Apr 7, 2019 Botulism in Babies: What to Know

Parents, be aware of the symptoms of this rare but serious ailment.

The infant who was brought to Saint Barnabas Medical Center around New Year’s Day had troubling symptoms. His parents reported that the baby was constipated, had discomfort swallowing, had lost weight, was drooling and had developed a weak cry. Doctors recognized these as symptoms of infant botulism, a rare but potentially serious ailment.

“Throughout the U.S., there are about 150 cases of infant botulism annually,” says Uzma Hasan, MD, Division Chief for Pediatric Infectious Diseases at SBMC. “At Saint Barnabas Medical Center, we usually see one or two babies suffering from the condition each year.” Botulism can be treated effectively if caught early, but is fatal to infants in about 1 percent of cases.

“Although infant botulism is rare, we want to get the message out about what you need to look for,” says Dr. Hasan. “If you see a child who is constipated, a floppy baby with a weak cry who is not feeding well, seek immediate care.”

HOW IT BEGINS

Botulism is caused by a poison produced by Clostridium botulinum bacteria. The germ can enter a person’s gastrointestinal tract via contaminated food, through a wound, after being inhaled or during a medical procedure.

The main source for botulism in infants is transmission via aerolized botulism spores in soil, particularly in areas near construction sites where soil is disturbed. “An infant’s gastrointestinal tract is not mature enough to handle the spores. They germinate, release a toxin, and that causes trouble,” says Dr. Hasan.

Other risk factors include eating honey or improperly home-preserved food and being exposed to vacuum cleaner debris and dust.

TIMELY TREATMENT

Doctors can confirm a suspicion of infant botulism by testing the baby’s stool for signs of the bacteria. Sick babies are given a medicine called Botulism Immune Globulin intravenously, which usually reverses the effects of the toxin. “It leads to a pretty speedy recovery if given in a timely fashion,” says Dr. Hasan. Babies often spend two weeks in the hospital, and may require supportive care including feeding tubes. “Babies who don’t get treated with Botulism Immune Globulin typically are placed on a mechanical ventilator,” she says.

Given the need for quick treatment, parents and caregivers should be alert to signs of botulism in infants. Says Dr. Hasan, “Infants who don’t get treated early enough can be stuck in a hospital setting for a six-week period, or even longer.”

POSSIBLE SIGNS OF INFANT BOTULISM

Seek medical care for a baby if he or she has the following symptoms:

  • Not feeding well
  • Constipation
  • Drooling
  • Trouble swallowing
  • Weak cry
  • Hypotonia (low muscle tone and reduced strength), also known as “floppy infant syndrome”

To find a pediatrician at Saint Barnabas Medical Center, call 1.888.724.7123 or visit our website.