A Connecticut couple is warning about the danger of small button batteries in children’s toys after their 18-month-old son swallowed one in December. The battery caused serious injury to Cameron Soto’s esophagus, WTIC Fox 61 reported this week, and the toddler had to be hospitalized—complete with breathing and feeding tubes—for several months.

Cameron’s mother, Marisa Soto, told WTIC that she first realized something was wrong when the boy showed signs of discomfort. “It looked like he probably had a sore throat,” she said.

She took Cameron to a nearby emergency room, where he began foaming at the mouth and vomited. After doctors performed an X-ray, they discovered a button battery—the type used in watches, hearing aids, small remote controls, LED devices, and some children’s toys—in his esophagus. He was rushed into surgery at Connecticut Children’s Medical Center, but the battery had already caused severe burns and inflammation.

Soto said Cameron’s esophagus was “swollen from the bottom of his brain to the top of his heart.” To give him the best chance at a full recovery, doctors intubated him for two and a half months. Fortunately, Cameron has learned to walk and eat again—although he still wears a tracheostomy tube to assist with breathing, and doctors don’t know yet whether the device will be permanent.

So what makes these tiny batteries so dangerous? For starters, they’re just the right size for children to swallow, says Sarah Combs, MD, an emergency medicine specialist at Children’s National Health System. Dr. Combs was not involved in Cameron’s case, but she has seen quite a few similar injuries.

“Those of us in the emergency department know that kids will put anything and everything in their mouths and everywhere else,” she says. All batteries are dangerous when swallowed, she says, but button batteries are small enough that they can become lodged in the throat without totally obstructing a child’s airway—so he or she may not have noticeable symptoms after swallowing one.

No symptoms doesn’t mean no damage, however. Saliva can interact with the battery to trigger an electric current that can burn surrounding tissue. Doctors estimate that a toddler with a 2-centimeter button battery lodged in his or her throat can suffer esophageal damage in as little as two hours, says Dr. Combs.

In fact, button batteries are so notorious that some doctors say they won’t keep them in their homes. “Toddlers like shiny objects and will ingest them,” David J. Mathison, MD, pediatric emergency room physician and mid-Atlantic regional medical director, PM Pediatrics, told Health in 2016. “When a coin gets stuck, it often passes on its own. But when a button battery gets stuck, the battery acid can eat through the wall of the esophagus, causing lifelong disability.”

That’s why it’s so important for parents to bring children to a hospital immediately if they suspect a button battery may have been swallowed. “Even if your child seems fine—they could be swallowing, walking, drinking, crying, talking—if you are missing a button battery, bring them in so we can investigate,” Dr. Combs says.

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An X-ray can determine if a battery is stuck in the esophagus or if it’s passed to the stomach, where there’s less danger of a chemical reaction. Once a battery reaches the stomach, Dr. Combs says, children over 2 can usually pass them safely without medical intervention. (If it remains in the stomach for more than four days, however, it will need to be removed.)

Dr. Combs says children’s toy manufacturers are moving away from using these batteries in their products, but that parents should still be on the lookout. She also stresses the importance of keeping any household batteries—as well as medications and other small objects—away from children’s curious hands and mouths.

“Childproof your home,” she says. “It’s old-school, but with all of the battery-operated devices and medications people have in their homes today, it applies now more than ever.”

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