Button Battery First Aid: New Advice for Babies Under 12 Months
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Button Battery First Aid: New Advice for Babies Under 12 Months
Button battery ingestion guidelines has an important update for infants under 12 months. For first aid trainers, it is a small but significant change that may mean updating your slides, trainer notes and learner resources.
Button battery ingestion is a medical emergency, particularly in young children. A battery lodged in the oesophagus can cause serious injury very quickly, so early recognition and urgent medical care are critical.
What has changed with button battery honey guidance?
The ANZCOR Guideline 9.5.1: First Aid Management of Poisoning includes specific advice about the use of honey and jam when button battery ingestion is suspected.
For children over 12 months, the guidance is to give 10 mL (2 teaspoons) of honey every 10 minutes until they reach a higher level of care. If honey is not available, jam can be used.
The important amendment is the addition of specific guidance for infants under 12 months.
If the child is under one year of age:
Give 10 mL (2 teaspoons) of jam every 10 minutes until they reach a higher level of care.
Do not give honey.
Most importantly, giving honey or jam should never delay urgent medical care.
Why jam instead of honey for babies?
Honey is not recommended for infants under 12 months due to the risk of infant botulism.
(Read more about infant botulism HERE)
However, some research suggests that honey may help reduce injury following button battery ingestion by reducing the change in pH in the oesophagus and forming an insulating layer around the battery due to its high viscosity.
The updated guidance allows jam to be used for infants under 12 months, providing an option for this age group where honey should not be given.
Why is button battery ingestion so urgent?
A button battery lodged in the oesophagus can cause serious injury very quickly.
Damage has been observed in experimental models within 15 minutes of ingestion, with injury increasing over time.
Importantly, a battery does not need to be new to be dangerous. Even an old button battery can cause serious injury or death.
This is why suspected ingestion should be treated as an emergency. You do not need to wait until you know for certain that a battery has been swallowed.
What does the button battery honey update mean for first aid trainers?
This is a small amendment, but an important one.
If you teach button battery ingestion as part of your first aid courses, now is a good time to check your:
- PowerPoint slides
- Trainer notes
- Learner resources and handouts
- Scenario activities
- Knowledge questions
- Online course content
In particular, make sure your resources do not simply state “give honey” without differentiating by age.
A simple way to teach the current guidance is:
Under 12 months
10 mL jam every 10 minutes. No honey.
12 months and over
10 mL honey every 10 minutes. If honey is unavailable, use jam.
For everyone
Seek urgent medical care immediately. Do not delay medical care to find honey or jam.
If the person has difficulty breathing or there is bleeding, give nothing by mouth. Otherwise, give nothing else by mouth other than the jam or honey.
The trainer takeaway
The key change is easy to remember:
Under one? Jam, not honey.
Button battery ingestion remains a time-critical emergency. The role of honey or jam is not to treat the ingestion or replace medical care. It is an immediate first aid measure used while the person is being transferred to a higher level of care.
For first aid trainers, the practical action is simple: check your button battery content and make sure the new advice for infants under 12 months is included.
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