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The U.S. is in the grips of a botulism outbreak tied to a premium infant formula brand. Dozens of babies have been affected as of November 19.

All the reported cases of the paralyzing bacterial infection occurred between August and November and have been linked to powdered infant formula produced by ByHeart, according to a Food and Drug Administration report. The company voluntarily recalled all its products on November 11, and experts caution that more cases of the potentially fatal disease may surface.

“In some cases, after exposure, it may have taken up to a month for some babies to actually show symptoms,” says Randal De Souza, a pediatric infectious disease specialist at Golisano Children’s Hospital at the University of Kentucky.

As of November 19, the FDA and the Centers for Disease and Control and Prevention are currently investigating illnesses in babies from several states, including Arizona, California, Idaho, Illinois, Kentucky, Maine, Michigan, Minnesota, New Jersey, North Carolina, Oregon, Pennsylvania, Rhode Island, Texas, and Washington State.

In an e-mail to Scientific American, ByHeart’s co-founder and president, Mia Funt, said the company was working with the FDA and independent experts on its product recall and ongoing investigations.

“Our number one priority is infant health. We express our deepest sympathy to the families currently impacted by the cases of infant botulism,” Funt wrote. The FDA did not immediately respond to a request for comment from Scientific American.

Here’s what to know about the outbreak and how to stay safe.

What to know about the botulism outbreak in babies

Botulism is a relatively rare but potentially severe infection caused by the soil-dwelling bacterium Clostridium botulinum. The bacterium produces toxins that damage nerves, De Souza says. According to the most recent CDC data, there were 243 lab-confirmed cases in the U.S. in 2021, and 181 of those infections were in infants. Between 5 and 10 percent of cases are fatal.

In infants, the first signs of infection are usually constipation, followed by varying degrees of paralysis. Babies might initially lose control of their facial expressions, mouth, and eyes. They might also drool more, take longer to feed or have a weaker cry, De Souza says. The paralysis slowly progresses down through the body, he explains.

“The presentation tends to be a ‘floppy baby,’ which essentially means you lose head control first, then you lose limb control, and the last tends to be respiration: you lose your ability to breathe,” De Souza says.

How are infected infants diagnosed and treated?

A clinical diagnosis, using stool samples, can take up to a week, so any infant with a suspected case of botulism must be monitored closely, De Souza says.

If infants are hospitalized, they are placed on feeding tubes and may be intubated. Infections are treated with an antitoxin that binds to and neutralizes excess toxins in the body to stop the infection.

“Then it’s up to the body to essentially regenerate nerves,” De Souza says. That process can take weeks or months, and some babies may require further speech or feeding therapy. In extreme cases, they might require a breathing tube.

Infants who recover from botulism aren’t known to have permanent issues, De Souza says, but “a very young baby requiring multiple support modalities for months is not great.”

All 23 infants that were infected in the recent outbreak—almost all of whom are currently under seven months old—have been hospitalized, and no deaths have been reported.

How to stay safe

ByHeart and the FDA are alerting people not to use recently purchased ByHeart infant formula. Barbara Kowalcyk, director of the Institute for Food Safety and Nutrition Security at George Washington University, says to check any ByHeart formula parents might have stocked up.

“People have stuff in their pantries that they don’t always know about, or they may not hear about the recall,” Kowalcyk says. “The voluntary recall language can lead people to potentially believe that it’s not as big of an issue.”

She suspects that more cases of botulism will be uncovered in the coming weeks.

Is baby formula particularly susceptible to botulism?

Botulism has been detected in baby formula before. The pathogen mostly exists as a hardy spore, and while high pressure or heat at an industry level can kill them, “your typical heating, say, in your home kitchen will not,” De Souza says. Otherwise, “the spores just live forever.”

According to the Infant Botulism Treatment and Prevention Program (IBTPP), 84 infants in the U.S. have received treatment for botulism since August, and at least 36 of those cases have been linked to powdered infant formula exposure. The California Department of Public Health found at least six cases of infant botulism linked to exposure to ByHeart powdered formula that occurred from November, 2024 to June, 2025—months before the current outbreak.

It’s unclear if C. botulinum contamination occurred at any point during the manufacturing process at ByHeart’s facilities or at stores that sold the product, or in people’s homes after that process. The California Department of Public Health reported on November 8 that an already opened can of ByHeart formula tested positive for C. botulinum, and officials are now testing unopened products for the bacterium.

In an open letter to the FDA, ByHeart alluded to a wider “unprecedented spike” in national infant botulism. Representatives of IBTPP have also said that the spike in cases may be indicative of a broader trend, the Associated Press reported.

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Natalie Johnston was scrolling on Facebook a couple of years ago, when she came across a group called, “One And Done On The Fence”. Seeing it, she felt a sense of relief.

“It was nice to hear someone giving it a name,” she says.

She and her husband have a five-year-old daughter called Joanie, but they knew they probably wouldn’t have a second child, not because they couldn’t, but not out of choice, either: Natalie finds it hard to imagine having the time and money for one.

“You know you’d love that baby, everyone tells you, but there’s a little teeny niggle where you think, ‘what if I put my first in that position where she can’t do the activity she wants to do because I’ve got to spread money out between two’?”

She adds: “Is it okay to say you’re only having one because they don’t fit into modern ways of parenting?”

Modern parenting, for Natalie, 35, looks like family holidays with Joanie. It looks like weekday evenings hearing about her day at school and helping her with homework. But, with demanding jobs and no family living nearby to help with childcare, it also looks like an expensive childcare jigsaw.

But ultimately, deciding whether or not to have a second is a tough decision. “I think you worry you’d regret it,” she says.

The fertility rate was 1.41 children per woman in England and Wales last year, according to the Office for National Statistics (ONS) – the lowest on record for a third year running.

And the proportion of families with one child has grown since the turn of the century.

They made up 44% of all families with dependent children in England and Wales last year, up from 42% in 2000. (Though the peak was 47% in the early 2010s, which then dipped before picking up again after Covid.)

The UK’s falling birth rate is part of what the United Nations calls a “global fertility slump”, which it puts down, in part, to money worries.

People aren’t “turning their backs on parenthood”, says the UN in a summary of its Population Fund’s State of World Population report, which surveyed people across 14 countries.

Instead, it says they “are being denied the freedom to start families due to skyrocketing living costs, persistent gender inequality and deepening uncertainty about the future”.

Bridging the ‘fertility gap’

Education Secretary Bridget Phillipson said earlier this year that she wants “more young people to have children, if they so choose”.

She pointed to the expansion of funded childcare hours in England as a way the government was trying to recover “dashed dreams”.

Annual nursery costs for a child under two in England did fall this year for the first time in 15 years, according to the children’s charity Coram. They are now an average of £12,425, down 22% on the previous year. However, they are slightly up in Scotland and Wales, at £12,468 and £15,038 respectively.

A study from University College London (UCL) last year suggested two-fifths of 32-year-olds in England want children – or more children, if they are already parents – but only one in four of them are actively trying to conceive.

Dr Paula Sheppard, an anthropologist at the University of Oxford, believes parents in the West still think of having two children as “the norm”.

However, she says there is a “fertility gap” and that “for every three kids wanted… only two are born”.

“A lot of this gap is driven by… people starting families later and later in life,” she explains – often a result of education and career opportunities for women and changing gender roles.

“It becomes a whole lot more difficult to get pregnant [and] it becomes a whole lot more difficult to keep the pregnancy.”

Fewer pupils, less cash for schools

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Bridging the ‘fertility gap.’

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Before we go any further, it’s important to define our terms. This newsletter is going to focus on the laws of war, not a related concept called rules of engagement. The laws of war reflect the mandatory, minimum level of lawful conduct, and all soldiers are legally obligated to obey them at all times and in all conflicts.

Rules of engagement are rules devised by commanders that are often more restrictive than the laws of war. For example, when I was in Iraq, our rules of engagement sometimes kept us from attacking lawful targets, in part because we wanted to be particularly careful not to inflict civilian casualties.

In my service, we were often frustrated by the rules of engagement. We did not, however, question the laws of war.

There are now good reasons to believe that the U.S. military, under the command of President Trump and Hegseth, his secretary of defense, has blatantly violated the laws of war. On Nov. 28, The Washington Post reported that Hegseth issued a verbal order to “kill everybody” the day that the United States launched its military campaign against suspected drug traffickers.

According to The Post, the first strike on the targeted speedboat left two people alive in the water. The commander of the operation then ordered a second strike to kill the shipwrecked survivors, apparently — according to The Post — “because they could theoretically call other traffickers to retrieve them and their cargo.” If that reporting is correct, then we have clear evidence of unequivocal war crimes — a no quarter order and a strike on the incapacitated crew of a burning boat.

And if it’s true, those war crimes are the fault not of hotheaded recruits who are fighting for their lives in the terrifying fog and fury of ground combat but rather of two of the highest-ranking people in the American government, Hegseth and Adm. Frank M. Bradley, the head of Special Operations Command — the man the administration has identified as the person who gave the order for the second strike.

My colleagues in the newsroom followed on Monday with a report of their own, one that largely mirrored The Post’s reporting, though it presented more evidence of Hegseth’s and Bradley’s potential defenses. Hegseth, our sources said, did not order the second strike, and the second strike might have been designed to sink the boat, not kill survivors.

But if that’s the explanation, why wasn’t the full video released? The administration released limited video footage of the first strike, which created the impression of the instant, total destruction of the boat and its inhabitants. Now we know there was much more to see.

At the same time, Hegseth and the Pentagon have offered a series of puzzling and contradictory statements. Sean Parnell, the Pentagon spokesman, told The Post that its “entire narrative was false.”

Hegseth weighed in with a classic version of what you might call a nondenial denial. In a social media post, he said the Post report was “fabricated, inflammatory, and derogatory,” but rather than explain what actually happened (and make no mistake, he knows exactly what happened), he followed up with an extraordinary paragraph:

As we’ve said from the beginning, and in every statement, these highly effective strikes are specifically intended to be “lethal, kinetic strikes.” The declared intent is to stop lethal drugs, destroy narco-boats, and kill the narco-terrorists who are poisoning the American people. Every trafficker we kill is affiliated with a Designated Terrorist Organization.

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Illustration by George Douglas; source photographs by Douglas Sacha and SENEZ/Getty Images

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Jerry Jackson/Baltimore Sun/Tribune News Service via Getty Images

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‘Tis the season to be wary. You can blame a glitch in the North Pole’s AI or a stocking full of data breaches, but this holiday season, our inboxes are getting stuffed with more phishing emails and texts more often than ever before. Scammers are getting smarter, too. Not only are they crafting more suspicious links, but they’re making their schemes harder to call out than ever. Putting a stop to these digital Grinches is a full-time job all its own. According to the the FBI’s Internet Crime Complaint Center, phishing and spoofing scams stole more than $70 million in holiday joy (and funds) in 2024.

Unfortunately, these criminals are good at what they do. Several scammy links do actually include standard “https” encryption and domains similar to legitimate websites in order to trick everyday people. 

If you unwrap a scam link, you risk more than just a lump of coal. You could suffer major financial loss, hand over your credit card details to a “Secret Santa” you definitely don’t know, or accidentally download malware that freezes your device faster than a winter storm. Here’s how you can freeze scammers in their tracks this holiday season and protect yourself. 

How to identify scam links

Scam links are regularly found in phishing emails, text messages or other communications sent by cybercriminals. They’re designed to fool you into downloading malware or bringing you to a fake website to steal your personal identifying information. Some examples of popular phishing scams include unpaid toll, gold bar, and employment scams. 

Criminals typically send these links out en masse — often aided by artificial intelligence. Enough people fall victim to phishing scams every year that con artists find it worth their while to follow the same playbook.

Here’s how to avoid taking the bait.

Check the URL

“Smartphones do their best to block scam links, so attackers use tricks to make their links clickable,” said Joshua McKenty, CEO of Polyguard.ai, a cybersecurity company that helps businesses protect mobile phones and call centers from AI-driven phishing scams.

For example, you’ll want to watch for an “@” sign in the URL, or you might have two different URLs “glued together” by a question mark, he added. Especially if the first URL is a Google.com or an Apple.com link.

Dave Meister, a cybersecurity spokesman for global cybersecurity company Check Point, added that you may be able to hover over the URL to reveal the actual destination. People should also look out for “typo-squatting,” when the URL looks authentic, but it has “PayPa1” instead of “PayPal.” That should tip you off that it’s a bad link.

Remember the URLs you frequently visit

It would behoove everyone to pay attention to the URLs they visit often.

“Major brands, especially banks and retailers, don’t often change up their domain names,” McKenty said. “If the link says Chase.com, it’s likely safe. If it says, Chase-Banking-App.com, stay away.”

Be suspicious of short links

Short links are often in texts and on social media. “Sadly, there’s no safe way to check a shortened URL,” McKenty said. He recommended not clicking on them.

“Bit.ly” or “shorturl” links often have standard “https://” encryption, which makes them appear trustworthy. In these cases, it’s best to read the message itself and pay attention to any threatening language or pressure to act immediately to identify the scam.

How are scam links sent to victims? 

Text scams

Ironically, these don’t always rely on website links. In fact, phone numbers are a frequent vehicle used in scammers’ phishing attempts, according to McKenty. 

“People get tricked into clicking a phone number that’s not actually their bank or the IRS, and then surrendering identity information on the phone,” he said.

If you think you got a message from a scammer, as tempting as it is to mess with them, do your best to resist. If you interact with the scammer, they may want to circle back, knowing that you’re reachable. 

Email scams

Emails can also have scam links.

McKenty said that while clicking on phone numbers and links in texts is happening more frequently, “the biggest dollar losses are still the classic email scams.”

He suggests copying any link you see into a notes app so that you can properly inspect it before clicking.

QR code scams

Sometimes, scams can even be embedded into a QR code.

“QR codes have become the new stealth weapon, used everywhere from restaurant menus to parking meters,” said Meister.

“Scammers are known to slap fake codes on top of real ones in public, or embed them in phishing emails, linking to cloned websites or malware downloads,” he said.

Before you scan, make sure the QR code makes sense. If it’s on the side of a gas pump, on a random park bench or in an unrecognized email, it’s better to avoid it.

Social media direct messages

Chances are, you’ve run into these scam links. Sometimes social media accounts get compromised by cybercriminals posing as people you know. 

If your “uncle” sends you a direct message while sounding like a pushy timeshare salesman, telling you to check out this investment opportunity by clicking on a link, call your uncle first.

What if I already clicked a link?

If you clicked on a scam link, a number of things could happen. If you have software protecting your device, the firewall probably blocked it. If you don’t have software protecting you from computer viruses and malware, then you might have a problem.

Try these tips if you think you might’ve clicked on a phishing link:

• Get anti-virus software.

• If you don’t already have anti-virus software that can help rid your laptop or desktop of viruses, you should get one. There are plenty of free and paid options to choose from

• Be aware of malware. Your phone isn’t immune to malware. Scam links are often designed to trick somebody into downloading malware, which can then give the scammer access to your phone. If your phone is infected with malware, do not access any financial apps. Instead, clear your browser cache, remove any apps you don’t recognize, or try a factory reset. If you’re really stuck, you could also call your phone’s tech support. Your phone might be slow or unresponsive, and you may see increased pop-up ads if it’s infected.

• Contact your bank or credit card issuer.

• If you’ve been visiting your bank website or app on a compromised device, to be safe, let your financial institution know.

• Contact the authorities. If you clicked on a spam link and were scammed out of money, report it to the Federal Trade Commission so they can spread the word about the scam. You’ll also want to call your police department and anyone else you can think of. The more people are aware of a scam, the less likely they’ll fall for it.

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You should never be clicking unexpected links sent to you via text.  Getty/Karl Tapales

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Where Things Stand

• James indictment: A grand jury declined to reindict Letitia James, New York’s attorney general, rejecting efforts to revive a criminal case that had been sought by President Trump, according to people familiar with the matter. The unsuccessful attempt to revive the case against Ms. James does not necessarily end the administration’s efforts to put her on trial. Read more ›

• Boat attack video: Top military officers showed senior members of Congress video of a Sept. 2 attack on a boat suspected of carrying drugs, and defended the follow-up strike that killed two survivors. Lawmakers left the closed-door meetings with starkly different conclusions: Democrats said the video deepened their concerns about the legality of the Trump administration’s military campaign, while several Republicans said they were satisfied it was lawful. Read more ›

• Pipe bomb inquiry: A Virginia man was charged with placing two pipe bombs outside the headquarters of both Democratic and Republican headquarters buildings on the night before the Jan. 6, 2021, riot at the Capitol. Attorney General Pam Bondi and Kash Patel, the F.B.I. director, did not offer a motive, and falsely accused the Biden administration of allowing the investigation to languish. Read more ›

Trump switches architects for his White House ballroom project.

President Trump has hired a new architecture firm to oversee the design of his new ballroom, the White House said on Thursday, a move that comes after he had multiple disagreements with his original designer.

The president chose Shalom Baranes Associates, a Washington, D.C.-based firm that has designed other government buildings, to oversee the next phase of the project, a White House spokesman, Davis R. Ingle,​ said in a statement. He added that the firm would join​ “a team of experts to carry out President Trump’s vision on building what will be the greatest addition to the White House since the Oval Offic​e.”

Tim Walz calls Trump’s tirade against Somalis in Minnesota ‘vile.’

Gov. Tim Walz of Minnesota on Thursday called President Trump’s recent tirades against Somalis in the state “vile,” warning that xenophobic rhetoric could lead to bloodshed.

“This creates danger,” Mr. Walz, a Democrat, told reporters during a news conference. “We know how these things go, they start with taunts, they turn to violence.”

The Trump administration cuts the length of work permits for asylum seekers and refugees.

The Trump administration said it would reduce how long work permits are valid for refugees and asylum seekers, intensifying a sweeping crackdown on legal immigration after an Afghan national was charged with the shooting of two National Guard members in Washington.

The federal government will now require some migrants to renew their work permits every 18 months instead of every five years, according to a statement from U.S. Citizenship and Immigration Services on Thursday. The agency said the change would help it screen and vet migrants more often, allowing it to identify people with “potentially harmful intent so they can be processed for removal.”

The Supreme Court clears the way for Republican-friendly Texas voting maps.

The Supreme Court cleared the way on Thursday for Texas lawmakers to use newly redrawn congressional maps favoring Republicans in the 2026 midterm elections.

The decision overturns, at least for now, a lower-court ruling that the new maps were likely an unconstitutional racial gerrymander. That decision had blocked lawmakers from using the maps in the midterms.

Grand jury is said to decline to re-indict Letitia James, New York State’s attorney general.

A grand jury in Norfolk, Va., declined on Thursday to re-indict Letitia James, New York’s attorney general, rejecting efforts to revive a criminal case that had been sought by President Trump, according to people familiar with the matter.

The unsuccessful attempt to revive the case against Ms. James does not necessarily end the administration’s efforts to put her on trial, even after a federal judge dismissed an earlier indictment last month in ruling that the prosecutor who brought the case was unlawfully appointed by Mr. Trump and Attorney General Pam Bondi.

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Letitia James, the New York attorney general, outside a courthouse in Norfolk, Va., in October.Credit…Allison Robbert for The New York Times

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