The condition can be serious, but it's rare and treatable
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Infant botulism is a rare but treatable neurological condition caused by Clostridium botulinum spores growing inside a babys intestines.
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A nationwide ByHeart infant formula recall in November 2025 drew new public attention to the condition; the FDA continues to investigate.
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Despite recent headlines, infant botulism remains extremely uncommon, and with prompt treatment, survival rates range from 98100%, according to experts at Childrens Hospital Los Angeles (CHLA).
Infant botulism a condition many parents had never heard of until late 2025 has recently come under intense scrutiny. In November, the infant formula manufacturer ByHeart voluntarily recalled all formula products after a link to infant botulism was identified. The U.S. Food and Drug Administration (FDA) is continuing to investigate the incident, which marks the first time a U.S. formula product has been associated with infant botulism.
While the news has heightened concern among parents and caregivers, medical experts stress that infant formula in the U.S. is typically very safe, held to strict FDA manufacturing standards. And importantly, infant botulism itself is both rare and highly treatable.
Infant botulism is fortunately quite rare, and its treatable with a highly effective antidote, said Dr. Colleen Kraft, pediatrician at Childrens Hospital Los Angeles. Most babies recover fully with timely care.
Below is a breakdown of what infant botulism is, how contamination can occur, and what parents should watch for, featuring insights from CHLA specialists Dr. Kraft, Dr. Leigh Maria Ramos-Platt, neurologist, and Dr. Eni Jano, neonatologist.
What is infant botulism?
Infant botulism occurs when Clostridium botulinum spores enter a babys digestive system and begin producing a toxin that interferes with nerve function and muscle control. Babies under one year old are vulnerable because their gastrointestinal tracts are still developing.
Babies gastrointestinal tracts are not mature, and they don't have the natural bacterial flora that older children and adults have, explains Dr. Ramos-Platt. This is why ingesting even a few spores can cause the bacteria to colonize and grow in their gut.
About 95% of cases occur in infants younger than six months.
Where do these spores come from?
Infant botulism has several possible sources:
Honey: Honey is the most widely known risk. Babies under 12 months should never consume it.
Food or Formula: Very rarely, contamination can occur during improper handling, manufacturing, or storage. The ByHeart recall falls into this category, though such incidents are extraordinarily uncommon.
Soil and Dust: Certain areas of the U.S., including California, western states, and parts of the Northeast, naturally harbor more C. botulinum spores in the soil. Construction, excavation, and other activities that stir up dirt can release spores into the air.
There are only a few places in the U.S. we consider hotspots, said. Ramos-Platt. Doctors trained in California, for example, tend to have the most experience with infant botulism because it's endemic in our soil.
Symptoms: What parents should look for
Infant botulism is rare and can be hard to recognize. Some doctors may see only one case in their entire career.
Common symptoms include:
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Constipation
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Poor feeding (difficulty suckling or swallowing)
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Weak or muffled cry
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Progressive muscle weakness, often starting in the face
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Drooping eyelids
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Reduced facial expressions
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Floppy arms and legs
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Poor head control
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Pupils that respond slowly to light
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Telltale signs for us are growing muscle weakness, constipation, and slow-to-respond pupils, said Ramos-Platt. There are very few things it can be besides infant botulism when seeing this combination of symptoms.
Symptoms can appear days to weeks after exposure.
What to do if you suspect infant botulism
Infant botulism is a medical emergency:
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If your child shows symptomsespecially muscle weaknessgo to an emergency department, preferably one specializing in pediatrics.
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If your baby is not symptomatic but may have been exposed, contact your pediatrician for guidance.
How doctors diagnose the condition
A pediatric teamoften including neurologists and neonatologistswill examine the infant and may order tests such as:
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EEG (monitoring brain activity)
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EMG (measuring nerve and muscle response)
If botulism is suspected, doctors can perform stool or blood tests, though stool testingwhich is most accuratecan take up to a week. Crucially, treatment can begin immediately, even before test results return.
Infant botulism has a remarkably high recovery rate. Treatment centers on Botulinum Immune Globulin, known as BabyBIG, an antitoxin administered intravenously.
Posted: 2025-12-02 12:34:24















