I accidentally gave Honey Nut Cheerios to my baby! by Dr Alexis Lieberman
How big a risk is it if you accidentally give processed foods with Honey in the name to your baby under 1?
Clearing Up Misconceptions About Processed Foods With Honey in the Name
Most parents know that honey should be avoided for babies under the age of one, but how many understand why? It’s because honey can potentially contain botulism spores, which pose a risk to infants but not to older children or adults. If you’ve ever wondered about the botulism risk in honey, this article will clarify everything you need to know and provide reassurance about processed foods with “honey” in the name.
What is Botulism and Why is it a Concern for Babies?
Botulism is a rare, but serious illness caused by Clostridium botulinum, a bacteria that produces a potent neurotoxin. This toxin attacks the nervous system, leading to symptoms like muscle weakness, difficulty swallowing, and even paralysis. While botulism spores are commonly found in the environment, they only pose a risk when they are allowed to grow and produce toxins in low-oxygen environments, such as in the digestive system.
Babies, particularly those under one year old, have a less developed immune system and digestive tract, making them more vulnerable to botulism. In contrast, older children and adults have a more mature digestive system that can prevent the spores from growing and causing illness. An infant with botulism might have a weak cry, constipation, drooping eyelids, loss of head control, trouble having the energy to feed, and floppy arms and legs. (If the baby JUST has constipation or poor feeding, that is NOT likely to be botulism!)
Infant botulism is not the same as the botulism that older children and adults get. “In infant botulism, the swallowed botulism spores activate and produce botulinum toxin inside the baby's large intestine. In foodborne botulism the botulism spores activate in the food and produce botulinum toxin.
Older children and adults get foodborne botulism by eating the food in which the botulism bacteria have produced botulinum toxin.” (https://www.cdph.ca.gov/, California Department of Public Health)
My Personal Experience with Botulism
In my 30 years of medical practice, I’ve only encountered two cases of botulism. One involved a infant who contracted botulism from old wallpaper paste during a home renovation, and the other occurred after an infant consumed tea made from a large bunch of dried chamomile flowers purchased at a health food store. Neither of these cases involved honey, which is why I want to emphasize that while botulism in honey is a theoretical risk, it’s very rare in practice. In the United States, about 20% of infant botulism cases are linked to honey consumption. (NIH, Stat Pearls, https://www.ncbi.nlm.nih.gov/books/NBK493178/#:~:text=In%20the%20USA%2C%20there%20are,corn%20syrup%2C%20and%20medicinal%20herbs.)
The Real Risk: Why Babies Should Avoid Honey
The key concern with honey is its potential to contain botulism spores. “Although honey is a known food vehicle for the bacteria that causes infant botulism, we typically don’t consider an individual honey exposure to be overly risky for acquiring the bacteria that causes infant botulism. Honey is the one dietary reservoir of C. botulinum spores thus far definitively linked to infant botulism by both laboratory and epidemiologic evidence. However, that said, not every jar of honey has botulinum spores in it. To date, avoiding feeding honey to infants 12 months of age or less is the only known prevention measure for infant botulism.” (https://www.cdph.ca.gov/, California Department of Public Health)
The Reason for This Article: Reassuring Parents About Processed Foods with Honey
I often hear from parents after they accidentally give their baby processed foods with the word "honey" in the title—like Honey Nut Cheerios or Honey Grahams. While there is no proof that there are no botulism spores in these foods, in my opinion, the risk is negligible. The amount of honey in these processed foods is extremely small.
We do need to keep in mind that “commercial heat pasteurization (including vacuum packed pasteurized products and hot smoked products) may not be sufficient to kill all spores” (WHO, https://www.who.int/news-room/fact-sheets/detail/botulism) so while you should not CHOOSE to give foods with ANY honey to an infant under 1 years old, at the same time, there is so little honey in most foods named “honey” that if you do accidentally give these, you should not worry.
To help reassure parents, I’ve put together a table of common processed foods that contain honey. This table provides an approximation of the amount of honey in each item, showing that these foods do not carry the botulism risk that plain honey does.
Common Processed Foods with "Honey" in the Name: Are They Safe for Babies?
| Product Name | Amount of Honey (approx.) |
|---|---|
| Honey Nut Cheerios | ~1g per serving |
| Honey Bunches of Oats | ~2g per serving |
| Honey Graham Crackers | ~3g per 2 crackers |
| Honey Wheat Bread | ~1-2g per slice |
| Honeycrisp Apple Cereal | ~2g per serving |
Conclusion: No Need to Worry About an Accidental Ingestion of Processed Foods With Honey In the Name
In summary, while honey itself can pose a botulism risk for babies, the presence of honey in processed foods does not carry the same risk. The small amounts of honey used in these products, coupled with pasteurization and other food safety measures, make them less risky for babies. So, if you've accidentally given your baby processed foods like Honey Nut Cheerios, there's no need to worry.
If you're ever in doubt about what foods are safe for your baby, don’t hesitate to reach out to your pediatrician.
