Babies Have Gotten Sick With Botulism From Honey-Filled Pacifiers

When you become a parent, you hear all kinds of old wive's tales about what you should and shouldn't do. Don't take your baby outside without a hat. Make sure you put your baby to sleep on their back and not their tummy. Little pieces of advice that have been passed down for generations - some of it sound, some of it sort of silly. One of the most common pieces of advice we hear is not to give honey to babies under the age of 12 months.

4 Texas Infants Got Botulism, Why You Should Never Give Infants Honey Pacifiers

Remember "Honey Child" is probably OK if it is"Honey One Year or Older Child." But honey infant? That's a no-no.

Botulism and Honey. What's the Connection?

Children under the age of twelve months are at risk of infant botulism if they are fed honey or anything with honey in it. Botulism spores can be found in honey; when swallowed, the spores release a toxin. Infants' systems are too immature to prevent this toxin from developing. In fact, most cases of botulism in the U.S. are in infants.

Honey and Infant Botulism

HONEY SHOULD NOT BE GIVEN TO CHILDREN YOUNGER THAN 12 MONTHS...Infant botulism can occur any time in the first year of life, but like SIDS it is most common in the first six months. In fact it has been suggested that it might be the cause of death in up to 10% of SIDS cases (Nelson Textbook of Pediatrics; Saunders 1992). Thankfully, in most instances of infant botulism, the amount of toxin is so incredibly minuscule that the case remains mild. For this reason it is often misdiagnosed. The first symptom of infant botulism is constipation (which is also a common benign finding in many infants). This can appear 3 to 30 days following ingesting spore-containing honey (The AAP Red Book, 2000).

Infant Botulism

Infant botulism is a rare condition caused by intestinal colonization with Clostridium botulinum. The enteric toxin causes intestinal immobility and progressive descending paralysis due to the effect on acetylcholine release at the neuromuscular junction and other cholinergic nerve terminals, particularly in the gut. Infant botulism was described in 1933 but at the time was misclassified as hypotonia of other etiology.

Infant botulism following honey ingestion

An apparently well baby girl born at term was presented with signs and symptoms suggestive of acute onset of generalised floppiness at the age of 3 months. Clinically, the baby had lower motor neuron type of muscle weakness; detailed investigation lead to the diagnosis of neuromuscular junction disorder secondary to botulism toxicity. Further tests confirmed the botulism toxicity secondary to honey ingestion. The baby was treated with specific anticlostridium antibodies; she recovered remarkably, now growing and developing normally.

The War on Honey: Fearing Infant Botulism

I personally believe that the fear of using honey has grown out of proportion to its actual risks because of media hype, but it’s up to each parent to decide what they are comfortable with and I can respect that choice too. I thought I would at least share some of the reasons why I believe honey isn’t as dangerous as most people believe and offer some of the benefits that swayed me to its usage with my son.

Theatre Botulinum

During medical school we are introduced to many diseases, some sparking particular interest because of a personal connection (for example, a past beloved relative afflicted by leukemia) or a discovered thrill over how a certain disease presents. For me, botulism is a disease ripe with dramatic intrigue.

Why Babies Shouldn't Suck on Honey

Around 10 percent of honey in the U.S. contains spores from the bacteria Clostridium botulinum. That's not really a problem for big humans because it's just the spores, not the botulinum toxin. In infants (humans less than 13 months old), though, those spores can turn into botulinum toxin in their intestines.