Herb Effects Parents May Do More Harm Than Good When They Give Children Some Herbal Remedies

It wasn’t that long ago that mothers gave their children cod liver oil to keep them healthy. Nowadays, many prefer to dish out herbs, things such as cherry bark and astragalus, horehound and lemon balm.

Sunny Mavor, in fact, can rattle off the names of more than 50 plant-based products she has tried out on her son and daughter in the past few years.

And that is a conservative estimate.

“There have been as many as 100,” she says.

The Bozeman, Mont., mother’s affinity for herbal alternatives to drugs is certainly shared by hundreds of thousands of Americans, more and more of whom are purchasing herbal products for their kids despite potential safety risks. A 1999 survey on the nation’s use of supplements found that 18 percent of parents give their children herbal products - a classification that doesn’t even include vitamins or minerals.

“I guess it was inevitable,” says Anne Maher, assistant director for advertising practice at the Federal Trade Commission. “Just as you see over-the-counter drugs being marketed to kids, you’re seeing herbal supplements being marketed to kids.”

It’s a phenomenon that has horrified some pediatricians.

Herbal products with smiling rhinos, dancing frogs and diaper-clad teddy bears on their labels are now filling up the shelves of health food stores and even mainstream supermarkets. Most are touted as “all natural,” and many come in flavors kids love. Some are sold as lollipops, chewy candies and even fruit smoothies. And it seems that all manufacturers of dietary supplements are scrambling to offer their own kid-friendly version of adult formulations.

“Everybody’s trying to sell the `miracle pill’ to fix things,” says Dr. Kathi J. Kemper, director of the Center for Holistic Pediatric Education and Research at Children’s Hospital in Boston. Yet Kemper, who considers herself pro-herbs, says parents might be better off if they didn’t give in to the hype.

What many consumers aren’t aware of is that dietary supplements sold in the United States are not subject to the same stringent safety regulations applied to drugs. They can be sold without any pre-market testing or approval. They aren’t required to be effective.

So-called children’s products aren’t necessarily the right formulations for a growing kid. And the ingredients listed on product labels aren’t always what’s inside.

“In our country, it’s sort of Russian roulette. You really don’t know what you’re getting,” says Varro Tyler, a professor emeritus at Purdue University who is considered one of the leading experts on herbal medicines.

When it comes to manufactured herbal products, Tyler says, “If adults wish to use them themselves and take whatever chances are involved, that’s fine. But I don’t recommend them for children.”

Which is a shame, some herbal advocates maintain. After all, mild herbs such as peppermint, ginger and chamomile have been used by some cultures for thousands of years. And many children seem to tolerate them well.

“I’ve always had good results with herbal medicines. I know I can trust them,” says Mavor, who has written “Kids, Herbs & Health” and launched her own children’s herbals company.

The key, she says, is in selecting a safe and efficacious product. Parents shouldn’t be blindly buying capsules they know nothing about without even discussing them with a physician or herbalist first.

“Some of these products are patently not safe for children,” says Dr. Ed Cox, chairman of the American Academy of Pediatrics’ task force on complementary and alternative medicine.

“It’s possible that they’re doing more harm than good.”

The academy’s warning, however, has gone relatively unheeded, as parents have snapped up herbal products to treat everything from asthma to attention deficit disorder in kids.

There are tablets to relieve bedwetting symptoms, colic, teething and cramps. There are capsules to support the immune system and a child’s ability to focus.

Store shelves are now filled with dozens upon dozens of these tinctures and tonics, many costing about $8 a package. But many health experts believe some consumers could end up getting more than they bargained for.

In February, researchers in Great Britain discovered eight brands of “herbal” skin ointments contained a potent prescription steroid. Although they were marketed as “natural” treatments for eczema, the creams had large quantities of dexamethasone in them that could damage delicate skin permanently. And the creams for children, whose skin is extremely sensitive, contained five times the steroids of the adult products.

Ephedra, a toxic stimulant many pediatricians and herbalists agree should not be given to children, also has been found in products, including some targeted toward kids with attention deficit disorder. The Food and Drug Administration investigated 134 cases in which patients had adverse reactions after taking ephedra-based products.

Those reactions included insomnia, seizure, hypertension, stroke and death. Ten of the cases involved children.

In the United States, the FDA can restrict the sale of an herbal product only if the agency receives well-documented reports of health problems associated with it. But in 1998, the agency virtually stopped most of its monitoring because of budget constraints.

“Right now there is no way to protect children from the harmful effects of dietary supplements. Consumers need to be aware of that,” says Charles Santerre, an associate professor in the department of foods and nutrition at Purdue University.

Indeed, last year, 6,313 children were poisoned by herbal supplements nationwide, according to the American Association of Poison Control Centers. Accidental overdose was the most likely reason, says Daniel Cobaugh, associate director of the association.

Parents just need to use a little more caution. After all, many of the herbal formulas for kids come with warnings to keep them out of the reach of children.

“We go to the store and pick something up, and we have no idea what it is. It has a pretty label. And we’re willing to give it to our kids without knowing this is as safe as it is pretty to look at,” Kemper says.

“It would be like going out in the woods and picking a mushroom you don’t know and giving it to your child. Most mushrooms in the woods are OK, but we do know there are some very toxic mushrooms.”

Two sidebars appeared with the story: 1. Groups offer information about herbs By Julie Sevrens Lyons San Jose Mercury News

If you’re interested in more information about herbs or herbal products, here are some resources:

The American Herbalist Guild is the only governing body for herbalists in the United States. Check out www.healthy.net/herbalists or call (770) 751-6021.

The American Herbal Products Association, at www.ahpa.org, is a member organization of manufacturers of herbal products. The site contains links to the makers of many herbal remedies.

ConsumerLab, at www.consumerlab.com, provides independent test results on health and wellness products. The nonprofit organization lists products that pass its tests by name and reports on questionable substances found in some supplement formulations.

The Food and Drug Administration Center for Food Safety and Applied Nutrition, at www.cfsan.fda.gov, has information about supplements.

The Herb Research Foundation has data on herbs and links to other resources. Go to www.herbs.org or call (303) 449-2265.

The journal Medical Herbalism operates its own Web site, www.medherb.com, which provides links to resources in herbalism. Information on adverse effects can also be found here.

The National Institutes of Health International Bibliographic Information on Dietary Supplements, http://odp.od.nih.gov/ods/databases/ibids.html, is a database of published, scientific findings on supplements.

2. Some remedies linked with serious side effects By Julie Sevrens Lyons San Jose Mercury News Inappropriate for most children

Belladonna. A toxic alkaloid.

Black cohosh. Has hormonal properties.

Cascara sagrada. Chronic usage could cause electrolyte imbalance.

Chaparral. Can cause liver disease.

Chaste berry. Has hormonal effects.

Comfrey. When taken internally, obstructs blood flow to the liver, with potentially fatal results.

Dong quai. Triggers hormonal changes.

Ephedra (Ma Huang). Can cause heart attacks, stroke, seizures and death.

Germander. Can lead to liver disease.

Ginseng. Not considered necessary for children.

Guarana. Strong central nervous system stimulant.

Lobelia or Indian tobacco. Can cause breathing problems, rapid heart beat, coma or death.

Kava root. Not studied in children.

Kola nut. Stimulant that contains caffeine.

Poke root. Toxic alkaloids could cause poisoning.

Senna. Stimulant laxative capable of causing electrolyte imbalances.

Willow bark. Linked to Reye’s syndrome, a potentially fatal disease.

Wormwood. Can cause neurological problems.

Yellow jasmine. Toxic alkaloids, small doses of which can kill children.

Safe for kids

Aloe Vera. Applied externally to help heal burns and minor wounds.

Catnip. Used to promote sleep, relieve menstrual cramps and infant colic.

Chamomile. Thought to soothe nerves, indigestion, stomach upset and headaches.

Echinacea. May boost immune functioning.

Ginger. Aids digestion and is known to relieve nausea.

Goldenseal. Used to treat everything from sore throats to earaches.

Lemon balm. A calmative for the nerves and stomach.

Peppermint. Aids digestion and can quell nausea.

Sources: “The American Pharmaceutical Association Practical Guide to Natural Medicines;” U.S. Food and Drug Administration; “The Healing Spirit of Plants;” Sunny Pendleton Mavor, co-author of “Kids, Herbs & Health”