From the Guidelines
Babies under 1 year old should never be given honey, and if accidental consumption occurs, immediate medical attention is necessary by contacting a pediatrician or poison control. Honey can contain Clostridium botulinum spores that may cause infant botulism, a rare but serious illness that can lead to paralysis and breathing difficulties, as noted in the guidelines for diagnosis and treatment of botulism 1. While these spores are generally harmless to adults and children over 1 year old due to their developed digestive systems, infants' immature intestinal tracts cannot prevent the spores from germinating and producing toxins. Symptoms of infant botulism include constipation, weakness, poor feeding, weak cry, decreased facial expression, and potentially respiratory failure. These typically appear within 12-36 hours after honey consumption. According to pediatric health guidelines, foods to avoid in infancy include honey 1. There is no home remedy for infant botulism; medical treatment with Botulism Immune Globulin Intravenous (BIG-IV) in a hospital setting is required. Some key points to consider in the care of infants include:
- Dietary intake guidelines that exclude honey for infants under 1 year old 1
- The importance of immediate medical attention if honey is accidentally consumed by an infant
- The potential for infant botulism to cause severe symptoms, including respiratory failure, if left untreated 1 After age 1, children can safely consume honey as their digestive systems have developed enough to handle these spores. It is crucial to follow the guidelines and recommendations for infant care, including dietary restrictions, to prevent such serious conditions and ensure the best possible outcomes for morbidity, mortality, and quality of life.
From the Research
Precautions for Babies Under 1 Year Old Eating Honey
- Honey should be avoided for infants up to one year due to the risk of infant botulism, which can cause acute muscle weakness, floppiness, constipation, and feeding difficulties 2.
- Infant botulism is caused by the ingestion of Clostridium botulinum spores, which are frequently present in honey, and can lead to life-threatening descending motor weakness and flaccid paralysis in infant children 3.
- Symptoms of infant botulism include constipation, weakness, and hypotonia, and can lead to respiratory failure, making it essential to consider this condition in cases of acute muscle weakness or floppiness in infants 3.
Treatment and Prevention
- Botulism immune globulin (BIG) is used to treat infant botulism and has been shown to lead to a significant reduction in intensive care unit and hospital stay for these patients 3, 4, 5, 6.
- Human-derived botulinum immune globulin (BIG) has been found to decrease the duration of hospitalization, mechanical ventilation, and tube or parenteral feeding in infant botulism patients 5.
- The use of BIG-IV has reduced mean length of hospital stay from 5.7 to 2.2 weeks and resulted in a mean decrease in hospital charges of $88,900 per patient 6.
Important Considerations
- Diagnosis of infant botulism is based on stool culture and toxin detection in stool, and respiratory failure and need for mechanical ventilation is common, but full recovery is gradually obtained 2.
- It is crucial to administer BIG-IV soon after hospital admission to achieve the greatest reduction in length of hospital stay 6.