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I was told that honey and corn syrup should never be used for infants less than one year of age, because of the risk of botulism from those products in infants. Is this true?


Answer from Linda Mackowiak, diabetes nurse specialist:

At our program, we don't give honey to kids less than one year of age. I haven't heard about problems with corn syrup.


Answer from Dr. O'Brien:

A contribution, not a substantive reply!

  1. Honey can be sterilised by heat and irradiation.
  2. In a statistical analysis of 68 cases of infant botulism the CDC reported an association with honey and also with corn syrup (about half the risk factor). There was no report though of corn syrup samples being contaminated.

It's not a very satisfactory reference; but I was interested in the corn syrup story and looked it up in Medline under 'botulism AND corn syrup'. There was only one reference, which was by Spika JS et. al. "Risk Factors for Infant Botulism in the United States" Amer. J. Dis. Child. 143:828, 1989. They quote a factor called an 'odds ratio' that was 9.8 for honey and 5.2 for corn syrup; but don't say exactly what this means.

If you look under 'Corn syrup AND Botulism AND Honey' I got about 23 references including the one on sterilisation. Trying to put it all together it was clear that infants got botulism from other sources besides honey, e.g., house dust; but the chances of developing a clinical syndrome were enhanced by living in Japan, being mildly constipated and by the ingestion of honey or corn syrup. Sort of interesting; but I'd still stay away from honey in infancy although apparently it has some use as a topical antibiotic!


Original posting 21 Sep 97


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