A rare but serious illness, infant botulism, has become a growing concern for some parents and caregivers across the country. Recognizing the signs of botulism in babies is key to keeping your child safe and ensuring they receive prompt medical care when needed.
This article explains the botulism signs or symptoms in babies you should watch for and what steps to take if you are concerned about your child’s health.
What is Infant Botulism?
Infant botulism is rare, but it is a serious illness that can affect babies, typically under 12 months of age. It happens when an infant ingests spores from a bacterium called Clostridium botulinum, which are present in the environment and some foods.
Once inside a baby’s immature digestive system, the spores can germinate and produce the powerful botulinum toxin. This toxin attacks the body’s nerves, leading to muscle weakness and potential breathing difficulties.
Unlike foodborne botulism, where a person ingests the pre-formed toxin, infant botulism occurs when the toxin is produced inside the baby’s intestines.
Understanding the Recent Formula Recall: Why Infant Botulism Awareness Matters
In November 2025, the U.S. Food and Drug Administration (FDA) issued a recall of certain powdered infant formulas due to a multistate outbreak of infant botulism.
While this recall has heightened public concern, it is important for parents and caregivers to understand that infant botulism can arise from several sources — not just formula.
The recent recall is a reminder to stay alert. Knowing the broader causes, symptoms and prevention strategies for infant botulism is crucial for protecting your baby’s health.
How Do Infants Get Botulism?
An infant’s gut is not yet fully developed, making them vulnerable to Clostridium botulinum spores that would not harm older children and adults.
Common sources of these spores include:
- Contaminated food: Powdered infant formula can become contaminated with spores, as seen in the current recall.
- Honey: Honey is a well-known risk for babies under one year old because it can contain C. botulinum spores.
Environmental exposure: The spores are naturally present in soil and dust. An infant might ingest them through contact with contaminated surfaces or by breathing in dust.
Botulism Symptoms in Babies
The signs of infant botulism can develop slowly, appearing anywhere from three to 30 days after ingestion of the spores. The symptoms often start subtly and can be mistaken for other common infant issues. It is crucial to recognize the early signs.
Key symptoms to watch for include:
- Constipation: This is often one of the very first signs to appear.
- Poor feeding: The baby may have a weak suck, tire easily during feedings, or take in less milk or formula than usual.
- Weakness and floppiness: Look for a loss of head control, “floppy” movements or reduced muscle tone.
- Altered cry: The baby’s cry might sound weaker or different than normal.
- Decreased facial expression: The infant may appear less expressive or have a “flat” look.
- Difficulty swallowing: This can lead to excessive drooling.
As the illness progresses, more severe symptoms like muscle paralysis and difficulty breathing can occur. Botulism can be fatal if not treated, so early medical intervention is critical.
Diagnosis and Treatment of Infant Botulism
Infant botulism is diagnosed in the following ways:
- Diagnosis starts with a clinical exam: Doctors look for symptoms like muscle weakness, poor feeding and reduced movement.
- Lab testing: A stool test can confirm the presence of botulinum toxin, but doctors do not wait for results before starting treatment if botulism is strongly suspected.
- Immediate treatment is critical: If symptoms point to botulism, doctors begin therapy right away.
Treatment includes:
- Botulism Immune Globulin (BabyBIG®): The BabyBIG® antitoxin is given through an IV to neutralize the toxin in the bloodstream.
- Supportive hospital care: Babies may need to stay in an intensive care unit (ICU) for close monitoring.
- Respiratory support (like a breathing machine) if breathing becomes difficult
- Help with feeding, often using a feeding tube
With prompt treatment and expert care, most infants recover fully from infant botulism.
What to Do If You Think Your Baby Has Botulism
If you think your baby has botulism and is showing any of the symptoms mentioned above, take these steps immediately:
- Seek medical care: Call your pediatrician right away or go to the nearest emergency department.
- Communicate clearly: Inform the medical staff about your concerns regarding botulism, especially if you think the botulism was consumed.
Advocate for your child: Ask the healthcare provider to contact the Infant Botulism Treatment and Prevention Program (IBTPP) for expert consultation, which is available 24/7.
Protecting Your Baby
The recent outbreak is a serious reminder for all parents to be vigilant. Here are key actions you can take:
- Avoid honey: Never give honey to a child under 12 months of age.
- Practice good hygiene: Thoroughly wash and sanitize all feeding equipment, such as bottles and nipples.
- Monitor your baby: If your infant consumed the recalled formula, for instance, watch them closely for several weeks for any developing symptoms.
Knowing the signs of infant botulism and acting quickly can make all the difference. While the illness is rare, awareness and swift action are your best tools for keeping your baby safe.
