Ingesting honey after swallowing button battery reduces injury and improves outcomes

CHOP and NCH researchers found household and clinical options for rapidly protecting against caustic effects.

Little girl coughing at the doctor checkup - a health professional consulting her
Little girl coughing at the doctor checkup - a health professional consulting her Image: Shutterstock

Button batteries are ingested by children more 2,500 times a year in the United States. Since serious damage can occur within two hours of ingesting a battery, the interval between ingestion and removal is a critical time to act in order to reduce esophageal injury. Now, specialists of Ear, Nose, and Throat (ENT), suggests that eating honey after swallowing a button battery has the potential to reduce serious injuries in small children.

Button batteries posed a risk for toddlers for decades. At the point when the battery responds with salivation and tissue of the throat, it makes a hydroxide-rich, antacid solution that basically dissolves tissue. Kids with an esophageal button battery may give indications of a sore throat, cough, fever, difficulty swallowing, poor oral intake or noisy breathing.

This can cause severe complications like esophageal perforation, vocal cord paralysis, and erosion into the airway or major blood vessels. The longer it takes for the battery to be removed, the higher the risk for these children, particularly those without access to hospitals with specialized anesthesiologists and endoscopists experienced in removing foreign objects.

The study aimed to determine successful interventions for mitigating these wounds in both a home and clinical setting and test their viability in a live animal model, for this situation, laboratory pigs.

In particular, the scientists looked for acceptable, more viscous fluids that could make a barrier between the tissue and the battery, and additionally neutralize alkaline levels. The group screened different choices, including basic household beverages, for example, juices, soft drinks, and sports drinks, in lab examinations.

Kris R. Jatana said, “We explored a variety of common household and medicinal liquid options, and our study showed that honey and sucralfate demonstrated the most protective effects against button battery injury, making the injuries more localized and superficial. The findings of our study are going to be put immediately into clinical practice, incorporated into the latest National Capital Poison Center Guidelines for management of button battery ingestions.”

Prior published studies by this team had tested weakly acidic liquids like lemon juice as a proof of concept. However, many children do not enjoy drinking lemon juice. By contrast, the sweet taste of honey is much more palatable to children.

“Our recommendation would be for parents and caregivers to give honey at regular intervals before a child is able to reach a hospital, while clinicians in a hospital setting can use sucralfate before removing the battery. Still, we caution against using these substances in children who have a clinical suspicion of existing sepsis or perforation of the esophagus, known severe allergy to honey or sucralfate, or in children less than one-year-old due to a small risk of botulism.”

“While future studies could help establish the ideal volume and frequency for each treatment, we believe that these findings serve as a reasonable benchmark for clinical recommendations. Safely ingesting any amount of these liquids prior to battery removal is better than doing nothing.”

“Button batteries are commonly found in households, and they should always be stored in a secured container, out of reach of children. Parents and caregivers should check all electronic products in the home and make certain that the battery is enclosed in a compartment that requires a tool to open and periodically check to ensure it stays secure over time.”

Jacobs collaborated with researchers at CHOP and Co-Principal Investigator, Kris R. Jatana, MD, a pediatric otolaryngologist and Director of Pediatric Otolaryngology Quality Improvement at Nationwide Children’s Hospital, in a study published online in The Laryngoscope.