A few weeks ago we posted a blog entitled “Nutritional Supplements: Are the Benefits Worth the Cost?.” This week, we are shifting our focus to another population group while continuing our conversation on herbal remedies and supplements.

An eye-opening study was published in the May 2011 online edition of the Pediatrics Digest regarding the administration of herbal medications and teas to infants one year of age and under by parents. A major finding was that 9% of infants, some as young as one month old, were given non-prescription products for a variety of conditions. Examples of products given to babies included gripe water, chamomile, teething tablets, and teas such as chrysanthemum tea, lemon tea, orange tea, and rosemary leaf tea.

The four most common reasons that mothers fed dietary botanical supplements (dbs) and teas to their infants were to help with fussiness, digestion, colic and relaxation.  Infants were more likely to be given these products if the mother used herbals herself or provided longer breastfeeding. The study showed sources of information about herbs and teas were obtained largely from friends and relatives, healthcare professionals, and the media.

The use of dietary botanical products and herbal teas in children and infants is not well studied however; utility vs. harm is not well described for these products.  For children 4 to 6 months, the common recommendations are that they should receive only breast milk or infant formula with the addition of medicines and vitamins as necessary.

Many herbal medicines, supplements, and teas are unregulated by the FDA, thus their safety and efficacy is often in question, especially in children. These products may cause drug interactions or contain heavy metals (eg. mercury, lead) and other contaminants. Additionally, infants may be more at risk for adverse effects based on differences in their physiology, metabolism, and dose per body weight.

A  few examples of quality and/or safety problems associated with dietary botanical products and alternative therapies used for infants include:

• Hyland’s Teething Tablets: voluntarily recalled by the manufacturer in October 2010 for inconsistent amounts of the botanical belladonna. The FDA warned that it may pose a risk to children.
• Baby Bliss Gripe Water: recalled in September 2007 for contamination with cryptosporidium, a parasite that can cause intestinal infections
• Teavana Peppermint Organic Herbal Tea: recalled in March 2011 for Salmonella contamination

So, what’s our take home message about giving your infant herbal products or teas? Here are a few pointers to keep it simple:

• Stick to feeding your baby only human milk or infant formula during the first 4 to 6 months.
• Give medications or vitamins only as directed by your pediatrician
• Always consult a pediatrician, pharmacist, or another trusted healthcare provider before giving your baby non-prescription drugs or alternative medicine products

If you suspect your child is having an adverse reaction to any nutritional supplement or herbal medication, please call the Illinois Poison Center at 1-800-222-1222 for immediate assistance.

Kelly Mattes, PharmD Candidate, Balaji Venkat, DO, Tony Burda, RPh, DABAT