4mo infant who presented with confirmed (positive stool) infantile botulism. Admitted to ICU with profound cephalocaudal hypotonia, experienced bradycardic arrest on 12/17 requiring sedation and intubation. Received routine 4-month vaccines (DTaP, HepB, HiB, IPV, PCV20, Rotavirus) on 12/12 and started new Enfamil neuropro canned formula three weeks prior to presentation. Reportedly began to develop acute symptoms on 12/12, which has progressively worsening until current medical state in ICU.