Potential botulism- what to look for?

[catroddick]

I just posted this in the Recall area:
Plum Organics of Emeryville, Calif., is recalling some of its apple and carrot portable pouch baby food because of concerns over possible botulism contamination.
http://www.windsorpeak.com/vbulletin/showthread.php?p=2508089#post2508089

This is what DD had for dinner last night and the night before. It says there have been no illnesses yet. But what do I look for as signs of botulism? How soon would it hit?

I'm pissed and freaked. It took a lot for me to feed her a commercially prepared food. I've been making all her food, but found these to feed her when we travel (which we are doing a lot of this month and next month). Now this. I'm probably overeating. But I don't overreact often, and they're messing with my baby.

So, what do I look for?

[Cheburashka]

From webmd.com:

What are the symptoms?

The symptoms of food-borne botulism may include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, and muscle weakness. Infants with botulism appear to have little energy (lethargic), eat poorly, are constipated, and have a weak cry and poor muscle tone. These are all symptoms of the muscle paralysis caused by the nerve toxin. If botulism is not treated, advanced symptoms may cause paralysis of the arms, legs, and trunk and the muscles that help you breathe. In food-borne botulism, symptoms generally begin 18 to 36 hours after eating a contaminated food, but they can occur as early as 4 hours or as late as 10 days after eating the food

http://www.webmd.com/hw-popup/botulism
http://www.webmd.com/food-recipes/food-poisoning/food-poisoning-and-safe-food-handling-symptoms

Hope your DD is safe and well. :hug:

[catroddick]

Wow- that simultaneously made me feel better, and even more freaked out. Thank you for the info- I appreciate it.
So far she is eating well, is her cheerful energetic self, and is certainly not constipated. But she'll be under close watch. Thank you!

[Cheburashka]

Not a problem! You might also consider calling DD's doctor, and tell the doc/nurse that DD ate this food, and while she's been fine so far, you want to know specific signs to look for, just in case. Better to be on the safe side and overreact a little bit, IMHO. Glad to hear she's doing fine. :)

[catroddick]

I talked with my mom, who is with DD today. She assured me that she would keep a close eye on DD. When I told her the symptoms to watch out for- lethergy and constipation, she laughed out loud. "Oh honey, that's not a problem with THIS child today!"

[JenaW]

My son contracted infantile botulism at 3mos old. We are still not sure HOW he contracted it because at the time he was 100% breastfed. It seems there is an inhaled form and an ingested form, but I think they present fairly similar. I am not certain of the exact incubation period, but his appeared to be approximately 2-3 weeks. He went from having BMs with every feed to not going at all. He simply stopped pooing. Our pedi office kept blowing me off when I called because he initially had no other symptoms. Over the next 2 weeks, he had 1 or 2 small smears of stool, but nothing like you would expect after not having gone at all for several days. Then, within 36 hours, he stopped eating, got extremely weak (to the point of appearing floppy) and lethargic, lost his ability to smile (the toxin preferentially paralyzes the muscles that the cranial nerves innervate), and had a very weak suck. However, at 3 mos of age, the symptoms were pretty mild, and it was only my maternal instinct that something was wrong and a very astute pediatrician that diagnosed this. The sx started at mid-day on a Tuesday. Tuesday night he could not nurse because his suck was so weak. But I only knew he was not getting milk because I was able to pump 20 ounces total AFTER him "nursing" for 15 minutes....way more than I would typically get. Wed am we saw a different pedi (we were out of town), and were sent to the ER from his office. By Wed night he was on a ventilator in the PICU. It was unbelievably scary, but we were fortunate to be in a place where they recognized the sx immediately and we were able to get tx. We lived in Pittsburgh at the time, with a major Children's Hospital, but they had not seen any cases of it, and it was our pedi there who blew us off. We were visiting family in NY when he was diagnosed, and I am convinced that our pedi there saved his life. He was given botulism immune globulin (BiG) which was an experimental drug at the time (it is now FDA approved), so we had to get him approved for the clinical trial and have the drug flown in from CA. He spent about 3 weeks on the ventilator, then another week re-learning to eat, but is perfectly fine now with no long term effects at all.

Apparently the period of time from the initial onset of symptoms to respiratory failure and even death can be extremely fast. Because our son was involved in a clinical trial and DH and I are both in health care, we got involved with the group out of CA doing botulism research. They think (not sure how much of their speculations have ever been proven) that some cases of SIDS may actually be caused by botulism. There are approx 70 cases a year in the US, and most of them have been in breastfed babies. They tried to find a link between breastfeeding and botulism (did the mother ingest and somehow pass the toxin to her infant wihtout it affecting her?). They finally discovered that breastfeeding actually provides some amount of protection and slows the onset of illness. Formula fed babies seem to have a more fulminant course with a much more rapid progression of symptoms. They think it is possible that a formula fed baby could contract botulism, be sent to bed appearing perfectly healthy, and never wake us because they experienced respiratory failure in their sleep. The only way to test for botulism is with a stool assay that takes several weeks, and usually has to be sent out of state. We did not get confirmation of my son's botulism until well AFTER he was discharged from the hospital.

Anyway.....not trying to scare anyone. Just wanted to share my experiences. To the OP, please feel free to PM me if you have any questions. DH and I did a lot of reading/research about this while our son was hospitalized. At 70 cases a year, botulism is very rare. Obviously if there has been a food contaminant, the risk increases though. However, there IS a treatment available, but I do not think that many pediatricians are aware of it, or are even aware of the symptoms since it is not something that is diagnosed very often.

[catroddick]

JeraW- I am soo glad to hear that your little one is doing well. What an awful thing to go through. At least I have the fact that I know this is a threat, so if she starts acting funny, I can push for this to be considered. Thank goodness all apears well now. I'll certainly PM you if anything funny comes up and causes questions. Thank you!

[ThreeofUs]

Jera. O.M.G. Thank you so much for sharing this story. I'd never heard of this presentation before and will ask my ped about it. (Not that I'm worried about my DSs, but this is something that could easily happen, I think.)

[DrSally]

Wow, Jera. How scary and very informative. I'm so glad your DS is fine now.

[Cheburashka]

JeraW - so happy to hear your DS went through such a scary time and was strong enough to pull through. Thanks for sharing your story.

catroddick - good to hear that DD was fine today. I already know you're going to keep a close eye on her, so give DD an extra hug for us here on the boards tonight. :hug:

[catroddick]

Oh yeah- she shot outta bed like a rockett this morning. Work up at full speed!
Normally I nurse her at 5am before going to the gym, and put into bed with DH. She doesnt really wake up, just snuggles in and sleeps with him.
This morning when I finished nursing her, I lifted her to my shoulder to burp and she started her silly shrieks. She was wide awake and singing.
My husband cracked an eye- "it's lethergy we're looking for? I dont see it". :hysterical:
I left her with him, and went to the gym. I could hear her singing as I left. :D

[DrSally]

Good news! Eventhough the possiblity was small, I know it's very hard not to worry.

[ThreeofUs]

Great to hear it! Thanks for the update.