Botulism is a rare illness that it is often related to eating contaminated food. It is caused by poisons (toxins) that are made by Clostridium botulinum. Botulism can be a very serious disease that can damage the nerves, leading to weakness and paralysis.
Types of botulism
Foodborne botulism can happen when food becomes contaminated with C botulinum spores and then is stored improperly. Improper storage allows the bacteria to grow and make toxins. Outbreaks of this type of botulism have occurred by eating not only homemade foods that have been improperly canned, preserved or fermented, but also restaurant-prepared foods such as cheese sauce, baked potatoes wrapped in foil and bottled garlic.
Wound botulism can develop when the spores of C botulinum get into a wound or injured tissue, grow and produce toxins which enter the blood stream.
What causes infant botulism?
Infant botulism occurs mostly in babies younger than 6 months. It develops when C botulinum spores are eaten by a baby and the germs grow in the intestines and make toxins. The source of the spores is usually not known. Spores may be in soil or dust and then float into the air where they are breathed in and swallowed by the child.
Honey is another source of these spores and should be avoided in children under 12 months of age. The American Academy of Pediatrics (AAP) recommends that you do not give honey to a baby younger than 12 months. Honey is safe for children 1 year and older. Breastfeeding parents may eat honey.
In 2025, baby formula was recalled for botulism concerns. Learn about the recall here.
Preventing foodborne botulism
Food preparation and home canning can be made safer from botulism by following guidelines such as:
Use recommended processes for home canning of food (ie. use a pressure cooker/canner, especially for low-acid foods such as vegetables or meat).
Boil home-processed, low acid canned foods for 10 minutes to destroy toxins. Additional time may be needed for higher altitudes.
Refrigerate all leftover and cooked foods within two hours after cooking.
Do not eat or feed your child any foods that appear to be spoiled.
Discard any food containers that are bulging. They may contain gas produced by C botulinum.
Symptoms of botulism
Botulism that is caused by contaminated food can get worse very quickly. Symptoms often begin with feelings of weakness and loss of muscle tone that start with the muscles of the face and spread downward throughout the body.
Children may have:
The toxin can cause paralysis of the muscles of the trunk, arms, legs, and respiratory system. In these food-borne infections, symptoms start soon after the contaminated food is eaten—typically within 12 to 48 hours but occasionally as long as 10 days later.
Infant botulism symptoms
Signs of botulism in infants may range from mild to severe, often beginning with:
Constipation
Difficulty feeding (inability to suck and swallow)
Poor head control
Weak or different-sounding cry
Less facial movement
Overall weakness or floppiness
The typical time for symptoms of infant botulism to appear after exposure to the spores can range from 3 to 30 days.
How is botulism diagnosed?
A child's symptoms will help the doctor diagnose botulism. The diagnosis can be confirmed by finding toxin in a child's stool (poop), stomach contents, blood or the foods they ate. To diagnose wound botulism, tissue samples may be examined in the laboratory.
How is botulism treated?
Medications
Botulism is treated with antitoxin medicine that is given through a small tube placed into the vein (IV). Antitoxin blocks the activity of the toxin the bloodstream. It works best when it is given early in the course of illness. This is why antitoxin is given when the diagnosis of botulism is suspected. There is no need to wait for lab test results. Botulism is considered a medical emergency.
Antibiotics are not helpful in treating most cases of botulism. They are usually only given when another infection is present.
Supportive care
Supportive care is an important part of the therapy for children with botulism. Almost all children will need to be hospitalized. Children should be kept well nourished, their airway should be kept clear, and they need to be watched carefully for breathing problems. Seriously ill children may need help breathing, using a mechanical ventilator, and eating, using feeding tubes or intravenous feeding.
Recovery from botulism
Most children recover fully from botulism, although it can take several weeks to months. In cases in which the condition is untreated, the symptoms of food-borne botulism sometimes progress to a stage in which the breathing muscles become paralyzed, causing death from respiratory failure.
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