The Centers for Disease Control and Prevention (CDC) reports infant botulism is the most common form of botulism in the United States, with approximately 75 cases occurring annually. Infant botulism occurs when a baby ingests the spores of the bacterium Clostridium botulinum. The spores--a dormant form of the bacteria--become active in the baby's intestine and produce a protein called botulinum toxin. The toxin poisons nerve cells causing muscle weakness or paralysis. Although infant botulism is rare, knowing the symptoms may help you identify the illness if it occurs in your baby. Immediate medical attention is necessary if you notice any of the symptoms of infant botulism.
Constipation
Constipation is a common symptom of infant botulism due to the effects of the botulinum toxin on intestinal muscles. The muscles in the intestinal wall normally keep digested food and waste material moving through the bowel. With infant botulism, the intestinal muscles slow dramatically, causing constipation. In CDC's "Botulism Handbook," it is noted that constipation may precede other symptoms of the illness by several days. However, this is not uniformly the case.
Poor Feeding and Excessive Drooling
Babies with infant botulism develop feeding problems due to weak sucking and difficulty swallowing. Excessive drooling occurs because the baby has difficulty swallowing her saliva. These symptoms occur because the botulinum toxin affects the nerves supplying the muscles involved in these activities, causing partial paralysis. The symptoms are often progressive, which means they will get worse over time.
Droopy Eyelids and Decreased Facial Movement
Facial muscle involvement in infant botulism may cause droopy eyelids and limited eye movement. Partial paralysis of the facial muscles leads to decreased facial movement. This causes an expressionless appearance. The baby's pupils are often dilated.
Poor Head Control, Floppiness and Decreased Movement
The botulinum toxin causes weakness of the neck muscles, which manifests as poor head control. As the effects of the toxin spread, generalized muscle weakness develops, causing decreased muscle tone. The baby becomes floppy--the limbs uncontrolled and not held close to the body when the baby is picked up. There is an overall decrease in movement of the limbs.
Weak Cry and Breathing Difficulty
Babies with infant botulism often have an abnormally weak cry. This symptom is caused by decreased muscle strength in the throat and chest. Breathing difficulties may develop and are an ominous symptom that may herald impending respiratory failure. If your baby develops any breathing difficulty, regardless of cause, it is a medical emergency. Call 911.
Irritability
Babies with infant botulism can be exceptionally irritable, although this symptom is not present in most cases.
Absence of Fever
With infant botulism, the absence of fever is an important clue in diagnosing the illness. Other illnesses that may cause symptoms similar to infant botulism typically cause fever. Therefore, the absence of fever is an important physical finding.
