Honey and Infant Botulism

Introduction

Honey has been enjoyed for its natural sweetness for a long time, but did you know that it is not safe for consumption by infants under 12 months old? Let’s learn more about why honey is risky for infants, what to look out for and how to prevent the risk

How does honey cause infant botulism?

Studies have shown that honey may be contaminated with spores of Clostridium botulinum. The spores of this bacteria can persist in honey when it becomes contaminated through the hive, dust, water, or pollen from the environment. When the conditions become favourable, the spores can “wake up” and grow into new bacteria.

The spores of C.botulinum can germinate and grow in an infant’s gut when infants consume honey. This can produce harmful toxin known as botulinum toxin. Infants are more vulnerable to this condition as their digestive system is still developing. In contrast, older children and adults have more developed digestive systems that can digest the bacteria in honey. A breastfeeding mother who eats honey will also not transmit the botulism spores to her child.

Symptoms of infant botulism may range from mild to severe. Early signs include constipation, loss of appetite, weakness, tiredness, weak cry, poor feeding, and dry mouth. In severe conditions, infant botulism may cause breathing problems.

How can we prevent Infant Botulism?

The Singapore Food Agency (SFA) ensures food safety through monitoring and testing for chemical or microbiological contaminants in food, including honey. Honey that are found with C.botulinum are not allowed for sale in Singapore. While SFA has safeguards in place, food safety is a joint responsibility. The industry and consumers can play their part to ensure food safety.

Importers and retailers must ensure that the honey they sell are obtained from SFA-approved sources. They should also check with the manufacturer that the source of honey is not contaminated and is properly stored and handled.

Parents or caregivers of infants can also take precautionary measures to prevent your child from the risk of infant botulism. Here are some tips:

• Do not give infants less than one year old any type of honey or honey products eg. honey in cakes, as they can potentially contain C.botulinum spores. 

• Parents and caregivers are advised to carefully review the product labels and consult with their pediatrician to ensure the product is suitable for their child’s age and needs.

• Do not add honey to infant food, water, formula, or soothers.

• Always check whether a dish contains honey before feeding it to an infant at food retail establishments.

• Avoid potential cross-contact of honey and other foods when preparing infant meals.

• Seek immediate medical attention if you suspect your child to be exposed to botulism spores or shows symptoms of infant botulism.

References

• Information on Botulism by the World Health Organisation is available here.
  
  
• Malcolm T. Sanford, Eddie Atkinson, Jeanette Klopchin, and Jamie R., 2019. “Infant Botulism and Honey”. ENY-128. The Entomology and Nematology Department, University of Florida, Institute of Food and Agricultural Science.
  
  
• Keith R. Schneider, Renée M. Goodrich Schneider, Ploy Kurdmongkoltham, and Bertoldi., 2017. “Preventing Foodborne Illness: Clostridium botulinum”. FSHN0406. The Food Science and Human Nutrition Department, University of Florida, Institute of Food and Agricultural Science. 

About the author

Soon Fang Min is a Scientist from the Risk Assessment and Communications Department of the National Centre for Food Science. She has attained a Bachelor of Science with Honours in Food Science and Technology from the National University of Singapore.