, so give them an extra look.

What to do if your little one swallows a button battery

If you saw it happen, if you found them chewing one, or if a battery has gone missing and they may have had access to it, treat it as swallowed. Don't wait for symptoms, because a lodged battery often causes no symptoms at all in the first couple of hours while it's already burning.

1. Call 000 if they're struggling. Any difficulty breathing, choking, drowsiness, bleeding or becoming unresponsive means an ambulance, straight away.

2. If they're breathing normally, call the Poisons Information Centre on 13 11 26. It's open 24 hours, Australia-wide. They'll tell you which hospital to go to for an urgent X-ray and talk you through the honey steps below. If you can't get through quickly, head to your nearest emergency department and call on the way.

3. Give honey if your little one is over 12 months. Two teaspoons (about 10 mL) every 10 minutes, up to six doses or until you reach hospital. Honey coats the battery and slows the burn, because it creates a barrier between the battery and the tissue and helps neutralise the alkaline reaction. It buys time. It doesn't fix the problem, so keep moving towards hospital while you're giving it.

4. Under 12 months? Give jam instead. Babies under one shouldn't have honey because of the risk of infant botulism. Two teaspoons of jam every 10 minutes works as the alternative, and jam is also the backup if you don't have honey in the house.

5. Grab the packaging or a matching battery if you can. Knowing the size and type helps the hospital team. Don't waste time searching, though. If it's not to hand, go without it.

Only give honey or jam if your little one is awake, alert and able to swallow normally, and it's been less than 12 hours since they swallowed it. Stop if they vomit, can't swallow or start having trouble breathing.

Honey on the way, hospital straight away. Don't wait for symptoms and don't wait to see if it passes.

What NOT to do

Don't wait for symptoms, because the burn is already happening while they look fine

Don't try to make them vomit, because bringing the battery back up can burn the food pipe a second time

Don't give food or drink other than the honey or jam, because they may need a procedure under anaesthetic and an empty stomach makes that safer

Don't reach into their mouth or throat with your fingers, because you're more likely to push it further down than get it out

Don't do back blows or chest thrusts if they're breathing normally, because those are for a blocked airway, not a swallowed object

Don't give laxatives or try to "flush it through," because a lodged battery needs to come out, not move along

Don't assume a flat battery is harmless, because it still holds enough charge to burn

Don't wait at home checking nappies, because the only way to know where the battery is sitting is an X-ray

Signs to watch for

Symptoms can be absent at first, and when they do show up they can look a lot like a cold, reflux or a tummy bug. Look out for:

Coughing, gagging or choking, especially when eating or drinking
Drooling or trouble swallowing
Refusing food or drink
Vomiting
Noisy or laboured breathing
Chest, throat or tummy pain
A hoarse voice or a change in their cry
Unexplained fever
Blood in their saliva or vomit, a nosebleed, or black or bloody poo

If a battery is missing and your little one has any of these, say the words "possible button battery" as soon as you call or arrive. It changes how quickly they're seen.

Batteries in the nose or ear

Little ones post batteries into noses and ears too, and the same burn happens there. It's still an emergency, but the first aid is different: don't give honey or jam for a battery in the nose or ear, because it does nothing for a battery that isn't in the food pipe. Don't try to dig it out either.

Call 13 11 26 and follow their advice, or head straight to ED. Call 000 if there's heavy bleeding, breathing difficulty or your little one becomes drowsy.

After the hospital

Even once the battery is out, the tissue can keep breaking down for days, and some problems (like narrowing of the food pipe or slow bleeding) can show up weeks later. Go to every follow-up appointment you're given, and if your little one develops trouble swallowing, chest pain, vomiting or blood in their vomit or poo in the weeks afterwards, get them seen straight away and mention the battery.

How to battery-proof your home

Do a room-by-room hunt. Use the list above and check every room, the car and the garage. Check grandparents' houses too, because that's exactly where the mum at the top of this blog found hers.

Check the compartments. Since June 2022, products sold in Australia that use button batteries must have secure compartments that need a tool or two separate movements to open, and the batteries themselves must be sold in child-resistant packaging. Older items and overseas purchases won't have met these rules. If a compartment is loose, cracked or pops open with a fingernail, tape it shut or get rid of the item.

Lock away spares. New and used batteries go in a locked or high, out-of-sight container. Never on the bench, the bedside table or in a handbag.

Change batteries out of sight. Swap them over when your little one isn't around, and never leave a battery or an open device on the bench mid-change, even for a moment.

Tape and recycle used ones. Put sticky tape over both sides of a used battery straight away and drop it at a battery recycling point (Bunnings, Battery World, many supermarkets and councils have them). Don't leave them in a household bin, because that's within reach.

Look for the newer safer batteries. Some brands now sell lithium coin batteries with a bitter coating and a food-safe blue dye that stains a child's mouth within seconds of touching saliva, so you know straight away. They're a helpful extra layer, but they don't replace locking batteries away.

Tell everyone who cares for your little one. Grandparents, babysitters and daycare all need to know where batteries live, which items contain them, and that a swallowed battery is a call to 13 11 26 immediately.

Two numbers to save right now

🚨 000 for breathing difficulty, choking, heavy bleeding, drowsiness or unresponsiveness

🚑 13 11 26 Poisons Information Centre, 24 hours a day, Australia-wide

FAQs About Button Battery Ingestion

My little one seems completely fine. Do I still need to go to hospital?
Yes. A battery lodged in the food pipe can burn for hours before any symptoms show, and the only way to know where it's sitting is an X-ray. Call 13 11 26 and go.

How much honey do I give, and how often?
Two teaspoons (about 10 mL) every 10 minutes, up to six doses or until you reach hospital, for little ones over 12 months who can swallow normally. Under 12 months, give jam instead.

Does the type of honey matter?
No. Any honey you have in the house is fine. Don't delay leaving to find a particular kind.

What if I'm not sure they swallowed it, I just can't find the battery?
Treat it as swallowed. A missing battery plus a little one who had access to it is enough to call 13 11 26 and get an X-ray.

Should I give honey for a battery in the nose or ear?
No. Honey only helps with a battery in the food pipe. Call 13 11 26 or go to ED, and don't try to remove it yourself.

Know the steps before you need them

Our Baby & Child First Aid Course, designed by former paramedic Nikki Jurcutz, covers poisoning, choking, burns and CPR, because in an emergency your brain falls to the level of your training.

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