Honey for Babies

I know that babies under 1 are not supposed to eat raw honey but when can they eat food with honey in them (i.e., Honey Nut Cheerios, Honey Maid graham crackers, etc.)?

Raw honey is not recommended for children less than 12 months old because of the risk of infant botulism.

Botulism is caused by a neurotoxin produced by Clostridium Botulinum. Clostridium Botulinum is a bacteria commonly found in soil and dust. The toxin is produced by the spore form of the bacteria and can be lethal in extremely small doses. Botulism toxin causes muscle paralysis. Botox is a commercially available form of this toxin. In is used in cosmetic procedures to paralyze muscles that cause wrinkles.

While adults are protected by the healthy bacteria of a mature digestive system, infants do not enjoy the same protection. The peak incidence of infant botulism is between 2 to 4 months. There are about 100 cases each year in the United States. In 2004, there were 3 cases of botulism in Florida. One of these cases was infant botulism secondary to honey ingestion. Nationally 15 to 30% of botulism cases are linked to honey.

There are two issues when discussing processing honey to make it safe and reduce the risk of botulism - the spore bacteria and the toxin.

according to a 2000 Pediatrics in Review article

“The toxin is heat-labile and is neutralized by cooking for at least 10 minutes at temperatures higher than 80°C (176°F). The spores, on the other hand, are very heat-resistant and survive even several hours of boiling. Consequently, there is a theoretical risk for infants consuming even processed foods containing honey. “

Honestly, this theoretical risk was news to me. In general, food products cooked with honey should be safe. Our 9 month olds have been served both Honey Nut Cheerios and Honey Made graham crackers. Given this small risk, it is probably best to wait until 12 months for any honey containing products.