A common misconception many parents have is that infants are allergic to honey. While this may not be true, infants are susceptible to a bacterial infection in honey known as botulism. Botulism is a severe infection that can be fatal if not quickly recognized and treated. Though adults can also get botulism, only infants can get it from honey.
Cause of Infant Botulism
Infant botulism is caused by the bacteria Clostridium botulinum that produces a toxin called botulinum toxin. It acts by blocking transmission of nerve impulses to muscles, leading to muscle weakness. Botulinum toxin is considered to be the most lethal naturally occurring toxin in humans. Adults can get the disease by eating the toxin in poorly stored food or after a wound infection. Infants, however, also can get the infection by ingesting the bacteria itself, which can grow in the gastrointestinal tract, produce toxins and cause disease. For reasons unknown, the bacteria often grows well in honey.
Symptoms of Infant Botulism
Infant botulism is rare; only 80 to 100 cases are diagnosed in the United States every year. Infants are most susceptible between 3 weeks to 6 months of age. Symptoms may start within hours of eating honey. Constipation often is the first symptom, followed by muscle weakness that usually begins in the face. Affected babies develop poor feeding and sucking, a weak cry and drool saliva. Weakness can extend to the neck and prevent the infant from holding up his head. When the muscles needed for breathing are affected, the disease can become deadly.
Diagnosis and Treatment
Because botulism is so rare, its diagnosis is missed or delayed in many cases. Blood tests to identify the toxin can be done. Treatment is given in the form immunotherapy, which neutralizes the toxin. In addition, infants may need a breathing tube if they are unable to breathe on their own. However, even with treatment, affected infants may continue to have muscle weakness lasting up to several months.
Recommendations for Parents
Though botulism is rare, it is a serious disease. According to Dr. Jay L. Hoecker, parents shouldn't give their infants honey until their first birthday. In addition, corn syrup also can harbor the deadly bacteria and should be avoided. Parents should ensure that food is stored properly and that foods canned at home are done according to proper technique.
References
- "Nelson Textbook of Pediatrics, 18th Edition"; Kliegman et al.; 2008
- "Infant botulism: How can it be prevented?"; Jay L. Hoecker, M.D.
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