As many as 9% of infants are given an herbal tea or dietary botanical supplements (DBS) in the first year of life, according to data from an FDA study, raising concerns about the potential health implications that these products pose.

“Health care providers should recognize that infants under their care may receive a wide variety of different supplements and teas,” Yuanting Zhang, PhD, of the FDA’s Center for Food Safety and Applied Nutrition, and colleagues wrote in the study, published online first Pediatrics.

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Clinicians should be aware of potential medication reactions and adverse events, the researchers urged.

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The finding comes from analysis of data collected in the Infant Feeding Practices Study II, a longitudinal survey of women from late pregnancy through their infant’s first year of life, conducted by the FDA and the CDC between 2005 and 2007, according to the researchers.

The study is the first to study herbal tea and DBS use exclusively in infants, and yielded a much higher prevalence than earlier studies, including the 0.8% prevalence found among children in the National Health and Nutrition Examination Survey and the 3.9% prevalence found among children in the National Health Interview Survey.  

Among the sample of 2,653 mothers and their healthy infants, the most commonly used DBS and teas were gripe water, chamomile, teething tablets and unspecified teas, the researchers found.

“Because the purity and potency of such supplements and teas are not regulated in the same way as pharmaceuticals, their administration concomitantly with medicines may cause drug interactions, and they may contain heavy metals or other contaminants,” the researchers wrote, adding that differences in physiology, metabolism and dose per body weight may make infants more susceptible to adverse events.

Mothers who had used DBS themselves were nearly four times more likely to give these substances to their infants than those who had not (adjusted OR=3.69; 95% CI: 2.78 -4.89; P<0.0001), survey responses indicated. Other predictive characteristics include Hispanic race (adjust OR=1.85; 95% CI: 1.12-3.06; P=0.016) and longer breastfeeding (adjuster OR=1.02; 95% CI: 1.01 to 1.02; P<0.0001).

Soothing fussiness, digestion and colic and aiding relaxation were the four most common reasons mothers indicated for using these products, the researchers wrote.

The study was not nationally representative, according to the researchers, and therefore, the findings are not generalizable to the overall U.S. population. The researchers noted that older non-Hispanic white mothers of high socioeconomic status were overrepresented.

Zhang Y. Pediatrics 2011; DOI: 10.1542/peds.2010-2294.