Emergency Medical Minute Episode 988: Infant Botulism
Contributor: Aaron Lessen, MD
Educational Pearls:
A 2025 multistate outbreak of infant botulism has been linked to ByHeart infant formula
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As of December 10-17th, there have been at least 51 infants with suspected or confirmed botulism who were exposed to this formula across 19 states
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All reported cases resulted in hospitalization but no deaths reported to date
Infant botulism
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Occurs when C. botulinum spores germinate in the infant's intestine, producing toxin
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Spores are classically found in honey but can also be in dirt or contaminated in infant formula
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Infants are particularly susceptible because their body can't neutralize the spores
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Symptoms may include initial constipation, poor feeding, weak cry, floppy movements, loss of head control, difficulty swallowing, generalized weakness, and respiratory compromise if progressive
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Can be treated with antitoxin
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Maintain a high index of suspicion for infant botulism in infants fed the recalled formula presenting with neuromuscular symptoms.
References
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Human Foods Program. Outbreak Investigation of Infant Botulism: Infant Formula. U.S. Food and Drug Administration. Published 2025. https://www.fda.gov/food/outbreaks-foodborne-illness/outbreak-investigation-infant-botulism-infant-formula-november-2025
Summarized by Meg Joyce, MS2 | Edited by Meg Joyce & Jeffrey Olson, MS4
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