Feb. 26, 2001 -- It's perfectly safe for a pregnant woman to eat honey, though it should not be fed to children under age 1 because it may contain the deadly bacterium Chlostridium botulinum. Botulinum spores are also commonly found in dust and some uncooked foods. When they grow in contaminated foods or inside the digestive tract of a young child, they can produce a toxin that causes botulism, a rare but sometimes deadly disease.

An adult may become ill with botulism after eating improperly canned foods or, occasionally, contaminated fish. In this case, the toxin is absorbed by the intestines and attaches to the nerves, causing signs and symptoms that include blurred vision, dry mouth, difficulty in swallowing or speaking, general weakness, and shortness of breath. The illness may progress to complete paralysis, respiratory failure, and even death.

Infant botulism, on the other hand, is usually not caused by eating the toxin itself but by eating the spores of the botulinum bacterium, and honey is one source of these spores. If an adult eats honey containing botulinum spores, protective acid and other mechanisms in the intestine inhibit the spores from growing and producing the toxin. But a young child's digestive system isn't yet protective enough to inhibit the growth of the bacteria and production of the toxin. A pregnant woman can safely eat honey because her digestive tract will keep the botulinum bacteria from growing, and her honey consumption poses no danger to her fetus.

As with adults, the very rare form of food poisoning in babies or young children affects the nervous system and can result in death. The signs of infant botulism may include difficulty breathing; visual disturbances; lack of appetite; poor reflexes; weakness in the neck, arms or legs; inability to suck or cry normally; and persistent constipation. In adults, symptoms of food-borne botulism usually appear 12 to 36 hours after ingestion, but may take up to several days to develop. The incubation period for infant botulism varies. In most cases, patients with botulism are admitted to the hospital and treated symptomatically; an antitoxin is given in certain cases of food-borne botulism, but not to infants.

Although infant botulism poisoning is extremely rare, you can take some simple steps to prevent your baby from becoming infected: don't add honey to baby food, water, formula or medicine; and don't dip a baby's pacifier in honey. As children get older, stomach acid, bacteria, and the maturing intestinal tract make them less susceptible to botulism spores. By age 1, these defense mechanisms seem to be in place and honey can be safely consumed.

You can lessen your chances of getting adult botulism by properly processing and preparing canned and preserved foods. Don't open bulging food cans, and don't even taste any foods that smell "off." If a can of food has a bulging lid, don't open it but do return it to the grocery store. If you do home canning, follow strict hygienic recommendations to reduce contamination risk. And people who eat home-canned foods should ensure that strict safety guidelines are followed in preparing and processing the foods and should consider boiling them for 20 minutes before eating them in order to destroy the toxin.

Amos Grunebaum is a practicing obstetrician and gynecologist in New York specializing in high-risk pregnancies.

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