Infant botulism is a rare, potentially serious illness that occurs when a baby’s intestines are colonized by Clostridium botulinum and a toxin is produced there. It most commonly affects babies under about 6 months, though cases can occur up to a year old. The condition is not caused by eating pre- formed toxin in food; rather, the botulinum spores contaminate the gut, germinate, and release toxin inside the infant. Key points:

• Causes: Ingested spores of Clostridium botulinum found in soil, dust, and certain foods (most notably honey). In healthy adults, mature gut bacteria usually prevent toxin production, but in some infants the gut environment allows spore germination and toxin formation.

• Symptoms: Early signs often include constipation, followed by poor feeding, weak cry, diminished facial expressions, drooping eyelids, “floppy” or weak muscle tone, feeding difficulties, and reduced movement. In severe cases, breathing problems and paralysis can occur. Symptoms can appear within days to months after exposure and require prompt medical assessment.

• Diagnosis: Based on clinical presentation and may be supported by stool testing for toxin or bacteria, blood tests, and sometimes EMG studies. A careful history (including potential honey exposure) helps.

• Treatment: Medical care in a hospital, often in a pediatric intensive care unit. Supportive care is critical, and in some cases antitoxin therapy is used to neutralize circulating toxin if started early. Recovery can take weeks to months, and most infants recover with appropriate care.

• Prevention: Do not feed honey or honey-containing products to children under one year old, and follow general hygiene measures to minimize exposure to environmental spores.

If you or someone you know is caring for an infant and notices constipation, poor feeding, weak cry, unusually floppy movement, trouble breathing, or reduced alertness, seek urgent medical attention. Early evaluation and management are important for the best outcome.