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June 16, 2026

Infant botulism associated with Nara Organics Powdered Infant Formula in the U.S.

➜ This health advisory is also available in PDF format (234 KB)

Current situation

On June 13, 2026, the Centers for Disease Control and Prevention (CDC) announced an outbreak of infant botulism linked to infant formula. Since April 2026, at least 3 cases have been identified in 3 states, including one Thurston County infant in Washington state. Although infant botulism is potentially fatal, no deaths have been reported at this time. 

Also on June 13, 2026, the Food and Drug Administration (FDA) announced a voluntary recall by Nara Organics of the powdered formula, sold under the name Nara Organics Powdered Whole Milk infant formula due to the potential risk of Clostridium botulinum contamination. The recall includes ALL lot numbers of Nara Organics Powdered Whole Milk infant formula sold in cans nationwide in Target retail stores, and online through Target.com, and Nara.com between July 2025 and June 2026.

Actions requested

  1. Identify

    Be alert for infants presenting with symptoms consistent with infant botulism. Early recognition and treatment are critical. Symptoms can include:

    • Constipation
    • Poor feeding; diminished suck and gag reflexes
    • Ptosis/Drooping eyelids; altered/blunted facial expression
    • Decreased pupillary reaction or dilated pupils
    • Weak or altered cry
    • Poor head control
    • Hypotonia and generalized weakness
    • If left untreated: symmetric, descending flaccid paralysis

  2. Manage

    • Immediately contact the California Department of Public Health Infant Botulism Treatment and Prevention Program (IBTPP) at 510-231-7600 for clinical consultation if you suspect infant botulism.
      • Consultation is available 24 hours a day, 7 days a week.
      • The IBTPP serves the entire country and provides evaluation and access to treatment for infants - Botulism Immune Globulin Intravenous (Human) (BIG-IV), known as BabyBIG®.
      • For suspected botulism in ADULTS, please call Public Health at 206-296-4774.
    • If clinical consultation supports infant botulism, begin treatment with BabyBIG® without delay. Do not wait for laboratory confirmation.
      • Administering BabyBIG® will prevent progression of paralysis, but it will not reverse symptoms.

  3. Test

    Coordinate testing with Public Health at 206-296-4774. Collect a stool or enema specimen following specimen collection and transport guidance from the WAPHL.

  4. Notify

    Immediately report suspected cases of botulism to Public Health at 206-296-4774. 

  5. Counsel

    Advise parents/guardians whose infants consumed this product to:

    • Do not use any Nara Organics Powdered Whole Milk infant formula.
    • Seek healthcare immediately if their infant develops symptoms of infant botulism.
      • Clinical testing of infants who have used this formula but are NOT symptomatic is not currently recommended.
      • Symptoms of infant botulism can take several weeks to develop, so encourage parents to carefully watch their infants for symptoms.
    • If they currently have any Nara Organics Powdered Whole Milk infant formula:
      • If possible, take a picture and record the lot number and use-by-date.
      • Put the formula into a container/bag, label it "DO NOT USE" and keep it stored in a safe place (like a high cabinet) for at least a month.
      • If their infant develops symptoms of infant botulism, Public Health may want to collect it for testing. If no symptoms appear after a month, throw the leftover formula away.
      • If they are unable to safely store and label the leftover formula, discard the product or return it to the place of purchase.
    • Wash items and surfaces that may have touched the recalled formula using hot soapy water or a dishwasher.

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