I was concerned to see that 5 month old infant was receiving Karo syrup in
Nutramigen.  Honey and corn syrup are the two most common vehicles for
transmission of botulism spores, resulting in infant botulism.  20% of corn
syrup samples contain viable botulinum spores, and about 10% of honey
samples.  Infant botulism can range from mild to severe, with death as a
possible outcome. Between 60-100 cases of infant botulism are reported to
CDC annually.
Symptoms can be hard to recognize in young infants.  The illness begins with
diarrhea and progresses within 48 hours of initial onset to muscular
weakness.  Symptoms like drooling and difficulty walking, easily identified
in older patients, are not obvious in babies.  Honey and corn syrup are
considered safe after age 1, by which time gut pH is low enough that the
spore doesn't germinate, and gut flora is well enough established that
illness would have to occur from ingestion of the botulism toxin not the spores.
Donna Logan

Midura, T.F.