Parents should opt for non-battery operated toys for their toddlers to minimise swallowing risk. Photo: Freepik
It seemed to have started with a simple cough that refused to go away.
For five days, the patient – a six-year-old girl – also struggled with swallowing anything other than liquids and soft foods, and even then, she would vomit.
She was diagnosed with a common respiratory infection – twice – but nothing changed until an X-ray revealed the real culprit behind her worsening condition: A button battery lodged deep in her oesophagus.
By then, serious internal injuries had already set in. Although the 20mm lithium battery was immediately removed, it had caused a deep ulcer along the child’s oesophageal wall, leading to weeks of hospitalisation and tube feeding.
This was a real case, reported in a paper titled “Delayed Presentation Of Button Battery Ingestion In A Six-Year-Old Girl” by the Department of Otorhinolaryngology, Shah Alam Hospital.
Sadly, such a case is not an isolated incident.
Consultant paediatrician Dr Wong Yee Ming says such cases are on the rise due to the increasing number of smaller electronic items and toys powered by button batteries.
“Even though such incidents are rare, medical healthcare professionals are trained to recognise that button battery ingestion is at the top of the list of medical emergencies involving foreign body ingestion,” he says.
What puts button battery ingestion at the top, he adds, is how elusive the initial symptoms can be.
“They may range from nothing to non-specific signs like drooling, coughing, throat pain, choking, wheezing and noisy breathing,” Dr Wong explains.
In short, he says, it is impossible to differentiate button battery ingestion from other types of foreign body ingestion unless one is already aware of it.
What makes matters worse is that young children, especially toddlers aged six months to three years old, often can neither clearly communicate their discomfort, nor explain to their parents what they have swallowed.
Given the subtle symptoms, Dr Wong stresses the importance of early suspicion.
“An X-ray can be a simple and helpful tool if done early. But if discovered late, more advanced imaging like CT scans may be required to assess the extent of tissue damage,” he explains.
Dr Wong recalls a case that was swiftly diagnosed and treated via endoscopic surgery, resulting in minimal damage, as the ingestion was witnessed by a parent.
However, not all cases ended well. His colleague, he says, had a tragic case in which the battery was only discovered during surgery – after the child had suffered severe internal bleeding and required intensive care.
Dr Wong says if the battery gets lodged in the airways, it can cause breathing difficulties. Photo: Dr WONG YEE MING
The danger within
The danger of swallowing one tiny button battery is far greater than many people realise. Once swallowed, it can lead to devastating internal damage within just two hours.
“If the battery gets lodged in the airways, it can cause breathing difficulties. If stuck in the oesophagus, it can lead to difficulty swallowing and persistent vomiting,” Dr Wong explains.
Even worse, a chemical reaction between the battery and the body’s moist tissues generates an alkaline substance, which is highly harmful to surrounding tissues.
“This chemical reaction will erode through any part of the organs that the battery touches, and this can happen as early as two hours post-ingestion,” he continues.
Dr Wong adds that the injuries are not only immediate but can be life-threatening and lead to long-term complications.
“No doubt the most serious complication is death, but there are others, such as abnormal connections between the airways and oesophagus or between the oesophagus and aorta, narrowing of the airway or gut due to tissue scarring, vocal cord paralysis and severe lung infection,” he says.
These, Dr Wong says, can lead to lasting effects such as chronic swallowing difficulties, nutritional challenges that may require tube feeding, repeat surgeries for strictures and psychological and emotional trauma.
Dr Wong was speaking after the launch of “Know the Risks, Protect Your Kids” campaign by Energizer, which also unveiled its lithium battery featuring child protection technology: It turns the saliva blue to alert caregivers to get help and comes with non-toxic, bitter taste to discourage swallowing and ingestion.
Diyana says parents and adults should take proactive action to avoid incidents of toddlers swallowing button batteries. Photo: DIYANA HASHIM
Raising awareness
For Diyana Hashim, 37, a mother of a two-year-old daughter, parents and adults should take proactive action to avoid incidents of toddlers swallowing button batteries.
“Keep these batteries out of reach of children and make sure their toys or other items that use them are securely screwed so toddlers can’t peel off the battery cover and take it out,” she adds.
“It’s important that adults and older kids in the house are on the same page on this and know what to do in case of an emergency. The consequences are terrifying, and this is not something that parents should take lightly,” Diyana says.
“Anything that happens inside a child’s body feels much scarier because we have so little control over it,” she adds.
Diyana also admits that awareness about the dangers of button battery ingestion remains low, as many people don’t realise how severe the effects can be.
Dr Wong agrees. “This is perhaps due to the lack of warning labels and preventive campaigns, while social media and news platforms tend to be more reactive than proactive.” “Even if a campaign is launched without a preceding event, the public may still take it lightly and not view it seriously,” he continues.
Dr Wong and Diyana agree that raising awareness saves lives. “We can’t afford to be reactive only after accidents happen. We have to be proactive, educate ourselves and make our homes as safe as possible,” Diyana says.
“Many household hazards are hidden in plain sight, making it crucial to raise awareness of potential risks for young children,” concludes Dr Wong.
