New button battery technology could strengthen injury prevention efforts, with Kris R. Jatana, MD

Watch part one of this interview here.

A newly developed lithium coin-cell battery designed to reduce esophageal injury following accidental ingestion may represent an important milestone in pediatric injury prevention, according to Kris Jatana, MD, whose team recently evaluated the technology in a preclinical study.

Although the study demonstrated substantially less tissue injury compared with traditional lithium coin-cell batteries, Jatana emphasized that pediatricians should continue recommending existing emergency management strategies while incorporating the new technology into anticipatory guidance for families. The findings were published in OTO Open.

How does the new battery fit into existing injury prevention efforts?

Jatana said the new titanium-based battery represents the latest step in a broader effort to reduce serious injuries from button battery ingestions.

"I think it's important for pediatricians and other healthcare professionals... to be aware that this battery exists. This technology exists," said Jatana, professor of otolaryngology-head and neck surgery at Nationwide Children's Hospital and The Ohio State University.

He noted that recent years have brought multiple safety improvements, including child-resistant packaging, stronger warning labels, and requirements established under Reese's Law. However, those measures primarily reduce access to batteries rather than addressing the hazard itself.

"With the esophageal protective battery, we're addressing the actual hazard itself," Jatana said. "So we think about ways that we can actually reduce the hazard severity of the battery, and that's what this technology is accomplishing."

The laboratory study found that the titanium-based battery produced substantially less visible esophageal tissue injury than traditional lithium coin-cell batteries while maintaining the same characteristic radiographic appearance. However, investigators also found that the battery continued to generate alkaline hydroxide, supporting continued use of existing treatment recommendations.

What should pediatricians tell families about the new technology?

Jatana believes pediatricians can incorporate information about the new batteries into routine anticipatory guidance without changing their emergency recommendations.

"Just knowing that this is out there when performing anticipatory guidance on different types of hazards... I think it's important for pediatricians to consider, just letting parents know that there is this safer technology available to power devices in the home."

Because coin-cell batteries are commonly found in toys, remote controls, key fobs, greeting cards, flameless candles, hearing devices, and other household electronics, he said informing families that safer battery technology is now available may become another component of injury prevention counseling.

Does a safer battery change emergency management?

Despite the improved safety profile, Jatana emphasized that accidental ingestion remains a medical emergency.

"...still treat that as an emergency. If you suspect or witness a child swallow one of these coin cell batteries to seek medical attention," he said.

"...our approach to that shouldn't change until we have data to suggest otherwise, as far as just emergent removal, pre-removal mitigation strategies, and also the post-removal neutralizing acetic acid irrigation."

The study confirmed that protective batteries continued to generate hydroxide despite reducing tissue injury. Honey and sucralfate remained effective preremoval mitigation strategies, and postremoval irrigation with 0.25% sterile acetic acid continued to neutralize residual hydroxide, supporting current clinical guidelines.

How does the new technology affect recommendations for infants?

Jatana also addressed questions surrounding honey use in infants with suspected button battery ingestion.

"Our American Academy of Pediatrics recommends honey only after 12 months of age," he said.

He explained that while the risk of infant botulism from commercially produced honey is extremely low, the recommendation has led investigators to validate sucralfate as an alternative mitigation strategy that can be used after diagnosis in the hospital setting.

"One of the reasons we adopted the sucralfate recommendation as well... is it gives us a medicinal option that can be used for an infant... once the diagnosis is confirmed."

What comes next for battery safety?

Although Jatana described the new battery as a major advance, he believes additional innovation remains possible.

"This is a huge milestone as far as innovation and technology development," he said.

While the protective battery substantially reduced injury in the study, it continued to generate some hydroxide at the tissue level. Future improvements, he said, should focus on minimizing hydroxide production even further.

"I think we have a new bar for other members of the battery industry to try to meet with this new technology."

He also encouraged electronics manufacturers—not only battery manufacturers—to prioritize safer power sources in consumer products.

"Our hope is that all electronics manufacturers will consider the safest options available for their products, so that we can try to decrease the risk of these hidden dangers in our homes."

The authors concluded that broader adoption of injury-reducing battery technologies throughout the battery and electronics industries could further reduce severe pediatric injuries and deaths while maintaining established emergency management protocols.

Reference

Jatana KR, Rhoades K, Litovitz T, et al. Evaluation of an esophageal-protective lithium coin-cell battery within current management paradigms. OTO Open. 2026;10(2):e70266. doi:10.1002/oto2.70266