Liam Howard's 6-year-old sister Grace saved his life.
Twelve months old and curious, Liam had found a way to pop the shiny, coin-shaped battery out of Grace's handheld digital toy and had swallowed it.
"I had no idea what he was choking on," said his mother, Susan Howard, 40, of Leesburg, Virginia. Liam was retching and grabbing at his throat, so Susan scooped up the children and was on the way out the door to the hospital when Grace noticed that her toy wasn't working. She asked her mother if Liam might be choking on the battery.
Sure enough, an X-ray at the hospital showed a flat disc lodged in Liam's esophagus, the passage that connects the mouth to the stomach.
Three hours later, the battery had been removed, but the damage had been done: Liam had third-degree burns to his esophagus and the wall of his windpipe.
Liam stayed in the hospital for a month. He needed a breathing tube for a week, a feeding tube for three weeks, and several follow-up procedures to widen his scarred esophagus.
"We're still dealing with it," said his mother. "He vomited 3 or 4 times a day for at least 18 months. He lost his teeth from the stomach acid. He now has a lot of breathing issues."
But overall, she considers her family lucky. Now 4, Liam is doing great.
For a curious toddler, the home is full of exciting potential toys to explore -- from light-up sneakers and jewelry to singing greeting cards, remote controls and electric toothbrushes. But these devices, as well as numerous other powered items found in nearly every home, have a hidden danger in the form of flat, round batteries known as button batteries.
A pair of studies published in Monday's issue of the journal Pediatrics reports an alarming rise in the number of battery ingestions that can be serious or even fatal. The studies make strong recommendations for ways that product designers, parents and physicians can work to keep children safer.
The rate at which people accidentally swallow batteries each year has remained more or less constant over the past 25 years, bouncing between 6.3 and 15.1 per million. However, the percentage of those ingestions that end up being serious or fatal increased 6.7-fold over the time period studied. These numbers came from the National Battery Ingestion Hotline (NBIH), a service that provides guidance to families and health professionals after battery ingestions.
Dr. Toby Litovitz, an emergency medicine physician and medical toxicologist in Washington, D.C., founded the center in 1982 when she realized that guidelines for families and physicians on how to deal with battery ingestions were scarce.
"For many years, most of the cases were benign," she said. Kids would swallow batteries, the batteries would pass through the stomach and not need to be retrieved, and the kids would do fine.
"In the last five years or so, things have changed," she said, "and we've done an about-face because of the emergence of the 20-millimeter lithium cell as a very popular cell for consumer electronics."
This coin-shaped battery, which is frequently used in remote controls and other household devices, is larger than most older "button batteries," so it more frequently becomes lodged in the esophagus.