Why Babies Shouldn't Suck on Honey

Possibilities include floppy baby syndrome and death, but honey-pacifiers still exist.
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Around 10 percent of honey in the U.S. contains spores from the bacteria Clostridium botulinum. That's not really a problem for big humans because it's just the spores, not the botulinum toxin. In infants (humans less than 13 months old), though, those spores can turn into botulinum toxin in their intestines. Not the kind of toxin that throws off chakras or warrants a juice cleanse, but the sort that poisons nerve endings and paralyzes muscles. It is the same toxin that's commercially sold as BOTOX® to assuage muscle spasms and treat migraines and smile lines. In this case, the tiny humans can get a full-blown case of botulism. 

Infant botulism can mean anything from subtle changes in muscle tone to so-called "floppy baby syndrome" to "sudden, unexpected death." None of this is common, but it's been repeatedly documented and established that infant botulism from honey does happen. It's not common for kids to get eaten by alligators, either, but that doesn't mean you let your baby live with an alligator family. Unless you do.

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A study last week in the journal Pediatrics found that of 397 parents of infants in the Houston area, 11 percent reported using honey-pacifiers with their infants. That means buying pacifiers that contain honey, which are still sold. Some actually contain corn syrup instead of honey -- even if they're still sold as "honey pacifiers" but that too can contain botulinum spores.

Most of the parents (81 percent) at the clinic where this study took place were Hispanic, most indigent and of Mexican descent. The parents said they use the honey pacifiers either out of tradition, because the infants seem to prefer them, and/or because they felt there were health benefits (e.g., "helps with constipation or colic").

The only research about botulism and honey-pacifiers specifically are case reports around dipping a pacifier in honey. Even though the honey-pacifiers in question don't drip honey, it does amount to putting a tenuous sack of honey in the infant's mouth. Even assuming it remains intact, this kind of promotes a suboptimal baby-loves-honey culture. That's potentially a gateway to, as the study's authors put it, "dipping the pacifier in honey, or adding it to other foods or drinks."

There are obviously cultural traditions and folk wisdom about the benefits of honey-pacifiers to consider, of the sort that would not likely persist if there were no truth to them. They deserves research, but, as a greater pacifier debate rages, spreading word about botulism and honey is important. About 80 percent of the parents in this study said they did not know that honey was potentially dangerous in any way, much less the thing about sudden unexpected death.

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James Hamblin, MD, is a senior editor at The Atlantic. He writes the health column for the monthly magazine and hosts the video series If Our Bodies Could Talk.

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