Open Source Apothecary At Home / Safety

Children: smaller, and different

The dose that is safe in an adult can be the dose that stops a child breathing.

safety

Children are not small adults. The differences that matter are not proportional dose but mechanism: immature liver enzymes change how a compound is cleared, the airway is narrower so a topical decongestant or a menthol vapour can cause apnoea, and a small body means a small absolute volume of an essential oil is a large dose per kilogram.

The specific hazards in a normal household:

• Menthol, camphor, and eucalyptus oil on or near the face of an infant or young child
• Honey must not be given to a baby under 12 months. Infant botulism spores are the
• Essential oils are a common paediatric poisoning. Store them as medicines, not as
• Herbal products marketed for colic, teething, and sleep in infants have caused

What is reasonable for a child. Honey for cough above one year; saline nasal drops or irrigation for a blocked nose; zinc for acute diarrhoea in the settings where it has trials; oral rehydration solution for diarrhoea and vomiting; paracetamol or ibuprofen at a weight-based dose for fever and pain. Below that list, the honest answer is usually that the evidence does not exist for children specifically and a clinician should decide.

What the studies found

Cautions and interactions

• No honey under 12 months. No menthol, camphor or eucalyptus on the face of a young child.
• No essential oils internally, ever, in a child.
• Herbal cough and cold products for children under 6 have no reliable evidence and a record of harm.
• Do not use a teething gel containing belladonna — it is toxic and has caused deaths.

When this is not a self-care problem — get help

• A baby under 3 months with a temperature above 100.4 F / 38 C — emergency assessment.
• A child who is drowsy, floppy, breathing fast or noisily, not drinking, or with fewer wet nappies — urgent assessment, not a home remedy.

Related

• Coughs and colds: honey, zinc, and the honest list
• Acute diarrhoea: rehydration first, everything else second
• Fever: what it is for, and when it means something else

Sources

1. Zinc supplementation for acute and persistent watery diarrhoea in children: A systematic review and meta-analysis. Journal of global health 2024; doi:10.1016/S0140-6736(14)61698-6 PubMed 39641338
2. The efficacy and safety of St. John's wort extract in depression therapy compared to SSRIs in adults: A meta-analysis of randomized clinical trials. Advances in clinical and experimental medicine : official organ Wroclaw Medical University 2023; doi:10.17219/acem/152942 PubMed 36226689
3. Chinese herbal medicine for subfertile women with polycystic ovarian syndrome. The Cochrane database of systematic reviews 2021; doi:10.1002/14651858.CD007535.pub2 PubMed 34085287
4. Probiotics for treating acute infectious diarrhoea. The Cochrane database of systematic reviews 2020; doi:10.1002/14651858.CD003048.pub3 PubMed 33295643
5. Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials. Complementary therapies in medicine 2019; doi:10.1016/j.ctim.2018.12.004 PubMed 30670267