What happens when kids bite off more than they can chew? Today we discuss pediatric foreign body ingestion, specifically focusing on button batteries. This episode was written by pediatric resident Mariama Lei Poquiz and pediatricians Lidia Park and Tammy Yau, with content support from pediatric gastroenterologist Dean Libet. Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

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Key Points:

• Children of all ages are at risk for foreign body ingestion, with children ages 6-36 months at the most risk due to their developmental stage. Other vulnerable populations include children and adolescents with behavioral, developmental, and psychiatric conditions. About 98% of all foreign body ingestions in children are found to be both accidental and composed of common items found in the home, including magnets, batteries, coins, toys, jewelry.
• Button batteries in the esophagus are an emergency and should be endoscopically removed within 2 hours of ingestion. It is important to assess for esophageal injury and aortic involvement because esophageal associated injuries are common and aortoenteric fistulas have a high mortality rate.
• Button batteries distal to the esophagus can be managed depending on the child’s age and battery size in conjunction with the clinician’s clinical decision-making skills. If a button battery has not passed the stomach within 14 days of ingestion or if a child develops GI symptoms, the battery must be removed endoscopically.
• For more information regarding button battery safety, please visit the National Safety Council’s page on button batteries and the US Consumer Product Safety Commission’s page on button, cell, and coin batteries. For button battery ingestion, please call 911 and for immediate triage questions please call the National Battery Ingestion Hotline at 1-800-498-8666.

References

Anfang RR, Jatana KR, Linn RL, Rhoades K, Fry J, Jacobs IN. pH-neutralizing esophageal irrigations as a novel mitigation strategy for button battery injury. Laryngoscope. 2019;129(1):49-57. doi:10.1002/lary.27312

Clinker C, Alvey B, Reynolds E, Wieck M. Post-extraction management of esophageal button battery injuries in children: A scoping review of imaging, ICU admission, and NPO practices. Journal of Pediatric Surgery. 2026;61(7):163066. doi:10.1016/j.jpedsurg.2026.163066

Dana E. Stone, Bryan C. Lembo; Foreign Body Ingestion and Aspiration. Pediatr Rev June 2026; 47 (6): 352–355. https://doi.org/10.1542/pir.2025-006817

Foreign Body Ingestion Algorithms: Button Battery, Coin/Blunt Objects, Magnet, Sharp Objects, Esophageal Food Impaction.

Kramer RE, Lerner DG, Lin T, et al. Management of ingested foreign bodies in children: a clinical report of the NASPGHAN Endoscopy Committee. J Pediatr Gastroenterol Nutr. 2015;60(4):562-574. doi:10.1097/MPG.0000000000000729

Leinwand K, Brumbaugh DE, Kramer RE. Button Battery Ingestion in Children: A Paradigm for Management of Severe Pediatric Foreign Body Ingestions. Gastrointest Endosc Clin N Am. 2016;26(1):99-118. doi:10.1016/j.giec.2015.08.003

Litovitz T, Whitaker N, Clark L, White NC, Marsolek M. Emerging battery-ingestion hazard: clinical implications. Pediatrics. 2010;125(6):1168-1177. doi:10.1542/peds.2009-3037

McMahon K, Conners GP, Mohseni M. Pediatric Foreign Body Ingestion. [Updated 2025 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430915/

National Capital Poison Center’s Button Battery Ingestion triage and treatment guideline | poison control. National Capital Poison Center. 2018. Accessed July 22, 2026. https://www.poison.org/battery/guideline.

Sutherland J, Bowen L. Ingestion of foreign bodies and caustic substances in children. BJA Educ. 2023;23(1):2-7. doi:10.1016/j.bjae.2022.09.003