Recognizing Infant Botulism – Multistate botulism outbreak prompts infant formula recall

Recognizing Infant Botulism – Multistate botulism outbreak prompts infant formula recall

By Dr Stan


Over 80 cases nationwide of botulism have been suspected or diagnosed recently. At least 15 infants have been hospitalized. While this condition can be life-threatening, particularly in infants, no deaths have been reported according the Food and Drug Administration (FDA).


Open cans of one infant formula, ByHeart, have been found in at least 15 babies across 12 states have been diagnosed since August. The company initially recalled two lots of infant formula,
(206VABP/251261P2 and 206VABP/251131P2), but now they have stopped selling all of their formula while an investigation proceeds. No other brands have been implicated.

Because the risk of infants developing botulism has long been known, with parents reminded to avoid honey, where the bacteria can grow, and this new outbreak, parents should recognize the signs and symptoms of infant botulism.

The Signs and Symptoms of Infant Botulism

Many of the signs and symptoms are common and do not suggest the disease individually, but a significant change from usual or several together can suggest you should call your baby's doctor as soon as possible

  • poor feeding,
  • constipation,
  • difficulty swallowing,
  • difficulty breathing
  • weak or altered cry,
  • sluggish pupils,
  • less facial expression,
  • loss of head control,
  • poor muscle tone

These symptoms may progress to a floppy paralysis and then to respiratory failure if treatment is not initiated.

The time for infant botulism to show up is estimated at 3 to 30 days from the time of consuming the affected formula or honey.

Consumer Recommendations from the American Academy of Pediatrics**

*Parents and Caregivers should stop using any ByHeart infant formula products immediately.

*If your child consumed ByHeart formula and is experiencing symptoms (see below) seek immediate medical attention.

*If your child consumed ByHeart formula and is not currently showing symptoms, continue monitoring them and seek medical attention if symptoms develop.

*If you still have the formula in your home, you should: take a photo or record the information on the bottom of the package. Pictures of where to find the lot number can be found on FDA's website. Keep the container in a safe spot and be sure to label that product as DO NOT USE.

*If your child develops symptoms your state health department might want to collect your formula container for testing. If your child does not develop symptoms after 30 days, throw your containers out.

*If infant botulism is a possible diagnosis, keep a stool sample when one is available to be held refrigerated.

*Botulism can be fatal. If your child has consumed is experiencing signs and symptoms of botulism above, seek immediate medical attention.

For more information, see the Georgia Dept. of Public Health – Infant Botulism Health Alert,your own Public Health Department's advisory or the FDA website.

Resources:

Tatayana Hofmekler, Christina Rostad, Multistate Outbreak Botulism, Georgia Chapter, American Academy of Pediatrics physician communication, November 11, 2025