IDPH urges halting use of ALL Nara Organics Whole Milk Organic infant formula until further notice after several botulism cases were reported in other states

Summary and Action Items

1. On June 13, 2026, all lots and sizes of Nara Organics Whole Milk Organic infant formula were recalled after a CDC and FDA investigation.
2. IDPH urges parents and guardians to avoid using all lots and sizes of Nara Organics Whole Milk Organic infant formula till further notice. No Nara Organics Whole Milk Organic infant formula should remain for sale.
3. Clinicians who suspect infant botulism should immediately call the Infant Botulism Treatment and Prevention Program at 510-231-7600 for case consultation (consultation is available 24/7), obtain information related to infant formula use and notify their local health department immediately. Clinical consultation is necessary to access treatment with BabyBIG and testing through the public health lab.

Background

As of June 15, Nara Organics Whole Milk Organic infant formula has been linked to 3 cases of botulism in California, Pennsylvania, and Washington. They ranged in age from 2–5 months when illness began. No cases linked to this outbreak have been identified in Illinois.

Botulism is an illness caused by a bacterial toxin, which can produce life-threatening symptoms. Botulism can be in foods that look and taste normal, which means consumers cannot inspect food on their own for botulism safety. Infant botulism happens when a baby swallows Clostridium botulinum spores that then grow in the gut and make toxin. Infant botulism often starts with constipation but is usually first noticed as difficulty feeding (sucking and swallowing), a weak and altered cry, and lack of head control.

Parents and caregivers have reported feeding infants in this outbreak lots of Nara Organics Whole Milk Organic infant formula. On June 13, 2026, this product was recalled. This formula was sold at Target retail stores, target.com and nara.com. This brand makes up less than 1% of all infant formula used in the United States so shortages of formula are not expected.

Product testing by CDC and FDA is ongoing with results expected in the coming weeks. Symptoms of Infant Botulism

• Most infants with infant botulism will initially develop constipation, poor feeding, loss of head

control, and difficulty swallowing.

• If untreated, infants with infant botulism experience a progressive, flaccid paralysis that can lead to breathing difficulties and require weeks of hospitalization.
• Treatment with BabyBIG® is recommended for all suspected cases of infant botulism.

Guidance for Clinicians

Diagnosis:

• Initial diagnosis of infant botulism is based on clinical symptoms.

• If you suspect your infant patient has botulism, immediately call 510-231-7600 for case consultation. Consultation is available 24/7.
• You will reach the on-call physician at the Infant Botulism Treatment and Prevention Program (IBTPP) at the California Department of Public Health.
• The physician will provide a no-cost clinical consultation and release BabyBIG treatment if the patient's clinical findings indicate infant botulism.

Treatment:

• If clinical consultation supports infant botulism, treatment should begin as soon as possible. Do not wait for laboratory confirmation.
• Infant botulism is treated with BabyBIG which is available through IBTPP.

Laboratory Testing:

• Laboratory testing CANNOT be requested unless IBTPP has released BabyBIG for the infant. Please do not directly contact the IDPH State Laboratory to inquire about testing.
• Serum is generally not useful in the diagnosis of infant botulism but if collected, it must be done prior to the administration of anti-toxin.
• A stool or enema specimen is required for definitive diagnosis of infant botulism. Enemas should be performed with sterile, non-bacteriostatic water. Guidance on performing and collecting and an enema specimen can be found here. Stool and enema samples may be collected prior to or after the administration of anti-toxin. Testing is performed at the Ohio Department of Health. Guidance on specimen collection and shipment can be found here. ALL specimens must be shipped through an IDPH Public Health Laboratory.
• This specialized testing often takes several days to complete and treatment should not be withheld pending suspected cases.
• Product testing is only performed on formula collected from infants that receive BabyBIG, the treatment for botulism, after a consultation with IBTPP.

Notification:

• Report suspect cases to your local health department or IDPH immediately.

Guidance for Parents/Guardians

• Do not use recalled infant formula. If you can safely retain the product, write DO NOT USE on the container and save it for 30 days. If you cannot safely store it and/or after the 30-day monitoring period has ended, dispose of the unused formula in the garbage with DO NOT USE marked on the container. Be sure to document the lot number by writing it down or taking a photo before disposing of the product. You can also return the formula to the store where you bought it.
• Wash items and surfaces that may have touched the recalled formula using hot soapy water or in a dishwasher.
• Monitor your baby for 30 days from the last date they were fed Nara Organics Whole Milk Organic infant formula. Contact your physician if you have questions. Symptoms of infant botulism can take as long as several weeks to develop, so parents should remain vigilant if they used Nara Organics Whole Milk Organic infant formula.
• Seek immediate health care if your infant has consumed Nara Organics Whole Milk Organic infant formula and has any of these symptoms:
  • Poor feeding
  • Loss of head control
  • Difficulty swallowing
  • Decreased facial expression