The bottle says it's safe and natural. The sales clerk in the health food store swears by it. But, before you give your child an herbal remedy, check with your pediatrician. Karen Norton, MD, a community pediatrician at Esse Health, isn't convinced herbal remedies are always a safe health alternative for kids.

"The main problem with most herbal remedies and over-the-counter supplements is that they have not been scientifically tested and proven to be effective or safe by randomized, double-blind studies," she says. "Society is beginning to fall back on anecdotal information instead of relying on scientific evidence." The difference, Dr. Norton adds, can often be difficult to understand. If a remedy truly works, it can be proven with a study in which two similar groups of patients are given either the studied remedy or a placebo (such as a sugar pill). The study then follows the patients' outcomes and demonstrates that the changes seen in the patients given the new remedy are statistically different from those who received the placebo. Anecdotal information refers to reports that claim a substance has made a difference in symptoms, but has no well-performed comparison study to support the claim. "This is similar to days when the medicine man sold bottles of tonic from his cart for whatever ailed you," Dr. Norton says. "That can be harmful when it comes to medication for children."

Dr. Norton says that while the Internet can be a wellspring of good health information, it can also be a pipeline for the spread of suspicious claims by questionable marketers. "I encourage my patients to go after information, but I always caution them to not believe everything they read. They should always ask whether the claims have been scientifically proven." Dr. Norton says she empathizes with parents looking for relief from certain chronic conditions and encourages them to be wary of misusing antibiotics and other prescription medications but again urges them to rely on tested remedies, not hearsay.

Because herbal products are sold as food supplements rather than medications, they aren't regulated by the Food and Drug Administration, adds Marilyn Tanner, a St. Louis Children's Hospital registered dietitian. "Under those circumstances, we have no way of determining safe dosages because concentration levels of the active ingredients may differ substantially from one bottle to the next. We can't risk a child's health that way."

She and Dr. Norton remind parents that children are not tiny adults. Chemicals that have been proven safe for adults can be a threat to still-developing bodies. "Just because the label says it's safe, you can't assume it means safe for a child," Tanner says. And Dr. Norton points out that many prescription medications have their roots in natural substances. "Natural doesn't automatically mean safe and good for everyone."

When parents insist on using herbal remedies for their child, Dr. Norton reminds them to consider the medical oath she follows: "First, do no harm." She encourages them to first make absolutely certain that they are aware of any potential negative effects that the particular substance may have on a child.

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