Overview, Causes, & Risk Factors
Botulism is a condition caused by a toxin made by bacteria
called Clostridium botulinum. This toxin triggers sudden,
and paralysis. Infant botulism is usually seen in babies younger than
6 months old.
What is going on in the body?
In adults, botulism occurs only after eating foods that contain
the full-blown toxin.
In infants, tiny spores from the bacteria that would not be harmful to
an adult can grow in the baby's gut.
Once there, they mature and release toxins.
These toxins enter the bloodstream and are carried to the
ends of the nerves that control muscles. They block the release of a
chemical called acetylcholine that transmits signals from nerves to
muscles. If this chemical is not released at the right time, the muscle
cannot contract. This causes muscle weakness
The diaphragm is a strong layer of muscle below the lungs.
If nerves in the diaphragm are blocked, the baby will not be able to breathe.
If untreated, this can cause death.
What are the causes and risks of the infection?
The Clostridium botulinum bacteria makes one of the most
poisonous substances known to man. Just a small amount of the
toxin it produces can be fatal. Some sources of the bacteria and its
honey, which should never be fed to babies younger than age 12 months
soil, which can infect a wound
canned or home-preserved foods that were not cooked enough to
destroy the spores
Symptoms & Signs
What are the signs and symptoms of the infection?
Usually, symptoms start 12 to 36 hours after the bacteria
spores enter the body. It can take just a few hours, though, or as long
as a week. The symptoms include:
as muscles in the gut stop working properly
fewer movements of the arms and legs
loss of head control
a weak cry
loss of the gag reflex and other nervous system problems
of the muscles of the body
respiratory failure, which is the inability to breathe
Diagnosis & Tests
How is the infection diagnosed?
Diagnosis includes a thorough exam by a doctor.
The diagnosis can be made based on the infant's signs and symptoms .
Be sure to tell the doctor about any possible exposures.
Tests to confirm the diagnosis include the following:
a stool sample to check for the bacteria
testing of the food that may have caused the botulism
also called an EMG, which may show signs of abnormal muscle function. An
EMG is a study of how the muscles respond to electrical stimulation.
Prevention & Expectations
What can be done to prevent the infection?
To keep babies safe, follow these steps.
Never give honey to an infant under age 1in a bottle, on a nipple, or in
any other way.
Do not allow soil or dirt to get into the belly button before the
cord stub falls off at around 2 weeks of age.
Handle food carefully and make sure it is fully cooked.
Never eat canned goods if the can is swollen or the
safety button on the lid has popped up before the lid was opened. Food
safety cannot be judged by appearance. Food may not taste or look
spoiled even if the toxin is present.
Botulinum spores are heat-resistant. Although the toxin may be destroyed by heat,
by boiling foods for 10 minutes or heating at 176 degrees to
212 degrees Fahrenheit for 30 minutes before eating, only high
temperatures obtained in a pressure cooker can destroy bacterial
spores in food. All low-acid foods must be canned in a pressure canner
at 240 degrees Fahrenheit (or 115.6 degrees Celsius) to destroy botulism spores.
Commercially canned foods are rarely responsible for
botulism. But when sealed foods are not processed at high enough
temperatures to kill the organism, the toxin and spores can thrive in
the sealed container. The bacteria do not need oxygen to survive.
What are the long-term effects of the infection?
When botulism is not treated, the death rate is very high.
In recent years, it has decreased among adults due to the development
of an antitoxin.
If a baby survives the first few days after botulism has been
diagnosed and treated, recovery is usually complete. If serious respiratory
paralysis occurs, this condition may be fatal.
What are the risks to others?
This illness does not spread from one person to another.
However, tainted food or soil may affect anyone who comes into contact
Treatment & Monitoring
What are the treatments for the infection?
Treatment of infant botulism includes:
supportive measures, such as bed rest, fluids given through a vein,
comforting the infant and family
which may be used to clear out the spores in the intestinal tract
penicillin to kill the bacteria in the gut
or artificial breathing machine
It is not clear whether antitoxin can help in infant botulism.
What are the side effects of the treatments?
Side effects vary depending on the treatment used.
Penicillin can cause stomach upset and allergic reactions.
Before the botulism antitoxin is given, a doctor may order a
skin test to make sure the baby does not have an allergy to the antitoxin.
What happens after treatment for the infection?
Once a baby has been treated and symptoms have
gone away, no further treatment is needed. If a baby survives the first
few days of botulism, it may take months for symptoms to subside. Recovery
is usually complete. If necessary, physical therapy
or occupational therapy
may help a baby recover muscle function.
How is the infection monitored?
A doctor may monitor the baby closely over
the first few months while symptoms of botulism disappear. The
baby's ability to breathe properly and muscle control will be watched closely.
Any new or worsening symptoms should always be reported to the doctor.