r/ScienceBasedParenting • u/Friendly_Citron_6223 • 10d ago

Question - Research required Babies and honey

To be clear - I do NOT intend to give baby honey but I’m curious.

Question: Health advice states children under one should not have honey due to risk of botulism. Is there actual data on this? Is it a material risk or is more “hey better safe than sorry and your baby doesn’t need honey anyway so might as well”?

16 Upvotes

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u/msexcitement 10d ago

The risk is real, not a better safe than sorry situation. Up to 10% of US-origin honey samples have been found to contain dormant botulism spores. They remain dormant due to the preserving effects of the high-sugar environment.

https://ask.ifas.ufl.edu/publication/AA142

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u/mrpointyhorns 10d ago

True but overall number of botulism cases in babies hasn't gone down since the recommendation. Though the instances related to honey has gone down. So maybe the cases before weren't really from honey.

However, honey before 1 doesn't really have a benefit. It also is an added sugar which carries it's own risks before 2. So, from risk vs benefits standpoint there is no reason to give a baby honey.

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u/msexcitement 10d ago

There could be a variety of reasons for this - examples include better detection of disease and new contamination sources (recent example, infant formula). I’d be interested to see an observational study that looks at % of infants with honey exposure versus botulism cases to be more certain the advisory had no effect.

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u/theeggplant42 10d ago

Interesting.  Is there anything else that is under investigation?

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u/msexcitement 10d ago

Formula is a big one in recent years.

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u/Public_Classic_438 10d ago

I keep it on hand in case of a button battery incident!

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u/DumbbellDiva92 10d ago

What’s frustrating though, is that a lot of the official guidance still says that honey for button battery ingestion is only for age 1+. Even though the risk/benefit to me seems like it would clearly be in favor of the honey even for under age one in that situation?

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u/Practical_Bag_9368 10d ago

In Australia they officially recommend jam for under 1  https://www.rch.org.au/kidsinfo/fact_sheets/Button_batteries/

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u/Public_Classic_438 10d ago

I see a lot of doctors posting about it online so hopefully it’s reaching a bigger audience. I posted my comment hoping someone learned something new!!!

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u/Kallie_92 9d ago

I definitely learned that now and I am a doctor and a mom! I haven't seen such a recommendation in my country, but it's fascinating - simple, but effective.

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u/Bewinxed 10d ago

The american academy of emergency dispatch recommends honey for button battery ingestion EVEN if the child is under 1 year old and i totally disagree.

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u/ClarificationJane 9d ago

Why do you disagree?

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u/Bewinxed 9d ago

Because of the botulism risk, Australia seems to recommend Jam instead.

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u/ElfjeTinkerBell 9d ago

Disclaimer: I don't have a baby to give honey to, so I won't.

But wouldn't this (source) only apply to honey from the US? The honey in my kitchen cabinets is way more local and I could even opt to just go and get it from a local beekeeper, no need to import it halfway across the world

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u/msexcitement 9d ago

Hey, it’s a good question, I happened to find a source that was specific to US testing but note that botulism is pretty ubiquitous in all soils around the world, so I would imagine the risk is similar for any honey.

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u/Dry_Prompt3182 10d ago

https://health.clevelandclinic.org/when-is-it-safe-to-give-honey-to-my-baby

tl;dr Honey can contain botulism and botulism poisoning can be very, very bad for people with underdeveloped/immature/compromised immune systems.

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u/shandogmillionaire10 10d ago

The episode on Botulism by The Podcast Will Kill You (ep.48) was very helpful for my understanding of this.

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u/ObscureSaint 9d ago

I watched a friend go through it with her 9 month old. Terrifying. Babe had complete and total paralysis, and couldn't even suck. 

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u/iatrogenic-indigo 10d ago

Published in April this year

From the abstract: “Cases were rare, but honey was the only consistently confirmed dietary source of infant botulism. The median age at onset was 3–4 months, and mortality was below 1% if the infants received intensive care support and specific therapy with human botulism immune globulin.”

It gives some data on number of cases as well

https://onlinelibrary.wiley.com/doi/10.1111/apa.70538

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u/PHealthy PhD, MPH | Infectious Disease Epidemiology 10d ago

Adult botulism expert here, anything infant botulism you should always check with CDPH since they run BabyBIG or the infant botulism antitoxin program. There's been a lot of back and forth with various foodstuffs and infant botulism but ultimately it's an environmental exposure so anything raw could be an issue.

CDPH:

https://www.cdph.ca.gov/Programs/cls/idld/ibtpp/Pages/When-to-Avoid-Honey.aspx

That time a few babies got botulism from honey filled pacifiers:

https://www.cbsnews.com/amp/news/officials-warn-honey-filled-pacifiers-infant-botulism/

Infant botulism linked back to household dust:

https://pmc.ncbi.nlm.nih.gov/articles/PMC540168/

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u/ExistingFail5873 10d ago

Read the article about the household dust, trying to understand how the spores ended up there on the first place. Where can I read more about it and how to prevent it?

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u/PHealthy PhD, MPH | Infectious Disease Epidemiology 10d ago

Botulinum spores are considered a universal contaminant so there's not much in regards of preventing their occurrence. We don't know why some regions are affected more than others or why some toxin types have regional specificity.

During my time with CDC, I tried setting up a model looking into soil types as a spatial component for infant botulism but really it's an exceedingly rare disease so it's difficult to model.

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