Infant Botulism: The Cause, Symptoms and Treatment

by Health Canada

Infant botulism is a rare disease that can affect otherwise healthy children who are less than a year old. The only food linked to cases of infant botulism in Canada is honey, so Health Canada is advising parents and caregivers not to feed honey to infants.

The Cause of Infant Botulism

Infant botulism is caused by a food poisoning bacterium called Clostridium botulinum. When an infant swallows spores of this bacterium, the spores grow and produce a poison in the baby's intestine.

It's easy for infants to come into contact with this bacterium, because it's quite common in soil and dust. The spores have also been found in samples of honey, which is the only food source that has been linked to actual cases of infant botulism.

Infant botulism is rare in Canada, with only seven cases reported since 1979. In three of the cases, the child had been given honey. In the United States, about 70 to 90 cases of infant botulism are reported every year. It's quite possible that there have been additional cases in both countries that were misdiagnosed, and therefore not reported.

Symptoms of Infant Botulism

The earliest and most common symptom of infant botulism is constipation. Other symptoms include general weakness, a weak cry, a poor sucking reflex, irritability, lack of facial expression, and loss of head control. In some cases, the child may have trouble breathing due to paralysis of the diaphragm.

Treatment

Most babies with infant botulism have to go the hospital for a few days, or even a few weeks. During treatment, doctors pay close attention to their nutritional needs, and make sure they are able to breathe properly. The babies usually don't need antibiotics or antitoxins, and most make a complete recovery.

Honey and Infant Botulism

Most honey produced in Canada is not contaminated with the bacteria that can cause infant botulism. Random sampling shows that less than 5 percent of honey produced here contains the bacteria spores. When the spores are found in honey, the numbers are usually low. However, it doesn't take a lot of spores to cause infant botulism in a baby who is less than one year old.

No one can say for sure how honey gets contaminated. One theory is that bees pick up the bacteria spores from dirt, dust or something else in the environment, and bring them to the hive.

Preventing Infant Botulism

The Government, parents and caregivers all have a role to play in preventing infant botulism.

Health Canada's Role

The Botulism Reference Service for Canada, which is part of Health Canada's Food Program, helps investigate suspected outbreaks of botulism in Canada. It also maintains a supply of antitoxin, and analyses bacteria spores and toxins found in clinical and food samples from across the country. Health Canada also does research to try to find out how honey gets contaminated, and continues to track the percentage of contaminated honey through national surveys.

Your Role as a Parent or Caregiver

Parents and caregivers should not give honey to infants who are less than one year old. Even though most honey produced in Canada is not contaminated with the bacteria that causes infant botulism, you are better off playing it safe.

You should never add honey to baby food, or use honey on a soother. If you are looking for a way to quiet a fussy or colicky baby, ask your doctor about some alternative methods.

Contact your doctor if your baby shows any of these symptoms:

• Is too weak to cry or suck as usual
• Does not have bowel movements and has weak muscles
• Has a wobbly head because the neck is weak
• Has weak arms and legs
• Is not able to swallow

Infant botulism in Canada is rare. We can all do our part to keep it that way.

About the Author

www.hc-sc.gc.ca
Health Canada is the Federal department responsible for helping Canadians maintain and improve their health, while respecting individual choices and circumstances.