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Starting solids
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In one pass A baby is born with a store of iron already in the body.
Educational content, not medical advice — consult a clinician.
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Chapter 1
Why around 6 months
A baby is born with a store of iron already in the body. About half the iron a baby needs for growth is transferred from the mother late in pregnancy. So for most healthy babies born at term, this store lasts until around 6 months.
By then the store is running down while the baby is growing fast. Breast milk is naturally low in iron, so breast milk alone can no longer keep up. That is the body's reason for starting solid food at around 6 months.
The European Society for Paediatric Gastroenterology, Hepatology and Nutrition advises not before 4 months and not later than 6 months. The NHS advises starting at around 6 months. Babies born early or weighing under 2500 g at birth have smaller iron stores, so ask a paediatrician when to start.
If a baby chokes and cannot cough or breathe in, or their lips or tongue swell or they struggle to breathe after eating, call emergency services now.
By then the store is running down while the baby is growing fast. Breast milk is naturally low in iron, so breast milk alone can no longer keep up. That is the body's reason for starting solid food at around 6 months.
The European Society for Paediatric Gastroenterology, Hepatology and Nutrition advises not before 4 months and not later than 6 months. The NHS advises starting at around 6 months. Babies born early or weighing under 2500 g at birth have smaller iron stores, so ask a paediatrician when to start.
If a baby chokes and cannot cough or breathe in, or their lips or tongue swell or they struggle to breathe after eating, call emergency services now.
Clinical · Three signs a baby is ready
The NHS lists three signs that, when they appear together, show a baby is ready for a first taste of solid food:Can stay sitting and hold the head steady.Can coordinate eyes, hands and mouth: look at food, pick it up and put it in the mouth.Can swallow food rather than spit it back out.
Some behaviours are often mistaken for readiness but are normal: chewing fists, waking at night more than usual, wanting extra milk feeds. Solid food also won't make a baby sleep through the night.
At first, how much the baby eats doesn't matter. Most of their energy and nutrients still come from breast milk or formula; solid food is for getting used to new tastes and learning to move food around the mouth and swallow.
Chapter 2
Iron comes first
Two position papers from the European paediatric society agree: from 6 months, every baby should have iron-rich solid foods, including meat and/or iron-fortified foods.
Iron comes in two forms. Meat contains heme iron, which the body absorbs well and which is the best source of iron; most of the iron children eat is non-heme iron, which is absorbed less well. Even among meat eaters, only about 10% of the iron in children's diets is heme iron, so foods such as puréed meat and iron-fortified baby cereal belong near the front of the line.
Another easy mistake: before age 1, ordinary cow's milk should not be the main milk. The calcium and casein in cow's milk slow the absorption of non-heme iron, and cow's milk may also cause small, hidden blood losses from the gut; together they drain iron. Toddlers over 1 should have less than 500 mL of cow's milk a day.
All of this gets iron in. The next step is getting the baby willing and able to eat.
Iron comes in two forms. Meat contains heme iron, which the body absorbs well and which is the best source of iron; most of the iron children eat is non-heme iron, which is absorbed less well. Even among meat eaters, only about 10% of the iron in children's diets is heme iron, so foods such as puréed meat and iron-fortified baby cereal belong near the front of the line.
Another easy mistake: before age 1, ordinary cow's milk should not be the main milk. The calcium and casein in cow's milk slow the absorption of non-heme iron, and cow's milk may also cause small, hidden blood losses from the gut; together they drain iron. Toddlers over 1 should have less than 500 mL of cow's milk a day.
All of this gets iron in. The next step is getting the baby willing and able to eat.
Evidence · Should babies get iron drops
Countries differ on this.The American Academy of Pediatrics recommends iron supplements by body weight from 4 to 6 months for babies who are exclusively or mostly breastfed.An Italian expert panel gives iron only to babies with confirmed iron deficiency, out of concern that iron given to babies who don't need it may do harm.The European paediatric society finds not enough evidence to supplement every healthy baby of normal birth weight; babies weighing 2000 to 2500 g at birth should get it.
So don't buy iron drops on your own. Start with iron-rich solid foods, and leave the question of extra iron to a paediatrician who knows your baby.
Delaying the clamping of the umbilical cord at birth lowers the baby's risk of iron deficiency.
Chapter 3
Taste and chewing take practice
The first time a baby tastes a vegetable, they often frown and push it out. That doesn't mean they dislike it; it just isn't familiar yet.
One study fed 36 babies aged 4 to 6 months the same vegetable (peas or green beans) once a day for 10 days. After 10 tries, every baby was eating clearly more, and breastfed babies increased more. The NHS likewise says it may take 10 tries or more for a baby to get used to a new food, flavour and texture. The European paediatric society advises offering a variety of flavours, including bitter green vegetables.
Chewing takes practice too. The NHS advises moving from purées to mashed, lumpy and finger foods as soon as the baby can manage. In an English cohort of 7821 families, children first given lumpy food after 9 months ate less fruit and vegetables at 7 and had more feeding problems. This is an observational study, but it points the same way as the advice.
How you feed matters too: follow the baby's pace; a closed mouth or turned head means they've had enough, so don't force it; turn off the TV and phones at meals; and don't use food to comfort or reward.
One study fed 36 babies aged 4 to 6 months the same vegetable (peas or green beans) once a day for 10 days. After 10 tries, every baby was eating clearly more, and breastfed babies increased more. The NHS likewise says it may take 10 tries or more for a baby to get used to a new food, flavour and texture. The European paediatric society advises offering a variety of flavours, including bitter green vegetables.
Chewing takes practice too. The NHS advises moving from purées to mashed, lumpy and finger foods as soon as the baby can manage. In an English cohort of 7821 families, children first given lumpy food after 9 months ate less fruit and vegetables at 7 and had more feeding problems. This is an observational study, but it points the same way as the advice.
How you feed matters too: follow the baby's pace; a closed mouth or turned head means they've had enough, so don't force it; turn off the TV and phones at meals; and don't use food to comfort or reward.
Chapter 4
Allergy foods: earlier is better
Many parents assume that the later a baby meets allergy-prone foods, the safer. The evidence says the opposite.
One explanation is the dual-allergen exposure hypothesis: when eczema breaks the skin barrier, food proteins get in through the skin and the immune system tends to treat them as enemies, whereas eating them on time teaches the immune system to accept them. That is why eczema is the strongest early-life risk factor for food allergy.
The LEAP trial randomized 640 babies with severe eczema, egg allergy or both, at 4 to 11 months, to eat peanut regularly or avoid it. By age 5, among babies whose skin test was negative at the start, 13.7% of the avoidance group had peanut allergy versus 1.9% of those who ate it; among babies who started skin-test positive, it was 35.3% versus 10.6%.
The NHS now advises introducing allergy-prone foods (eggs, peanuts and tree nuts, cow's milk, grains with gluten, fish, soya, sesame and others) from around 6 months, one at a time so you can see which one causes a reaction, and once tolerated, keeping them in the usual diet. Delaying peanut and egg beyond 6 to 12 months may make allergy more likely.
If the baby has eczema or a diagnosed food allergy, or a family member has food allergy, eczema, asthma or hay fever, talk to a doctor before introducing these foods.
One explanation is the dual-allergen exposure hypothesis: when eczema breaks the skin barrier, food proteins get in through the skin and the immune system tends to treat them as enemies, whereas eating them on time teaches the immune system to accept them. That is why eczema is the strongest early-life risk factor for food allergy.
The LEAP trial randomized 640 babies with severe eczema, egg allergy or both, at 4 to 11 months, to eat peanut regularly or avoid it. By age 5, among babies whose skin test was negative at the start, 13.7% of the avoidance group had peanut allergy versus 1.9% of those who ate it; among babies who started skin-test positive, it was 35.3% versus 10.6%.
The NHS now advises introducing allergy-prone foods (eggs, peanuts and tree nuts, cow's milk, grains with gluten, fish, soya, sesame and others) from around 6 months, one at a time so you can see which one causes a reaction, and once tolerated, keeping them in the usual diet. Delaying peanut and egg beyond 6 to 12 months may make allergy more likely.
If the baby has eczema or a diagnosed food allergy, or a family member has food allergy, eczema, asthma or hay fever, talk to a doctor before introducing these foods.
In practice · A first taste of peanut
The 2017 US addendum guidelines sort babies into three groups by risk:Severe eczema, egg allergy, or both: can start as early as 4 to 6 months, but first have a doctor assess the baby (blood or skin test); the doctor decides whether to feed at home or in the clinic.Mild to moderate eczema: start around 6 months; this can be done at home.No eczema and no food allergy: introduce it freely along with other solid foods.
In every group, other solid foods should come first, to show the baby is ready. For babies a doctor has assessed as fine to try at home, the guideline sets out a first feeding:
Feed only when the baby is well, not with a cold, vomiting or diarrhoea; do it at home, not at day care or a restaurant; have at least one adult giving the baby full attention.Give a tiny taste on the tip of a spoon and wait 10 minutes; if there is no reaction, give the rest at the usual pace.Stay with the baby and watch for 2 hours afterwards.
Once peanut is in the diet, the guideline suggests about 6 to 7 g of peanut protein a week, over 3 or more feedings.
The form matters. Thin smooth peanut butter with hot water and let it cool, or stir it into a fruit or vegetable purée the baby already eats. No whole peanuts or nuts before age 5, and no peanut butter by the spoonful or in lumps before age 4: both are choking hazards.
Most of this research was done in Western countries where peanut allergy is common; in Japan, where it is rare, early peanut seems to make less difference.
Chapter 5
What to skip, and preventing choking
A few rules all come down to the baby's body:
No added salt, stock cubes or gravy: a baby's kidneys can't yet cope with extra salt. When cooking for the family, set the baby's portion aside before adding salt.No added sugar, juice or sweet drinks: they cause tooth decay. Fruit is fine.No honey before age 1: honey occasionally carries bacteria that can produce toxin in a baby's gut, causing infant botulism, a very serious illness.No rice drinks in place of milk before age 5: they may contain too much arsenic.Cook eggs until both white and yolk are solid; no raw or lightly cooked shellfish; avoid unpasteurised and mould-ripened soft cheeses.
Preventing choking also starts with the size, shape and hardness of food:
Hold off on hard foods such as whole nuts, raw carrot and raw apple.Remove pips, stones, fish bones and other bones.Cut small round foods like grapes and cherry tomatoes into quarters.Always stay with the baby while they eat.
A baby gagging (watery eyes, tongue pushing forward, retching to bring food to the front of the mouth) is learning to handle food, which is not the same as choking.
No added salt, stock cubes or gravy: a baby's kidneys can't yet cope with extra salt. When cooking for the family, set the baby's portion aside before adding salt.No added sugar, juice or sweet drinks: they cause tooth decay. Fruit is fine.No honey before age 1: honey occasionally carries bacteria that can produce toxin in a baby's gut, causing infant botulism, a very serious illness.No rice drinks in place of milk before age 5: they may contain too much arsenic.Cook eggs until both white and yolk are solid; no raw or lightly cooked shellfish; avoid unpasteurised and mould-ripened soft cheeses.
Preventing choking also starts with the size, shape and hardness of food:
Hold off on hard foods such as whole nuts, raw carrot and raw apple.Remove pips, stones, fish bones and other bones.Cut small round foods like grapes and cherry tomatoes into quarters.Always stay with the baby while they eat.
A baby gagging (watery eyes, tongue pushing forward, retching to bring food to the front of the mouth) is learning to handle food, which is not the same as choking.
Chapter 6
When to get help
Choking: if the baby is coughing loudly, encourage the coughing and stay close; if the cough is silent or they can't breathe in, shout for help and get someone to call emergency services. For a baby under 1 who is still conscious:
Lay the baby face down along your thigh or forearm, supporting the head and neck, and give up to 5 sharp back blows with the heel of your hand between the shoulder blades, checking after each one whether the object has come out.If it hasn't, turn the baby face up with the head lower than the feet, put two fingers on the middle of the chest just below the nipple line, and give up to 5 sharp chest thrusts.If a round doesn't clear it, call emergency services, then keep alternating until help arrives. Don't poke blindly in the mouth with your fingers.Even if the object comes out, see a doctor. If the baby becomes unconscious, lay them on a firm flat surface, call emergency services (on speaker) and start CPR.
Severe allergic reaction: call emergency services now: swollen lips, face or tongue, difficulty breathing, wheezing, repeated coughing, vomiting, hives all over the body, pale or blue skin, or suddenly floppy and listless.
A mild allergic reaction (a little rash or a few hives around the mouth or face): contact a doctor and ask how to carry on. Don't cut out a major food such as milk on your own; the baby could miss out on nutrients.
Lay the baby face down along your thigh or forearm, supporting the head and neck, and give up to 5 sharp back blows with the heel of your hand between the shoulder blades, checking after each one whether the object has come out.If it hasn't, turn the baby face up with the head lower than the feet, put two fingers on the middle of the chest just below the nipple line, and give up to 5 sharp chest thrusts.If a round doesn't clear it, call emergency services, then keep alternating until help arrives. Don't poke blindly in the mouth with your fingers.Even if the object comes out, see a doctor. If the baby becomes unconscious, lay them on a firm flat surface, call emergency services (on speaker) and start CPR.
Severe allergic reaction: call emergency services now: swollen lips, face or tongue, difficulty breathing, wheezing, repeated coughing, vomiting, hives all over the body, pale or blue skin, or suddenly floppy and listless.
A mild allergic reaction (a little rash or a few hives around the mouth or face): contact a doctor and ask how to carry on. Don't cut out a major food such as milk on your own; the baby could miss out on nutrients.
References · 13
- Miniello, V. L., Verga, M. C., Miniello, A., Di Mauro, C., Diaferio, L., & Francavilla, R. (2021). Complementary feeding and iron status: 'the unbearable lightness of being' infants. Nutrients, 13(12), 4201. Narrative review: about half the iron needed for infant growth is transferred from the mother in the third trimester, so most healthy term infants have iron stores at birth adequate for about six months; stores become gradually depleted around then and breast milk alone, whose iron content is low, can no longer meet requirements; preterm or under-2500 g infants have low stores at birth; heme iron is highly bioavailable but only about 10% of dietary iron in children of meat-eating populations; unmodified cow's milk harms iron status through calcium and casein lowering non-heme iron absorption and occult intestinal blood loss, so it should not be used in the first 12 months; the AAP recommends iron supplements of 1 mg/kg/day from 4 to 6 months for exclusively or mostly breastfed infants, whereas the Italian expert panel gives iron only to infants with confirmed iron deficiency because of concerns about supplementing iron-replete infants (full text PMC8707490). 10.3390/nu13124201
- Fewtrell, M., Bronsky, J., Campoy, C., Domellöf, M., Embleton, N., Fidler Mis, N., Hojsak, I., Hulst, J. M., Indrio, F., Lapillonne, A., & Molgaard, C. (2017). Complementary feeding: a position paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition. Journal of Pediatric Gastroenterology and Nutrition, 64(1), 119–132. Complementary foods should not be introduced before 4 months (17 weeks) and not delayed beyond 6 months (26 weeks); offer a variety of flavours and textures including bitter green vegetables; whole cows' milk should not be the main drink before 12 months; allergenic foods may be introduced any time after 4 months; infants at high risk of peanut allergy (severe eczema, egg allergy or both) should have peanut introduced between 4 and 11 months after specialist evaluation; gluten between 4 and 12 months, avoiding large quantities in the first weeks; all infants should receive iron-rich complementary foods including meat and/or iron-fortified foods; no added sugar or salt, avoid fruit juice and sugar-sweetened drinks; respond to hunger and satiety cues and avoid feeding to comfort or reward (abstract, PMID 28027215). 10.1097/MPG.0000000000001454
- NHS. (2026). Your baby's first solid foods. Start at around 6 months; breast milk or first infant formula provide the energy and nutrients needed until then (except vitamin D in some cases); premature babies: ask a health visitor or GP. Three signs together show readiness: sits and holds head steady, coordinates eyes, hands and mouth to pick up food and put it in the mouth, swallows rather than spits out; chewing fists, waking more at night or wanting extra milk feeds are normal and not signs of readiness, and solids will not make a baby sleep through the night. Do not add sugar or salt (salt is not good for babies' kidneys; sugar causes tooth decay). Go at the baby's pace, stop at signs of fullness such as closing the mouth or turning the head away, do not force; it may take 10 tries or more to get used to new foods; minimise screens at meals. Move from purées to mashed, lumpy or finger foods as soon as the baby can manage. Avoid hard foods like whole nuts, raw carrot or apple; remove pips, stones and bones; cut small round foods like grapes and cherry tomatoes into quarters; always stay with the baby while eating; gagging (watering eyes, tongue pushing forward, retching) is different from choking (page last reviewed 2026). www.nhs.uk/baby/weaning-and-feeding/babys-first-solid-foods
- NHS. (2024). How to stop a child from choking. If the child is coughing loudly, encourage coughing and stay; if the cough is silent or they cannot breathe in properly, shout for help; while conscious, for babies under 1 give up to 5 back blows (face down along your thigh or forearm, head supported, heel of the hand between the shoulder blades) then up to 5 chest thrusts (face up, head lower, 2 fingers just below the nipple line), checking between each; for children over 1, give up to 5 back blows in a forward-leaning position, then up to 5 abdominal thrusts, checking between each; call 999 if the blockage does not come out and keep repeating until help arrives; get medical help even if the object comes out; don't poke blindly with fingers; if the child becomes unconscious, call 999 and start CPR (page last reviewed 28 October 2024). www.nhs.uk/baby/first-aid-and-safety/first-aid/how-to-stop-a-child-from-choking
- NHS. (2024). Food allergies in babies and young children. Introduce foods that can trigger allergy from around 6 months, one at a time, so a reaction can be spotted; if the baby has eczema or a diagnosed food allergy, or there is a family history of food allergy, eczema, asthma or hay fever, talk to a GP or health visitor first; once introduced and tolerated, keep these foods in the usual diet; delaying peanut and hen's egg beyond 6 to 12 months may increase the risk of allergy to them. Reactions usually start within minutes, up to 2 hours (cow's milk allergy up to 3 days): swollen lips or face, itchy watery eyes, wheezing and coughing, red itchy rash, worse eczema, vomiting, tummy pain, diarrhoea; anaphylaxis (breathing problems, swollen throat or tongue) is a medical emergency; do not cut out a major food such as milk without advice (page last reviewed 22 October 2024). www.nhs.uk/baby/weaning-and-feeding/food-allergies-in-babies-and-young-children
- Domellöf, M., Braegger, C., Campoy, C., Colomb, V., Decsi, T., Fewtrell, M., et al. (2014). Iron requirements of infants and toddlers. Journal of Pediatric Gastroenterology and Nutrition, 58(1), 119–129. ESPGHAN position paper: rapid growth gives young children high iron requirements; risk factors for iron-deficiency anaemia include low birth weight, high cow's-milk intake and low intake of iron-rich complementary foods; no evidence that iron supplementation of pregnant women improves their offspring's iron status in a European setting; delayed cord clamping reduces the risk of iron deficiency; insufficient evidence for general iron supplementation of healthy normal-birth-weight European infants; marginally low-birth-weight infants (2000-2500 g) should receive iron supplements of 1-2 mg/kg/day; formula-fed infants up to 6 months should get iron-fortified formula; from 6 months all infants and toddlers should receive iron-rich foods including meat products and/or iron-fortified foods; unmodified cow's milk should not be the main milk drink before 12 months, and toddlers should have under 500 mL a day (abstract, PMID 24135983). 10.1097/MPG.0000000000000206
- Sullivan, S. A., & Birch, L. L. (1994). Infant dietary experience and acceptance of solid foods. Pediatrics, 93(2), 271–277. 36 infants aged 4 to 6 months were randomly assigned to be fed one vegetable (peas or green beans, salted or unsalted) on 10 occasions over 10 days; after 10 exposures all infants significantly increased their intake; breastfed infants increased more than formula-fed infants (abstract, PMID 8121740). pubmed.ncbi.nlm.nih.gov/8121740
- Coulthard, H., Harris, G., & Emmett, P. (2009). Delayed introduction of lumpy foods to children during the complementary feeding period affects child's food acceptance and feeding at 7 years of age. Maternal & Child Nutrition, 5(1), 75–85. ALSPAC cohort of 7821 mothers in England: 12.1% introduced lumpy solids before 6 months, 69.8% at 6 to 9 months, 18.1% after 9 months; children first given lumps after 9 months ate less of many food groups at 7 years, including all 10 fruit and vegetable categories, and had more feeding problems than those introduced at 6 to 9 months; observational, mother-reported (abstract, PMID 19161546). 10.1111/j.1740-8709.2008.00153.x
- Yamamoto-Hanada, K., Koplin, J. J., Groetch, M., du Toit, G., & Ohya, Y. (2026). Preventing food allergy by early food introduction: East meets West with the Lack dual-allergen exposure theory. Journal of Allergy and Clinical Immunology: In Practice, 14(4), 740–750. Eczema is the strongest early-life risk factor, supporting the dual-allergen exposure hypothesis that a disrupted skin barrier facilitates sensitization while timely oral exposure promotes tolerance; early peanut introduction has strong preventive effects in Western countries with high peanut allergy prevalence but appears less impactful in Japan, where consumption and prevalence are low; early egg results are mixed; moisturizers alone are insufficient, eczema management may be crucial; sustained regular intake after introduction likely supports tolerance (abstract, PMID 41187903). 10.1016/j.jaip.2025.10.036
- Du Toit, G., Roberts, G., Sayre, P. H., Bahnson, H. T., Radulovic, S., Santos, A. F., et al. (2015). Randomized trial of peanut consumption in infants at risk for peanut allergy. New England Journal of Medicine, 372(9), 803-813. The LEAP trial (640 high-risk infants 4-11 months); early regular peanut consumption reduced peanut allergy at age 5 (3.2% vs 17.2% with avoidance, ~80% relative risk reduction), reversing prior 'avoid early' guidance. Participants had severe eczema, egg allergy or both and were randomized at 4 to under 11 months; in the 530 skin-prick-negative infants, peanut allergy at 60 months was 13.7% with avoidance vs 1.9% with consumption; in the 98 skin-prick-positive infants, 35.3% vs 10.6%; no significant difference in serious adverse events; peanut-specific IgG4 rose mainly in the consumption group (abstract, PMID 25705822). 10.1056/NEJMoa1414850
- Togias, A., Cooper, S. F., Acebal, M. L., Assa'ad, A., Baker, J. R., Beck, L. A., et al. (2017). Addendum guidelines for the prevention of peanut allergy in the United States: report of the National Institute of Allergy and Infectious Diseases-sponsored expert panel. Journal of Allergy and Clinical Immunology, 139(1), 29–44. Guideline 1: infants with severe eczema, egg allergy or both should have age-appropriate peanut-containing food as early as 4 to 6 months, with peanut-specific IgE and/or skin-prick testing strongly considered first; Guideline 2: mild-to-moderate eczema, around 6 months, may be at home; Guideline 3: no eczema or food allergy, introduce freely with other solids; other solids first to show developmental readiness; about 6 to 7 g of peanut protein a week over 3 or more feedings; whole nuts not under 5 years, peanut butter from a spoon or in lumps not under 4 years; home first feeding: give a small taste on the tip of a spoon, wait 10 minutes, then the rest at the usual pace, and stay with the infant for 2 hours; mild signs are a new rash or a few hives around the mouth or face; lip swelling, vomiting, widespread hives, face or tongue swelling, difficulty breathing, wheeze, repetitive coughing, pale or blue skin or sudden limpness need immediate medical attention (full text PMC5226648). 10.1016/j.jaci.2016.10.010
- NHS. (2026). Foods to avoid giving babies and young children. No added salt, stock cubes or gravy, as salt is not good for babies' kidneys; no sugar or sweeteners including honey, syrup, fruit juice and smoothies (tooth decay), though fruit is fine; honey occasionally contains bacteria that can produce toxins in a baby's intestines causing infant botulism, so no honey before 1 year; no whole nuts under 5 years (choking), but crushed or ground nuts and nut butter spread on food are fine from around 6 months, and talk to a GP first if there is a family history of allergies; avoid mould-ripened soft and unpasteurised cheeses (listeria); hens' eggs without the British Lion mark should be cooked until white and yolk are solid; no rice drinks instead of milk under 5 (arsenic); avoid raw shellfish and shark, swordfish and marlin (mercury); raw jelly cubes are a choking hazard (page last reviewed 18 February 2026). www.nhs.uk/baby/weaning-and-feeding/foods-to-avoid-giving-babies-and-young-children
- Centers for Disease Control and Prevention. (2026). Botulism prevention. Honey can contain the bacteria that cause botulism; do not feed honey to a child who is younger than 1 year old. www.cdc.gov/botulism/prevention/index.html