Symptoms of infant botulism include weakness in the neck, arms, or legs; inability to suck or cry normally; inability to feed or swallow; and persistent constipation. The first symptom is constipation, which can appear three to 30 days following ingestion of honey. The next symptoms observed are listlessness, decreased appetite, and a weakened cry over the next several days. Gagging and sucking reflexes diminish and the child moves less and less. Infant botulism frequently causes an infant to have an unusual breathing pattern, which often requires putting the infant on a ventilator to help with breathing.
Most infants recover from botulism with hospital care. However, if infant botulism is not treated immediately, it could result in death. Hospital care is necessary. Identifying the botulism toxin in the stool is needed for proper diagnosis. This toxin can cause nerve damage for weeks or even months. Neither antibiotics nor antitoxin have proven beneficial in treating infant botulism and may even make the illness worse. There is also a link between infant botulism and SIDS (sudden infant death syndrome), because breathing is affected in the most severe stages of the illness. It is believed to be the cause of death in 10% of SIDS cases. As children get older, the stomach acid, bacteria, and the intestinal tract mature to make them less susceptible to the toxins that botulism spores produce. The single most effective way to prevent infant botulism is to avoid giving honey to infants younger than 12 months of age.
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