Swallowed button cells can cause serious harm to small children

During the Christmas season, products powered by button cells – such as LED tea lights, Christmas lights, and remote controls – are widely used. This increases the risk of children handling these batteries and accidentally swallowing them. If a button cell becomes lodged in the oesophagus, it can cause severe damage to the mucous membrane.

"We advise keeping button cells out of the reach of infants and young children," says Professor Andreas Hensel, President of the German Federal Institute for Risk Assessment (BfR). "If a button cell has been swallowed, the child should be examined in a clinic immediately." Over the past decade, several hundred cases of swallowed button cells have been reported to the BfR by clinics and poison centres.

Button-cell-powered devices are particularly common during the Christmas period, increasing the risk for infants and toddlers. EU regulations require toys with button cells to have secure battery compartments, often locked with screws, avoiding direct access. However, many non-toy items, including LED tea lights, Christmas lights, greeting cards that play music, thermometers and remote controls, lack these safety measures posing similar risks. To prevent accidents, such products – and packaging for new or used button cells - should always be stored out of the reach of children. This also applies to packaging containing new and used button cells. Used button cells should be disposed of promptly.

Swallowing a button cell often goes unnoticed initially, which becomes particularly hazardous if the battery gets stuck in the oesophagus. Contact with the moist mucous membrane generates an electrical current, triggering a chemical reaction that can lead to severe internal burns.

Early symptoms after ingesting a button cell may be mild or absent, but within hours, vomiting, loss of appetite, fever, or coughing can develop. As the condition progresses, tissue damage at the contact site can lead to bleeding, tissue death, and even scarring of the oesophagus. In rare cases, these complications can be fatal.

The risk is particularly high with large button cells (20 mm or more). The more heavily charged the battery and the longer it remains lodged in the oesophagus, the greater the potential harm. If the button cell passes through the oesophagus, complications are rare and medical supervision is typically sufficient to ensure it is expelled naturally.

The BfR recommends an immediate examination at a paediatric clinic if button cell ingestion is suspected. The same applies if a button cell is inserted into the ear or nose.

Doctors report poisoning incidents, including suspected cases, to the BfR's Poisoning Documentation and Assessment Centre. These reports cover a range of cases, from exposure to chemicals and toxic plants to the ingestion of button cells and the associated risk of chemical burns. A 2023 amendment to the Chemicals Act mandates for a National Poisoning Register at the BfR by 2026, centralizing data on poisoning cases across Germany to enhance early risk detection and prevention.

For more information on handling poisoning emergencies and tips for child-safe households, download the BfR app "Poisoning accidents in children".

Further information on the BfR website on the subject of button cells