Aside from the lack of research on herbal treatment use in infants, other concerns warrant parents' attention. "The purity of the product is one issue: Is it free of pathogenic microbes, heavy metals, and other pollutants?" says Dr. White. "Newborns don't have fully mature immune systems."
Contaminated herbs, generally more of a problem with herbs grown outside of the U.S., could have strong central-nervous-system effects. "Infants' rapidly developing bodily systems, especially the nervous system, are vulnerable," Dr. White adds.
Looking at 2,650 mothers, researchers studied data relating to the tail end of a mother's pregnancy and feeding habits through her child's first year. They found that nearly 10 percent of moms administered botanicals to the baby in its first year of life, including herbal leaves or plant roots, oils, seeds, and teas. Mothers who took dietary botanical supplements themselves also were more likely to give herbal treatments to their children. Herbal ointments were not included in this study, but researchers did find that gripe water (an over-the-counter herbal tonic for cranky babies), chamomile, teething tablets, and teas were the herbs most commonly given to children, some as young as 1 month old. The study authors also point out that supplements are not strictly regulated as drugs, either.
Very few research studies have investigated the use of herbs in infants, although some appear to be safe based on centuries of historical use, not high-quality scientific study. "There are quite a few [smaller] studies looking at a range of botanicals or supplements for the treatment of colic, for example," explains David Becker, MD, MPH, associate clinical professor of pediatrics at the Osher Center for Integrative Medicine at the University of California, San Francisco. "But larger studies assessing safety and efficacy are lacking. It’s too early to offer routine recommendations with complete confidence."
Dr. Becker says part of the problem, though, is that there's little money being invested in investigating herbal botanicals use in medicine, but rather in chemicals that can be patented by pharmaceutical companies. "Botanical products are complex, with many different chemical components," he says. "That does not inherently make them dangerous. In fact, it’s plausible it may improve relative safety. But the research is complex, difficult to do, and poorly funded."
Typical medical education does not cover the history of botanical uses or our current scientific understanding of safety and efficacy. And because our regulatory system has not yet developed a reliable way to screen all products available for risks related to quality and contamination, it takes more time to develop knowledge of reputable companies and sources.
Although he generally doesn't prescribe herbs for babies, Dr. Becker said he does occasionally recommend certain herbal remedies such as chamomile, fennel, or probiotics, on a case-by-case basis. "I generally counsel against the use of anything other than breast milk (or infant formula) for the first four to six months," he adds.
Like Dr. Becker, Dr. White is also concerned that herbs used for babies may replace vital nutrition needed in breast milk or formula. She also notes that an infant's intestinal tract is leakier, which raises the risk for allergic reactions.
Here are some general rules of thumbs when considering herbs for babies:
• Read up on kids and herbs. While it's not generally advisable to give herbs to newborns, that doesn't mean you can't use natural remedies as babies grow older. Dr. White recommends Naturally Healthy Babies and Children: A Commonsense Guide to Herbal Remedies, Nutrition, and Health (Celestial Arts, 2003) and The Holistic Pediatrician: A Pediatrician's Comprehensive Guide to Safe and Effective Therapies for the 25 Most Common Ailments of Infants, Children, and Adolescents (Harper Paperbacks, 2002) as useful resources for parents.
• Inform your doc. If you are giving your child herbal treatments, it's important to let the child's pediatrician know about it, Dr. White says.
• Know safer tea-time herbs. If you discuss herbal options with your pediatrician and decide it is appropriate to use herbs for your baby, Dr. White says time-honored herbs for colic include chamomile (Matricaria chamomilla), lemon balm (Melissa officinalis), catnip (Nepeta cataria), vervain (Verbena officinalis), fennel (Foeniculum vulgare), dill seed (Anethum graveolens), and caraway seed (Carum carvi). Making the tea involves bringing water to a boil, turning off the burner, adding ½ teaspoon of the herb for babies. Steep for 10 minutes, strain well, and cool until the liquid is comfortable on your inner wrist. Make a fresh batch each day. This can be fed to your baby using a sterilized dropper. (Never sweeten the tea with honey; infants younger than a year should never ingest honey.)