Infant Botulism: What you need to know

A recent recall of baby food in Canada due to the risk for botulism poisoning (February, 2019) following on 4 cases of infant botulism poisoning in the U.S. linked to honey-containing pacifiers (November, 2018) suggests that it’s a good time to remind everyone that botulism is dangerous for all ages, but particularly for infants and young children. In all ages botulism poisoning can suddenly paralyze muscles, including those used to breathe.

Clostridium botulinum is a spore-forming bacteria. When the spores find themselves in a food product that is high in pH (low in acid),  the bacterial spores can germinate and produce a toxin in the food. Conditions for the spores of C. botulinum to germinate in a food product include: high pH (low acidity), a warm environment (room temperature), and an oxygen-free environment (like in a sealed can or jar). Traditionally, we associate botulism poisoning with improperly home-canned foods.

In healthy individuals, ingesting the spores of Clostridium botulinum is not harmful! However when the spores germinate in a food product, the growing spores can produce a deadly toxin. Infant botulism is different; this illness can happen when a baby ingests spores of C. botulinum, Because an infant’s digestive system is not yet developed, the spores can actually germinate and grow in the baby’s gut, producing toxin. That toxin interferes with the normal interaction between the muscles and nerves and can hamper an infant’s ability to move, eat, and breathe.

Spores of Clostridium botulinum can be found in dirt, dust, and can contaminate products such as honey. The illness is rare, affecting fewer than 100 babies in the U.S. each year, but it’s also largely preventable. Infant botulism usually affects babies between 3 weeks and 6 months old, but all babies are at risk until their first birthday. For this reason, most pediatricians recommend that parents and care-givers avoid giving honey and processed foods containing honey to children until they are 1 year old. When botulism toxin is present in  a baby food product, the manufacturer has under-processed or mishandled the product; parents should choose processed baby food from a reputable company.

Sign and symptoms of infant botulism.Symptoms of botulism begin between 3 to 30 days after an infant ingests the spores. Constipation is often the first sign of botulism that parents notice (although there are many other causes of constipation). Other symptoms of botulism can include: flat facial expression, poor feeding (weak sucking), weak cry, decreased movement, trouble swallowing with excessive drooling, muscle weakness and breathing problems. Parents concerned about an infant’s health should always consult their health care team. Stay food safe, Barb