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Exploring parents' knowledge, attitudes and practices on honey and botulism in the West Bank, Palestine: a

Bashar Yaser Hasan Awad1, Farah Bilal Yousef Shahin1, Mohammad Yaser Hasan Awad1

  • 1Faculty of Medicine, Palestine Polytechnic University, Hebron, Palestine.

Annals of Medicine
|April 9, 2025
PubMed

Insights

Many Palestinian parents are unaware of the risks of honey for infants, with some feeding it to babies under one year old. This highlights a need for targeted health interventions to prevent infant botulism (IB).

Area of Science:

  • Public Health
  • Pediatrics
  • Food Safety

Background:

  • Honey can contain Clostridium botulinum spores, a risk factor for infant botulism (IB) in children under one year.
  • Infants' immature gut flora makes them particularly vulnerable to IB, which can lead to severe complications like respiratory failure.
  • Cultural beliefs regarding honey's benefits in Palestine influenced caregivers' feeding practices, despite general awareness of IB risks.

Purpose of the Study:

  • To evaluate Palestinian parents' knowledge, beliefs, and feeding practices concerning honey consumption by infants.
  • To identify gaps in understanding and cultural influences contributing to unsafe infant feeding practices related to honey.
  • To inform the development of targeted health interventions aimed at preventing infant botulism in Palestine.

Main Methods:

  • A cross-sectional study was conducted with 469 Palestinian parents in the West Bank.
  • A validated questionnaire assessed parental knowledge, attitudes, and practices regarding honey and infant feeding.
  • Data were analyzed using R software, employing frequency and Chi-squared/Fisher's tests to identify significant associations (p < 0.05).

Main Results:

  • While 58% of participants knew about honey-linked IB, only 32% identified C. botulinum as the cause.
  • 15.8% of parents reported feeding honey to infants under 12 months old.
  • Beliefs about honey aiding digestion or supplementing nutrition were common, influencing feeding practices, particularly among younger and lower-income parents.

Conclusions:

  • Significant gaps in knowledge and prevalent cultural beliefs about honey's benefits contribute to unsafe feeding practices.
  • Targeted health interventions are crucial in Palestine to enhance awareness and prevent infant botulism.
  • Addressing parental knowledge and cultural beliefs is essential for improving infant health outcomes related to honey consumption.
Abstract

Keywords:
Clostridium botulinumHoneyWest Bankinfant botulismmothers

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