Up till now, the usual practice in cases of asymptomatic children with acute button battery ingestion has been to keep the child nil orally until radiographic localization and emergency endoscopic removal of esophageal button batteries.
Now, based on findings in laboratory animals, a new study reported online June 11, 2018 in the journal The Laryngoscope says that early and frequent oral administration of either honey or sucralfate until the battery is removed may reduce the severity of esophageal burns or injury.
The child who is older than one year of age, with acute button battery ingestion (witnessed or likely to have occurred within 1 to 2 hours) can be given 5-10 ml of pure honey orally at the earliest after ingestion followed by more doses of honey at regular intervals. In the emergency department, the child may receive another dose of honey or a single dose of sucralfate 500 mg before confirmation of esophageal impaction and emergency battery removal.
The authors recommend that parents give honey till the child reaches a hospital, while physicians can use sucralfate before proceeding to remove the battery. However, they cautioned against using honey or sucralfate 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 younger than one year, due to a risk of botulism, even though small.