# 305 Honey- Related Infant Botulism
Parents are now routinely cautioned to not give honey to their infants until after one year. Honey has remarkable properties and is also used medicinally. However, if the honey is contaminated with spores of Clostridium botulinum, and less often, Clostridium butyricum, or Clostridium baratii bacteria, the immature intestinal biome allows colonization and growth. The toxin released from the spores causes the neuromuscular paralysis in botulism. The spores have been isolated from diseased patients in several countries. The disease may occur without finding organisms or a source.
Therefore, once the disease is suspected, due to its severity and possibility of death, notification of authorities, and treatment with BabyBIG-IV® (Baby Botulism Immune Globulin, IV) begun before any laboratory confirmation is obtained. If started early enough, the BabyBIG-IV® can shorten the course, lessen its severity, and make death infrequent..
The descending paralysis may be preceded by constipation, poor feed, lethargy, hypotonia (floppy baby, initially head and neck weakness), cranial nerves, respiratory failure, paralysis of torso and extremities. Not all symptoms may occur.
Botulism is a rare disease, rarer still to be caused by ingestion of honey. The connection with honey and infants has been shown since 1976 and is an avoidable cause. To think of the disease when indicated, advances the possibility of recovery.
Consult the references for further details, protocols, ordering of globulin, additional sources, and consultation services.
Siu, K., Rehan, M., Austin, J. W., Ramachandran Nair, R., & Pernica, J. (2017). It's not all about the honey. Paediatrics & child health, 22(1), 37-38. [PDF]
Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. Botulism. Last reviewed March 8th, 2019.
Infant Botulism Treatment and Prevention Programv (California Department of Public Health) © 2010
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