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This article is missing what I think is a pretty important PSA on the topic of bacteria in honey:

Honey commonly contains small amounts of the anaerobic bacteria Clostridium botulinum, which causes botulism.

This is why you should not feed honey to infants, because their immune systems cannot safely handle any amount of it yet. Even though the levels apparently are small enough for the rest of humans to consume worry-free.



Honey contains spores of Clostridium botulinum, not live bacteria. And as such, honey cannot in itself cause botulism.

But the intestinal microbiot of infants (not their immune system) is not necessarily developed enough, and as such Clostridium botulinum can colonize their intestine (it strives in anaerobic environment) and then they can develop a special kind of botulism where the toxin is actually produced in their own body (as opposed to ingested, like in regular botulism).

It's not the only way a child can stumble upon the bacteria's spore though.


You state honey cannot cause botulism, and in the very next sentence explain how it can.

I think you're making a novel semantic difference, which is irrelevant to anyone puking their guts out from botulism.


I for one found the technical difference interesting


I remember having small kids we took this very seriously. I always wondered if this was just another overprotective order, or could really be an issue.


https://parentdata.org/honey-botulism-babies/

> Infantile botulism is extremely rare. There are an estimated 100 cases per year in the U.S., among approximately 4 million children in the age range under 1. That’s a risk of 1 in 40,000. This is somewhat less likely than the chance of visiting the ER for a blanket-related injury in a given year (yes, I looked that up, and I do think it’s a good comparison).

> ... In an estimated 20% of cases — that’s about 20 cases a year — honey is one of the exposures. This doesn’t necessarily mean that the botulism actually came from honey; it’s just that because we know the spores can live in honey … it seems possible.

> At best, this suggests that by avoiding honey, you could lower the risk of infantile botulism from 1 in 40,000 to 1 in 50,000.


I don’t think these probabilities are correct. Every parent is told not to feed their under 1 year olds honey, many times.

In an extreme example… only 20 parents fed their kids honey and 20 kids contracted botulism.

That would be a 100% risk. Obviously in real life it’s not 100% of kids, but still could be a meaningful percentage and likely higher than 1 in 50,000 for babies that eat honey.


It is correct. They are considering the most extreme case; in the most extreme case, no non-botulism-infected infants eat honey, and honey was the cause of botulism for those 20 infants.

If that is so, then completely removing honey exposure for infants would mean that 80 rather than 100 infants get botulism poisoning.

So the new probability of contracting botulism is (80 / 100) * (old probability), and (80 / 100) * (1 / 40000) = 1 / 50000.


There are no errors in the calculation, but it's wrong anyways because it calculates the answer to the wrong question. "At best" suggests this is the largest possible effect, but it is the smallest possible. To get an upper bound estimate on the usefulness of avoiding honey, you would need to know how many parents of 1-year-olds are avoiding honey.


Thanks! You said that much better than I did.


Feeding honey to newborn babies is a common practice in India. Sometimes it's their first ever food.


Yeah, and their infant mortality is on par with Sub-Saharan Africa.

"The second most common prelacteal feed is honey, a delicious natural sweetener. Numerous studies [29,30] have shown that the ingestion of honey under one year of age is linked with infant botulism, a disease that results in a blockade of voluntary motor and autonomic functions. Apart from this, other prelacteal feeds get contaminated due to unhygienic environment, especially in rural India and in urban slums, resulting in infantile diarrhea. Thus, a wide range of prelacteal feeds and the introduction of early supplements result in recurrent diarrhea with multiple illness finally ending lives because of inaccessibility and unaffordibility of treatment and delayed or inappropriate care seeking behavior."

Rohini Ghosh - Child mortality in India: a complex situation (https://doi.org/10.1007/s12519-012-0331-y)

The paper lists a bunch of other traditional practices that have deleterious effects on the infants' health, such as putting unsanitary herbal concoctions on the babies navel while it's still healing, etc.


> result in recurrent diarrhea

This mind-blowing statistic stays in my head:

"Diarrhoea is a leading killer of children, accounting for approximately 9 per cent of all deaths among children under age 5 worldwide in 2021. This translates to over 1,200 young children dying each day" - https://data.unicef.org/topic/child-health/diarrhoeal-diseas...

Almost one per minute.


We waited until our kid was four, just to be safe, but it's was also honey from our own bees, so I somehow felt it less safe.

Kid went full Winnie-the-Pooh on the jar.


"OK, sister bees, now remember: this season we'll be feeding the hu-man's child, so wipe your feet before entering the hive, and if you feel the sniffles coming on, Don't Make Honey!"


It's more about the below minimum wage people harvesting, bottling for transport, transporting, then bottling for sale than the bees themselves. More intermediate steps to introduce contamination and more potentially contaminated sources all mixed together.


> Every parent is told not to feed their under 1 year olds honey, many times.

Huh, I think this might be my first time hearing it.


I'm not sure that number is meaningful without knowing how many parents are giving their infants honey. Granted I'm in a high-income, high-education area, but at least in my bubble, "don't give babies honey" seems to be common knowledge, so it's possible there are relatively few instances and a high percentage result in complications.


I think the rate was similar before we told parents not to give their infants honey. So we sort of have an A/B comparison.

> Some people have pointed out that botulism cases haven’t fallen over time despite parents being told not to give kids honey.


Whole food crunchy Instagram grifters push that infants should eat honey

Though tbh do people really eat that much honey? I only have some in my kitchen to have with tea when I have a cold. Other then that I almost never use it.


Oh man buttered toast with honey... English muffins... But most controversially, and most deliciously, it dresses up a pizza something lovely...

For me the shift happened when I stopped thinking of it as a sweetener for liquids and started thinking about it as a condiment to deploy conservatively but frequently.


Hot honey on pizza is the BEST


The United States is the second largest honey consumer behind China according to the latest data available from the United Nations Food and Agriculture Organization (FAO) in 2019. In 2021, consumption increased 8 percent from the previous year. Between 1991 to 2021, the average rate of growth is 10.7 million pounds per year. This translates to about 1.9 pounds per capita of honey consumption in 2021 compared with 1.2 pounds per capita in the early 1990s.


Breakfast buns go well with honey. Often switched up with jam every few days. Also pancakes and waffles are great with honey from time to time when I'm tired of maple syrup. Jam works too.


Yes. I literally collect different honey (including from my own hives) and my love of it is very strong.

And no, I don’t have diabetes yet. I’m not insane about it, but I do have it frequently.


(Diabetes isn't caused by sugar intake.)


Not directly, no. But indirectly, by increasing weight gain and eventual metabolic syndrome, if eaten in excess… which was my point :)


Type 1 isn't caused by any of this stuff. Type 2 is caused by excess body fat -- consuming too many calories in total over a long period of time. It doesn't matter what the composition of those calories is. You can eat mostly sugar, at maintenance levels, and never be at risk for T2D.


No honey with greek yoghurt?


A truncated version of Bayes used here:

A=Infantile botulism

B=Kid eats honey

P(A|!B) = P(A) * (1 - P(B|A))

Not sure it is correct!

The ACX signature says:

P(A|B) = [P(A)*P(B|A)]/P(B)

So

P(A|!B) = [P(A)*P(!B|A)]/P(!B)

= (1/40000) * .8 / ???

??? Is very small though if people take the medical advice.

Their number assumes nobody follows the advice!


When my kid was under one year old, we were especially careful about this we didn’t let her have even a tiny bit of honey. It really drove home the idea that everything has two sides. Honey can sit on a shelf for years without spoiling, but it can still be dangerous for the most vulnerable. It’s a reminder that just because something is natural and long lasting doesn’t mean it’s safe for everyone.


It's one of those things where honey is both a wonder of nature and a reminder that biology doesn’t always play nice with everyone


Americans/people on the internet worry far far far too much about botulism.


same with immunocompromised folks, though all that only applies to raw honey; pasteurized honey is more common in grocery stores and totally safe


I would not expect this to make a difference as pasteurization does not inactivate Clostridium endospores.


In Finland honey is rarely pasteurized. It is seen as a quality defect if honey is heated after extraction from the hive. Heating is thought to destroy some of the beneficial compounds in honey.

Similarly one should not put honey to too hot tea if one wants the benefits instead of just sugar.


Pasteurization would also destroy the delicate honey taste. It takes almost nothing to do that, and heating honey above about 40 C even for 30 seconds will kill any honeyness and all you have left is the sweet.

I'll bet only the imported Chinese honey is pasteurized on the supermarket shelf. Most of that goes to industrial use anyway.


Spores of Clostridium botulinum require temperatures way above boiling point to destroy. Pasteurization doesn't do anything to them.


It's pasteurised to stop you from making mead, not because it does anything to Clostridium spores.


Pasteurization doesn't in any way prevent honey from remaining fermentable.


OK. So?


So your claim is refuted


The pasteurisation is not done to destroy yeast?


I doubt it, but even if that were the case it would not support your earlier claim. When fermenting things you will generally intentionally introduce a very small quantity of a carefully controlled culture to the bulk media. Which is to say, you would almost certainly have your own yeast culture at home that you would inoculate the mead-to-be with. Maintaining a sourdough start is an example of this practice.

If you want to start your own culture from scratch there are established practices for culturing "wild" yeast from the environment.


It's absolutely why its done, because people would otherwise inadvertently initiate fermentation with it.

Not seeing this and instead going for 'hehe my little dude, pasteurisation doesn't destroy the sugar, you can still add yeast and ferment it' doesn't come across as particularly impressive from my perspective.


> pasteurisation doesn't destroy the sugar

I never said that? It's well known that heat alters honey.

Obviously the purpose of pasteurization is either preservation or food safety (but I repeat myself) as opposed to preventing people from making mead. I claim no particular knowledge of which specific microorganisms are primarily responsible for the spoilage that might otherwise occur, nor the precise consequences of such spoilage.




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