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​Infant Botulism treatment and prevention program

Important Notice​

The Infant Botulism Treatment and Prevention Program (IBTPP) is currently receiving a high volume of calls and emails. 

Parents and caregivers

  • If you have questions, e-mail IBOHotline@cdph.ca.gov. ​​E​​mails will be answered daily.
  • The Infant Botulism Hotline (1-833-398-2022)​​ is available toll-free 7 days a week, 7 a.m.–8 p.m. Pacific Time (PT).

Health care providers

  • The clinical support line (510-231-7600) remains open 24/7 for suspected infant botulism cases. Calls from medical providers receive priority response.

If your child has clinical symptoms or you are concerned about their health, contact your health care provider. In an emergency, seek medical care immediately.

Prevention

​For Parents and Families

​​What You Need to Know

  • Infant botulism is caused by a poison (toxin) that is made by a germ (bacteria) called Clostridium botulinum.
  • When ingested, it can produce a neurotoxin in the body. This can affect a baby's nerves and muscles.
  • If your child has clinical signs or you're concerned about their health, contact your health care provider. In an emergency, seek medical care immediately.  
  • As of November 8, 2025, CDPH is working with the CDC and FDA to investigate a multistate outbreak of infant botulism linked to ByHeart Whole Nutrition Infant Formula.
  • Stop using ByHeart Whole Nutrition Infant Formula immediately.
  • Symptoms of infant botulism can develop very quickly or may take up to 30 days to appear.
  • If you have questions related to ByHeart formula or infant botulism, please call the toll-free Infant Botulism Outbreak Hotline at 1 (833) 398-2022. The hotline is open 7 days a week from 7 a.m. to 8 p.m. Pacific Time (PT). 

What is infant botulism?

Infant botulism is caused by a poison (toxin) that is made by a germ (bacteria) called Clostridium botulinum.  The germs that make babies sick with infant botulism live in nature. Babies can swallow the germs and they can live in the baby's gut for a short time. Sometimes they can live for weeks to months and make the poison inside the baby's gut. Note, for most cases, the people who study infant botulism are not able to find a reason why a baby became sick. The inactive state of the germs that cause infant botulism (Clostridium botulinum spores) live in the soil and dust. It can survive most harsh conditions in nature (like wildfires or floods). Most babies who get sick likely swallowed spores. These can be stuck to tiny, invisible bits of dust floating in the air. ​

How to avoid infant botulism?

Recalled Powdered Infant Formula

As of November 8, 2025, CDPH is working with the CDC and FDA to investigate a multistate outbreak of infant botulism linked to ByHeart Whole Nutrition Infant Formula.

The investigation into lots of ByHeart powdered infant formula and other potential sources is ongoing.

Do not give your baby powdered infant formula that has been recalled. ​

Honey

Do not feed honey to babies under 12 months old. This is the only known way to prevent infant botulism. After age one, babies are less likely to get sick from the poison of Clostridium botulinum makes.

It is the only food that has been proven to cause infant botulism.1-10 In every case studied, the type of bacteria in the honey exactly matched the type that made the baby sick.

Spores of the bacteria have been found in honey in many countries. Countries including the U.S., Canada, China, and others.1,7,11-23 Because of this, all major health and food safety groups agree: Never feed honey to a baby under one year old.

For more information on honey see When to Avoid Honey page.

Corn Syrup

Based on current research, corn syrup is not considered a risk for infant botulism.

There were two studies that raised questions about corn syrup and infant botulism. In 1989 the Centers for Disease Control and Prevention (CDC) did a 2-year investigation. It found a link between infant botulism and feeding babies corn syrup.24,25

However, later investigations in 1988 and 1991 found no spores in corn syrup samples from Canada and the U.S.15,26 Interestingly, one older investigation found babies who had corn syrup were less likely to get sick11 . This may be because parents who used corn syrup weren't also feeding their babies honey.11

Herbal Teas

C. botulinum spores have been found in some chamomile29 and linden flower30 teas. However there are no cases of infant botulism where it was proven to be from herbal tea exposure.​

Peanut Butter

Recent evidence shows that earlier introduction of peanut-containing foods to babies can prevent peanut allergies.31 Many pediatric medical groups, organizations, and federal agencies have developed updated guidelines to address the prevention of peanut allergies in children.32

No cases of infant botulism in the U.S. have been proven to be from eating peanut butter. There is one baby in the United Kingdom who became sick with infant botulism that was linked to peanut butter.35

A 2007 Canadian survey of peanut and nut butters found that three (3) of 92 sampled peanut butter spreads contained Clostridium botulinum spores.31 It's unclear if the spores came from the peanuts themselves or from added ingredients like honey. We also don't know if peanut butter gives the bacteria a good place to grow.32 Or if the manufacturing process kills the spores.32

If your baby is hospitalized with suspected infant botulism and you are interested in a Parent Support Group, call (510) 231-7600.

References​​

  1. Abdulla CO, Ayubi A, Zulfiquer F, Santhanam G, Ahmed MA, Deeb J. Infant botulism following honey ingestion. BMJ Case Rep. 2012;7.
  2. Arriagada SD, Wilhelm BJ, Donoso FA. Infant botulism: case report and review. [Spanish]. Rev Chil Infectol. 2009;26(2):162-167.
  3. Balslev T, Ostergaard E, Madsen IK, Wandall DA. Infant botulism: the first culture-confirmed Danish case. Neuropediatrics. 1997;28(5):287-288.
  4. Fenicia L, Ferrini AM, Aureli P, Pocecco M. A case of infant botulism associated with honey feeding in Italy. Eur J Epidemiol. 1993;9(6):671-673.
  5. Harris RA, Tchao C, Prystajecky N, Cutler J, Austin JW. A summary of surveillance, morbidity and microbiology of laboratory-confirmed cases of infant botulism in Canada, 1979-2019. Can Commun Dis Rep. 2021;47(78):322-328.
  6. Jung A, Ottosson J. Infantile botulism caused by honey. [Danish]. Ugeskr Laeger. 2001;163(2):169.
  7. Sakaguchi G, Sakaguchi S, Kamata Y, Tabita K, Asao T, Kozaki S. Distinct characters of Clostridium botulinum type A strains and their toxin associated with infant botulism in Japan. Int J Food Microbiol. 1990;11(3-4):231-241.
  8. Smith JK, Burns S, Cunningham S, Freeman J, McLellan A, McWilliam K. The hazards of honey ingestion: infantile botulism. BMC Case Rep. 2010;2010:pii: bcr0520103038.
  9. Thompson JA, Glasgow LA, Warpinski JR, Olson C. Infant botulism: clinical spectrum and epidemiology. Pediatrics. 1980;66(6):936-942.
  10.  van der Vorst MM, Jamal W, Rotimi VO, Moosa A. Infant botulism due to consumption of contaminated commercially prepared honey. First report from the Arabian Gulf States. Med Princ Pract. 2006;15(6):456-458.
  11.  Arnon SS, Midura TF, Damus K, Thompson B, Wood RM, Chin J. Honey and other environmental risk factors for infant botulism. J Pediatr. 1979;94(2):331-336.
  12. Aureli P, Franciosa G, Fenicia L. Infant botulism and honey in Europe: a commentary. Pediatr Infect Dis J. 2002;21(9):866-868.
  13. Berkwitt A, El Saleeby CM, Murphy SA. Case 3-2024: an 8-week-old male infant with inconsolable crying and weakness. N Engl J Med. 2024;390:358-366.
  14. Grenda T, Grabczak M, Sieradzki Z, et al. Clostridium botulinum spores in Polish honey samples. J Vet Sci. 2018;19(5):635-642.
  15. Hauschild AHW, Hilsheimer R, Weis KF, Burke RB. Clostridium botulinum in honey, syrups and dry infant cereals. J Food Prot. 1988;51(11):892-894.
  16. Huhtanen CN, Knox D, Shimanuki H. Incidence and origin of Clostridium botulinum spores in honey. J Food Prot. 1981;44(11):812-815.
  17. Midura TF, Snowden S, Wood RM, Arnon SS. Isolation of Clostridium botulinum from honey. J Clin Microbiol. 1979;9(2):282-283.
  18. Mustafina R MB, Wisniewski J, Tracz M, Anusz K, Grenda T, Kukier E, Goldsztejn M, Kwiatek K. Contamination of honey produced in the Republic of Kazakhstan with Clostridium botulinum. Journal of Veterinary Research. 2015;59(2):241-246.
  19. Nakano H, Okabe T, Hashimoto H, Sakaguchi G. Incidence of Clostridium botulinum in honey of various origins. Jpn J Med Sci Biol. 1990;43(5):183-195.
  20. Nevas M, Hielm S, Lindstrom M, Horn H, Koivulehto K, Korkeala H. High prevalence of Clostridium botulinum types A and B in honey samples detected by polymerase chain reaction. Int J Food Microbiol. 2002;72(1-2):45-52.
  21. Sugiyama H, Mills DC, Kuo C. Number of Clostridium botulinum spores in honey. J Food Prot. 1978;41(11):848-850.
  22. Wojtacka J WB, Kabasinskiene A, Wiszniewska A, Gomolka-Pawlicka M, Szteyn J, Malakauskas M, Migowska-Calik A. Prevalence of Clostridium botulinum Type A, B, E and F Isolated From Directly Sold Honey in Lithuania. Journal of Agricultural Science and Technology. 2017;19:335-343.
  23. Olsen SJ, Swerdlow DL. Risk of infant botulism from corn syrup. Pediatr Infect Dis J. 2000;19(6):584-585.
  24. Spika JS, Shaffer N, Hargrett-Bean N, Collin S, MacDonald KL, Blake PA. Risk factors for infant botulism in the United States. Am J Dis Child. 1989;143(7):828-832.
  25. Lilly T, Jr., Rhodehamel EJ, Kautter DA, Solomon HM. Clostridium botulinum spores in corn syrup and other syrups. J Food Prot. 1991;54(8):585-587.
  26. Brett MM, McLauchlin J, Harris A, et al. A case of infant botulism with a possible link to infant formula milk powder: evidence for the presence of more than one strain of Clostridium botulinum in clinical specimens and food. J Med Microbiol. 2005;54(Pt 8):769-776.
  27. Barash JR, Hsia JK, Arnon SS. Presence of soil-dwelling clostridia in commercial powdered infant formulas. J Pediatr. 2010;156(3):402-8.
  28. Bianco MI, Lúquez C, de Jong LI, Fernández RA. Presence of Clostridium botulinum spores in Matricaria chamomilla (chamomile) and its relationship with infant botulism. Int J Food Microbiol. 2007;121(3):357-360.
  29. Bianco MI, Lúquez C, de Jong LI, Fernández RA. Linden flower (Tilia spp.) as potential vehicle of Clostridium botulinum spores in the transmission of infant botulism. Rev Argent Microbiol. 2009;41(4):232-236.
  30. Harris RA, Bussey J, Flint A, Blondin-Brosseau M, Weedmark K, Austin JW. Prevalence of Clostridium botulinum in Retail Peanut Butters from a 2007 Survey in Ottawa, Canada. Current Microbiology. 2024;81(10):322.
  31. Clavero MRS, Brackett RE, Beuchat LR, Doyle MP. Influence of water activity and storage conditions on survival and growth of proteolytic Clostridium botulinum in peanut spread. Food Microbiology. 2000;17(1):53-61.
  32. Crane RJ, Amar CF, Omoruyi H, Ahmed B, Finch J, Kendrick R, Ladhani S, Painset A, Rajendram D, Raphaely N, Dwarakanathan B, Guruprasad S, Zuhur-Adi H, Wong VK, Godbole G. Peanut butter confirmed as the source in a case of infant botulism, United Kingdom, 2024. Euro Surveill. 2025 Jul;30(30):2500512. doi: 10.2807/1560-7917.ES.2025.30.30.2500512. PMID: 40747570; PMCID: PMC12315516.​​​
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