May I Give My Child Herbal Medicine?

"Can I give my child herbal medicine? They're still so young."

This is the question parents ask most carefully. And I think this carefulness is right. It is because a child is not a miniature adult.

A child's body responds differently

This is not a matter of "the weight is smaller, so reduce the amount."

In a child's body, the very machinery that processes medicine is different from an adult's. The enzymes in the liver that break down medicine mature over several years even after birth. The kidneys' ability to filter and expel medicine is the same. So even the same medicine stays in the body for a different time and at a different concentration than in an adult.

Also, a child has a higher water proportion relative to body weight, a faster metabolism, and a state that changes abruptly. A change that would take an adult several days comes to a child in half a day. It is fast when they improve, and fast when they worsen.

Up to here is established pharmacology dealt with in pediatrics. And this is why I prescribe for a child more narrowly, more briefly, and with more frequent checks than for an adult.

So the principles I keep with a child

First, I set the goal narrow.

With an adult, there are times I look at several problems together. With a child I do not do that. I decide on the one thing that is troubling the child most right now and look only at that. If I get greedy, the medicine grows complex, and once it is complex, I can no longer tell what is working and what is not.

Second, I set the duration in advance.

I do not say, "Take it for a month and see." I tell the parents what should have changed a few days later and see them again then. If the expected change is not there, the medicine is wrong, so I change or stop it.

Third, I state the cautions in advance.

Along with the prescription, I tell them what event, if it happens after taking this medicine, means to stop at once and contact me. A child cannot describe symptoms well on their own. So the parents must know what to watch for.

Fourth, I do not touch growth itself.

Making a child taller, making them smarter — I am very skeptical of medicines aimed at these. Growth is made by genetics, nutrition, sleep, exercise, and hormones together. To say that one medicine changes that board is, I think, not honest.

That said, it is different when a child cannot eat, is often ill, and cannot sleep so that the conditions for growing are not there. That is the work of clearing away an obstacle, and it is something I can do. I make a clear distinction between these two when I speak.

Cases where a child often benefits

In my experience, the situations in which a child gains something by coming to the clinic are generally these.

• Frequent indigestion, frequent stomachaches, and poor eating
• A cough or runny nose that lingers long even after a cold has passed
• Not sleeping well at night, waking often, and being sensitive
• Recurring bellyaches with no abnormality on tests

There is a common thread. A state where tests show no major abnormality, yet the child keeps being uncomfortable. In these places I look toward returning the body's conditions.

Conversely, there are clearly cases where herbal medicine is not the answer for a child. I will write those below.

A child's medicine is made together with the parents

There is one more thing I want to say.

A child's problem is often not the child's alone. Sleep times, what they eat, screen time, tension in the home. I ask about these together. If I change only the medicine and leave the rest as it is, it returns the moment the medicine stops. (The disease that returns when you stop the medicine)

There are times parents say, "But that has nothing to do with the medicine." I see it as having everything to do with it. The whole environment in which the child's body sits is itself the object of treatment.

Cases where the hospital must come first

There are signals in children that must not wait. For the below, it is pediatrics or the emergency room first, not the clinic.

• A fever in an infant under 3 months old — see a doctor immediately, without exception.
• A child who is limp and unresponsive, or hard to rouse even when woken
• Labored, rapid breathing, or the spaces between the ribs sucking in
• A seizure
• Unable to drink even water, with no urine for more than half a day (dehydration)
• Vomiting that will not stop, or vomiting green bile
• A stiff neck with severe headache, or a rash like purpura that does not fade when pressed
• A fever continuing for more than 5 days

Thinking of herbal medicine first in the face of these signals is dangerous. I do not take such a child; I send them to the hospital. That is part of my work.

Finally

Using medicine in a child is always something to be careful about. I think it should be.

To the question "May I give my child herbal medicine?", I do not answer with a short "Yes."

With what goal, how much, for how long, and watching what — only when I can say this far do I use it. And the child for whom I cannot, I send elsewhere.