Do herbal remedies for kids work?

Herbal and "natural" remedies have been available for thousands of years. Recently, there has been an increase in their popularity, availability, and use. Some doctors have embraced them and use them readily; other doctors are hesitant to recommend them. We are often asked where we stand on this important health issue. Here are three principles we look at when evaluating the use of any medication (not just herbals, homeopathics, or other remedies.)

 Principle No. 1: First, do no harm.

In other words, medicines should be safe before anything else. This is especially important in children, whose bodies respond to medications of all kinds differently. Some remedies have been tested for safety in adults, but there have been very few studies documenting safety of herbals in infants and children. Even with "natural" remedies, it is still important to prove they're safe. Remember that an adult dose can be 5 to 10 times a child's dose. Also, while the herb itself may have been proven safe, other contaminants or materials in the herbal preparation may not be.

 Principle No. 2: Good remedies can be proved effective in studies.

The best kind of study to test a medicine is called a "blinded placebo" study. Volunteers are randomly divided into two groups. One group takes the medicine to be tested; the other group takes a "placebo" (sugar pill). To avoid bias, neither group knows which medicine they're taking. Both groups record changes in their symptoms. Finally, the outcomes of both groups are compared. If the medicine is truly effective, a significant difference should be seen between the medicine group and the placebo group.

 These studies can be hard to do. Enough people have to volunteer to make it worthwhile. (For example, it is better to compare two groups of 1000 people each then two groups of 10 people each.) The researchers doing the study shouldn't have any financial interest in the results. False assumptions, or attempting to "compare apples and oranges," can also produce flawed results. For the best proof, several studies over a period of years should all produce the same results.

 Some herbal remedies have already been tested in this way, and more are being tested all the time. Some remedies look very promising, such as camomile tea for colic in babies. Other remedies haven't stood up to the test, such as melatonin as a cure for ADHD. Still others have conflicting results, such as echinacea for colds.

 You may be interested to know that many traditional medications commonly recommended for cold symptoms (Robitussin, etc.) haven't stood up to this test either! (We are hesitant to recommend them for this reason.)

Principle No. 3: "Natural" isn't necessarily the same thing as "safe".

A good example is an herbal remedy that was touted for many years to produce relaxation and calming effects. Harvested from a plant, it was inexpensive and readily available. It was proved efficacious for relaxation and many people took it several times a day without any apparent side effects. By the 1940s, many doctors were even recommending this herb for their patients. It wasn't until the herb had been in use for 400 years in this country before doctors finally realized its devastating side effects. The herb in question, of course, is tobacco, and even today we continue to discover its implications in ill health.

More recently, in June 2009, the FDA advised consumers to stop using Zicam, a homeopathic cold remedy, because it can cause permanent loss of smell. Its manufacturers never sought FDA testing or approval before it was marketed.

 In summary, some herbal remedies may indeed be effective for some of common problems of children. A few herbals (like camomile) have been shown safe and helpful, and we can recommend those enthusiastically. However, studies for most herbals in kids just haven't been done yet. Until then, we won't feel comfortable recommending them. If you do choose to treat your child with herbal remedies, please let us know when we ask, "Is your child taking any medications right now?"

 If you have questions about a specific herbal remedy, let us know. We can look up the most up-to- date research on that herbal together.