More advice on keeping honey away from infants

Readers posed several follow- up questions to a recent Parental Guidance column warning people never to give honey to babies younger than 1 (April 14): "My daughter-in-law drinks hot tea and puts honey in it. She is breast feeding; can this cause botulism in the baby?" And "I heard a doctor say you should never give honey to a child under 2. Which age is correct?"

Parental Guidance returned to the source, Suzette Smookler, administrator for clinical nutrition and education at Stony Brook University Hospital, who was happy to elaborate.

"A baby cannot get botulism originating from honey through the mother's milk," Smookler reassures. The nursing mom's digestive system, which has mature adult gastric juices, would kill any botulism. "Once it's digested by Mom, it's not going to baby," Smookler says. Other substances, such as caffeine and alcohol, can be passed through breast milk, but not botulism spores in honey, she says. (So limit the amount of caffeinated hot tea, she does warn.)

As far at the age - 1 or 2 - the prevailing medical literature supports age 1, though some doctors may say age 2 to be super-cautious, Smookler says. "What it's really about is the development of the child's immune system and ability to make gastric juices," Smookler says. That's what will kill any small amount of botulism that may exist in honey.