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Gifts and fairy lights: Button cells can cause serious health damage to small children if swallowed

45/2022, 12.12.2022

The BfR and the BfR Commission for the Committee for the Assessment of Intoxications advise parents to store button cells inaccessibly

Especially during the Christmas season, button cells are often used in battery-operated toys and decorations. If button cells are swallowed, they can get stuck in the oesophagus and severely damage the mucous membrane. The Commission "Committee for the Assessment of Intoxications " of the German Federal Institute for Risk Assessment (BfR) advises special caution. In the past ten years, several hundred cases of button cell swallowing have been reported to the BfR by hospitals and poison centres. "We therefore advise all parents to keep button cells out of reach of infants and young children. After swallowing a button cell, an examination in a hospital should be carried out immediately," recommends BfR President Professor Dr. Dr. Andreas Hensel.

Devices powered by button cells are everywhere at Christmas. LED tea lights, Christmas lights, greeting cards with music and remote controls for lights must be used with children's safety in mind. Toys with button cells sold in the EU must be secured in such a way that no direct access to the button cell is possible (e.g. by a battery compartment secured with screws). For other devices that are operated with button cells, as well as when storing new and used button cells, parents should make absolutely sure that any (even supposedly empty) button cells are kept out of reach of children.

Often the swallowing of the button cell is not noticed at first.

If the button cell gets stuck in the oesophagus, this is particularly dangerous. Contact with the moist mucous membranes causes current to flow. Hydroxide ions are formed at the interface between the button cell and the mucous membrane, which can lead to serious chemical burns. There is an increased risk for small children when swallowing large button cells (from 20 mm), as it is then particularly likely that they will get stuck in the narrow oesophagus of the child.

If the button cell gets stuck in the oesophagus, often no symptoms develop at first, or only mild discomfort. After a few hours, vomiting, loss of appetite, fever or coughing occur. As time progresses, tissue damage increases at the point of contact between the button cell and the oesophagus, which can lead to bleeding and death of the tissue. The oesophagus can scar and constrict as sequela. In rare cases, the complications can lead to death.

The more the battery is charged and the longer the button cell remains in the oesophagus, the more pronounced the damage to health can be.

If the button cell can pass through the oesophagus, complications are rarely to be expected. In these cases, it is usually sufficient to wait for the natural excretion of the button cell under medical supervision.

The BfR advises immediate examination at the paediatric hospital even if there is a well-founded suspicion that a button cell has been swallowed.

Tips on the prevention of poisoning and advice on first aid are provided by the free BfR app "Poisoning accidents in children" (in German):

Physicians report cases of poisoning, including suspected cases, to the Documentation and Assessment Centre for Poisonings at the BfR. In addition to poisoning by chemical substances and poisonous plants, this reporting obligation also includes the swallowing of button cells and the associated risks of chemical burns. The basis for the reporting obligation is Art. 16e of German Chemicals Act.

About the BfR

The German Federal Institute for Risk Assessment (BfR) is a scientifically independent institution within the portfolio of the Federal Ministry of Food and Agriculture (BMEL) in Germany. It advises the Federal Government and Federal Laender on questions of food, chemical and product safety. The BfR conducts its own research on topics that are closely linked to its assessment tasks.

This text version is a translation of the original German text which is the only legally binding version.


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