Infant botulism is fortunately rare, but can certainly occur in breastfed
infants.  The botulinum bacteria can grow in the gut of a breastfed baby and
produces the toxin which causes the paralysis & muscle weakness.  The
bacteria doesn't grow in the mixed-E Coli flora of the adult gut.  Adult
cases of botulism are from ingesting the toxin itself from food sources
(i.e., canned goods, etc.)  The babies present with constipation (lack of gut
motility) and weakness; can progress to respiratory insufficiency (from
paralysis of respiratory muscles).  Botulism will resolve with supportive
treatment.
Linda Shaw MD FAAP

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