Solids in the first year /

What's the fuss about honey in the under ones

01 In Brief

Honey is considered by most to be a natural, healthy food but it's a definite no-no for the babies under one because of the risk of infant botulism.

02 What Do I Need To Know?

Honey is considered by most to be a natural, healthy food that can add sweetness to food and contains nutrients such as protein, vitamins and minerals. Darker honeys contain more nutrients than lighter ones.

Although the benefits are undisputed, up to one year of age babies should not be fed raw honey or manufactured foods that are cooked or baked with honey.

Honey can carry Clostridium botulism spores which are not destroyed even with cooking and baking. Up to a year of age a baby's immune system is not mature enough to deal with this normally benign strain of bacteria. Infection can occur from ingesting spores and leads to a rare condition known as infant botulism. The spores then reproduce in the baby's gastro intestinal tract and produce a toxin.  Although most honey is not contaminated even a small numbers of spores can cause infant botulism.

The risk is present in pasteurised and non pasteurised honey. Pasteurisation prolongs the shelf life of honey but the temperature is insufficient to kill the spores.

Infant botulism can also be caused by exposure to contaminated dust, soil and uncooked foods, however honey is the only food that has been associated with infant botulism. As a rule baby food manufacturers do not include honey in their foods for the under ones.

Infant botulism results from the  effects of the toxin on the baby's muscle. The earliest and most common symptom is constipation but it can progress to  flaccid paralysis with weakness of muscles making the baby floppy and other symptoms such as lethargy, poor feeding, weak cry, droopy eyelids, drooling or swallowing problems and rarely breathing problems. Although it is rarely lethal, honey is easy to avoid in an infants diet.

An old practice of dipping dummies into honey should not be practiced.

Why is it ok after 12 months? Children over one year are considered to have sufficient bowel flora or helpful bacteria and acid in their digestive system to deal with the toxins, so while adults and childen can cope with small amounts babies cannot.

Some may suggest that avoiding honey until over one year of age is overly cautious, however since guidelines have been introduced there has been a significant reduction in case reports of infant botulism.

 

03 What Others Say

  • Health Cananda: Infant botulism

Infant botulism

  • Mayo Clinic

How can I protect my baby from infant botulism

04 I Want To Know More

  • BabyBIG Treatment  for infant botulism: website contains extensive information

BabyBIG treatment and infant botulism

The information published here has been reviewed by Flourish Paediatrics and represents the available published literature at the time of review.
The information is not intended to take the place of medical advice.
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Last updated: 09/11/2013 by Dr Liz Hallam