The world's largest honey-producing group yesterday warned that there may be a risk of botulism if honey is fed to infants under a year old.
The statement by the Sioux Honey Association of Sioux City, Iowa, said recent research has shown that some honey may contain botulism spores.
Under certain conditions, such spores can produce the poison that causes sometimes deadly botulism infection. Other new research has shown that botulism has caused some cases of "crib deaths" - deaths in their sleep of apparently healthy infants.
Some public health doctors now believe that several hundred cases of unrecognized botulism - some severe, some mild - occur in infants every year.
The cooperative hone-producing association said the recent findings about about cast no suspicion at all on the honey as a food for older children or adults.
The association also said there is exactly the same "possibility of a risk factor" in feeding "any raw agricultural product" to infants.
A California health official said he agrees that "it would seem prudent" to avoid feeding honey to infants under a year old. But he said that, until further research is done, nothing can be said about other foods.
Scientists agree that botulism spores may be found in soils and dust all over the world. Such soils are found on many fruits and vegetables. The spores are diluted but not removed by washing, so in fact people eat such spores without harm all the time.
They ordinarily affect human beings only when processed foods are inadequately heated in a canning or bottling process, or improperly fermented. Then the botulism spores can produce the toxin that results in death.
So-called "infant botulism" is apparently a very different kind of problem. One theory is that an infant's intestinal tract somehow fails to produce some kind of inhibiting factors which kill any toxins in older children and adults.
No infant botulism has been found in anyone over 26 weeks old.
"I think the honey association is taking a prudent and responsible public position," said Dr. Stephen Arnon, senior botulism investigator in the California Health Department in Berkeley.
Some parents add honey to infants' milk or give babies honey and water or spread honey on a nipple to induce the infant to take a bottle.
"Honey is not essential in infant nutrition," Arnon said. "Since under some circumstances honey can obtain spores which can infect susceptible infants, and since we don't know yet which infants are susceptible, it would seem prudent to avoid exposing one's baby to a known source."
Dr. Roger Feldman of the federal Center for Disease Control in Atlanta did not disagree with anything the honey association or Arnon said. but he said "the data are not yet strong enough" for CDC to issue a warning about honey, though "we think" parents should be aware of the findings so they can make their own decisions.
"There may be other foods involved," he said. "It may be that honey is no risk whatsoever. We just don't know."
What CDC has reported is that:
Since 1976, when the first case of the new-found infant botulism was identified in California, 70 cases have been discovered in the United States, with two deaths.
Among 15 cases in 1976 and 42 in 1977, botulism spores were found in opened honey jars in the homes of three infants who had been fed honey and water.
There has been no other common food source of the spores. Botulism spores have since been found in honey in two other homes of affected infants.
Most of these findings, and cases, were in California, simply because that state has conducted the most extensive search so far, the health officials said.
But "botulism spores have also been isolated from honey in four other laboratories across the United States," Arnon said.
In another investigation - reported in the Lancet, the British medical journal - the California Health Department investigators isolated botulism-causing bacteria from 10 out of 211 crib death victims. The 10 represented only 4.7 per cent of these babies.
But it is probable, the Lancet article said, that botulism is an unsuspected cause of a larger number, since all the evidence of botulism may have been destroyed by the time the investigators received any autopsy material.
None of these infants had been exposed to honey, Arnon added.
It is obvious, Feldman said, that "we're all in a very early stage of studying a new illness, and there is a great deal we don't know about its cause or causes."