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A: I wouldn't give kava kava to children. A number of reports from Europe suggest that the herb, used to reduce symptoms of anxiety or stress, can be toxic to the liver, although actual cases of liver damage are rare. The FDA is now investigating whether the use of dietary supplements containing kava poses public health concerns to Americans. Because the issue of kava and liver toxicity is unsettled, I suggest that no one take this herb on a daily basis for more than four weeks and that no one with liver problems or a history of liver disease (such as hepatitis) take it at all.
As far as echinacea is concerned, there is no reason to think it is harmful to the liver. My colleague, pediatrician Russell Greenfield, MD, a co-author of Healthy Child, Whole Child: Integrating the Best of Conventional and Alternative Medicine to Keep Your Kids Healthy, tells me that it is okay to give children echinacea as long as you follow this advice:
Use on a short-term basis only, three to seven days at most.
Give one-quarter of the adult dosages to children ages 2-6; for those between 6-12, give one-half the adult dosage.
Be aware that alcohol is present in the tincture form, (this may be the reason for concern about liver damage), but each dose contains so little that the alcohol is unlikely to cause any health problems.
As a general rule, I don't advise giving children herbal supplements on a regular basis. I give my own daughter echinacea when she's starting to get sick, but other than that, I don't give her any herbs routinely.
Andrew Weil, M.D.
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