Monday Health & Wellness: Is Honey Really Bad for Babies?

honey edit

Everyone knows babies under a year old shouldn’t eat honey, right?

But — is it true? Where does that recommendation come from?  What does the science show?  At what point is it truly safe to feed babies honey?

I can never just accept what others believe as fact.  I have to do some digging myself to find out what the evidence actually shows.  So let’s dive in and take a look at the honey recommendations.

Why Skip the Honey?

The mainstream tells you to skip the honey because it can contain botulism spores, which an immature gut can’t handle (it could make the baby really sick), but an adult can handle.  Okay, babies do have immature guts — that part’s legit.  But what about the claims that botulism is found in honey or that an adult wouldn’t get sick from it?  What about the idea that one year is the cut off point where infants can handle the botulism? Where did those claims come from, and are they true?

There are no other reasons to skip honey, by the way.  It’s not a choking hazard, it’s not too sweet (obviously it’s sweet and should be used in moderation by everyone), there’s not something magical about it that makes it dangerous.  It’s the botulism concerns alone that drove the recommendation to avoid honey in babies under one year.

Where Did the Botulism Concern Come From?

Botulism is caused by the bacteria clostridium botulinum.  In adults and older children, the bacteria itself is harmless, but when it grows (usually in protein-rich spoiled food, like improperly canned meats) it produces a toxin that can be lethal even in small doses.  In infants, however, the bacteria itself can lodge in the immature gut and can produce the toxin, making the baby sick.

Clostridium botulinum is an anaerobe and is found commonly in dust, dirt, and on produce (from the dirt).  “Anaerobe” means that it doesn’t grow well in the presence of oxygen.

Honey is a thick, viscous liquid where the spores can reside, but not grow (not protein-rich).  Back in 1976, a few infants got sick with infant botulism, and it was ultimately traced back to honey in about half of the cases.  In a 1979 study, 9 out of 90 honey samples (all commercial) were found to contain low levels of botulism spores.  Only one of the 9 samples contained higher levels, more easily detectable.

It is important to note that infant botulism from honey was never noted prior to 1976, and in European countries, wasn’t reported until the early 90s.  Even then, there is an average of about 1 case per year in Europe, while the U.S. sees about 75 cases annually (U.S. data includes all cases of infant botulism; perhaps 20 or fewer are due to honey).  Most cases occur in babies around 3 months old, but have been reported from about 1 week to 14 months of age.

Interestingly, most cases occur in babies born to fairly wealthy, well-educated white mothers who are otherwise healthy and are likely to be breastfed.  In the majority of cases, the source of infection is unclear.

What changed in 1976 that led to botulism being present in honey?  This study explains that honey is highly likely to be contaminated by pesticides, herbicides, heavy metals, antibiotics, and more.  Unlike other foods, honey is not regulated very well and has no legal limit set on contaminants, including antibiotics.  The lower quality of honey may have led to the presence of the botulism spores.  A lot of honey is imported, too, and isn’t really pure honey.  It’s been filtered (honey is supposed to retain some of the pollen; that’s where its beneficial effects come from) and in some cases, adulterated.

Ultimately, the thought is that honey can become contaminated from dust and dirt which contain botulinum spores and this is how it gets to the babies.

Is It Really Dangerous?

The samples in the study cited above (where 9/90 samples were contaminated) largely contained tiny amounts of the spores.  Another study notes that about 10% of all honey contains botulinum spores prior to being brought into a home (where it could get contaminated due to use, such as from unwashed utensils).

On the other hand, the same study notes that about 65% of infant botulism cases are not related to honey.  Some sources note that corn syrup may also be contaminated.

The vast majority of infant botulism cases occur in babies who are 6 weeks to 6 months of age, although they have been reported rarely up to one year.  (Interestingly, another risk factor for infant botulism is having fewer than one bowel movement a day for a period greater than two months — this can suggest disturbed gut flora and greater susceptibility to the clostridium botulinum spores.  No, it is not normal for babies, even exclusively breastfed babies, to have infrequent bowel movements.)

Raw honey is known to have many benefits, as well.  One study shows that it is an effective antibiotic against staph bacteria, e. coli, and others.  Others note its effectiveness as a wound dressing or to treat burns.  Still others have had benefits from reduced allergy symptoms, improved cold/cough symptoms, and more.

Should Babies Get Honey?

Babies under 6 months should not get honey.  Their immature digestive tracts make it so that honey could be dangerous to them, if they were to receive one of the 10% of contaminated samples.

With babies over 6 months, I believe it is a judgment call.  If they are eating solids and need honey medicinally, a small amount from a trusted farmer may outweigh the potential danger.  The older a baby is and the more established his/her gut flora, the less dangerous it is.

Be aware of where you are purchasing your honey.  Don’t offer it to a baby as “food” due to the high sugar content, but a tiny amount in a 10-month-old to calm a cough and help the baby rest may be worth it.

The point here isn’t to tell you what you should do — if you feel safer avoiding honey until past a year, do so — but to shed light on where the recommendation came from and think critically about it.

Do you give babies honey?  Why or why not?

Comments

  1. Susan Alexander says

    Hmm, couldn’t it also be more likely to see botulism in an infant with trouble pooping because mom gave the corn syrup per doctor’s orders to get the poop moving? You already said that corn syrup often has botulism spores as well…

    I am not convinced that non-daily poops in a EBF infant is a reason for concern. All of my babies have done this and seemed just fine…

    • says

      That’s possible, about the corn syrup and botulism. the source wasn’t clear on the reason, just that it increased the risk.

      Yes, it is very common for EBF babies not to poop daily but I don’t think it is normal. I’ve noticed it being related to the development of cradle cap as well as to when I do not eat enough. That leads me to believe that there are a lot of factors involved but it really isn’t ‘normal’ per se. Not that it’s a serious problem, but it isn’t optimal.

  2. Karen says

    If honey were cooked, would it kill off the botulism spores? For example, if I used honey in baking bread or cookies?

    • betsy says

      Spores are only killed at high heat AND high pressure – that’s why we don’t just heat when making canned goods, but must use a pressure cooker. Spores are actually how the bacteria are able to survive and produce offspring in harsh conditions. So any live organisms will die at high heat, but sadly not the spores!

  3. Tisha S says

    Agree with most of what you said. The part I didn’t agree with is about infant bowel movements. It is not uncommon for breatsfed babies to have infrequent bowel movements. In La Leche League I have read that some babies may go a few weeks without a BM. Mine all went close to a week without a BM.

    • says

      Yes, this is very *common* but it’s not really *normal.* Unfortunately it’s so common we’ve begun to assume it’s normal! But new research shows that’s not really true.

  4. says

    Really interesting post–I knew to be careful about where I got my honey (and to choose raw honey when I can afford it), but I’d never really stopped to think about where the botulinum might come from. I just assumed it was naturally occurring from bees’ contact with dirt. BTW, here’s a nifty bit of trivia about honey: it’s a hypotonic solution, which means that it sucks the moisture out of any microbes living in it. Botulinum bacteria can survive in a hypotonic solution, but most microbes can’t; that’s why honey has an indefinite shelf life and can be used to treat wounds (it’s also why salt water is usually antiseptic). I learned this in a college biology class taught by a professor who researches bees.

  5. MEG says

    Never give babies 1 and under sugar period~ their little brains are developing and it is deadly thats why you don’t need to feed store bought baby food too~ its got sugar in it… Babies under one have not yet developed their immune system making it unsafe for babies under 1 year old due to botulism spores present in honey. This post alarms me its not okay to give babies under 1 honey while you surmise and wonder if it could be true, it could have very deadly consequences!

    • says

      I’m sorry, this is silly.

      Sugar isn’t a health food but it isn’t poison. It certainly isn’t “deadly” to babies as you claim! My goodness. By the way did you read any of the medical journals that I linked to through this post? this is based on actual research, not “surmising and wondering.” Please click through to read the sources next time before saying such a thing.

  6. Jami says

    My chiropractor recommended honey before 1, as long as i knew the source. Honey isn’t “sugar” as the above poster claims. It is a very healthy alternative to sugar. Great article with Great sourcing.

  7. says

    The other “food” that you shouldn’t give a baby under 1 is elderberry. I give my kids elderberry syrup almost everyday during cold/flu season and couldn’t wait until my youngest pasted the 1 year mark to give it to her. Is this also a myth?

  8. Cassds@gmail.con says

    My 8.5 month old is only having a bm every 8 days. I’ve tried massaging her belly, gave her her first prune today. What would you suggest to get her regular? She is breastfeeding and has some solid food, maybe once a day.

    • Tiffany says

      My baby, now 9 mo. Was very similar starting out on solids. Even now he goes about every other day or so.
      What i did, every baby is different , but some tale longer adjusting to solid foods. So i didn’t offer each day, i would just nurse keeping him well hydrated to help with digestion . As it takes more work to digest the solid foods.
      Also try decreasing or temporarily avoiding foods like bananas or grains . Stick with foods that aid in digestion such as peaches , pears, prunes and mangos.
      My older son didn’t have the same issues as my 9 mo. Old so each is different and develop at different rates . I hope that helps….oh and now

      • Tiffany says

        Oh and i took forever with both babies on feeding and progressing with solids. I offer and they experiment but i think focus on nursing is more important until you get closer to 1 yr…. Trial and error! :)

  9. Fiona says

    1. Bees travel up to a 7 mile radius of their hive, so even if you ‘know your farmer’ there is no guarantee that your honey will be free from pollutants.

    2. Honey IS sugar. And all types of sugar are not recommended for babies under 1 year because they can develop a sweet tooth and refuse to eat healthy non sweet foods. It’s a bad habit to start which can lead to obesity. Plus it’s terrible for their teeth!

    3. The risk of infant botulism from honey exists, there are several cases every year and it can be deadly. So why would you even risk giving it to your baby? Babies do not need to eat honey. Having a sore throat is a minor health issue that will resolve on it’s own without any treatment at all, you do not need to give them honey.

    4. The risk from botulism from honey is avoidable. If there was no risk to babies from honey then sure, you could give them a honey drink when they get sick. But when you take into account that botulism risk, the benefits of honey don’t outweigh those risks. Your baby will recover from a cold, but botulism can kill.

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