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The Signs and Symptoms of Infant Botulism

The Signs and Symptoms of Infant Botulism

As the name suggests, infant botulism commonly occurs in babies, specifically those aged younger than 6 months. Reports say the youngest reported case was just 2 weeks old and the oldest was 12 months. Infant botulism is an illness caused by the ingestion of Clostridium botulinum bacterial spores. Here’s what you need to know about the signs and symptoms of infant botulism plus its treatment and prevention.

How babies get infant botulism

C. botulinum is a spore-forming bacteria. Being able to form spores means the bacteria can withstand physical and chemical assaults that non-spore-forming bacteria typically cannot survive.

Please note that C. botulinum bacteria normally live in soil, and sometimes, they find their way to dust as well as surfaces like carpets and floors. Some foods, like honey and corn syrup, contain the same bacteria, too.

It is usually harmless in older children and adults because their digestive system is matured enough to eliminate the toxin before it can cause any harm. But when a baby takes in the spores, the bacteria may grow and multiply in their intestines and release the toxin that causes infant botulism signs.

The signs and symptoms of infant botulism

The toxin initially causes constipation in about 90% of patients. Afterward, the following signs and symptoms may occur:

  • “Floppy,” which means that your baby may feel limp in your hold as if they are a rag doll
  • Ptosis, where their eyelids drop or look partially closed
  • Sluggish pupil
  • Being expressionless
  • Loss of head control
  • Paralysis that spreads downward
  • Breathing that stops or slows down; this may progress to respiratory failure
  • Weak cry
  • Extreme fatigue
  • Poor feeding
  • Absence of gagging

Complicated cases may result in disabilities or death. But when detected early babies often recover fully. This is why it’s crucial to spot the signs of infant botulism as soon as possible.


The diagnosis usually revolves around confirming the signs and symptoms of infant botulism; however, since the clinical manifestations can be confused with other conditions, such as hypothyroidism, congenital muscular dystrophy, sepsis, and benign congenital hypotonia, the doctor will most likely order a stool test.

Finding the toxin or the bacteria in the stool establishes the diagnosis. But since results may take some time, the doctor usually begins treatment as soon as there is suspicion. Waiting can be dangerous.

Treatment for Infant Botulism

Babies who present with the signs and symptoms of infant botulism need hospitalization and even intensive unit care. They might also need mechanical ventilation for their breathing difficulties.

Doctors use an antitoxin called human botulism immunoglobulin intravenous (BIGIV) to treat infant botulism. Reports indicate that babies who receive BIGIV sooner require a shorter hospital stay and recover quicker.

Although the pathogen is a bacteria, experts say antibiotic therapy does not seem to help the baby improve their condition. The doctor may still prescribe them, however, if the child develops another infection, such as pneumonia.

Finally, since weak suckling and poor feeding are also signs and symptoms of infant botulism, the baby may need tube feedings, too.


To prevent infant botulism, parents and guardians must ensure their baby is not exposed to the C. botulinum bacteria. Keeping them away from the soil is helpful. And of course, don’t give them honey and corn syrup until after their first birthday.

Key Takeaways

Infant botulism is caused by spore-forming bacteria called Clostridium botulinum, which can be found in soil and some foods. The signs and symptoms of infant botulism include constipation and neuromuscular weakness and paralysis. Treating this disease often requires human botulism immunoglobulin intravenous (BIGIV). The sooner a child gets the treatment, the quicker they can recover.

Learn more about Infectious Diseases in Children here.

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Hello Health Group does not provide medical advice, diagnosis or treatment.

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Written by Lorraine Bunag, R.N. Updated Jul 22, 2021
Fact Checked by Hello Doctor Medical Panel