While medical investigators hunt for the definitive causes of infant botulism, they recommend taking these steps for prevention and early detection:
*Consider breast-feeding, which seems to offer some protection against infant botulism and other diseases affecting newborns -- perhaps even sudden infant death syndrome (SIDS) -- according to studies in the United States and Europe. This enhanced immunity seems to be related to proteins, called immunoglobulins, which pass from mother to child in breast milk.
Even if the immunoglobulins don't completely protect breast-fed infants, they may make them less vulnerable to botulism infection. Studies suggest that formula-fed babies develop botulism at an earlier age than their breast-fed counterparts. The American Academy of Pediatrics recommends that full-term newborn infants be breast-fed for the first six months of life, except when there are specific reasons not to, such as contaminated breast milk, illness of the mother, or when breast-feeding is unsuccessful.
*Avoid giving honey and corn syrup to children 1 year old and younger. Tests by the Food and Drug Administration and others show these foods can contain spores of the bacteria Clostridium botulinum, which causes botulism in babies. Older children and adults can digest these spores without harm, but for unknown reasons, these same spores are able to flourish in an infant's intestine, allowing the bacteria to colonize and produce a harmful -- sometimes even deadly -- toxin.
*Look for early symptoms of infant botulism, which include listlessness, lethargy, poor feeding, loss of muscle tone, head control and body limpness. During a botulism infection, a baby's cry may be different (usually higher pitched) and irritability is common. These early symptoms are often followed by constipation. What confuses parents is that because the infants do not have fevers, the warning signs are often dismissed. Yet experts say those symptoms warrant a visit to the doctor.
*Ask your pediatrician about infant botulism, advises Dr. Stephen Arnon, head of California's Infant Botulism Research Project. Both the Centers for Disease Control and researchers like Arnon believe that the illness is probably misdiagnosed or missed altogether by some doctors. In one recent case, the father of a sick baby had read about infant botulism and insisted that his child be tested. The baby's doctor reluctantly agreed, believing instead that the child had a muscle or neurologic disease. Tests showed that the baby did have botulism. The lack of a fever "is one of the things that makes infant botulism easy to overlook," says Arnon. "It's really an orphan, and falls between all sorts of diseases." -- Sally Squires