What is botulism? And why is Sonam Kapoor warning people against feeding honey to infants?

Actor Sonam Kapoor was recently appreciated and equally trolled on X for speaking about Botulism dangers from feeding honey to a baby.

ByChetana Belagere

Published Sep 29, 2023 | 8:00 AMUpdatedSep 29, 2023 | 8:00 AM

Actor Sonam Kapoor has a one-year-old child. (Wikimedia Commons)

Actor Sonam Kapoor was both appreciated and trolled recently when, in an interview, she narrated how she argued passionately with a priest while advocating against the traditional practice of giving honey as the first food to her son.

She spoke about the risks of botulism associated with feeding honey to infants. While many appreciated the actor’s knowledge about botulism, some trolled her too.

What Sonam Kapoor said

Sonam Kapoor said, “Whatever books that I have read says that, in the first year, you cannot give your kid honey because it causes botulism, which is a disease that a child can get because honey has a specific bacteria. And I had this argument with the panditji that I am giving him apple puree, whether you like it or not as the first food. There are some old old things that we do in our culture…which are not….may be there are mothers who have done that and their kids are fine, but I am not comfortable,” she said in the interview.

South First spoke to experts to understand more about Botulism and why is it not safe to give honey to infants, especially as their first food.

Also read: How cultural beliefs are hindering breastfeeding campaigns

What is botulism?

Explaining what Botulism is, Dr Gopikrishna, a paediatrician from Bengaluru, says, “Botulism is a serious and potentially life-threatening illness caused by a toxin produced by the bacterium Clostridium botulinum. This toxin is one of the most potent toxins known to humankind. There are different kinds of botulism: Food-borne, infant botulism, wound botulism.”

He says, Sonam Kapoor was talking about infant botulism, which occurs when infants ingest spores of Clostridium botulinum, typically through contaminated honey or soil. The spores can grow and produce the toxin in the infant’s intestines.

Renowned paediatrician, Dr Asha Benakappa, Head of Department at Chandramma Dayananda Sagar Institute of Medical Education & Research, tells South First that Infant botulism is the infectious (intestinal) form of botulism.

“Botulinum toxin causes weakness and loss of muscle tone because it blocks the nerve ending’s ability to signal the linked muscle to contract. The illness often begins with constipation, but is usually first noticed as difficulty feeding (sucking and swallowing), a weak and altered cry, and diminished facial expression,” she explains.

feeding honey to baby is not safe

Honey is giving to children as ceremony. (Wikimedia Commons)

Also, young children have immune systems that are still developing and might not have the defenses to combat harmful bacteria, like older children or adults, she adds. The toxins produced by the botulinum bacteria can cause muscle weakness, difficulty feeding, constipation, and in severe cases, breathing problems.

Meanwhile Dr Cyriac Abby Philip — aka TheLiverDoc — took to X and posted along with Sonam Kapoor’s video, “Traditions are just peer pressure from dead people.”

He adds that giving honey to newborns is contraindicated and not recommended in the interest of the health of the infant. It can lead to infantile botulism, which kills.

Quoting the Indian Academy of Pediatrics, Dr Philips said, “The newborn should not be given any other fluid or food like honey, ‘ghutti’, animal or powdered milk, tea, water, glucose water, etc, since these are potentially harmful.”

Also read: Why health experts have a beef with the promo of iron-rich diet

Dangers of feeding honey to infants

Explaining the dangers, Dr Benakappa says honey is sugar and it will destroy the delicate gut microbes that protect against future non-communicable diseases. Babies have no taste for sweets and the introduction of sweet taste has future consequences.

However, she says that she has not come across any case of botulinum toxicity due to honey, yet.

Renowned Tamil Nadu paediatrician Dr Selvan R, tells South First, “A newborn’s intestines are free of any organisms. Breast milk carries good bacteria from the mother to the baby’s intestines, which is essential for healthy microbiota of the baby. Giving anything other than breast milk is called prelacteal feeds. It includes sugar water, dextrose, tea, and honey.”

He says that this practice will reduce the baby’s interest in suckling and getting milk, and make establishing breastfeeding harder. These have sweetness and probable pathogens, babies may develop problems, and they may not like to feed at the breast or they may develop dangerous infections.

Also read: Back to basics: The forgotten art of patient history-taking

Honey giving is ceremonial

In many parts of India, the first food is traditionally honey or milk (animal’s milk), both of which are not recommended. Doctors explain that if the child is lactose intolerant, then any milk other than breast milk can cause problems in the child and, hence, are best avoided.

Representative pic

Homemade food is best for infants but not before 6 months. (Wikimedia Commons)

In several cultures, as soon as the baby is born, a gold ring is dipped into a bowl of honey and touched on the baby’s lips. This is also dangerous and is a common practice in rural areas, explains Dr Shalini V, a gynaecologist from Karnataka.

“Even packaged foods need to be avoided. Homemade food is best for infants as their first food, that too not before six months of exclusive breastfeeding,” she says.

Dr Selvan explains that honey-giving is celebrated like a ceremony in many places and cultures. It is practiced as a social custom and it doesn’t have any scientific validity or background. He says, “It is best to not practice it. In fact, this must not be encouraged. Many brands of honey do not maintain quality and even if the quality is maintained, there are always chances of infection, specially botulism.”

While claiming that he hasn’t seen cases of botulism either, Dr Selvan says that he has seen babies presenting with bowel infections and sepsis after feeding honey.

Also read: Are you over-seasoning your child’s future with salt?

Meanwhile, paediatrician from Telangana, Dr Sivaranjani Santosh, tells South First that while botulism is an extremely rare condition today, she questions why anyone would want to risk putting their child in harm’s way.

She says, “Though rare, botulism is a known risk. It can cause descending paralysis and no antidote is available anywhere in India for this. In my entire career, I haven’t seen a case, but it is a mentioned clearly in our textbooks. Without evidence, it won’t come into our textbooks.”

Citing an anecdote, she says, “Couple of months ago, a paediatrician colleague’s baby developed paralysis. Patient history showed that it was more likely due to honey, but they couldn’t prove it as there are not many labs that check for this.” She adds that it’s best to refrain from giving honey.

She also asks the so-called culture protectors to stop trolling Sonam Kapoor and others, who are talking science.

Symptoms of botulism

Doctors explain that the symptoms of botulism often begin with weakness, blurred vision, difficulty speaking and swallowing, and muscle paralysis. In severe cases, it can lead to respiratory failure, which can be fatal if not treated promptly and properly.

Treatment typically involves administering an antitoxin to neutralise the botulinum toxin, along with supportive care, such as assisted breathing and monitoring. If diagnosed and treated early, individuals affected by botulism can recover, although recovery may take several weeks to months.

Before introducing any new food to your infant, it’s important to consult with a paediatrician or healthcare professional for guidance and recommendations, say doctors. These professionals can provide personalised advice, based on the child’s family history, development, and health status.