DoingItLocal

The U.S. Centers for Disease Control and Prevention (CDC) is alerting medical and public health partners to a multistate outbreak of infant botulism associated with ByHeart powdered infant formula. This advisory provides updated epidemiologic information, guidance for early case identification, and critical actions for clinicians, hospitals, and public health agencies.

CDC has identified 15 infants with suspected or confirmed infant botulism across 12 states, all of whom required hospitalization and treatment with BabyBIG® (Botulism Immune Globulin Intravenous). While no deaths have been reported, new national data reveal a disproportionate number of illnesses among infants who consumed ByHeart Whole Nutrition formula, prompting an immediate nationwide recall of all ByHeart Whole Nutrition products on November 11. Neither CDC nor FDA has identified safety concerns with other formula brands at this time.

Infant botulism occurs when Clostridium botulinum spores colonize an infant’s digestive tract and produce toxin, leading to symptoms such as constipation, poor feeding, decreased head control, weak facial expression, and reduced muscle tone. Without early recognition and treatment, the illness can progress to life-threatening respiratory failure. Symptoms may appear up to 30 days after exposure.

Clinicians are urged to consider infant botulism in any infant presenting with unexplained weakness, feeding difficulty, or decreased muscle tone—particularly if ByHeart formula was consumed. CDC emphasizes that providers should not wait for laboratory confirmation before initiating treatment. The Infant Botulism Treatment & Prevention Program (IBTPP) remains available 24/7 at 510-231-7600 for immediate consultation and access to BabyBIG®. Infant botulism is a nationally notifiable condition and should be reported to state or local health departments without delay.

Parents and caregivers are advised to stop using any ByHeart Whole Nutrition infant formula, including cans and single-serve packets. Caregivers should retain leftover formula labeled “DO NOT USE” for at least a month in case testing is needed if symptoms develop. Families should closely monitor infants for signs of botulism and seek immediate medical evaluation if symptoms appear.

Health systems, laboratories, and public health partners should remove all recalled ByHeart formula from inventory, sanitize any affected feeding areas or equipment, and ensure staff are aware of reporting and testing procedures. CDC, FDA, and state health agencies continue to investigate the contamination source and will provide updates as more information becomes available.

For clinical questions, consultation requests, or BabyBIG® release, contact the IBTPP at 510-231-7600. Health departments may reach the CDC Division of Foodborne, Waterborne, and Environmental Diseases at botsurveillance@cdc.gov. After-hours public health inquiries may be directed to the CDC Emergency Operations Center at 770-488-7100.

(Hartford, CT) – Attorney General William Tong shortly after midnight sought a temporary restraining order to block the Trump Administration from demanding that states “undo” Supplemental Nutrition Assistance Program (SNAP) benefits already paid out to millions of Americans.

“Donald Trump wants us to take food off the plates of Connecticut families who finally just now got the chance to eat. Undo food stamps? Those funds were out the door on Saturday, and families were in the grocery stores all weekend. We’re fighting this one to the bitter end,” said Attorney General Tong. “Trump’s actions have been unconscionable, unlawful and erratic, and states like Connecticut had a moral imperative and legal right to act quickly to get funds out the door. Trump never had the authority to deny SNAP, and he doesn’t have the authority now to retaliate against states for doing our job.”

Connecticut and 26 states sued the Trump Administration on October 28 in Massachusetts federal court for unlawfully and arbitrarily suspending SNAP benefits for 42 million Americans during the government shutdown. Separately, a coalition of non-profits and municipalities, including the City of New Haven, filed a similar challenge in Rhode Island federal court. In both cases, the courts have ruled against Trump and issued rulings directing payments to resume either in part using contingency funds, or in full. The Trump Administration initially presented a series of unworkable bureaucratic calculations for awarding partial benefits, then later, in response to additional court actions, said they would issue full benefits. Then, after appealing to the Supreme Court and receiving a temporary stay of the lower court orders, the Trump Administration once again reversed course. Guidance has shifted seemingly by the hour, with millions of American families left unsure of how they would afford to eat.

Relying on guidance at the time, Connecticut and other states quickly processed full SNAP benefits. In Connecticut, approximately 366,000 families then received their full November benefits on Saturday, averaging $324 per month and totaling $72 million. Then, late Saturday, the Trump Administration shifted course once again, issuing a memo ordering states not to seek full benefits. For those who already did, the memo stated: “States must immediately undo any steps taken to issue full SNAP benefits for November 2025.” The memo further threatened that “failure to comply with this memorandum may result in USDA taking various actions, including cancellation of the Federal share of State administrative costs and holding States liable for any overissuances that result from the noncompliance.”

The filing seeks a court order to block the Trump administration from carrying out these threats.

Joining Attorney General Tong in tonight’s filing were the attorneys general of Arizona, California, Minnesota, Colorado, Delaware, the District of Columbia, Hawaiʻi, Illinois, Maine, Maryland, Massachusetts, Michigan, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Rhode Island, Vermont, Washington, and Wisconsin, along with the governors of Kansas, Kentucky, and Pennsylvania.