Honey should never be given to a child under the age of 12 months old.
Spores of C.botulinum are usually harmless to adults and children over 1 year of age, because the microorganisms normally found in the intestine prevent these bacteria from growing. There are many who feel that honey is not really a danger to babies because in one form or another, honey has been given to babies well under the age of 12 months old. In different parts of the world, people still continue to give babies honey almost from birth and also incorporate it early into the baby’s diet. It is better to exercise caution while giving honey to a baby under 12 months of age honey – it is recommended that parents thoroughly discuss this with their pediatricians.
In fact, the WHO advises that honey should not be added to water, food, or the formula that is fed to infants younger than 12 months of age. This applies even to honey in processed or baked foods.
What is Infant Botulism?
This illness usually affects babies who are between 3 weeks and 6 months old, but all babies are at risk of it until they turn one.
Spores of the bacteria Clostridium botulinum that can be found in dirt and dust can contaminate honey. These bacteria are near to harmless to older kids and adults because their mature digestive systems can move the spores through the body before they cause any harm.
But very young babies haven't yet developed the ability to handle the spores. So if an infant ingests them, the bacteria germinate, multiply, and yield a toxin. This toxin obstructs with the normal interaction between the muscles and nerves and can obstruct the ability of an infant to eat, move, and breathe.
What are the Signs and Symptoms of Botulism in infants?
Symptoms of botulism begin from 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). It is advised to call the doctor immediately if baby has not passed motion in 3 days.
Some other symptoms of botulism can include:
- poor feeding (weak sucking)
- weak facial expressions
- weak cries
- reduced movement
- having trouble swallowing, excessive drooling
- breathing problems
- muscle weakness
Infant botulism can be treated, but it is important to get medical help as soon as possible.
How is Infant Botulism treated?
Infant botulism is treated in the hospital, usually in the intensive care unit, where doctors will try to limit the problems caused by the toxin in the baby's body. The toxin can affect the breathing muscles, so doctors may put the infant on a ventilator. The toxin can affect the swallowing muscles; hence they may administer intravenous (IV) fluids or feedings to the baby through a tube to provide nourishment. An antitoxin is now being available for treating infant botulism, called botulism immune globulin intravenous (BIGIV), which should be administered as soon as possible. Babies with botulism who have received BIGIV recover sooner and spend less time in the hospital. These occur as a result of muscle paralysis caused by bacterial toxin. If the infant has signs of botulism, it is recommended to visit the emergency immediately as this can be life-threatening.
Symptoms typically appear within 12-36 hours after consuming the contaminated food, but it may occur as early as a few hours to as late as 10 days. Symptoms of botulism in infants may occur up to 14 days later.
In adults, the effect of botulism spores ingested from honey is really very negligible because adults have mature intestines. An adult’s intestines contain enough acids to offset the production of toxins that can be produced by C.botulinum. Once an infant reaches the age of 1 year or older, their intestines have a balance of acids that help destroy and fight off any toxins that the botulism bacteria produce.
With early diagnosis and proper medical care, a baby should fully recuperate from the illness.
How can we prevent infant botulism?
Like many germs, the Clostridium botulinum spores that cause botulism in infants are everywhere in the environment. They are present in dust and dirt, and even in the air. Experts don't know why some infants get affected by botulism while others don't.
One way to lessen the risk of botulism is to not give infants honey or any processed foods that may contain honey before they turn a year old. Honey is a confirmed source of the bacteria and has led to botulism in infants who have consumed it in some form.
To be on the safer side, it is advisable not to cook with honey (in bread or pudding, for eg) if any infant or baby is going to eat the dish. Whilst the toxin is heat sensitive, the spores are hard to destroy. Commercial foods that contain honey, like ready-to-eat breakfast cereals and baby food, are safe for your baby because they have been heated enough to kill the spores.
Wholesome Baby Food
by Hridya Anand
A biochemist by education who could never put what she studied to good use, finally found GetDoc as a medium to do what she loved - bring information to people using a forum that is dedicated to all things medical. View all articles by Hridya Anand.