Honey and infant botulism

Recently, the case of a 5-month-old boy suffering from infant botulism in Ivrea has had great resonance. The pathology was diagnosed in Rome, where the family was on vacation for a few days, but the Zooprophylactic Institute confirmed that the infection occurred through the honey administered to the child a few days earlier.

Why is honey so dangerous?

Honey itself is not dangerous or toxic. Being a food of totally natural origin and little treated, there is the possibility that Clostridium botulinum spores are “hidden” inside it . Normally this does not expose to any risk, since the human intestine is able to neutralize the spores and avoid the development of the pathology.

However, this does not happen in children before weaning. It is with weaning that the intestine of newborns ends its development, enriching itself with the microbial flora and enzymes that provide protection to the entire organism.

A child who has not yet been weaned has an intestine which, not being able to kill the spores of C. botulinum, allows them to grow, with the development of botulinum toxin. Typical symptoms are weak crying, flat facial expression, excessive salivation and difficulty swallowing, up to breathing difficulties.

This is the reason why the main reference bodies (European Commission, Ministry of Health, see bibliography) for infant feeding in Italy and in Europe suggest avoiding giving honey at least until the sixth month, therefore until weaning and, for added security, up to one year.

Very rare cases

Fortunately, cases of infant botulism are extremely rare, because the European Union has always shown great attention to food safety, has issued Regulations on the matter (remember that the European Regulations are implemented directly in the member countries, without the need to transpose the standard with an internal law), which are frequently updated. Italy, for its part, boasting a food and wine production that makes it famous all over the world, has further tightened food control procedures .

Obviously, all of this doesn’t apply to our own honey productions. It is common practice to believe that anything “home-made” is better than the industrial equivalent and this is often true, but not in the case of home-made honey and, more generally, home-made preserves. Artisanal preserves do not have strict controls like industrial ones, an oversight, in that case, can be lethal.

However, since the spores can also be undetectable, being extremely small in size, a one-off error in the controls can happen, which is why the guidelines suggest not to use this food in the first months of life.

Furthermore, the pasteurization process of industrial honey does not ensure the complete elimination of botulism spores , as it is a treatment that is done only to keep the honey in a liquid state for longer without crystallisation.

Honey on the pacifier: is it possible?

It is common for parents and grandparents to put a little honey on the baby’s pacifier, or to sweeten a drink, perhaps because the baby has a sore throat, or to give the baby a food containing honey.

Beyond the risk of intoxication, however, it should be emphasized that honey is still a substance made up mostly of sugars.

According to the European Recommendations for feeding infants (see bibliography), sensitivity to flavors in children, and consequently food preferences, are strongly influenced by the frequency of exposure to a particular flavor and this occurs mainly during weaning.

This means that if a child gets used to sweet flavors from an early age, he will grow up with a preference for them over salty. Enriching the diet with foods of different flavours, but also different textures, colours, aromas, gets the little one used to eating everything, without particular preferences.

Furthermore, getting children used to sweet flavors right from weaning, as demonstrated by various studies (see bibliography), predisposes the child to the development of insulin resistance, diabetes and metabolic disorders, as well as obesity and oral problems (e.g. frequent caries) .