Infant Botulism: Frequently Asked Questions

Infant botulism is treated with meticulous supportive care with special attention to feeding and breathing needs. In the United States the orphan drug BabyBIG® is also used to shorten hospital stay and reduce complications.

Infant botulism is the infectious (intestinal) form of botulism, which results when swallowed spores of a particular bacterium (Clostridium botulinum) colonize the baby's large intestine and produce botulinum toxin in it. Botulinum toxin causes weakness and loss of muscle tone because it blocks the nerve ending's ability to signal the linked muscle to contract. ...

Honey should never be given to infants under the age of 1 year old. Honey, and other raw agricultural products, may contain a small number of spores called Clostridium botulinum. These are the same organisms that cause botulism. The spores don't thrive in the intestines of adults and older children. In the young stomachs of infants, the spores are able to grow, possibly causing a serious form of food poisoning known as infant botulism. For older children and adults, honey is unquestionably safe.

The only known prevention measure for infant botulism is to avoid feeding honey to infants 12 months of age or less. Breastfeeding may slow the onset of illness if it develops.

A baby contracts ("gets") infant botulism by swallowing the botulism spores at a moment in time when the baby's large intestine is vulnerable to spore germination and toxin production. Medical science does not yet understand all the factors that make a baby susceptible to botulism spore germination. Honey is the one identified and avoidable source of botulinum spores. ...

In the absence of serious hospital-acquired complications, no. The prognosis for infant botulism patients is for full and complete recovery. Recovery results from regrowth of the nerve endings that then are able to signal the muscles to contract. Botulinum toxin does not penetrate into the brain, and so infant botulism patients retain all the intelligence, athletic ability, musical ability, sense of humor and orneriness with which they were born.

In infant botulism the swallowed botulism spores activate and produce botulinum toxin inside the baby's large intestine. In foodborne botulism the botulism spores activate in the food and produce botulinum toxin. Older children and adults get foodborne botulism by eating the food in which the botulism bacteria have produced botulinum toxin in the food.

There are two ways to do this: 1) call the IBTPP collect and ask for assistance, or 2) go to the Parents' Forum on this website and follow the instructions there.

The Infant Botulism Laboratory (IBL) is part of the Infant Botulism Treatment and Prevention Program and is administratively separate from the MDL. Specimens from suspected cases of foodborne or wound botulism need to be submitted to the MDL for testing. Please contact your local public health laboratory to make arrangements for MDL testing of suspected cases of foodborne or wound botulism.

Please send all diagnostic stool specimens from California patients directly to the IBTPP laboratory at CDHS (please see laboratory information pages). Please note that a laboratory analysis will be conducted only on those specimens that have received prior authorization for testing by an IBTPP physician. Do not submit "unannounced" specimens as they will not be tested. Thank you.