Published: March 2011

Adverse events in children using complementary and alternative medicines

Prescriber Update 32(1): 3
March 2011

The use of complementary and alternative medicine (CAM) use in children has been associated with serious adverse events, including fatalities, either through the direct effects of use or through failure to seek conventional treatment.

A recent Australian study1 identified 39 CAM-associated adverse events, including four fatalities, reported by paediatricians between 2001 and 2003. In 64% of cases the adverse event was rated as severe, life-threatening or fatal. In 77% of cases the adverse events were considered to be probably or definitely related to CAM use. Forty-four percent of cases were associated with a failure to use conventional medicine.

The adverse events reported were varied but included constipation, bleeding and allergic reactions. All four reported deaths were related to a failure to use conventional medicine for conditions including epilepsy, chronic eczema and pulmonary emboli. Those at highest risk of adverse events from CAM were infants who had been advised to restrict their diet and children with chronic illness in whom conventional therapies were withdrawn in favour of CAM treatment.

The study also commented that consumers may be less likely to present with an adverse event related to CAM use compared with a similar event associated with conventional therapies. Events may go unreported due to the belief that CAM are natural and therefore safe. Other difficulties to reporting include: information on the product not always being available; CAM products often containing multiple ingredients; and the risk of adulteration with conventional medicines.

Health professionals are reminded that reports for suspected adverse reactions to CAM including herbal medicines, dietary supplements and homeopathic products can be submitted to the Centre for Adverse Reactions Monitoring (CARM) in the same manner as conventional therapies.

Further information on reporting adverse reactions is available at: or

  1. Lim A, Cranswick N, South M. 2010. Adverse events associated with the use of complementary and alternative medicine in children. Arch Dis Child. Published online 22 December 2010.