My kids have grown up with herbs, and my knowledge of herbs has grown just from having children, but for most people, using herbs is a new experience. We don’t mind experimenting with herbs and dietary supplements on ourselves, but when it comes to our children, we want to be sure that the treatments will work and, more importantly, that they are absolutely safe. Just because an herb is “natural” doesn’t mean that it’s safe, and just because it’s safe for adults doesn’t mean that it’s safe for children. Little if any research has been devoted to the use of herbs by children.
Children have rapidly changing bodies, with different metabolic rates, needs, and body chemistry from those of adults. My twelve-year-old son, Colin, is currently on a Shaquille O’Neal growth chart. He’s bigger than all his friends, has a huge bone structure, and grew 3 inches in height from March to July! For Colin, herbs are a fact of life, not a novelty, yet little if any research has been devoted to the use of herbs by children. Undoubtedly, many parents regularly give herbs to their children without scientific data attesting to their efficacy or safety.
What works? What’s safe? What do you need to know to get started? Let’s take a look.
For the past fifty years, U.S. physicians have almost universally relied on antibiotics in treating many childhood illnesses. If you want to use herbs to treat your child, talk to a physician or other health-care provider. If the physician is not yet open to using herbs, you may want to show him/her the excellent new book Phytotherapy in Pediatrics: A Handbook for Physicians and Pharmacists, by Heinz Schilcher. Schilcher, a physician and expert on plant medicines, is a former member of Germany’s Commission E, the federal regulatory body that developed the monographs that are the basis of herb regulation in that country. The book uses medical terminology, but it’s an excellent introduction to the subject. Peppermint tea tastes great and soothes an upset stomach. It can also help bring down a fever.
Here are Schilcher’s rules for treating children with herbs. They apply equally to adults.
• Establish the cause of the illness.
• Choose a proven remedy for a specific ailment rather than an herb with a general effect, such as ginseng.
• Take only one medication at a time.
• Use the lowest effective dose.
• Tailor treatment to current symptoms. If a child’s cold has nearly run its course but the child now has a pesky cough, don’t bother with echinacea but treat the cough. Different kinds of coughs need different treatments. If you can’t tell which kind your child has, call your doctor.
In any event, medicating your children is for the short term only. If symptoms persist or worsen, if you can’t tell what’s wrong, if there’s dizziness or pain that doesn’t go away, or if something doesn’t look right, seek medical advice.
With these guidelines in mind, here are a few herbs that I have found useful with my children.
Echinacea for sniffles
Echinacea, which helps the body fend off infections, can help with minor earaches, sore throats, and other cold symptoms. At the first sniffle or whimper of “Dad, I don’t feel good,” I give Colin or Abbey, age nine, some echinacea at half the adult dosage for as long as a week. Usually, symptoms don’t persist that long, but if they do, I call our doctor for advice.
Echinacea comes in capsules, teas, tinctures, glycerites, and lozenges, among other forms. Capsules may be hard to swallow. A tea can be used if the child will drink it; sweeten it with honey. Glycerites, herbal extracts made with glycerin, are sweet and go down easily. Some are formulated for children. My children prefer the lozenges because they love sugar. If you’re trying to cut down on children’s sugar intake, these lozenges are not a good choice.
Many tinctures have a harsh taste, and all contain at least 50 percent alcohol. I prefer to give my children the expressed juice of fresh flowering Echinacea purpurea. It contains 22 percent alcohol to prevent spoilage but has been used safely for decades by millions of people and is the form used in most clinical trials of echinacea. I dilute it in a little water or orange juice with a taste of honey.
Mint for tummy aches
When my children have an upset stomach, they know they can go to the pantry, find a box of peppermint tea bags, and make tea with water heated in the microwave. They feel proud to be able to perform this simple task without adult help. Peppermint tea tastes great and soothes an upset stomach. It can also help bring down a fever. Menthol is the main flavor component and active ingredient in the essential oil of peppermint leaves.
Don’t use menthol by itself. If applied to the nostrils of infants to relieve nasal congestion, it can cause lung collapse. Unless used in a vaporizer or diffuser, essential oils in general are too strong and potentially toxic to use in treating children. Store them in a locked cabinet out of children’s reach.
If you want to make fresh mint tea from plants in the garden, be sure you have peppermint (Mentha ¥piperita), not the related but toxic pennyroyal (M. pulegium). Recently, physicians in one hospital reported two cases of multiple organ failure, one fatal, in infants given pennyroyal tea by their mothers.
Chamomile for sleep
In The Tale of Peter Rabbit, by Beatrix Potter, Mrs. Rabbit gives her undisciplined son chamomile tea. Like a cup of warm milk, chamomile has gained a reputation as a soothing, quieting nighttime beverage that gently calms the digestion and helps a child drift off to sleep. I don’t believe that a single clinical study supports this use, but then there is the collective experience of millions of people (and rabbits) over the centuries. A teaspoonful of dried chamomile flowers in a tea bag or ball, steeped for 5 to 10 minutes in boiling water and cooled until only pleasantly warm, makes an apple-flavored tea that children like. Rarely, people have allergic reactions to chamomile; if your child is allergic to ragweed pollen, be aware that chamomile flower tea contains pollen and that chamomile belongs to the same family as ragweed.
In Europe, chamomile is also used to treat diaper rash and babies’ dry, sensitive skin. Steep 2 tablespoons of dried chamomile flowers in a tea bag or ball in the bathwater or dab cooled weak tea on the affected area with a cotton ball. Chamomile salves, some formulated for children, are also available. Here we have touched on a few gentle, useful herbs with few or negligible adverse effects that could be magnified in a small child. However, herbs are best used to complement other regimes. If your child has a cold, echinacea may help, but don’t forget the basics—plenty of rest and lots of fluids!
Schilcher, H. Phytotherapy in Pediatrics: Handbook for Physicians and Pharmacists. Stuttgart, Germany: Medpharm Scientific, 1997 (available from the American Botanical Council, Austin, Texas).
Witch Hazel’s Secrets
As a child, I was fascinated by the old apothecary jar labeled “Witch Hazel” that sat in my grandmother’s bathroom. When I asked her if it was a secret potion for grandmothers, she explained that it was simply a toiletry. Several years later, one New England autumn day while walking through Grandma’s woods near the pond, I came upon a small shrub decorated with tight clusters of fragrant, spidery yellow flowers. “Witch hazel,” she said when I showed her the branch I had broken off, and so I learned that the clear liquid in the old bottle came from a plant.
In Colonial America, the shrub’s flexible forked branches were a favorite “witching stick” of dowsers, who used it to search out hidden waters or precious metals. (This has nothing to do with witches but comes from the old English word for a tree with pliable branches, “wych”.) In England, dowsers used the branches of wych elms (Ulmus glabra) as their divining rods. Those who immigrated to America must have fancied the native witch hazel as a logical replacement.
European settlers learned of witch hazel’s benefits from Native Americans. Early writers noted its use to treat eye inflammations, hemorrhoids, bites, stings, skin sores, dysentery, and other conditions for which a plant rich in tannins might bring relief.
The genus Hamamelis contains about five species of shrubs or small trees native to North America and eastern Asia. The generic name, a combination of Greek roots meaning “apple” and “together”, refers to a different plant with a pearlike fruit, probably a kind of medlar. Common witch hazel (H. virginiana), the shrub I found blooming in Grandma’s woods, grows on north-facing slopes and along fencerows, country roads, and stream banks from Nova Scotia west to Ontario and south to Texas and Florida. It may grow 20 to 30 feet tall and up to 25 feet across. The bark is smooth and gray or grayish brown.
The leaves are alternate, strongly veined, and variable in size and shape on the same plant. An average leaf is roughly oblong, 3 inches long by 2 inches wide. Medium or dark green in summer, the leaves turn yellow in autumn and often have fallen by the time the flowers open.
The fruit, which takes a year to mature, is a woody capsule containing two shiny, hard black seeds that taste like pistachios. Native Americans living in the South knew and savored them. When ripe, the capsules explode, catapulting the seeds up to 10 yards away. If you bring in a bouquet of flowering witch hazel branches, be aware that the warmth of the house may well set off last year’s capsules.
Vernal witch hazel (H. vernalis), found in the wild along creek beds in the Ozark plateau, opens its fragrant, delicate, yellow to red blossoms in early spring, and the fruits mature in autumn of the same year. It is a smaller shrub than H. virginiana.
Witch hazels make handsome ornamental shrubs. Most commonly grown nowadays are the larger-flowered, spring-blooming cultivars of H. ¥intermedia, developed by crossing Japanese (H. japonica) and Chinese (H. mollis) witch hazels.
A multitude of uses
Native Americans found many uses for witch hazel. The Osage used the bark to treat skin ulcers, sores, and tumors. The Potawatomi placed the twigs on hot rocks in sweat lodges and bathed in the steam to soothe sore muscles. The Menomini rubbed a decoction of boiled twigs on their legs and back to keep muscles limber while the Mohegan used their decoction of leaves and twigs on cuts, bruises, and insect bites.
The Iroquois drank witch hazel tea to treat dysentery, colds, and coughs, and to purify the blood.
European settlers learned of witch hazel’s benefits from Native Americans. Early writers noted its use to treat eye inflammations, hemorrhoids, bites, stings, skin sores, dysentery, and other conditions for which a plant rich in tannins might bring relief. The same bark or leaf tea might be swallowed to check internal bleeding or injected into the rectum to allay the pain and itching of hemorrhoids. A fresh leaf or bark poultice or a cotton ball dipped in witch hazel water soothed chigger, tick, and mosquito bites, as well as poison ivy rash.
During the 1840s, Theron T. Pond of Utica, New York, learned from an Oneida medicine man of the esteem that his people held for witch hazel as a treatment for burns, boils, and wounds. In 1848, the two began marketing witch hazel extract under the name Golden Treasure. Eventually, a manufacturing plant was established in Connecticut, and after Pond’s death, the preparation was renamed Pond’s Extract.
Witch hazel today
The E. E. Dickinson Company, T. N. Dickinson Company, and American Distilling and Manufacturing Company, all based in Connecticut, produce most of the witch hazel extract sold in the United States. In northwestern Connecticut, landowners contract with the distillers to harvest the witch hazels in their woods. Branches are cut to the ground in autumn (the shrubs resprout and may be harvested again in a few years), chipped, and shipped to the factories, where they are steam-distilled for 36 hours. After the distillate has been reheated, condensed, and filtered, 14 percent alcohol is added as a preservative. By contrast, the witch hazel water commonly used in Europe is a nondistilled water-alcohol extract of the twigs and leaves.
Witch hazel is an ingredient of a wide range of deodorants, aftershave lotions, cloth wipes, soaps, ointments, and creams.
How does it work?
The active compounds of witch hazel include flavonoids and tannins and other components that may be responsible for its astringency and its ability to stop bleeding. The tannins, much more prevalent in the bark than in the leaf extract, include hamamelitannin and a number of proanthocyanidins. In commercially distilled witch hazel products, much of the tannin content is left behind during distillation.
A recent study revealed a fact about witch hazel that was not previously known. It showed that a fraction of witch hazel extract rich in proanthocyanidins strongly inhibited the growth of herpes simplex virus type 1 as well as reducing inflammation. A fraction high in hamamelitannin was less effective on both counts. Another study ascertained that some proanthocyanidin fractions quell inflammation by inhibiting chemical inflammatory mediators and the formation of platelet-activation factor.
A Japanese study of plant compounds that protect skin cells from damage by harmful forms of oxygen, such as those released in tissues during inflammation found that witch hazel, was an effective antioxidant. Further research is needed on its potential use in antiaging or antiwrinkling products.
Witch hazel is one of a very few American medicinal plants still approved by the U.S. Food and Drug Administration as an ingredient in nonprescription drugs. It may be used as an astringent to relieve pain and protect the skin and in pads, ointments, or suppositories for the symptomatic relief of hemorrhoids. In Germany, the bark and leaf are also approved for treatment of mild diarrhea, inflammation of the gums and oral mucous membranes, and varicose veins.
Few clinical studies on witch hazel have been conducted, but for nearly 200 years, Americans have kept this “secret potion” on hand for its astringent, tonic, and mild pain-relieving qualities. Grandma was right.
Cooner, S. New England Natives: A Celebrations of Trees and People. Cambridge, Massachusetts: Harvard University Press, 1994.
Erdelmeier, C.A.J., et al. “Antiviral and Antiphlogistic Activities of Hamamelis virginiana Bark”. Planta Medica 1996, 62(3):241–245.
Foster, S. Herbs for Your Health. Loveland, Colorado: Interweave
——. “The Wily Witch Hazel”. The Herb Companion December/January 1989, 34–36.
Korting, H. C., et al. “Comparative Efficacy of Hamamelis Distillate and Hydrocortisone”. European Journal of Clinical Pharmacology 1995, 48(6):461–465.
Lloyd, J. U., and J. T. Lloyd. “History of Hamamelis (Witch Hazel) Extract and Distillate”. Journal of the American Pharmaceutical Association 1935, 24(3):220–224.
Masaki, H., T. Atsumi, and H. Sakurai. “Protective Activity of Hamamelitannin on Cell Damage of Murine Skin Fibroblasts Induced by UVB Radiation”. Journal of Dermatological Science 1995, 10(1):25–34.
Tyler, V. E. Herbs of Choice: The Therapeutic Use of Phytomedicinals. Binghamton, New York: Pharmaceutical Products Press, 1994.
Vennat, B., et al. “Tannins from Hamamelis virginiana: Identification of Proanthocyanidins and Hamamelitannin Quantification in Leaf, Bark, and Stem Extracts”. Planta Medica 1988, 54:454–457.
Swedes Test Echinacea
The most common illness in the world is the common cold. A survey in the United Kingdom, for example, showed that 73 percent of the population had had at least one cold in the previous twelve months, with 25 percent reporting three to six. Increasingly, cold sufferers are turning to the herb echinacea, taking it to either prevent or reduce cold symptoms. A best-seller in U.S. health-food stores, echinacea works by stimulating the immune system to better defend the body against infection. In Europe, where echinacea products have been sold for more than sixty years, the most common form of echinacea is the juice expressed from fresh flowering plants of Echinacea purpurea preserved with 22 percent alcohol. Although this is also the best-studied form of echinacea, few clinical trials of its effectiveness have been carried out. One widely publicized German study on E. purpurea juice published in 1992 showed that when taken at the onset of symptoms, the preparation reduced the severity and duration of colds.
A 1996–1997 double-blind Swedish study investigated the benefits of taking echinacea juice at the first sign of cold symptoms. The 120 participants, all furniture factory workers with histories of recurrent upper respiratory tract infections, reported to the company physician at the onset of a cold and were randomly given either echinacea or a placebo. The dosage was twenty drops in a half glass of water every two hours for the first day, then three times a day for the next nine days. The fifty-six men and four women in the treatment group improved within four days, whereas the fifty-two men and eight women who received the placebo took an average of eight days to improve. Daily treatment with echinacea at the first sign of a cold also lessened the severity of symptoms. No adverse effects from taking echinacea were reported.(1)
Cranberry in Capsules
Studies of the effectiveness of cranberry in treating urinary tract infections have previously used commercial cranberry juice. Now a clinical study at Weber State University in Ogden, Utah, has tested encapsulated cranberry juice concentrate on nineteen sexually active women between eighteen and forty-five years of age with a history of recurrent urinary tract infections.
In the randomized, double-blind, placebo-controlled crossover study, the women received either 400 mg twice daily of cranberry or a placebo for three months, then switched to the other alternative for three months longer. Only ten women completed the study; nine became pregnant and dropped out.
Of twenty-one urinary tract infections reported during the course of the study, fifteen were experienced by women receiving the placebo and six by women taking the cranberry capsules. Most of the infections were attributed to the bacterium Escherichia coli, the most common cause of such infections.
A larger trial is planned. Because encapsulated cranberry juice concentrate does not contain the sugar or sugar substitute normally added to cranberry juice, women may find it an attractive alternative to the large quantities of cranberry juice prescribed in the current treatment regimen.(2)
Horehound (Marrubium vulgare) is a bitter-tasting herb traditionally used as a digestive stimulant and to break up phlegm, relieve coughs, and soothe sore throats. Its use as a cough suppressant has been recorded for at least 400 years.
In Brazil, where horehound is a widely used folk remedy for gastrointestinal disorders and inflammation, researchers studying its role in relieving pain reported that a water-alcohol extract of horehound significantly reduced smooth-muscle spasms in mice and was as effective as aspirin in relieving pain.
Further studies are under way to determine whether pain relief is associated with a reduction in inflammation, as this study suggested, and which compound or compounds are responsible for the pain-relieving and anti-inflammatory responses. (3)
(1) Hoheisel, O., et al. “Echinagard Treatment Shortens the Course of the Common Cold: A Double-Blind, Placebo-Controlled Clinical Trial”. European Journal of Clinical Research 1997, 9:261–268.
(2) Walker, E. B., et al. “Cranberry Concentrate: UTI Prophylaxis” (letter to the editor). Journal of Family Practice 1997, 45:167–168.
(3) de Souza, M. M., et al. “Analgesic Profile of Hydroalcoholic Extract Obtained from Marrubium vulgare”. Phytomedicine 1998, 5(2):103–107.