Frequently asked questions (FAQs) on cereulide poisoning for parents and caregivers

On 8 January 2026, the Singapore Food Agency (SFA) issued a direction to stop further sale five batches of Nestlé infant formula and follow-on formula products due to the potential presence of cereulide toxin, while SFA’s investigations are ongoing. This follows reports that overseas countries have issued public recalls of affected batches of infant formula that may be contaminated.

The affected products include various batches of NAN HA SupremePro HA 1, HA 2 and HA 3 infant formula with expiry dates extending to October 2027 (see Table 1 below for list of affected products). Given the extended shelf-life of these products, some may still be in households despite the stop-sale direction.

To date, there are no confirmed cases of illness associated with consumption of the affected Nestlé infant formula in Singapore. The Communicable Diseases Agency is conducting surveillance with doctors to monitor for potential cases of cereulide poisoning in children.

Consumers who have purchased the affected products are advised not to feed them to their children. Those whose children have consumed these products and are unwell should seek medical advice promptly.

The following frequently asked questions provide essential information about cereulide contamination, its health effects, and recommended actions for parents and caregivers.

Q1: What is cereulide?

Cereulide is a toxin produced by certain strains of Bacillus cereus bacteria.

Bacillus cereus is a type of bacteria commonly found in the environment, including in soil and dust which can contaminate foods such as rice, pasta and dairy products. Under certain conditions, the bacteria can grow and produce toxins such as cereulide which may cause food-poisoning when contaminated food or products are consumed.

Cereulide is highly heat-stable, meaning it is unlikely to be deactivated or destroyed by cooking, using boiling water, or when preparing infant formula. Even properly prepared formula can still contain the toxin and cause illness.

Q2: What are the symptoms of cereulide poisoning in infants?

In infants, symptoms may include vomiting, diarrhoea, abdominal pain and cramps (appearing as persistent crying and refusal to feed) and distress within a few hours of drinking contaminated infant formula. Infants may become lethargic, refuse feeding, or show signs of dehydration.

While most cases resolve without treatment within 6 to 24 hours, severe cases (usually persistent, frequent or intense symptoms) can be life-threatening if left untreated, just like other causes of food poisoning in infants.

Q3: How quickly do symptoms appear?

Symptoms typically develop very rapidly, usually within 30 minutes to 6 hours after consuming contaminated formula.

Q4: Is cereulide poisoning contagious? Can it spread to others?

No, cereulide poisoning cannot spread from person to person. It is caused by a toxin in contaminated food, not by germs that can be passed between people.

Q5: What should parents do if they suspect cereulide poisoning?

Parents should seek immediate medical attention if their infant shows symptoms of persistent vomiting, diarrhoea, or distress after consuming contaminated infant formula, and should not wait to see if symptoms improve. This is particularly important if symptoms are severe.

Q6: How is cereulide poisoning diagnosed?

Diagnosis is mainly based on symptoms and rapid onset after consuming the contaminated infant formula. If your child is taking both solid foods and formula, the doctor will make an assessment with a detailed history and assess for any alternative reasons for gastroenteritis. There are no specific clinical tests to confirm cereulide poisoning, so it is important to inform the doctor if your child has consumed any of the affected infant formula products and when the symptoms started.

Q7: What is the treatment for cereulide poisoning?

Treatment focuses on managing the symptoms and providing supportive care for the infant. This includes managing dehydration through fluid replacement, controlling vomiting and diarrhoea, and monitoring as guided by healthcare professionals. Since the symptoms are caused by the effects of a pre-formed toxin, antibiotics are not indicated and would not modify the course of illness. Feeding should resume with safe formula feeds.

Q8: Is there a way to remove cereulide, such as through warming or boiling or keeping formula in the fridge?

Cereulide is highly heat-stable, meaning it is unlikely to be deactivated or destroyed by cooking, using boiling water, or when preparing infant formula. Refrigeration, freezing, or other storage methods cannot get rid of the toxin.

Q9: What should be done with the suspected contaminated infant formula?

Do not use any of the affected infant formula products. Discard any milk that was made using the formula. If your child has symptoms of cereulide poisoning, retain the affected infant formula products for potential testing by agencies, where necessary.

Q10: Are there long-term effects from cereulide poisoning?

Most individuals recover completely from cereulide poisoning without the need for medical treatment. Severe cases associated with consumption of contaminated products with high levels of cereulide are rare but complications such as liver damage or multi-organ failure may occur. Early recognition and treatment of severe cases is important.

Q11: Will someone from CDA contact me if my child becomes ill after consuming the affected Nestlé infant formula?

If you have reported to SFA or CDA that your child has become ill after consuming the affected Nestlé infant formula, or if your child is reported as a suspect case by medical practitioners, CDA may reach out to your family during our investigation to verify case details and gather information that helps us better understand the situation. All information shared will be kept confidential and used only for public health purposes.