(RNN) - The U.S. Food and Drug Administration reminded parents and caregivers to not give honey to children 12 months old or younger, including pacifiers containing or dipped in honey.
Four infants in Texas needed life-saving treatment for botulism between August and October, and all four had used pacifiers containing honey, the FDA said.
"Infant botulism occurs when C. botulinum spores in food, dust or other materials are inhaled or ingested and germinate in the gut of infants who have not yet developed mature intestinal flora," said the Texas Department of State Health Services in a statement.
The toxin attacks the body’s nerves and causes difficulty breathing, muscle paralysis and even death.
Anyone who purchased a honey pacifier should stop using it and discard immediately, the FDA said. The agency also recommended online retailers discontinue sales of the products.
Texas reported seven to eight cases of infant botulism per year in recent years. Ten confirmed or suspected cases have been reported in 2018.