A 10-month-old Portland, Oregon, boy remains on a feeding tube and is relearning how to crawl and talk after contracting infant botulism from ByHeart baby formula his mother received through a charitable program serving poor and homeless families. Ashaan Carter was hospitalized twice — for nearly two weeks in November, then again in December — after an Oregon Department of Human Services caseworker provided the formula days before a nationwide product recall. His case is among more than 50 infant botulism infections across the United States linked to ByHeart products.

Ashaan’s illness exposes how ByHeart’s “OpenHearted Initiative” distributed nearly 24,000 cans of formula to nonprofits serving vulnerable families since June 2022 — formula the company has since recalled in its entirety, with contamination risk extending back to the start of production in March 2022.

A 10-month-old Portland boy is fighting to recover from infant botulism contracted after his mother received a can of ByHeart baby formula from an Oregon state caseworker — formula distributed through a company charitable program before a nationwide recall was issued.

Ashaan Carter’s mother, Angel Carter, 27, said the caseworker from the Oregon Department of Human Services provided the formula in early November, telling her it was “closest to breast milk.” Carter, who had been exclusively breastfeeding but said her milk supply was waning, accepted the can.

“I accepted it thinking, ‘OK, I’m hoping my baby can get on a bottle,’” Carter said. “It’s been all downhill since then.”

A rapid decline

Ashaan quickly developed severe constipation and muscle weakness, becoming so limp he could not move his head, his mother said. After an emergency room visit, he was admitted to Randall Children’s Hospital in Portland. Doctors there diagnosed him with presumed infant botulism linked to the ByHeart formula, according to Dr. Sylvia Peterson-Perry, a family medicine physician with Providence Medical Group who delivered Ashaan and continues to care for him and his mother.

He was treated with BabyBIG, an intravenous medication that delivers antibodies to halt the infection’s progress. He was discharged after nearly two weeks without a feeding tube, but his health deteriorated rapidly — including significant weight loss — and he was hospitalized again in December.

“He was just withering away,” Carter said.

Ashaan remains on a feeding tube, and his muscles are still weak. He is having to relearn how to crawl and to talk, his doctor said. The caseworker texted Carter after the recall was announced, warning her to stop using the formula. By then, it was too late.

Formula routed through nonprofits to vulnerable families

The can reached Carter through a chain of charitable organizations. ByHeart had established an “OpenHearted Initiative” partnering with nearly two dozen nonprofit groups to distribute formula to “families in need,” according to the company’s website. Since June 2022, nearly 24,000 cans had been distributed through the program to organizations aiding homeless and other vulnerable families, the company said.

In Oregon, PDX Diaper Bank received about 400 cans through Baby2Baby, a Los Angeles-based nonprofit with high-profile celebrity supporters that served as an intermediary. PDX Diaper Bank distributed more than 300 of those cans before the recall, said Rachel Alston, the group’s executive director.

“All of our partners confirmed that they took immediate action to inform families, and we offered support where we could along the way,” Alston said.

Oregon DHS acknowledged it received ByHeart formula from PDX Diaper Bank but declined to comment on Carter’s case. ByHeart said the company worked with Baby2Baby and partner organizations to ensure products were pulled and families were notified. Baby2Baby did not respond to requests for comment.

The news outlet Healthbeat was first to report that recalled formula had reached organizations serving at-risk families.

Scale of the outbreak

Ashaan’s case is part of a wider crisis. More than 50 infants across the United States have been sickened with infant botulism linked to ByHeart products. The company has recalled all of its formula — a recall that extends back to when production began in March 2022 — and production remains shut down.

The U.S. Centers for Disease Control and Prevention said no new cases tied to the outbreak had been reported since Dec. 17. The U.S. Food and Drug Administration has conducted inspections at ByHeart plants but has released no information about the source of the contamination.

Seattle food safety attorney Bill Marler said Carter is one of more than 30 families he represents whose babies were sickened by ByHeart products. At least 18 lawsuits have been filed against ByHeart and retailers that sold the contaminated formula. This week, Marler asked a federal panel to consolidate the cases in a U.S. district court in New York.

Peterson-Perry said the harm to Ashaan underscores how deeply the families affected were trusting the systems meant to protect them.

“It’s devastating, especially for our vulnerable families who are trusting this product to nourish their child and trusting our social services to provide safe food for their babies,” she said.