# Infant Honey Feeding and Associating Sociodemographic and Clinical Factors: Are there risks for infant botulism in Oman?

## TL;DR

This study in Oman found that nearly 40% of infants were fed honey in their first year, which could increase the risk of infant botulism.

## Contribution

The study identifies sociodemographic and clinical factors linked to infant honey feeding in Oman.

## Key findings

- 38.7% of infants were fed honey during their first year, often for cough relief or cultural practices.
- Higher maternal education and income were associated with lower odds of feeding honey to infants.
- Infants fed honey had a higher likelihood of constipation and muscle weakness.

## Abstract

This study aimed to assess the risks associated with infant botulism in Oman by examining honey-feeding practices among infants and related sociodemographic and clinical factors.

This cross-sectional study included Omani mothers with children under 5 years and were conveniently recruited from health centres. Mothers completed an infant feeding practices and beliefs survey between October 2023 and March 2024. Data were represented as frequencies and percentages and analysed via Chi-square test and logistic regression.

A total of 3,222 participants were included of which 58.8% were aged 26–35 years. The study found that 38.7% of children were fed honey during their first year. Local Omani honey was used by 34.6%, often for reasons including cough relief (15.2%), boosting immunity (11.6%) and Tahneek (8.6%). Additionally, 16.7% of mothers felt pressured to introduce honey and 45.9% viewed early honey feeding as acceptable. Multivariate logistic regression analysis revealed that infant honey feeding was negatively and significantly associated with maternal education (odds ratio [OR] = 0.77, 95% confidence interval [CI]: 0.65–0.91; P <0.001), family income (OR = 0.61, 95% CI: 0.51–0.74; P <0.001) and receipt of infant feeding counseling (OR = 0.83, 95% CI: 0.72–0.97; P = 0.007). Additionally, results indicated that infants who were fed honey had a higher likelihood of experiencing constipation (OR = 1.29, 95% CI: 1.10–1.51; P = 0.001) and muscle weakness (OR = 1.84, 95% CI: 1.15–2.95; P = 0.011).

This study highlights the potential risks of infant botulism in Oman, emphasising the importance of following updated clinical guidelines for optimal infant care and effective reporting.