Age for Introducing Honey to Children
Honey should not be introduced to infants under 12 months of age due to the risk of infant botulism. 1, 2
Why Honey is Dangerous for Infants
- Honey can contain spores of Clostridium botulinum, which can colonize the immature intestinal tract of infants and produce toxins 1
- These toxins cause infant botulism, a serious condition that can lead to blockade of voluntary motor and autonomic functions 1
- The Centers for Disease Control and Prevention (CDC) recommends that honey not be given to infants younger than 12 months old 1
- Infant botulism can present with symptoms including constipation, poor feeding, descending hypotonia, drooling, irritability, weak crying, and cranial nerve dysfunctions 3
- Respiratory failure requiring mechanical ventilation is common in severe cases, though full recovery is typically achieved gradually 2
Prevalence and Awareness
- Studies have shown that honey use in infants under 12 months is relatively common (approximately 11% in some populations) 4
- About 80% of parents in studies were unaware of the potential dangers of giving honey to infants under 12 months 4
- Honey is often used as a traditional remedy for respiratory tract symptoms and other ailments in infants 5
- Honey pacifiers and honey-containing products are sometimes given to infants despite the risks 4
Safe Introduction of Foods in Infancy
- The American Academy of Pediatrics recommends that complementary foods be introduced at around 6 months of age 6
- By 8-9 months, the diet should include breast milk or infant formula, whole grain cereals, vegetables, meats, eggs, fruits, and nut butters distributed among 3 meals 7
- Current guidelines recommend introducing common food allergens between 4-6 months of age, but this does not apply to honey 6
- Fruit juice, like honey, should not be introduced before 12 months of age 6
When Honey Can Be Safely Introduced
- Honey can be safely introduced after the child's first birthday (12 months of age) 1, 2
- After 12 months, the child's intestinal flora is mature enough to prevent colonization by Clostridium botulinum 2
- When introducing honey after 12 months, it should be used as part of a meal or snack, not as a continuous sipping beverage 6
Important Considerations for Healthcare Providers
- Healthcare providers should routinely ask about the use of honey and other traditional complementary approaches in infant care 5
- Providers should be aware that honey is sometimes used in traditional remedies and educate parents about the risks 5
- Honey-containing products, supplements, or honey as a flavoring agent should not be recommended for infants under 12 months 1
- Special attention should be paid to educating families from diverse cultural backgrounds who may use honey as a traditional remedy 5