Homeopathic Remedies for Kids

One of the most common questions we get as pediatric emergency physicians is, “What can I do for my child’s cough?” or “How can I make this cough go away?”  We like to recommend Honey for children over 12 months of age when dealing with a cough from a URI.  Of course, we must rule out other causes of a cough which need specific treatments and sometimes more workup, including croup, pertussis, aspirated foreign body, pneumomediastinum, and hemoptysis. But what should a parent do about that snotty, phlegm-laden, persistent, wet, chesty cough that kids hang on to for weeks?  Many parents are concerned about what is contained in medicines and if over-the-counter medications are safe for their children.  So, they turn to more “natural” remedies.  But are these homeopathic cough preparations safer, or are they sinister? Can parents give them to kids with peace of mind, or a grain of salt (it’s ok, salt is natural)? Does a spoonful of sugar help the medicine go down, or is the medicine just a spoonful of sugar?  Let’s explore homeopathic remedies for coughs and other pediatric complaints.

Homeopathic Remedies in Kids- Basics

  • Homeopathy was developed in Germany in the 1700’s [Ratini 2021]
    • Quinine from chinchona bark to treat malaria was the first homeopathic remedy [Lawson 2016]
    • Theorizes: “like cures like” or “the body can heal itself” [Ratini 2021]
      • If a substance can induce similar symptoms as the illness, then the substance can treat the illness with a healing response
      • Sometimes likened to the body’s response to immunizations or allergy treatments[Ullmann 2017]
    • “Law of minimum dose”- the lower the dose of medication, the more effective [Langevin 2021]
      • Some products so dilute that no actual active ingredient molecules remain.
  • Products come from plants, minerals, and animals [Langevin 2021]
    • Formulations – sugar pellets, ointments, gels, creams, tablets
    • Over 5000 substances available [Lawson 2016]
  • Most common indications for people seeking complementary (including homeopathic) remedies are back/neck pain, head or chest cold, anxiety and stress, and MSK complaints [Black 2015]

Homeopathic Remedies – Common Ingredients 

  • There are many options for brand names for cough preparations: Zarbee’s, Hyland’s, Maty’s, BeeKeeper’s Naturals, Mommy’s Bliss, Boiron, Wishgarden, Source Naturals, Kids Relief
    • Maty’s- nutmeg, agave syrup, chamomile tea, lemon balm extract, apple cider vinegar, Ceylon cinnamon, marjoram, sea salt (no inactive ingredients listed on box). [Maty’s website 2022]
    • Zarbee’s- African geranium root, agave syrup, dark honey, elderberry (Sambucus), English ivy leaf, melatonin, probiotics, vitamin C, zinc, aloe vera, beeswax, calendula, chamomile, citrus bioflavonoids, echinacea, eucalyptus, lavender, marshmallow root, pectin, saline, shea butter, sunflower, thyme (no inactive ingredients listed on box). [Zarbee’s website 2022]
    • Hyland’s- Allium Cepa, Hepar Sulph, Hydrastis, Natrum Muriaticum, Phosphorus, Pulsatilla, Sulphur, Citric Acid, Glycerine, Glycyrrhiza Extract, Purified Water, Sodium Benzoate [Hyland’s website 2022]
  • Written on each website: “This product is not intended to diagnose, treat, cure, or prevent any disease.”
  • Homeopathic.com, written by a CCH (certified in classical homeopathy) recommends aconitum, antimonium tart, belladonna, bryonia, drosera, ferrum phos, hepar sulphur, ipecac, kali bic, phosphorus, pulsatilla, rumex, and spongia for different times of coughs and at different times of illness. 

Homeopathic Remedies – Complications

  • Homeopathic products are not reviewed by the FDA for safety or effectiveness [Langevin 2021]
  • Some products do contain additional active ingredients that may have adverse side effects and cause drug interactions [Langevin 2021]
    • A 2012 systematic review mentions use of mercury or iron in homeopathic products
    • Liquid products may contain alcohol
    • A 2017 study found that homeopathic teething tablets had excessive belladonna, which may be toxic to babies [Abbasi 2017]
  • Systematic review of 38 reports of adverse events (pediatric and adult) from 5 electronic databases related to homeopathic remedies [Posadzki 2012]
    • 1159 adverse events
    • 4 fatalities
    • Rhus toxidendron was most frequent offender 
  • A 44-month retrospective case-control study found 11 infants had ALTE event (9% of 115 total admitted for ALTE) after taking infantile colic preparation “Gali-col” [Aviner 2010]
  • Case report of an infant with weight loss and life-threatening metabolic hyperchloremic acidosis after overdose of a homeopathic remedy coated in xylitol [Wille 2010]
  • Case report of a 20-day old with status epilepticus after correctly dosed homeopathic colic medication containing belladonna [Glatstein 2014]
    • Can cause anticholinergic syndrome

Homeopathic Remedies – Efficacy?

  • Australian National Health and Medical Research Council study in 2015 concluded no reliable evidence that homeopathy is effective to treat any health condition [Langevin 2021]
    • Inclusion criteria were rigorous
    • 57 systematic reviews that included 176 studies
    • Currently there is an updated review going on
  • NIH National Center for Complementary and Integrative Health states, “Little evidence to support homeopathy as an effective treatment for any specific health condition” [Langevin 2021]
  • A Cochrane review evaluated oscillococcinum to prevent and treat influenza like illness [Vickers 2000]
    • It called results “promising” that it probably reduces the duration of illness
    • But data still not strong enough to recommend it as a first line treatment
    • Data does not support the preventive effect
  • An RCT to compare homeopathic cough syrup to placebo in children found improved severity of composite cold symptoms according to parents, but no difference for any individual cold symptoms [Jacobs 2016]
  • A systematic review and metanalysis evaluated homeopathic preparations for preventing and treating URIs. [King 2021]
    • Did not find overall significant effectiveness.
    • All studies with low risk of bias showed no benefit.
    • No serious events were reports in these studies.
  • “Happiest Baby” author and blogger Dr. Karp endorses no evidence of efficacy of homeopathic colic remedies. [Karp 2022]

Moral of the Morsel

  • First Do No Harm! While you may want to mitigate the snot, be aware that unregulated “remedies” offer more potential harm than benefit.
  • Know what they are taking. Asking to see what therapies a family is giving a child can be helpful in finding potential problems.
  • “Over-the-counter” does not equate to “safe and effective.” There are case reports and case-control studies of adverse events associated with administration of homeopathic preparations.
  • Call 1-800-222-1222 if you are uncertain. I cannot pronounce most of the ingredients listed above and have no idea what any of them actually are… but our Toxicology friends do! Ask them!
  • As always, remain vigilant!

References:

  1. Ratini, DO, MS M. Homeopathy: What It Is, Benefits, Risks, and More. WebMD. https://www.webmd.com/balance/what-is-homeopathy. Published 2021. Accessed June 3, 2022. 
  2. Ullman MPH D. Why Homeopathy Makes Sense and Works – Homeopathic.com. Homeopathic.com. https://homeopathic.com/why-homeopathy-makes-sense-and-works-3/. Published 2017. Accessed June 3, 2022.
  3. Langevin, M.D. H, Shurtleff, Ph.D., NCCIH D. Homeopathy: What You Need To Know. NIH National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/homeopathy. Published 2021. Accessed June 3, 2022.
  4. Lawson, MD K. What Are Homeopathic Remedies? | Taking Charge of Your Health & Wellbeing. Taking Charge of Your Health & Wellbeing. https://www.takingcharge.csh.umn.edu/explore-healing-practices/homeopathy/what-are-homeopathic-remedies. Published 2022. Accessed June 3, 2022.
  5. Black LI, Clarke TC, Barnes PM, et al. Use of complementary health approaches among children aged 4–17 years in the United States: National Health Interview Survey, 2007–2012. National health statistics reports; no 78. Hyattsville, MD: National Center for Health Statistics. 2015.
  6. https://matyshealthyproducts.com/product-category/children/?filter_remedy=cough
  7. https://www.zarbeesprofessional.com/ingredients
  8. https://hylands.com/products/hylands-4-kids-cold-n-cough
  9. Abbasi J. Amid Reports of Infant Deaths, FTC Cracks Down on Homeopathy While FDA Investigates. JAMA. 2017;317(8):793–795. doi:10.1001/jama.2016.19090
  10. Posadzki P, Alotaibi A, Ernst E. Adverse effects of homeopathy: a systematic review of published case reports and case series. Int J Clin Pract. 2012;66(12):1178-1188. doi:10.1111/ijcp.12026
  11. Aviner S, Berkovitch M, Dalkian H, Braunstein R, Lomnicky Y, Schlesinger M. Use of a homeopathic preparation for “infantile colic” and an apparent life-threatening event. Pediatrics. 2010;125(2):e318-e323. doi:10.1542/peds.2008-3515
  12. Oberbaum M, Samuels N, Ben-Arye E, Amitai Y, Singer SR. Apparent life-threatening events in infants and homeopathy: an alternative explanation. Hum Exp Toxicol. 2012;31(1):3-10. doi:10.1177/0960327111417270
  13. Wille D, Hauri-Hohl M, Vonbach P, Tomaske M, Padden B, Bernet V. Too much of too little: xylitol, an unusual trigger of a chronic metabolic hyperchloremic acidosis. Eur J Pediatr. 2010;169(12):1549-1551. doi:10.1007/s00431-010-1249-9
  14. Glatstein M, Danino D, Wolyniez I, Scolnik D. Seizures caused by ingestion of Atropa belladonna in a homeopathic medicine in a previously well infant: case report and review of the literature. Am J Ther. 2014;21(6):e196-e198. doi:10.1097/MJT.0b013e3182785eb7
  15. Vickers AJ, Smith C. Homoeopathic Oscillococcinum for preventing and treating influenza and influenza-like syndromes. Cochrane Database Syst Rev. 2000;(2):CD001957. doi:10.1002/14651858.CD001957
  16. Jacobs J, Taylor JA. A randomized controlled trial of a homeopathic syrup in the treatment of cold symptoms in young children. Complement Ther Med. 2016;29:229-234. doi:10.1016/j.ctim.2016.10.013
  17. King D, Hawke K, McGuire T, van Driel M. Homeopathic Preparations for Preventing and Treating Acute Upper Respiratory Tract Infections in Children: A Systematic Review and Meta-Analysis. Acad Pediatr. 2021;21(2):211-220. doi:10.1016/j.acap.2020.07.016
  18. Karp H. Colic Remedies | Home and Natural Remedies for Colic in Babies – Happiest Baby. Happiestbaby.com. https://www.happiestbaby.com/blogs/baby/homeopathy-baby-remedies-alternative-medicine-babies. Published 2022. Accessed June 3, 2022.
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Christyn Magill
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