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What Is Infant Botulism?

Infant botulism is an illness that can happen when a baby ingests (takes in) toxins from a type of bacteria. Babies with infant botulism (BAH-chuh-liz-im) can have muscle weakness, a weak cry, and trouble breathing. They need to be treated in a hospital. With early diagnosis and proper medical care, a baby should fully recover from the illness.

What Causes Infant Botulism?

Infant botulism is caused by a toxin (a poison) from Clostridium botulinum bacteria, which live in soil and dust. The bacteria can get on surfaces like carpets and floors and also can contaminate honey. That's why babies younger than 1 year old should never be given honey or any processed foods that contain honey (like honey graham crackers).

These bacteria are harmless to older kids and adults. Their mature digestive systems can move the toxins through the body before they cause harm.

Infant botulism usually affects babies who are younger than 6 months old. But all babies are at risk for it until their first birthday.

What Are the Signs & Symptoms of Infant Botulism?

Babies with infant botulism might have:

  • constipation (often the first sign that parents notice)
  • weak facial muscles that makes their face look "flat"
  • a weak cry
  • weak muscles in the arms, legs, and neck, leading to floppiness
  • breathing problems
  • trouble swallowing with a lot of drooling

They also might not feed well or move as much as usual.

How Is Infant Botulism Diagnosed?

Doctors diagnose infant botulism by asking about the baby's symptoms. They'll do an exam, and might order tests to look for the toxin and to see how the baby's muscles are working.

How Is Infant Botulism Treated?

Babies with infant botulism need care in a hospital, usually in the intensive care unit (ICU). The health care team will try to limit the problems the toxin causes in the baby's body.

Doctors treat infant botulism with an antitoxin called botulism immune globulin intravenous (BIGIV). They give this to babies as soon as possible if they suspect botulism. Babies with botulism who get BIGIV early recover sooner and spend less time in the hospital than babies who don't.

If the toxin affects the breathing muscles, a baby might need to use a breathing machine (ventilator) for a few weeks until they get stronger. It also can affect the swallowing muscles, so babies usually need intravenous (IV) fluids or feedings through a tube to get nourishment.

Can Infant Botulism Be Prevented?

Experts don't know why some infants get botulism while others don't.

One way to reduce the risk of botulism is to not give infants honey or any processed foods with honey before their first birthday. Honey is a proven source of the bacteria. Light and dark corn syrups also might contain botulism-causing bacteria, but a link hasn't been proved. Check with your doctor before giving these syrups to a baby.

If you have questions about other products to avoid, ask your doctor.

Medically reviewed by: Larissa Hirsch, MD
Date reviewed: March 2023