DEAR DR.PAUL: I have heard that giving babies honey is dangerous. Is this true and if so why?
DR.PAUL ANSWERS: This is a common question. Although many people seem to know that there is some problem with giving honey to young babies they do not know exactly what the problem is. Honey itself is a natural product that is generally thought to be very healthy for people. However, there have been some cases of a very serious disease that had been traced to honey. This is “infant botulism”, which is a type of food poisoning caused by a bacteria called Clostridium botulinum. According to Health Canada, only 7 cases of infant botulism have been seen in Canada since 1979. In three of the seven cases the child had been given honey. In the USA there are about 70 to 90 cases of infant botulism yearly(not necessarily all due to honey).This bacteria forms spores which when swallowed by a baby will start to produce a poisonous toxin in the baby’s intestines. This toxin, known as botulin causes the various muscles in a baby to be paralyzed. The symptoms then develop because of this paralysis including, poor sucking, weak cry, irritability, lack of facial expression(i.e. cannot smile because the facial muscles are paralyzed.The most dangerous part of this infection is that if the diaphragm, our main breathing muscle, becomes paralyzed, than the baby will have trouble breathing.
The treatment is to hospitalize the affected babies and to help them breath and eat properly. This “supportive treatment” may be required for a few days or up to even a few weeks until all of the toxin has left the body. Most babies do recover completely and this, without any antibiotics or specific antidote or antitoxin treatment.
Why is honey a source of botulism? It is not very well understood because we know that most homey produced in North America is not contaminated with the botulism bacteria. Experts think that the honey gets contaminated by the spores from the dirt. The bees pick up these spores from the soil and then bring it to the hive, contaminating the honey that they produce.
How can infantile botulism be prevented? Although infant botulism is very rare, it is better to be safe and not take chances. For this reason, parents and caretakers should not give honey to babies less than one year of age. Also honey should never be added to baby food nor placed on a baby’s pacifier. NOTE: THIS APPLIES EVEN IF THE HONEY HAS BEEN PASTEURIZED because pasteurization does not kill the Botulism spores.Let me list the symptoms of infantile botulism:
- Baby is too weak to cry or suck as usual
- Baby does not have any bowel movements and has weak muscles
- The baby’s neck is quite week and so the head is wobbly
- The arms and legs are weak
- Baby is unable to swallow
If your baby develops any of these symptoms, call your doctor.
On a final note, light or dark corn syrup is often used to help babies with constipation. The American Academy of Pediatrics warns that due to the potential theoretical risk of botulinum contamination babies should also not be given corn syrup that has not been pasteurized(sterilized) or declared “botulism spore free”.
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Pediatrician DR.PAUL Roumeliotis is certified by the American Board of Pediatrics and Royal College of Physicians and Surgeons of Canada. The information provided above is designed to be an educational aid only. It is not intended to replace the advice and care of your child’s physician, nor is it intended to be used for medical diagnosis or treatment. If you suspect that your child has a medical condition always consult a physician.