Honey and infant botulism

The rule: no honey before 12 months

The CDC, the American Academy of Pediatrics (AAP) and the NHS all say the same thing: don’t give your baby honey until they are 12 months old.

That means honey in any form:

• Raw or cooked. The 2020–2025 US Dietary Guidelines say infants should not be given any foods containing raw or cooked honey. Baking honey into muffins, bread or porridge doesn’t make it safe for a baby.
• In food, water, formula or on a pacifier. The CDC lists all four. Never dip a pacifier in honey.
• Hidden in packaged foods. Check the ingredients list on cereals, crackers, yogurts and snacks, and leave out anything with honey in it until your baby’s first birthday.

From 12 months, honey no longer carries a risk of botulism, according to the AAP. It is still an added sugar, though. The US Dietary Guidelines (2025–2030) say to avoid added sugars from birth to age 4, and the NHS says to avoid food and drink with sugar, including honey and syrup, for children aged 4 or younger. So honey isn’t a regular food before age 4: see salt and sugar for babies.

Why honey is a risk for babies

Honey can contain spores of Clostridium botulinum, the bacteria that make botulinum toxin. The CDC explains that spores usually don’t make people sick, even when eaten. But in some babies, for reasons that aren’t fully understood, the spores get into the intestines, grow and make toxin there. This is called infant botulism.

The toxin attacks the nerves. It causes muscle weakness and, without quick treatment, can affect breathing. The NHS describes it as rare but very serious.

A few things are worth knowing:

• Infant botulism happens mostly in babies younger than 6 months, the AAP says. Honey is only one source of spores: they can also be in soil and dust, and often the source is never found.
• The botulism risk ends at the first birthday: the AAP says honey is safe for children 1 year and older. The added-sugar advice above still applies until age 4.
• If you’re breastfeeding, you can eat honey. The AAP confirms this is safe.

Signs of infant botulism

Symptoms usually appear between 3 and 30 days after a baby swallows the spores, according to the AAP. They often start mildly and get worse. Look for:

• constipation, often the first sign
• poor feeding: trouble sucking or swallowing, or milk pooling in the mouth
• a weak cry, or a cry that sounds different from usual
• drooping eyelids, or a face that shows less expression than usual
• poor head control, or a baby who seems floppy or weak overall
• being much quieter, less active or sleepier than usual

A baby with botulism might not have all of these at the same time.

What to do if you’re worried

Botulism is a medical emergency, and treatment works best when it starts early.

If constipation is the only sign, call your pediatrician or GP the same day and tell them about the honey. Constipation with any other sign, or any of the other signs on their own, is an emergency:

If your baby has any of the other signs, especially weakness, floppiness, or trouble feeding or breathing, call 911 or go to the emergency room straight away. Don’t wait to see if it gets better.If you think your baby may have symptoms of botulism beyond constipation, or your baby is limp or floppy, call 999. Don’t drive yourself to A&E.If your baby has any of the other signs, especially weakness, floppiness, or trouble feeding or breathing, call your local emergency number (such as 112 in Europe or 000 in Australia) or go to the nearest emergency department straight away.

Tell the doctor if your baby has had honey or any food containing honey, even a small amount.

Doctors treat infant botulism in hospital with a medicine (an antitoxin) that stops the toxin from doing more harm. Some babies need help with breathing or feeding while they recover. With treatment, most children recover fully, though recovery can take weeks or months.

If your baby already had a little honey

Many parents only learn about the honey rule after their baby has tasted some. Try not to panic: infant botulism is rare. What matters now is knowing what to look out for.

• Don’t give any more honey until 12 months.
• Watch for the signs above over the next few weeks.
• If constipation is the only sign, call your pediatrician or GP the same day and mention the honey. If you notice any of the other signs, with or without constipation, get emergency help right away (see above) and mention the honey.
• If you’re unsure, call your pediatrician, health visitor or GP for advice.

Honey-free ways to add flavor

Babies don’t need sweetness added to their food. If you’re used to adding honey to porridge, yogurt or baking, try these instead:

• mashed ripe banana stirred into oatmeal or plain yogurt
• grated or mashed soft fruit, or fruit cooked until soft without added sugar
• spices like cinnamon in baking

The NHS and the US Dietary Guidelines also advise no added sugar or syrups for children aged 4 and under, so swapping honey for maple syrup or table sugar isn’t the answer.

Is US and UK advice the same?

Yes. The CDC, AAP, US Dietary Guidelines and NHS all say no honey before 12 months, for the same reason. After the first birthday, honey counts as an added sugar, and both the US Dietary Guidelines (2025–2030) and the NHS say to avoid added sugar, including honey, up to age 4. For the full list of foods to hold off on, see foods to avoid for babies.