Botulism is a disease caused by the bacteria Clostridium botulinum. This bacterium produces a substance called botulinum toxin, which works at the cellular level, causing muscle paralysis. As it turns out, botulinum toxin isn’t all bad, and when limited quantities are injected into targeted areas, it can actually be quite helpful.
Botulinum toxin is the active ingredient in Botox, which not only erases facial wrinkles but also controls debilitating muscle spasms in conditions such as cerebral palsy. But when large amounts of botulinum toxin circulate unchecked throughout the body, bad things happen.
How Does My Baby Get Botulism from Homemade Baby Food?
Clostridium botulinum lives in the soil; so, high-risk foods include potatoes, carrots, beets, squash, spinach, and green beans. The bacteria exist in two forms: active bacteria (which make the botulinum toxin) and spores (an inactive form surrounded by a tough shell). Boiling food for 10 minutes will usually kill active bacteria and destroy toxins, but it will not eliminate the spores.
The spores present a couple of problems.
If high-risk foods are improperly canned, active bacteria may emerge from the spores and start making toxins. The toxins accumulate within the food and pose a serious danger to anyone who eats it, regardless of their age.
The other problem with spores occurs when they are eaten. While spores usually pass safely through the intestinal tract and exit the body in stool, there is a rare possibility that active bacteria will emerge from the spore and begin producing toxins while still inside the intestine. Infants under 12 months of age and anyone with a compromised immune system are most prone. When this happens, the toxin slowly accumulates and is eventually distributed throughout the body.
What Symptoms are Associated with Botulism?
In the case of improperly canned food, symptoms are swift and severe. Within 12 to 48 hours, blurry vision, droopy eyelids, and a dry mouth progress to difficulty swallowing and speaking. Muscles of the arms and legs become paralyzed, and breathing becomes difficult. Without rapid diagnosis and intervention, death occurs.
In the case of botulism from ingested spores, the build-up of toxin is slow, and the first symptoms are mild. You may not notice them immediately. Babies may initially demonstrate a weakened cry, diminished facial expression, slow feeding, and/or constipation. Then, as toxin accumulates over days and weeks, paralysis, floppiness, and respiratory difficulty settle in. Without intervention, death is likely.
How Common Is This?
Botulism directly linked to homemade baby food is rare. But this is because the food is usually gone by the time the disease is diagnosed. Remember, toxins accumulate slowly in the intestine. By the time symptoms develop, the food source is typically not available for testing.
What About Honey?
While out collecting pollen, bees pick up botulinum spores and transport them to the hive. This means honey often contains large numbers of spores. Ingested spores usually pass safely out of the body in stool, but they remain a risk for babies under 12 months of age (and anyone with a compromised immune system). Unlike homemade baby food, when honey is the source of botulism, the source is typically discovered because the honey jar remains on your kitchen shelf for a long period of time!
What is a Parent to Do?
Never feed honey to a baby younger than 12 months of age.
Because canning food at home is risky, it’s important to follow all canning instructions perfectly. To increase safety, boil canned food for 10 minutes before serving, throw out any food that appears spoiled, and discard any containers that are bulging because this may be a sign of gas produced by Clostridium botulinum.
At the end of the day, fresh is best. However, even fresh food can contain botulism bacteria and spores. High-risk fresh foods should also be boiled for 10 minutes, and parents should always be alert for those early symptoms of botulism.
Dr. Mike Patrick is an Assistant Professor of Pediatrics at the Ohio State University College of Medicine and Medical Director of Interactive Media for Nationwide Children's Hospital. Since 2006, he has hosted the award-winning PediaCast, a pediatric podcast for parents. Dr. Mike also produces a national podcast for healthcare providers—PediaCast CME, which explores general pediatric and faculty development topics and offers free AMA PRA Category 1 Credit™ to listeners.
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