Infant Botulism: A Patient’s Perspective

AS A YOUNG mom, the only thing Susan Dabalos Anderson knew about infant botulism was to avoid feeding her baby honey. When her exclusively breast-fed son became critically ill, she was shocked to learn he had contracted the potentially fatal illness, most likely from airborne spores.

BSTQ: Take us back 18 or so years ago. What were your son’s initial symptoms?

Susan: As a chiropractor, my specialty is children, so when our son wasn’t lifting his head anymore (which he had been doing since he was 1 month old), I knew something was wrong. He also wasn’t nursing properly. He had always been a happy baby, and his demeanor changed suddenly; he became very lethargic.

BSTQ: When did you know something was seriously wrong?

Susan: We took him to see the pediatrician within two days of noticing his symptoms. We were fortunate to see a doctor who had been in practice for over 30 years. Based on his experience and a consultation with another physician, he suspected our son had contracted botulism. That’s when they told us we needed to immediately go to Primary Children’s Hospital in Salt Lake City.

BSTQ: What happened next?

Susan: Thankfully, our pediatrician had called ahead, so our son was admitted to the hospital as soon as we arrived. During the initial intake, the attending physician discussed the need to give him BabyBIG (botulism immune globulin). The medical team said it was imperative to get him treated as soon as possible, even though they did not yet have a definitive diagnosis because they didn’t have a stool sample. Everything was happening quickly, and it was stressful to consider giving our child a medication that we knew nothing about, but within hours we did consent

BSTQ: You had a scare involving an inexperienced nurse. Tell us about that.

Susan: Due to him having very slow bowel movements, they decided to give him MiraLAX to get a stool sample. The first time he took it, he started throwing up bile. They waited a bit and then gave it to him again, and the same thing happened. We did not allow him to have MiraLAX again because one of the doctors said he was likely allergic to it.

BSTQ: Do you know how your son became infected with botulism?

Susan: Since he was purely breastfed and never given honey, we assume he contracted it from the environment. Salt Lake City had a lot of new housing developments at that time, and we later learned that botulism spores can be present in soil, and when construction disrupts the soil, these spores can become airborne as dust.

BSTQ: Tell us about your son’s recovery period. Were there any side effects or developmental issues?

Susan: Our son had a seamless recovery and was out of the hospital in two weeks. He had to drink 60 ccs of breast milk before he was released and, according to the therapist who fed him, he was the first botulism-infected baby she had seen released in fewer than four weeks. We did use suppositories to help him with bowel movements for a few months after he came home. I also started giving him a probiotic whenever he used a binky. The hospital recommended using a binky to help his sucking reflex since that skill can be diminished following a botulism infection. We did not introduce him to solid foods until he was about 8 months old, because I knew breast milk was more important for him, and I wanted to keep breastfeeding as long as possible. We also took him to the pediatrician more often to make sure he was gaining weight appropriately. Thankfully, he caught up with the growth charts at 8 months, and he never had any developmental issues. We were very grateful.

BSTQ: How is your son’s health today?

Susan: He is a healthy 21-year-old, 6 feet 3 inches tall and 160 lbs. He lives at home and attends college for mechanical engineering.