Infants under a year old should never be given honey. Parents sometimes assume this recommendation is to prevent an allergic reaction, but the real danger in honey comes from the highly toxic spore-forming bacteria, Clostridium botulinum. These bacteria are often found in soil and dust, which can contaminate wild honey. Once a child has reached 1 year, his digestive system has matured enough to destroy the bacteria, but before that age, exposure to botulinum spores can cause a variety of serious symptoms.
Symptoms of infant botulism, the illness that results when a baby consumes botulinum spores, can often be misdiagnosed because they begin mildly and may take weeks after the baby's exposure to honey to appear. A baby may start showing signs of the disease within 18 to 36 hours, but the bacteria can incubate for up to 30 days. Typically, the first symptom to develop is constipation, but since this is a common infant problem with many different causes, parents may not connect it to their baby's honey exposure at first.
If infant botulism isn't treated immediately, the baby will gradually weaken. Flat facial expressions will replace her smiles and laughs. Her cries will weaken, she will become listless and she will spend less time moving around and playing. Both her appetite and sucking reflux will diminish. If she is breastfeeding, this may result in her mom becoming painfully engorged. With milder cases of infant botulism, babies may recover after only exhibiting some of these more moderate symptoms.
In more severe cases of infant botulism, the symptoms worsen as the disease progresses. A severely infected baby may begin drooling excessively because of difficulty swallowing. His muscle weakness will grow more severe, including developing a floppy head and losing previously acquired head control. His gag and sucking reflexes will continue to decline. He may develop breathing problems -- either slowly or suddenly -- because of paralysis of his diaphragm. At this point, he may require hospitalization, with tube feedings and mechanical ventilation, in order to recover.
Ultimately, if infant botulism is left untreated the result may be death. According to pediatrician Dr. Alan Greene, fewer than 1 percent of babies hospitalized with infant botulism die from the disease. With proper treatment, most babies will recover completely. Failure to accurately diagnose infant botulism, however, may result in crib death. A 2008 study in "Pediatrics" points out that the age span for SIDS and infant botulism is identical: both affect infants in their first year and cases peak around 3 to 4 months of age. Since Clostridium botulinum spores have been found in the intestinal tract of some babies who died from SIDS, researchers speculate that infant botulism may be behind some unexplained infant deaths.