What's the Buzz About Honey and Babies All About?
Scroll through any list of "Foods NEVER to Feed Your Baby" and you're bound to come across honey.
We feeding folks advise not feeding honey to babies earlier than 1 year of age because of the risk for infant botulism.
Although incredibly rare, botulism is certainly serious. Symptoms are gory and include constipation, followed by lethargy, listlessness, poor intake, difficulty swallowing, loss of head control, vision problems and generalized weakness. The medical literature often refers to acute "floppiness" following constipation in the baby, and infant botulism can result in coma or death.
What's the Real Risk of Infant Botulism?
But like many things we worry about as parents - the real risk of infant botulism is actually very low. That is, unless the use of honey in infancy is present.
Wild or raw honey is a potential source of Clostridium botulinum (C botulinum) spores. Bacteria from the spores can grow and multiply in the GI tract of a baby, producing a dangerous - and deadly - toxin.
Data from the Centers for Disease Control and Prevention (CDC) National Botulism Surveillance from 2014 (the last year for which data are available) show 128 cases of infant botulism in the US from 27 states and the District of Columbia, with no deaths reported.
Preventing Infant Botulism
Although the CDC does not report the likely source of the 128 infant botulism cases, they acknowledge that total prevention is not possible, stating, "Most infant botulism cases cannot be prevented because the bacteria that causes this disease is in soil and dust. The bacteria can be found inside homes on floors, carpet, and countertops even after cleaning."
But, when it comes to honey, the CDC and American Academy of Pediatrics (AAP) maintain that children younger than 12 months should not be fed honey - but, that honey is safe for people 1 year of age and older.
Who Feeds Babies Honey?
Most parents are aware of the recommendation to avoid honey in infants under age one because of potential botulism risk.
As mentioned above, the side effects are serious - but the American Academy of Pediatrics (AAP) states “Most children recover fully from botulism, although it can take several weeks to months” and reminds parents that infant botulism can be fatal.
So when might a baby encounter honey?
There are some alternative medicine practitioners who recommend honey as a cough suppressant or in place of cough syrup. Cough syrup - even those formulated for children - are not appropriate for young children or infants. In place, some parents often consider offering honey or honey-based teas for cough relief in babies. Honey should not be given to babies in any form whether they are sick or not.
Some cultures also include honey with either pacifiers dipped in honey or in teas, tinctures or other foods as part of their weaning food culture - so in these environments babies may be exposed to honey.
...but What About Baked Goods?
So most parents get it: don't feed raw or wild honey to your baby.
But what about baked goods that contain honey?
Well, the jury is out on this one. The AAP and CDC both conveniently don't address baked goods in their formal statements.
There are bloggers and other pseudo-experts who warn against honey in baked goods - although without scientific literature to back up such a stance.
To be fair...most baked goods that would contain honey probably aren't appropriate or necessary to feed to babies under one year old anyway.
But will a bite do any harm? Hard to say.
As with many other (obnoxious) uncertainties in the realm of nutrition, the best advice is probably, "When in doubt...leave it out."
...and How About Honey-Nut Cheerios?
While we're talking about honey in baked goods, it makes sense to bring up Honey Nut Cheerios.
As previously mentioned, babies shouldn't be having much food in the way of a sugar-sweetened cereal like Honey Nut Cheerios to begin with.
But let's say they do...the honey here is really not of concern.
Regarding infant botulism risk, a spokesperson I talked to from General Mills relayed the official statement from the folks who manufacture Honey Nut Cheerios, stating,
"The honey in the General Mills products does not pose a food safety risk. The concern for botulism in honey pertains to raw honey only. The honey that is used in our products is cooked during the product manufacturing process."
A Better Cereal Bargain
Even though Honey Nut Cheerios may be safe on the honey front, they're not ideal for babies given the high sugar content.
A full serving of Honey Nuts (3/4 cup) has 9 grams of sugar...and that's 8 grams more (or 2 packets of sugar more) than you will find in the original yellow box of regular Cheerios.
The yellow box is a better bet for babies because it contains more iron, less added sugar (…and no honey) as well as more whole grain per serving than Honey Nuts.
And another cool thing about Cheerios: they're designed to dissolve in a baby's mouth. So once your kiddo gets that pincer grasp thing going on, Cheerios are a safe first food as well (...and way more practical, affordable and nutritious than "puffs" I might add!)
Other Causes of Botulism Besides Honey
But don't get down on honey all by itself. Other foods like dented canned foods or improperly home-canned goods can also cause botulism.
And in an odd twist to the botulism news feed, deer antler tea was found to responsible for two fatal cases of botulism in Los Angeles county recently….
Honey in the News Update
Since the publishing of this original article, the FDA has issued a Safety Alert regarding Honey Pacifiers suspected in 4 infant deaths in Texas. You can read the alert here.