Herbal medicines for children: an illusion of safety?

Abstract

Herbal medicaments are in common use. In general, the judicious use of carefully selected and prepared herbal medications seems to cause few adverse effects and may be beneficial. However, toxic effects of these products have been reported with increasing frequency. Infants and children may be even more susceptible to some of the adverse effects and toxicity of these products because of differences in physiology, immature metabolic enzyme systems, and dose per body weight. Although information promoting the use of herbal medicine is widespread, true evidence-based information about the efficacy and safety of herbal medications is limited. Although the most conservative approach is to recommend against use of herbal medicine until such evidence is available, some patients are not receptive to this approach. A reasonable approach for health care providers may be to follow such use closely, assist in herbal therapeutic decisions, and monitor for adverse effects and interactions. This manuscript discusses general concepts about herbal medicines, public health implications, and a framework for mechanisms of adverse effects from the use of botanicals. Adverse effects and toxicity of selected herbal products, including Chinese herbal medicines, are presented. The authors propose a risk reduction approach in which physicians actively seek information about the use of complementary or alternative medicine while taking medical histories.

Antihypertensive Activity of Aqueous-Methanol Extract of <i>Berberis Orthobotrys</i> Bien Ex Aitch in Rats

“…Hence biological evaluation of most of these traditional medicines remains yet to be elucidated [6].…”

Feeding of Dietary Botanical Supplements and Teas to Infants in the United States

“…2 Infants may be more susceptible to adverse effects because of differences in physiology, metabolism, and dose per body weight. [3][4][5] Studies conducted in the United States have documented the adverse effects of feeding certain DBS to children, including seizures in previously healthy infants 3 and death. 6 A major brand of DBS marketed for infants was recalled for microbiologic contamination in 2007.…”

A 3-year survey of acute poisoning exposures in infants reported in telephone calls made to the Tygerberg Poison Information Centre, South Africa

“…Three of the four herbal products contained valerian which has been associated with toxicity. [18] In this study serious CAMrelated poisonings occurred more in neonates (60%) compared with older infants (30%) ( Table 2). The low weight and physiological differences in this vulnerable population could be a contributing factor.…”