Why Can't Babies Have Honey?

Honey has long been celebrated for its natural sweetness, healing properties, and versatility in creating some amazingly delicious treats. We use it often in my home, and while honey is generally a great sweetener for adults and kids and seems like a harmless ingredient, it’s not recommended for babies under 12 months of age due to the potential for a significant (although extremely rare and unlikely) health risk. 

As a pediatric registered dietitian specializing in infant feeding and a mother of three girls, it’s important to me to help inform parents and caregivers about food safety—especially when it comes to babies, whose immune systems are still developing, which places them at greater risk for food-borne illness. 

To that end, this blog post will explore the reasons why babies younger than one year should not have honey, the potential dangers it poses to their health, and what to do if your baby accidentally eats honey.

Risk of Infant Botulism from Honey

Botulism is a rare but potentially life-threatening illness caused by the bacterium Clostridium botulinum. The most important reason why babies should avoid honey is the risk of infant botulism, which is very rare, but happens most commonly in babies under the age of 6 months. There are usually around 70-80 cases of infant botulism in the United States every year. 

The bacterium can be found in various environments, including soil, rivers, and ocean water. Honey can contain small, dormant Clostridium botulinum spores. While adults and older children have mature digestive and immune systems that can effectively combat the bacterium, infants under one year old may lack this capability. 

When an infant consumes even a tiny amount of honey contaminated with Clostridium botulinum spores, their immature digestive system can allow the bacteria to multiply and produce a dangerous toxin. This toxin can lead to a range of symptoms, including muscle weakness, difficulty breathing, poor feeding, and even paralysis. In severe cases, untreated infant botulism can be fatal. 

It is important to note that “honey” includes both raw and pasteurized honey, cooked and baked products made with honey, and honey-containing products, such as honey-flavored snacks or cereals (like honey graham crackers or Honey Nut Cheerios).

Treatment for infant botulism typically involves administering an antitoxin to counteract the effects of the botulinum toxin. In most cases, if administered early, a baby can fully recover and return to normal neurological functioning. 

At the age of 12 months, it’s not as if a light switch goes off and babies are suddenly no longer at risk for infant botulism. As a baby's digestive system matures throughout the first year of life, it can better handle the bacteria before it causes any harm. In other words, a 4-month-old baby is at higher risk for infant botulism due to ingestion of honey than an 11-month-old infant. By age 1, honey no longer poses a significant risk.

Avoiding Added Sugars in Infants

Aside from the risk of infant botulism, honey isn’t a good choice for babies anyway due to the fact that it’s an added sugar. While honey is a natural sweetener and contains some beneficial nutrients, the AAP, AHA, and CDC all recommend that added sugars be avoided for children under 2 years old. 

I interpret the added sugar recommendation as more of a general guideline than a hard and fast rule. Other added sugars aren’t necessarily dangerous for babies in the same way that honey is, but they don’t generally provide the nutrients babies and toddlers need to thrive and grow, and in excess, can lead to some long-term health issues.

For example, serving too much added sugar early on can displace more nutrient-dense foods from an infant's diet, potentially depriving them of essential nutrition. And excessive sweeteners can both reduce the diversity of foods a child is interested in eating and may increase their risk for dental caries (cavities) and type 2 diabetes.

In general, if you find yourself making something for the whole family (baby included) and it calls for honey, the best option is to just swap out the honey for mashed banana or cooked and pureed fruit. And if fruit doesn’t work for the recipe, maple syrup or regular sugar are safer choices for babies than honey.

What should I do if I accidentally give my baby honey?

If you accidentally give your baby honey and they are less than one year old, try not to panic—in all likelihood, it will be fine, as cases of infant botulism are extremely rare.

Do not try to induce vomiting, as this may not effectively remove any ingested honey and can pose additional risks of dehydration.

Simply monitor your baby for symptoms of botulism, especially within the first few hours to days after honey consumption. 

Symptoms of infant botulism may include:

   - Constipation or difficulty passing stools

   - Weakness, lethargy, or floppiness

   - A weak cry

   - Difficulty feeding or sucking

   - Poor muscle tone

   - Irritability or a change in behavior

   - Breathing difficulties

   - Trouble swallowing leading to excessive drooling

Contact your healthcare clinician immediately if you notice any concerning symptoms or if you are unsure about whether your baby is at risk. While infant botulism is rare and very few babies who consume honey will develop it, always consult with your pediatrician if you have any concerns or need guidance specific to your baby's situation.

Honey for Upper Respiratory Symptoms

You may have read that honey can benefit children with upper respiratory symptoms like coughing and congestion. This is true! However, the benefits of honey do not outweigh the risks associated with ingesting honey under one year of age.

If your baby is ill, please focus on hydration, as this is nature’s best expectorant. If you have concerns or questions about your child’s cough or congestion, it is always best to check in with your trusted healthcare professional. Consider asking your doctor about giving an over-the-counter product called Zarbees, which is an agave-based cough and congestion syrup specially created for babies.

If you’re getting ready to start your baby on solids, download my FREE Baby-Led Feeding Essential Checklist to make sure you have everything you need to get started. You might also want to check out my new online course for parents, based on my best-selling book, which will walk you through the whole process of starting solids using a baby-led approach.

If you’re interested in learning more about starting solids, baby-led weaning, and preventing food allergies, check out my new baby-led feeding cookbook!

And if you're looking for personalized nutrition support, I am currently accepting new clients in my virtual private practice. Thanks for reading!

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