I accidentally gave Honey Nut Cheerios to my baby! by Dr Alexis Lieberman
January 6, 2025
How big a risk is it if you accidentally give processed foods with Honey in the name to your baby under 1?
Clearing Up Misconceptions About Processed Foods With Honey in the Name
Most parents know that honey should be avoided for babies under the age of one, but how many understand why? It’s because honey can potentially contain botulism spores, which pose a risk to infants but not to older children or adults. If you’ve ever wondered about the botulism risk in honey, this article will clarify everything you need to know and provide reassurance about processed foods with “honey” in the name.
What is Botulism and Why is it a Concern for Babies?
Botulism is a rare, but serious illness caused by Clostridium botulinum, a bacteria that produces a potent neurotoxin. This toxin attacks the nervous system, leading to symptoms like muscle weakness, difficulty swallowing, and even paralysis. While botulism spores are commonly found in the environment, they only pose a risk when they are allowed to grow and produce toxins in low-oxygen environments, such as in the digestive system.
Babies, particularly those under one year old, have a less developed immune system and digestive tract, making them more vulnerable to botulism. In contrast, older children and adults have a more mature digestive system that can prevent the spores from growing and causing illness. An infant with botulism might have a weak cry, constipation, drooping eyelids, loss of head control, trouble having the energy to feed, and floppy arms and legs. (If the baby JUST has constipation or poor feeding, that is NOT likely to be botulism!)
Infant botulism is not the same as the botulism that older children and adults get. “In infant botulism, the swallowed botulism spores activate and produce botulinum toxin inside the baby's large intestine. In foodborne botulism the botulism spores activate in the food and produce botulinum toxin.
Older children and adults get foodborne botulism by eating the food in which the botulism bacteria have produced botulinum toxin.” (https://www.cdph.ca.gov/, California Department of Public Health)
My Personal Experience with Botulism
In my 30 years of medical practice, I’ve only encountered two cases of botulism. One involved a infant who contracted botulism from old wallpaper paste during a home renovation, and the other occurred after an infant consumed tea made from a large bunch of dried chamomile flowers purchased at a health food store. Neither of these cases involved honey, which is why I want to emphasize that while botulism in honey is a theoretical risk, it’s very rare in practice. In the United States, about 20% of infant botulism cases are linked to honey consumption. (NIH, Stat Pearls, https://www.ncbi.nlm.nih.gov/books/NBK493178/#:~:text=In%20the%20USA%2C%20there%20are,corn%20syrup%2C%20and%20medicinal%20herbs.)
The Real Risk: Why Babies Should Avoid Honey
The key concern with honey is its potential to contain botulism spores. “Although honey is a known food vehicle for the bacteria that causes infant botulism, we typically don’t consider an individual honey exposure to be overly risky for acquiring the bacteria that causes infant botulism. Honey is the one dietary reservoir of C. botulinum spores thus far definitively linked to infant botulism by both laboratory and epidemiologic evidence. However, that said, not every jar of honey has botulinum spores in it. To date, avoiding feeding honey to infants 12 months of age or less is the only known prevention measure for infant botulism.” (https://www.cdph.ca.gov/, California Department of Public Health)
The Reason for This Article: Reassuring Parents About Processed Foods with Honey
I often hear from parents after they accidentally give their baby processed foods with the word "honey" in the title—like Honey Nut Cheerios or Honey Grahams. While there is no proof that there are no botulism spores in these foods, in my opinion, the risk is negligible. The amount of honey in these processed foods is extremely small.
We do need to keep in mind that “commercial heat pasteurization (including vacuum packed pasteurized products and hot smoked products) may not be sufficient to kill all spores” (WHO, https://www.who.int/news-room/fact-sheets/detail/botulism) so while you should not CHOOSE to give foods with ANY honey to an infant under 1 years old, at the same time, there is so little honey in most foods named “honey” that if you do accidentally give these, you should not worry.
To help reassure parents, I’ve put together a table of common processed foods that contain honey. This table provides an approximation of the amount of honey in each item, showing that these foods do not carry the botulism risk that plain honey does.
Common Processed Foods with "Honey" in the Name: Are They Safe for Babies?

| Product Name | Amount of Honey (approx.) |
|---|---|
| Honey Nut Cheerios | ~1g per serving |
| Honey Bunches of Oats | ~2g per serving |
| Honey Graham Crackers | ~3g per 2 crackers |
| Honey Wheat Bread | ~1-2g per slice |
| Honeycrisp Apple Cereal | ~2g per serving |
Conclusion: No Need to Worry About an Accidental Ingestion of Processed Foods With Honey In the Name
In summary, while honey itself can pose a botulism risk for babies, the presence of honey in processed foods does not carry the same risk. The small amounts of honey used in these products, coupled with pasteurization and other food safety measures, make them less risky for babies. So, if you've accidentally given your baby processed foods like Honey Nut Cheerios, there's no need to worry.
If you're ever in doubt about what foods are safe for your baby, don’t hesitate to reach out to your pediatrician.
Many years ago, I had a patient with a terrible diaper rash — open, raw skin that looked painful enough to make everyone cringe at diaper changes. The family had used every cream known to man. Fancy creams, prescription creams, zinc creams, all the creams. Nothing was working. Finally, desperate, I sent the baby to dermatology. The dermatologist took one look and said: “Stop everything. Just use Vaseline.” Ever since then, Vaseline has been my go-to treatment for most diaper rashes. The other big lesson I learned is this: when the skin is really irritated, stop wiping. Even “gentle” sensitive wipes will wipe away the new skin cells trying to grow and heal the rash. Instead, use water. You can use a spray bottle, hold the baby under a faucet, or use a handheld showerhead. (Just be careful with flailing little arms and legs — nobody wants an accidental hot-water burn while cleaning baby!) For many babies, severe diaper rash improves with three simple things: * Gentle cleaning with water only * Thick barrier protection * Avoiding friction from wipes The one diaper rash that usually will not improve with just Vaseline is a yeast diaper rash. What Causes Diaper Rash? Diaper rash happens when the skin becomes irritated from moisture, urine, stool, friction, yeast, or bacteria. Some diaper rashes are mild and red, while others become raw, painful, or peely. Different diaper rashes need different treatments. Types of Diaper Rash 1. Smooth Red Diaper Rash (Irritant Diaper Rash) - This is the most common diaper rash. It happens because urine and stool irritate and essentially “burn” the skin. Symptoms include: * Smooth red skin * Tenderness * Irritation in areas touching the diaper Best Treatment for Irritant Diaper Rash Treatment options include: * Vaseline * Desitin * Butt Paste * Zinc oxide diaper creams * Over-the-counter hydrocortisone cream * Prescription hydrocortisone if needed If using hydrocortisone: * Use twice daily for 5 days * Then once daily for another week if needed For many babies, a VERY thick layer of Vaseline works surprisingly well and is all that is needed. 2. Yeast Diaper Rash A yeast diaper rash looks different from a standard diaper rash. It is often: * Dotty * Peely * Bright red * Surrounded by small “satellite” spots Yeast thrives in warm, wet environments, and a diaper is essentially a warm, damp plastic bag — the perfect setup for fungus to grow. Best Treatment for Yeast Diaper Rash Yeast diaper rashes need antifungal treatment, such as: * Lotrimin * Lamisil * Prescription Nystatin These should be applied 3–4 times daily and continued for one full week after the rash appears gone. Many pediatricians feel that if a diaper rash has lasted longer than 3 days, yeast may be contributing and an antifungal cream should be added. 3. Severe Raw Diaper Rash (Erosive Diaper Dermatitis) This is the diaper rash parents dread. The skin becomes: * Raw * Open * Eroded This happens when urine, stool, moisture, and digestive enzymes break down the skin barrier over time. These severe diaper rashes can take several weeks to fully heal. They look terribly painful, but most young babies act normal while they have the rash. Best Treatment for Severe Raw Diaper Rash The goal is to create a barrier so urine and stool cannot touch the damaged skin. This is where Vaseline often works best. And the key is using a VERY thick layer. Other barrier treatments include: * Corona ointment * Xeroform * Phytoplex Z-Guard paste * Cavilon spray * Coloplast barrier cream * Ilex barrier cream * Stomahesive powder mixed with diaper rash ointment Home Remedies for Diaper Rash Some families also find these soothing treatments helpful: * Baking soda baths * Domeboro soaks * Freshly pumped breast milk applied to the skin * Liquid Maalox dabbed on the rash and allowed to dry * Gentian Violet for raw, weepy rashes Gentian Violet can help dry the skin and may help with both yeast and mild bacterial infection. Fair warning: it stains everything purple. Stop Using Baby Wipes on Raw Skin One of the most important diaper rash tips is this: When the skin is raw, stop rubbing it. Even sensitive baby wipes can worsen severe diaper rash. Instead: * Use plain water * Use a spray bottle or rinse the baby under running water * Dab gently instead of wiping * Allow diaper-free time whenever possible Reducing friction is often one of the fastest ways to help the skin heal. When to See a Doctor for Diaper Rash Parents should contact their pediatrician if: * The diaper rash is worsening * The rash is not improving within a few days * The child develops a fever * The rash becomes blistered, crusted, or rapidly spreading A diaper rash with fever may indicate a bacterial infection and should be evaluated promptly. Final Thoughts on Treating Diaper Rash Parents are often surprised that the best diaper rash treatment is sometimes the simplest one. For many babies, the combination of: * Water instead of wipes * Thick Vaseline * Time out of diapers works better than a cabinet full of medicated creams. And if the rash looks dotty and peely instead of smooth and red, think yeast.
Traveling with a Baby or Toddler: Safety Tips for Flying, Sun Protection, Swimming, and International Travel Planning a vacation with a baby or toddler can feel overwhelming, but with the right preparation, family travel can be safe, enjoyable, and memorable. Whether you are flying with an infant, heading to the beach, or traveling internationally, understanding child travel safety is essential. This guide covers important tips for sun safety, airplane travel, water safety, and travel vaccines for babies and young children. Sun Safety for Babies and Toddlers Protecting babies and toddlers from the sun is especially important because young children have sensitive skin that burns easily. Choosing a Safe Sunscreen for Babies Sunscreen can be used at any age, including babies under 6 months old, as long as you choose a mineral or barrier sunscreen that primarily contains zinc oxide. Mineral sunscreens sit on top of the skin rather than being absorbed. When selecting sunscreen for children: Choose products with mostly zinc oxide Avoid oxybenzone, which may disrupt hormones Avoid retinyl palmitate, a form of vitamin A that may increase sun sensitivity Avoid spray sunscreens to prevent inhalation Parents can research sunscreen ingredients and safety ratings through resources such as EWG Skin Deep Cosmetics Database and look for products with a hazard score under 4. Safe Sun Exposure for Infants Even with sunscreen, babies should not spend long periods in direct midday sunlight. Safer sun habits include: Keeping babies and toddlers out of direct midday sun Allowing limited early morning or late afternoon sun exposure Using hats, rash guards, and shade whenever possible Short periods of sun exposure very early or very late in the day may be reasonable without sunscreen, but prolonged exposure should always be avoided. Flying with a Baby or Toddler Air travel with children requires planning, especially when it comes to safety and comfort. The Safest Way for Babies to Fly Although airlines allow children under age 2 to sit on a parent’s lap, the American Academy of Pediatrics recommends that infants travel in an FAA-approved car seat. Many car seats are approved for both motor vehicles and aircraft. Check: The sticker on the side of the car seat Your car seat manual Your airline’s measurement and seating requirements Older children may be able to use the CARES harness system on airplanes. Traveling with Car Seats If you are bringing a car seat to your destination: Ask your airline whether car seats count toward baggage limits Many airlines check car seats for free Car seats used on the plane with a purchased seat usually do not count as carry-on luggage Helping Babies with Ear Pressure on Airplanes Changes in cabin pressure can cause ear discomfort during takeoff and landing. To help reduce ear pain: Nurse, bottle-feed, or offer a pacifier during ascent and descent Older children can suck on lollipops If your child recently had diagnosed middle ear fluid or an ear infection, you can give ibuprofen about 30 min before take off. If more than 6 hours has passed, you can give a second dose 30 min before landing. Preventing Illness While Flying Airplane travel itself is generally safe for babies, but crowded public spaces can spread germs. Helpful travel hygiene tips include: Wash or sanitize your hands frequently Clean your hands before touching your baby Wipe down commonly touched surfaces if desired Can Benadryl Help Kids Sleep on Flights? Some parents consider using Benadryl during flights. However, children can occasionally have the opposite reaction and become hyperactive or irritable. If you want to try it: Test it at home first during nap time Be aware that effects may last about 6 hours Avoid routine use Entertainment Tips for Long Flights with Toddlers Older babies and toddlers can quickly become bored during travel. Helpful ideas include: Bring a bag of small toys your child has never seen before Borrow toys from friends specifically for travel Introduce a new activity or toy every 15 to 30 minutes And remember: if your child cries or fusses on the plane, most passengers understand. Many are parents themselves. Water Safety for Babies and Toddlers Pools, lakes, oceans, and bathtubs all require constant supervision around young children. Never Leave Children Alone Near Water Children can drown quickly and silently, even in small amounts of water. Important safety rules include: Never leave a child alone near pools, lakes, oceans, bathtubs, or buckets of water An adult who can swim should always remain within arm’s reach of infants and toddlers Supervision from a distance is not enough Water Safety and Alcohol Adults supervising children around water should avoid alcohol or other substances that impair judgment or slow reaction time. If it's a party, please arrange for a LIFEGUARD! Ocean Safety for Young Children If visiting the beach with babies or toddlers: Watch tide conditions carefully Stay alert for strong waves Learn how to recognize rip currents Keep young children at arm's length closeness to an adult at all times in the water Travel Vaccines and Medications for International Travel Families traveling internationally may need additional vaccines or medications depending on the destination. Please write on the portal to check in before international travel. Early Measles vaccine If your child is 6 months to 11 months, it is recommended by the American Academy of Pediatrics to get a measles vaccine prior to international travel. There is no specific recommendation for an early measles shot for travel within the US, but if you know you are going to a "measles hot spot," we DO recommend an early MMR. The measles vaccine given UNDER one year old does NOT count for the one year old vaccine, and it will need to be repeated. If your child already had their 1 year old measles vaccine, but has not yet had their 4 year old measles vaccine, you can get an early second MMR-V. This WILL count as the 4 year old vaccine and does NOT need to be repeated. Book a medical assistant visit to get this vaccine! Oral Typhoid Vaccine (Vivotif) Vivotif is approved for children ages 6 and older. Look at the CDC travel site for your destination to see if you need it. If you do, please book an appointment. If you have a recent weight, we can do that as a televist. Typical dosing instructions include: Take 1 capsule by mouth on days 1, 3, 5, and 7 Take capsules 1 hour before meals with a cold or lukewarm drink Complete the series at least one week before exposure Malaria Prevention with Malarone Malarone may be prescribed for travel to malaria-endemic regions. Look on the CDC travel site for your destination to see if you need it. Typical dosing recommendations: Start 1 to 2 days before entering the area Continue daily during travel Continue for 7 days after returning home Weight-based dosing: 11 to 20 kg: 1 pediatric tablet daily 21 to 30 kg: 2 pediatric tablets daily 31 to 40 kg: 3 pediatric tablets daily Over 40 kg: 1 adult tablet daily Book an appointment to get this prescribed. If you have a recent weight, we can do it as a telehealth visit. Travel Vaccine Clinics in Philadelphia Families in the Philadelphia area may consider the following travel medicine resources. General pediatricians cannot give Yellow Fever vaccine or injected Typhoid vaccine. Pennsylvania Hospital Travel Medicine Penn Presbyterian Medical Center Travel Medicine Passport Health Final Thoughts on Traveling with Young Children Traveling with babies and toddlers requires preparation, flexibility, and patience. Prioritizing sun protection, car seat safety, water supervision, and proper travel health precautions can help make your family vacation safer and less stressful. With thoughtful planning, traveling with young children can create wonderful family memories while keeping everyone healthy and safe.
Sunblock vs. Vitamin D for Kids: How to Protect Their Skin and Ensure Healthy Growth As parents, it’s essential to find the right balance between protecting your child’s skin from the sun and ensuring they get enough vitamin D. Too much sun exposure can lead to skin damage and even skin cancer, but not enough can result in vitamin D deficiency, which is crucial for bone health and the immune system. In this guide, we’ll break down the importance of sunblock for kids, the need for vitamin D in children, and how you can keep your little ones safe while they enjoy the outdoors. Why Sunblock Is Crucial for Protecting Your Child’s Skin Exposing your child’s skin to the sun can cause irreversible damage, especially when they are young. Ultraviolet (UV) radiation from the sun is the leading cause of skin cancer, and childhood sunburns can increase the risk of developing melanoma later in life. According to the American Academy of Dermatology (AAD), protecting your child's skin from UV damage is crucial for long-term skin health. Using sunblock for children is one of the most effective ways to prevent sunburns, premature aging, and skin cancer. It's important to apply sunblock regularly, even on cloudy days, as UV rays can still penetrate through the clouds and damage the skin. Be sure to choose a broad-spectrum sunscreen that protects against both UVA and UVB rays. Why Mineral Sunblock is the Best Choice for Kids When it comes to sunscreen, mineral sunblocks (also known as physical sunscreens) are often a safer choice for children. These sunscreens use zinc oxide and titanium dioxide, which create a physical barrier on the skin to block harmful UV rays. Mineral-based sunscreens are particularly effective for sensitive skin and are less likely to cause irritation or allergic reactions. Avoid sunscreens containing chemicals like oxybenzone and retinyl palmitate. Oxybenzone has been linked to hormone disruption, and retinyl palmitate may increase the risk of skin cancer when exposed to sunlight. You can refer to the EWG’s Skin Deep database to find safer sunscreen options. Also, it’s best to avoid spray sunscreens for kids. While they may seem convenient, they pose a risk of inhalation. The fine particles can be harmful to your child’s lungs, so stick with non-spray mineral sunblocks that are easy to apply and safer for their respiratory system. Vitamin D: Why Your Child Needs Sunlight Vitamin D plays an important role in your child’s health. It helps the body absorb calcium, which is essential for building strong bones. It also supports the immune system and can even have a positive impact on mood and overall well-being. The body naturally produces vitamin D when the skin is exposed to UVB rays from the sun. However, in today’s world, many children spend more time indoors, often engaging with screens rather than playing outside. This means they are not getting enough sunlight to maintain healthy vitamin D levels. The American Academy of Pediatrics (AAP) reports that vitamin D deficiency is becoming more common in children, particularly among those who don’t get enough time outdoors or live in regions with limited sunlight. Without adequate vitamin D, kids are at higher risk for bone problems and weakened immune systems. Balancing Sun Exposure: How to Get Vitamin D Safely You don’t need to expose your child to the sun all day, but it’s important to allow for short bursts of No-Sunblock time to let their bodies make vitamin D. During these short periods of sun exposure, your child will get a boost of vitamin D while minimizing the risk of sunburn. For babies, try No-Sunblock time before 9 am and after 5 pm. These hours provide weaker sun exposure, which reduces the risk of harmful UV rays. For older children, you can extend this window to before 10 am and after 4 pm. When you’re outside during peak sunlight hours (usually between 10 am and 4 pm), apply a non-spray mineral sunscreen to protect their skin from UV damage. This approach allows your child to get their daily dose of vitamin D without the dangers of sunburn and long-term skin damage. Best Practices for Sun Safety and Vitamin D Here’s a summary of key recommendations to balance sun protection with vitamin D production: Get outside early or late in the day—before 9 am for babies and 10 am for kids, and after 5 pm for babies and 4 pm for kids. These times offer weaker sun exposure, reducing the risk of sunburn. Use a mineral-based sunblock (zinc oxide or titanium dioxide) when spending extended time outside during peak sunlight hours. Avoid chemical sunscreens containing oxybenzone and retinyl palmitate. Avoid spray sunscreens—they can be harmful when inhaled. Stick to cream or lotion-based sunscreens. Check the EWG database to ensure you’re using a safe, effective sunscreen for your child. Conclusion: Keeping Your Kids Safe While Getting Their Vitamin D The key to keeping your child’s skin safe while ensuring they get enough vitamin D is to find a balance. Short, safe sun exposure allows them to produce the vitamin they need for healthy bones and immunity, while mineral sunblocks keep them protected from harmful UV rays. By following these sun safety guidelines, you can ensure your child enjoys the outdoors without compromising their health. With a little planning and a focus on safe sun practices, you can protect your child's skin and keep them healthy. Remember, sun safety for kids is about moderation and making smart choices when it comes to both sunscreen use and outdoor time. References American Academy of Dermatology (AAD). (2021). Sun Protection. Environmental Working Group (EWG). (2023). Skin Deep Cosmetics Database. American Academy of Pediatrics (AAP). (2023). Vitamin D on the Double.
