The Brief

Federal health officials on Wednesday expanded an outbreak of infant botulism tied to recalled ByHeart baby formula to include all illnesses reported since the company began production in March 2022.

The U.S. Food and Drug Administration said investigators "cannot rule out the possibility that contamination might have affected all ByHeart formula products" ever made.

The outbreak now includes at least 51 infants in 19 states. The new case definition includes "any infant with botulism who was exposed to ByHeart formula at any time since the product's release," according to the U.S. Centers for Disease Control and Prevention. The most recent illness was reported on Dec. 1.

No deaths have been reported in the outbreak, which was announced Nov. 8.

Previously, health officials had said the outbreak included 39 suspected or confirmed cases of infant botulism reported in 18 states since August. That's when officials at California's Infant Botulism Treatment and Prevention Program reported a rise in treatment of infants who had consumed ByHeart formula. Another 12 cases were identified with the expanded definition, including two that occurred in the original timeline and 10 that occurred from December 2023 through July 2025.

ByHeart, a New York-based manufacturer of organic infant formula founded in 2016, recalled all its products sold in the U.S. on Nov. 11. The company, which accounts for about 1% of the U.S. infant formula market, had been selling about 200,000 cans of the product each month.

News that ByHeart products could have been contaminated for years was distressing to Andi Galindo, whose 5-week-old daughter, Rowan, was hospitalized in December 2023 with infant botulism after drinking the formula. Galindo, 36, of Redondo Beach, California, said she insisted on using ByHeart formula to supplement a low supply of breast milk because it was recommended by a lactation consultant as "very natural, very gentle, very good for the babies."

"That's a hard one," Galindo said. "If there is proof that there were issues with their manufacturing and their plant all the way back from the beginning, that is a problem and they really need to be held accountable."

Amy Mazziotti, 43, of Burbank, California, said her then-5-month-old son, Hank, fell ill and was treated for botulism in March, weeks after he began drinking ByHeart. Being included in the investigation of the outbreak "feels like a win for all of us," she said Wednesday.

"I've known in my gut from the beginning that ByHeart was the reason Hank got sick, and to see that these cases are now part of the investigation brings me to tears — a mix of relief, gratitude and hope that the truth is finally being recognized," she said.

In a statement late Wednesday, ByHeart officials said the company is cooperating with federal officials "to understand the full scope of related cases."

"The new cases reported by CDC and FDA will help inform ByHeart's investigation as we continue to seek the root cause of the contamination," the statement said.

Lab tests detected contamination

The FDA sent inspectors last month to ByHeart plants in Allerton, Iowa, and Portland, Oregon, where the formula is produced and packaged. The agency has released no results from those inspections.

The company previously reported that tests by an independent laboratory showed that 36 samples from three different lots contained the type of bacteria that can cause infant botulism.

"We cannot rule out the risk that all ByHeart formula across all product lots may have been contaminated," the company wrote on its website last month.

Those results and discussions with the FDA led CDC officials to expand the outbreak, according to Dr. Jennifer Cope, a CDC scientist leading the investigation.

"It looks like the contamination appeared to persist across all production runs, different lots, different raw material lots," Cope said. "They couldn't isolate it to specific lots from a certain time period."

Inspection documents showed that ByHeart had a history of problems with contamination.

In 2022, the year ByHeart started making formula, the company recalled five batches of infant formula after a sample at a packaging plant tested positive for a different germ, cronobacter sakazakii. In 2023, the FDA sent a warning letter to the company detailing "areas that still require corrective actions."

A ByHeart plant in Reading, Pennsylvania, was shut down in 2023 just before FDA inspectors found problems with mold, water leaks and insects, documents show.

Infant botulism is rare

Infant botulism is a rare disease that affects fewer than 200 babies in the U.S. each year. It's caused when infants ingest botulism bacteria that produce spores that germinate in the intestines, creating a toxin that affects the nervous system. Babies are vulnerable until about age 1 because their gut microbiomes are not mature enough to fight the toxin.

Baby formula has previously been linked to sporadic cases of illness, but no known outbreaks of infant botulism tied to powdered formula have previously been confirmed, according to research studies.

Symptoms can take up to 30 days to develop and can include constipation, poor feeding, loss of head control, drooping eyelids and a flat facial expression. Babies may feel "floppy" and can have problems swallowing or breathing.

The sole treatment for infant botulism is known as BabyBIG, an IV medication made from the pooled blood plasma of adults immunized against botulism. California's infant botulism program developed the product and is the sole source worldwide.

The antibodies provided by BabyBIG are likely most effective for about a month, although they may continue circulating in the child's system for several months, said Dr. Sharon Nachman, an expert in pediatric infectious disease at Stony Brook Children's Hospital.

"The risk to the infant is ongoing and the family should not be using this formula after it was recalled," Nachman said in an email.

Families of several babies treated for botulism after drinking ByHeart formula have sued the company. Lawsuits filed in federal courts allege that the formula they fed their children was defective and ByHeart was negligent in selling it. They seek financial payment for medical bills, emotional distress and other harm.
Copyright 2025 NPR

This story first appeared on The LA Local.

Jacque Langston was driving down Manchester Boulevard in Inglewood when he came face-to-face with an odd sight: sea creatures floating across one of the city’s new, spiraling digital billboards. 

“Why am I looking at jellyfish? That has nothing to do with me,” said Langston, an Inglewood native. For Langston, the video billboards that have come to dominate stretches of Inglewood’s major roads are a square peg in a round hole.

“The city has never been touched like that,” Langston said. “Now you’ve got a mini-Vegas.” 

A digital billboard is seen on La Cienega Blvd. at Florence Ave. in Inglewood on April 18, 2026, in Los Angeles.

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Video billboards have proliferated in Inglewood in recent years, targeting the influx of people driving into the city for concerts and sporting events at SoFi Stadium, the Intuit Dome and the Kia Forum. 

Last summer, though, they became a flashpoint for a series of lawsuits that revealed fractures in the once-close relationship between the city and its major entertainment venues. The various parties are now fighting over lucrative advertising territory as major international sporting events approach.

That legal drama — reported last week by The LA Local — also threatens to undo the contract that underpins SoFi Stadium’s financial relationship with the city. 

Langston and other Inglewood residents might get a chance to weigh in on the billboards in November’s election, due to a proposed ballot initiative that would bar most advertisements on public streets. But that ballot initiative itself has now prompted its own potentially costly legal fight involving the city, which receives a steadily increasing stream of revenue from billboard companies, and people with ties to the billionaire-owned stadiums.

Meanwhile, the bright LED video screens have divided local opinion. 

Vanessa Cowan, an Inglewood resident, said the gleaming screens are a sign of progress in the city. “I like them,” she said. “It has a different look.” 

A person walks past a digital billboard on Prairie Avenue in Inglewood on April 18, in Los Angeles.

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Khnum Alexander, owner of Swank Men’s Fashion on Manchester, called the billboards “monstrosities” and said advertising on the screens is too expensive for small businesses like his. He also questioned the new, twisting screens that billboard company WOW Media has recently begun to install in groups of three across the city.

“Do we really need more?” he asked. 

Down the street from Alexander’s menswear store, EZ Will Driving School owner Will McDaniel felt differently.

“I’m all for it,” McDaniel said. “People are afraid of change. Change to them feels awkward.” 

If city leaders have their way, the Billboard Blight Elimination and Neighborhood Preservation Initiative won’t make it to voters this fall.

“What is packaged as an initiative by and for Inglewood residents appears to be a product of avaricious puppeteering by a billionaire developer,” lawyers retained by the city wrote in a March 4 court complaint filed in an attempt to block the initiative. 

That developer, the city’s lawyers contend, was SoFi Stadium owner Stan Kroenke. Attorneys later amended the complaint to include Intuit Dome owner Steve Ballmer.

“Voter suppression”

In February, Inglewood resident Shannon Roberts filed to circulate a petition to prohibit commercial billboards on public streets, sidewalks and medians. The petition, a step towards getting the billboard initiative on the ballot in November, also seeks to prohibit business arrangements for the city to profit from billboard deals. 

“Public spaces belong to people, not billboard companies,” Roberts wrote, adding advertising should instead prioritize public safety messaging, such as emergency alerts, not advertising for profit.

“Inglewood should not be for sale to billboard companies for decades at a time — especially when such arrangements permanently alter the character of our beautiful city and erase the legacy of those who fought to preserve our neighborhoods,” Roberts wrote.

Roberts did not respond to a request for comment. When The LA Local reached out to her lawyer, a veteran campaign spokesperson responded.  

John Shallman has been a consultant in Southern California politics for decades and formerly worked for the Clippers when they moved to the Intuit Dome. 

He is now working with Roberts to get the anti-billboard initiative on the ballot; their website and campaign are called Inglewood Not for Sale.

He said he’s never seen a city sue one of its residents over an idea they’re attempting to put before voters.

“It’s voter suppression,” Shallman told The LA Local. “You can run a campaign against it, but trying to stop it from getting in front of citizens at all, that’s a big red flag. We’re all about voter empowerment. They’re the public’s streets, parks and medians. They control how they’re used and how they’re sold.”

Inglewood Mayor James Butts did not return a request for comment. The city’s lawyers argued in court filings that the initiative shouldn’t be allowed to go before voters because it would unconstitutionally restrict speech, lay out illegal zoning guidelines and hurt the city’s contract with WOW Media, the company that controls many of Inglewood’s billboards. 

Shallman believes that the Inglewood City Council cut a bad deal in April 2025 with WOW Media when the city approved a 20-year contract, which can be extended for decades. “It’s sort of biblical in its length of time,” he said. “The city decided that the profit of one company is far more important than the residents who will have to live with these billboards.”

The campaign has already collected several thousand signatures, Shallman said. 

Shallman dismissed the city’s accusations that the coalition he works with does not authentically represent Inglewood’s residents. Though Roberts’ name is on the initiative, the filing fee was paid for by Gerard McCallum II, a longtime associate of Hollywood Park.

Shallman said the initiative is raising money from all sorts of supporters, including those tied to the Rams and Clippers professional sports teams.

“You’re talking about an insignificant sum of money that pales in comparison to the hundreds of thousands of taxpayer dollars that will be spent to sue this Inglewood resident,” Shallman said of the filing fee.

Inglewood’s November election could be packed

WOW Media is opposing the billboard initiative through its own campaign, Inglewood Residents for Stadium Accountability. 

CEO Scott Krantz wrote in a statement to The LA Local that the billboard initiative, which does not include stadium billboards, would deprive the city of up to $2 billion in revenue over 40 years.

“The stadiums share none of their advertising revenue with Inglewood residents. We trust the people of Inglewood to see the stadium owner billionaire’s scam for exactly what it is,” Krantz wrote.

Krantz and Inglewood Residents for Stadium Accountability are also backing a pair of initiatives that could have a big impact on stadiums’ bottom line: The initiatives seek to remove admissions tax caps for large venues and limit how much some parking lots can charge during major events. 

Longtime Mayor Butts is also up for reelection in November, as are Councilmembers Gloria Gray and Alex Padilla and a few school board members. 

Wherever the votes land, Inglewood’s rapid transformation doesn’t appear to be slowing down. 

“Times are changing around here,” said Rick Todd, who sat at a table on Manchester Boulevard on Thursday, selling jugs of soursop tea. Up the street, a video billboard flicked between an Inglewood police recruitment poster and an ad for “The Devil Wears Prada 2.” “This goes along with it.”

Gov. Gavin Newsom promised to help thousands of homeless Californians when he launched a new mental health court in 2023. So far, it has struggled to help the sickest, most vulnerable people, but a Southern California lawmaker is carrying two proposals this year that she hopes will fix gaps in the program.

Both bills reopen the debate among families and advocates over when it’s appropriate to put someone into mental health treatment without their consent.

One bill would create a pathway for the most severely incapacitated people to go directly from Newsom’s voluntary mental health court into involuntary treatment in a hospital. The other would make it easier for EMTs and other first responders to refer people to mental health court. Both bills recently passed through the Senate Judiciary Committee, despite concerns from disability rights advocates that they would force more people into unwanted treatment.

“While early implementation shows promise,” Sen. Catherine Blakespear, a Democrat from Encinitas, said during a recent committee hearing, “barriers in the current petition process are preventing the program from reaching many of the individuals it was designed to serve.”

CARE Court launched in 2023 as a major piece of Newsom’s strategy to get people in the grip of psychosis off the streets. It allows family members of people with untreated schizophrenia and other psychotic disorders to refer them into the court-based program, where they can work with a judge, a public defender and a case worker on a plan for medication, therapy, housing, and whatever other help they may need.

But a CalMatters investigation found the program is falling short of expectations. As of January, California courts had received 3,817 petitions on behalf of prospective CARE Court participants and approved just 893 treatment agreements. At its outset, the Newsom administration estimated between 7,000 and 12,000 Californians would qualify for the program.

Some families who attempted to use CARE Court to help their severely ill loved ones told CalMatters they were disappointed by the results. They thought a judge could order their family members into treatment. But that turned out not to be the case. If someone is too sick to realize they need treatment, CARE Court can’t help, which means that their case can be dismissed while the person continues to languish on the street.

That’s the problem Blakespear is attempting to tackle with Senate Bill 1016. It would allow anyone filing a CARE Court petition to request that a judge order a mental health assessment to determine if the subject of the petition is “gravely disabled” or a danger to themselves or others – if the subject can’t comply with voluntary treatment.

Depending on the results of the assessment, a judge could order that person into a conservatorship, which would likely mean a stay in a locked psychiatric facility and mandatory medication.

The idea is to create a formal bridge between voluntary treatment under CARE Court and involuntary treatment through a conservatorship.

Adding the specter of forced care will make people with mental illness less likely to accept help from CARE Court, Samuel Jain of Disability Rights California said during the committee hearing.

“SB 1016 adds an expensive, coercive and convoluted layer to CARE Court that will drive up costs and further erode the rights and trust of the Californians that our system is supposed to help,” he said.

An unhoused person secures their belongings on a bicycle near a homeless camp in north Sacramento on Jan. 26, 2026. Photo by Miguel Gutierrez Jr., CalMatters

Family 'frustrated' by CARE Court

Jennifer Farrell, who filed a CARE Court petition in late 2024 for her brother in Alameda County, sees it differently. Farrell’s 59-year-old brother, who struggles with schizophrenia and meth use, had been homeless off and on since 2017. He was able to stay housed via CARE Court for a few months, but then he left his placement in September and disappeared into the streets.

It was clear he needed more help than CARE Court could provide, but the program had no way to elevate him to a higher level of care, Farrell said.

“I was really frustrated at that point,” she told CalMatters.

Farrell’s brother spent three months deteriorating on the street before a case worker found him in December. He was hospitalized on a temporary psychiatric hold and eventually placed on a conservatorship. He’s still in a locked facility, where he’s medicated and seems to be doing much better, Farrell said.

To Farrell, it’s “absurd” that there isn’t already a direct link between CARE Court and a conservatorship — a connection that she thinks could have saved her family some grief.

At CARE Court’s inception, Newsom said people who didn’t follow their CARE plans could be moved into a conservatorship. But Farrell and other families CalMatters spoke with said if their loved one couldn’t consent to treatment, there was no clear path forward.

Technically, CARE Court judges can order participants to follow mandatory “CARE plans” — something that happened just 32 times between late 2023 and January — but judges can’t force participants to comply.

Easier CARE Court petitions

Blakespear’s other bill, SB 989, addresses another CARE Court challenge: the low number of people participating.

Filing a CARE Court petition is a complicated, time-consuming process. Whoever is filing the request needs the person’s medical records. Then, they need to appear at the first court hearing — something overworked first responders don’t always have time to do.

That’s a key reason that people who work in public safety, such as firefighters and EMTs, say they don’t file CARE Court petitions, said Meagan Subers of California Professional Firefighters, who spoke in support of the bill at the Senate Judiciary Committee hearing.

SB 989 would create a framework for first responders to refer clients directly to their county behavioral health department, which could then file a CARE Court petition on their behalf. The county would have 30 days to decide whether to file.

Some counties already make an effort to train and support their first responders in filing CARE Court petitions. Stanislaus County allows first responders to refer CARE Court clients directly to the county.

But that collaboration isn’t happening in a systematic way across the state, Subers said. This bill could help fix a broken system where first responders are constantly cycling people with severe mental illnesses in and out of emergency rooms, she said.

“When our members have to run these calls repeatedly on individuals and take them to the hospital, knowing that they’re going to have to respond to that person again, my members tell me that they feel helpless,” she said. “We see this pathway as another option for them.”

Blakespear’s bills follow a similar effort last year by Sen. Tom Umberg of Santa Ana to make CARE Court more effective. His new law, which went into effect in January, expanded CARE Court to include people who experience psychosis as a result of bipolar disorder. The program initially was exclusively for people diagnosed with schizophrenia and other limited psychotic disorders.

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.

The International Olympic Committee issued a new policy last month, banning transgender women from participating in women's sports starting at the 2028 Summer Games and requiring all athletes who want to compete in the female category to undergo genetic testing.

The policy represents a significant inflection point in the ongoing political battle over trans women's participation in sports at all levels, including in California. It also marks a return to genetic tests that for decades dictated women's participation in the Olympics, and excluded transgender and many intersex athletes — those whose sex characteristics don't fall into the binary categories of male or female.

Genetic testing was required of women athletes for much of the second half of the 20th century, including the last time Los Angeles hosted the Olympic Games in 1984. Athletes had to present "certificates of femininity," according to the official report on the 1984 Games.

Those types of tests were stopped after the 1996 Games in Atlanta amid questions about their scientific efficacy and ability to assess what was an "unfair advantage," according to the IOC's own retelling.

Blanket genetic testing will return to the L.A. Olympics in 2028, bringing with it questions about how it will be implemented and who it will keep off the Olympic stage.

IOC says the science is settled. Some experts disagree

How to measure fairness in women's competition has been debated for at least a century, and different approaches have been used and abandoned over the decades. In recent years, the IOC had stopped requiring genetic tests and left rules around sex testing to individual athletic federations.

When IOC President Kirsty Coventry announced that the IOC would re-introduce a mandatory genetic test for all female Olympic athletes last month, she presented it as the final word on who can and can't participate in women's sports.

IOC President Kirsty Coventry speaks during an IOC Executive Board press conference on Feb. 01, 2026 in Milan, Italy.

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All women Olympic athletes will have to take a test to identify if they have an SRY gene, which is on the Y chromosome. According to the IOC news release, that SRY gene represents "highly accurate evidence that an athlete has experienced male sex development." Those with the gene will be excluded from competition except in some limited cases where the athlete is found to not to "benefit from the anabolic and/or performance-enhancing effects of testosterone."

"At the Olympic Games, even the smallest margins can be the difference between victory and defeat," Coventry said. "So, it is absolutely clear that it would not be fair for biological males to compete in the female category."

The new policy faced immediate pushback from human rights advocates and some experts in the field, including UC Irvine genetic expert Eric Vilain, who has previously advised the IOC on its inclusion policies.

He told LAist that the new IOC policy ignores women athletes with sex traits that aren't neatly aligned with the gender binary.

" Many of these athletes who were born intersex, they [looked] like a female baby, they were raised as female. They don't necessarily have male levels of testosterone," said Vilain, who said the science isn't settled on what advantage intersex women with a Y chromosome have in sport. " The answer to that is very unclear."

Decades of scrutinizing women athletes

Attempts to define the category of woman in athletic competition are nothing new.

Suspicion over the identity of women athletes started when they entered Olympic track and field competitions in 1928, according to Jaime Schultz, a kinesiology professor at Penn State who studies the history of women in sports.

" Track and field was seen as a masculine sport. The fear was that the sport would either masculinize women or else 'masculine women' might be drawn to the sport," Schultz said. "There was suspicion from the very beginning at the Olympic Games."

In the 1930s, two prominent retired athletes who had competed in women's sports transitioned to become men — exacerbating anxieties about any athletes who did not fit gendered norms.

"In the early 20th century, women’s sports were a source of moral and gender panic," historian Michael Waters, who wrote a book on those athletes, told Mother Jones. "Sports officials saw the idea that an athlete could transition gender as a threat to the binary categories they had built."

This led to the scrutiny of women who didn't fit gendered norms, according to Waters.

Women had to submit certificates from a physician in order to compete in track and field competition by the end of the 1930s, Jaime Schultz told LAist. Then came World War II and after that, the Cold War, when Schultz said suspicions turned to Soviet athletes who were suspected of "masquerading" as women. By the 60s, women in professional sport were subjected to gynecological exams and "naked parades" where they had to show their nude bodies to a panel to prove their sex.

American track star Wilma Rudolph breaks the tape at the finish line for the United States at the 1960 Olympic Games in Rome on Sept. 8, 1960.

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" They ask the women athletes to strip naked and parade themselves in front of these three physicians, who sort of look them up and down and say, 'Yes, you're a woman, you can compete in women's events,'" Schultz said. "The visual inspections [were] humiliating to the women."

Those tactics were abandoned after outcry. That's when genetic testing entered the scene.

How genetic testing began for female Olympic athletes

At the 1968 Winter Games in Grenoble, the IOC began trialing a chromosome test called the "Barr body test," which counted X chromosomes to determine an athlete's sex. But that test was scientifically questioned.

French skier Marielle Goitschel (C), Annie Famose (R), and Canadian Nancy Greene after the slalom at the 1968 near Grenoble, during the Winter Olympic Games when the IOC began trialing a chromosome test for female athletes.

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"The stated aim was to detect male athletes posing as women, though in practice the test excluded women with naturally occurring chromosomal variations," according to a history posted to the IOC website in 2023.

One such athlete was Spanish hurdler Maria José Martínez-Patiño, who went to a competition in Japan in 1985, but forgot her certificate verifying her status as a woman. When she re-took the genetic test, she learned she had a Y chromosome and was barred from competition.

Martinez-Patino had androgen insensitivity syndrome, a condition that causes the person to have "genitals that appear female, but they don’t have female reproductive organs," as NPR reported. Officials determined she did not have an unfair advantage and she was eventually allowed to compete, but the process took years and was publicly humiliating.

Spanish hurdler Maria José Martínez-Patiño, who went to a competition in Japan in 1985, re-took the genetic test and learned she had an XY chromosome and was barred from competition.

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"I knew that I was a woman, and that my genetic difference gave me no unfair physical advantage," Patino wrote in The Lancet in 2005. "I could hardly pretend to be a man; I have breasts and a vagina. I never cheated."

In 1992, the IOC introduced the SRY gene test that will now be re-introduced for the L.A. Olympics, according to Vilain at UC Irvine. That test was abandoned by the 2000 Olympics.

"There was so much outcry from the scientific community because it was also deemed not very ethical with lots of issues of privacy," Vilain said.

The rise of testosterone testing

What rose in place of the genetic testing was a new focus on testosterone levels in women athletes. That started in 2009 with South African runner Caster Semenya, who has differences of sexual development that meant she had higher than typical testosterone levels.

At the track and field World Championships, Semenya faced intense scrutiny from the public and sports officials over her appearance and gender identity. This fervor, recounted in NPR's series "Tested," led the governing body for track and field to require Semenya to take medication to lower her testosterone and implement limits to testosterone levels for female competitors.

Double Olympic champion Caster Semenya (C) in 2024 during her legal battle against regulations requiring female athletes with high testosterone to take medication as she prepares for a May hearing. Semenya is seated with her lawyers Gregory Nott (R) and Patrick Brancher (L).

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That approach, too, has faced criticism from human rights organizations for its disproportionate impact on women from the Global South and the privacy issues it raises.

"A policy that calls for scrutiny of women’s naturally-occurring hormone levels — and, in practice, their bodies for signs of perceived “masculinity” ascribed to testosterone — is a form of policing women’s bodies, and passing judgment on their “femininity” as well as on their sex and gender identity," reads a 2020 report from Human Rights Watch.

The IOC's reintroduction of genetic testing has raised even more questions about the lines drawn around women's sports — and how those lines will be implemented come 2028.

In 1984, 1,610 women athletes underwent a "gender verification test" while in L.A., according to the official report on those Olympic Games. How testing will work this time around, who will pay for it, and what controversies it might unearth are still to be seen.