Katie Ferraro (0s):

And most parents are aware of the risk of feeding their baby honey for the potential for it to cause infant botulism. But there's this huge gray area with baked goods, right? Is the amount of honey in a baked good going to be problematic and is that something to avoid? Hey, there I'm Katie Ferraro, Registered Dietitian, college nutrition professor, and mama of seven specializing in baby led weaning.

Katie Ferraro (36s):

Here on the Baby-Led Weaning Made Easy podcast I help you strip out all of the noise and nonsense about feeding, leaving you with the competence and knowledge you need to give your baby a safe start to solid foods using baby led weaning. Hello, and welcome back to another episode of the baby led weaning made easy podcast. I'm your host, Katie Ferraro. I'm a registered dietician and mom of seven specializing in baby led weaning. And today we're going to be talking all about the sweet stuff in particular honey, and why honey is dangerous for babies. So as I like to do with every episode, I want to get started with a baby led weaning tip of the day. And because we're talking about honey today, honey is something that you're likely aware your baby should not have pretty much.

Katie Ferraro (1m 20s):

Everybody's heard that now we're going to get into why that is and how honey can be harmful here in this episode. But I think the bigger picture is, and a big takeaway here is that honey is an added sweetener. An added sweeteners of all types are not appropriate for babies. The American academy of pediatrics reminds us to avoid serving food and drinks with added sugar to children under two years of age. So when it comes to honey as with all sweeteners, if you're even a little bit curious or confused about it, when in doubt, leave it out. Now I want you to hang tight though, because I know you're cooking recipes and making foods for your baby that may call for a little bit of honey.

Katie Ferraro (2m 0s):

So in this episode, I'm going to be sharing a very simple ingredients swap that you can use. If you're preparing recipes for baby led, weaning that do call for honey. This is a safer alternative that if used in small amounts, you swap it out. One-to-one if you're making recipes and we're going to get to that in this episode. So let's go ahead and dive right in talking all about honey and why honey is dangerous for babies. Now you guys have probably heard that honey is problematic in infants and most parents know it has something to do with infant botulism. Many of the foods that I recommend you don't feed your baby. And that you learn about here on this podcast, oftentimes have to do with choking, right?

Katie Ferraro (2m 43s):

We talk about 15 foods, never to feed your baby and how to reduce choking risk and educating yourself about minimizing choking risk. Honey is totally different. Okay? It's on the do not feed list, but not because of choking because honey has the potential to cause infant botulism. So botulism is a very rare but serious condition that can result in coma or death. And botulism is caused by poisons or toxins that are produced by spore forming bacteria called Clostridium botulinum. Now food-borne botulism arises. If food becomes contaminated with these botulinum spores and is then stored improperly now with honey, you and I, as adults with developed immune systems, we're able to handle those botulism causing spores in our immune system, but your baby, your baby has this pristine little immune system.

Katie Ferraro (3m 42s):

And although again, the risk is very rare. The risk is real. And so infants can get botulism from honey. And we're going to talk a little bit about what causes botulism in babies, because it's not always honey. Okay. Now when we're talking about infant botulism, it occurs mostly in babies, younger than six months of age. If the spores are eaten by a baby and then the bacteria grows in their intestines, it makes toxins in the gut. And we don't always know the sources of the spores. So it can be present in things like soil or dust. Then it can become airborne and breathe in. Your child can swallow it. You can't avoid those things for the most part. But what we can focus on is honey, because honey is another potential source of those disease causing sports.

Katie Ferraro (4m 24s):

And honey should be avoided in children under 12 months of age. So the American academy of pediatrics reminds us that most children can recover fully from botulism, although it can take several weeks to months for that to happen. So in the event that the conditions untreated, the symptoms of food borne botulism can then progress to a stage where things like the breathing muscles become paralyzed and death even can result from respiratory failure. So I don't want you guys to listen to this podcast and then go home, think, oh my God, my baby is botulism. Okay. We are talking about a very, very, very rare cases, less than 200 cases a year as reported by the CDC for botulism across the board.

Katie Ferraro (5m 6s):

Although about 77% of cases the last year for which there was data, which is 2017, we're from infant botulism. So in 2017, the CDC reported 182 lab confirmed cases of botulism and 141 of those or 77% were infant. So again, it's rare, but it could happen. And if you're curious, the symptoms of botulism include things like lethargy, listlessness, poor intake, difficulty swallowing, loss of head control, vision problems, and then generalized weakness, or what sometimes gets described in the literature as floppiness, following constipation in the baby.

Katie Ferraro (5m 48s):

Okay. So again, don't automatically think your baby has botulism keep in mind that this is a very rare condition, but what can we do to prevent botulism? Well, the AAP, as well as other health bodies recommend that we don't give honey to a baby younger than 12 months. Now, honey is safe for babies age one year and older. But remember, again, we're recommended not to include any added sweeteners for children aged two and under. So even though it's safe to feed, honey, honey sometimes gets this perception of having what we call a health halo. People think or presume that honey is healthier than other added sugars because it's quote unquote natural, but added sugars or added sugars or added sugars, none of which are appropriate for children under two.

Katie Ferraro (6m 33s):

And in particular for babies and honey is an added sweetener and honey should be avoided for an additional reason because it has the potential to cause infant botulism. Now, botulism can also occur from improperly prepared and stored foods. And in particular, improper canning comes to mind. So food preparation and home canning can be made safe from botulism. If you, for example, boil the foods for 10 minutes, which in turn can destroy the toxins, be sure to never feed your baby any foods that appear to be spoiled. And then also, perhaps you're aware of that risk with bulging cans. So any food containers or cans that are bulging should be discarded, they may contain a gas that's produced by botulinum.

Katie Ferraro (7m 18s):

And just so you're aware, there's no vaccine to prevent botulism across the board in particularly in infants. So let's talk a little bit about botulism and infancy. It's actually been in the news in 2018. There were four reported infant deaths in Texas linked to infant botulism. And it was the use of a product called a honey pacifier. So the food and drug administration in the United States received reports from the state of Texas that four infants were hospitalized. And then eventually unfortunately died because of botulism and all four of those infants had used pacifiers containing honey. So those particular pacifiers were purchased in Mexico.

Katie Ferraro (8m 0s):

However, similar products are also available through online retailers in the United States and globally. So the FDA recommends parents and caregivers do not give pacifiers that are filled with honey or dipped in honey to infants or their young children. If you've ever bought one of these or dipped a pacifier and honey, stop that practice or discard that product. And then the FDA across the board recommends that online retailers discontinue the sale of any honey filled pacifier. And you might be wondering, well, why would someone dip a pacifier in honey? Honey is oftentimes used in childhood as a cough suppressant. So if you've ever looked at like children's cough syrup, if your baby had a cough, you'll see, oh, most costlier products will say, this is not appropriate for children age two.

Katie Ferraro (8m 48s):

And under, if you look up natural homeopathic remedies for coughs, honey is oftentimes listed and there's actually a good of research to support the use of honey in older children. So for children age one year and older, you can use honey somewhere between two or five milliliters as needed. The notion here is that honey does thin the mucus. It loosens the cough. If you don't have honey, corn syrup can also be used as an alternative. And there's even research again, to show that honey can be better than store-bought cough syrups at reducing how often coughing happens and then how bad the coughing is at night for children. So again, for older children, we don't use is a lot of excess or added sweeteners, but if your child does have coughing situation, honey may be helpful, but we should not be giving honey as a cough suppressant for infants under the age of one, another area where you sometimes see honey in the news again, very rare, but there are certain, there was like a, a number of cases in 2017, a deer antler tea.

Katie Ferraro (9m 49s):

So there was botulism deaths related to the use of deer antler tea the FDA investigated. It was a company making these herbal teas. They were held at particularly low acidity room, temperature, not produced according to guidelines, making them susceptible to Clostridium botulinum. So again, probably not as prevalent as the use of honey pacifiers, but from time to time, sometimes these things do crop up in the news. We're talking two deaths and four deaths by no means, you know, very large numbers, but certainly something just to be aware of something you're probably more inclined to be feeding your baby than deer antler tea would be baked goods. Parents always ask about, well, what about honey in baked goods? You guys probably get it.

Katie Ferraro (10m 29s):

Don't feed raw or wild honey to your baby, but in baked goods, this one's a little more challenging. Both the American academy of pediatrics and the CDC. I have to say they conveniently don't address baked goods in their formal statements. You can look online and there's all these other bloggers and pseudo experts who warn against honey and baked goods. But to be honest, there's no real scientific literature to back up that stance. The reality being though that most baked goods that would contain honey, they're probably not appropriate, certainly not necessary to feed to babies under age one anyway, right? Because honey is an added sweetener and there are so many other wholesome, intact foods. We can feed our babies long before we would ever need to. You know, and when I say need of course, a little tongue in cheek, but we're talking about trying to feed our baby a variety of foods.

Katie Ferraro (11m 14s):

Honey's not on the a hundred first foods list. Let's just put it that way. So my best advice is when in doubt, leave it out will a bite of a baked good with some honey do any harm. It really is hard to say. And just so you know, there's no like definitive ruling or statement on the use of honey in baked goods. Inevitably, when we're talking about baby parents will follow it up with a question about honey nut Cheerios. So previously mentioned babies. Shouldn't be having food that has added sugar in it. And honey nut Cheerios is a sugar sweetened cereal. Okay? So the honey is actually really not the problem of concern when we're talking about honey nut cheerios. It's the fact that you're feeding a food to your baby, which yes it's iron fortified, but it has additional sugar.

Katie Ferraro (11m 56s):

If you want to do Cheerios. I think Cheerios are great. Once your baby is eight months of age or older or a similar product. I know some of you guys do organic cereals and regular Cheerios. I've actually spoken with the team at general mills regarding what their official statement is on a number of different things. First of all, they claim that when the regular Cheerios in the yellow box, not honey nut Cheerios, that those are designed to actually dissolve on the baby's tongue. So sometimes you'll hear people say, oh, Cheerios are a great first food for babies. Well, I disagree with that because Cheerio's required your baby to have a pincer grasp, to pick the Cheerio up. And because six and seven month old babies don't have their pincer grasp. We would not feed them Cheerios because that's mean it's frustrating.

Katie Ferraro (12m 37s):

It's a challenge for a baby to pick up the food. We don't want your baby to be frustrated with their first foods. And it's why we choose among other reasons, the longer strips of food to start out with solids when we're doing baby led weaning, but at around eight months of age, when your baby does get that pincer grasp an unsweetened cereal, like regular Cheerios is fine. There's some sodium in there. Some parents prefer to avoid Cheerios. They're not an organic product. You know, that's up to you, but really honey nut Cheerios are not inappropriate substitution because it's a sugar sweetened cereal. However, in speaking to a spokesperson at general mills about the honey issue, what about the honey and honey nut Cheerios? Is it safe for babies to eat? Their official statement is the honey. And the general mills products does not pose a food safety risk.

Katie Ferraro (13m 21s):

The concern for botulism and honey pertains to raw honey, only the honey that is used in our products is cooked during the product manufacturing process. So again, you take from that, what you will, from a nutrition standpoint, honey, nut Cheerios are not an ideal first food because they do contain added sugars, but will a few bites of honey nut Cheerios here in there, especially for an older baby cause infant botulism, just, you know, there's no reported cases and from baked goods, as far as I'm aware, there's no reported cases as well, but we say when in doubt, leave it out. So as I mentioned at the top of the episode, I know a lot of you guys are preparing recipes that may have a little bit of honey in them.

Katie Ferraro (14m 2s):

Okay? If it calls for a cup of honey, it's not a recipe that you should be making for your baby. Cause that's a couple of an added sweetener, but there's recipes. For example, I make a corn bread recipe for baby led weaning. I make it for the rest of my family, rather older children. And it has two tablespoons of honey in it. Well, if I'm feeding that to a baby, an ideal swap would be agave nectar or a agave syrup. You can substitute one-to-one. So take out the honey and replace it with agave nectar or agave syrup provided it's in small quantities. So agave nectar, if you're not familiar, it's a fructose rich liquid sweetener derived from a plant. The Agave plant it's oftentimes promoted as like a low-glycemic alternative to refined sugar.

Katie Ferraro (14m 44s):

So there is some data to support its use in a blood sugar control in adults with diabetes or weight management, because you need a very small amount to get that sweet taste. Again, if you're using it one or two tablespoons here or there in a recipe, then agave nectar may be a good alternative. So again, we don't want to use honey in large quantities, but in small amounts, sub it out with agave because when in doubt we want to leave it out. Now, if you guys are looking for additional info about all the foods that you can feed your baby, cause I hate to, it's hard to spend a whole episode talking about one thing we shouldn't feed our babies. When there are so many foods out there, your babies can eat every week. I teach a free workshop called baby led weaning for beginners.

Katie Ferraro (15m 27s):

It's all about how to get your baby to try 100 foods before turning one. And they give everyone on that workshop, a free copy of my hundred first foods list. So yes, I don't want you to feed your baby honey. There are a hundred plus other foods your baby safely can eat. If you want to sign up for that free workshop, I'm going to link to that as well as a number of different news articles and research studies that talk about honey and the risk for babies, including infant botulism. That's all linked up on the show notes for this episode, which is blwpodcast.com/27. And again, that's all about honey and why honey is dangerous for babies.

Katie Ferraro (16m 7s):

So when in doubt, leave it out. Steer clear of honey. Thanks for listening to this episode. Bye now!