Is chamomile tea safe for children younger than five years?

Chamomile Tea Safety in Children Under 5 Years

Chamomile tea should not be given to children younger than 5 years of age due to significant safety concerns, including risk of infant botulism from spore contamination, potential for severe allergic reactions, and lack of established safety data in this vulnerable age group.

Primary Safety Concerns

Infant Botulism Risk

• Chamomile can be contaminated with Clostridium botulinum spores, which pose a serious risk for infant botulism in children under 12 months of age 1
• Studies found 7.5% of chamomile samples contaminated with botulinum spores, with significantly higher contamination rates in unwrapped chamomile sold by weight in herbal stores 1
• The spore load detected was 0.3-0.4 spores per gram, with types A, B, and F identified 1
• Infant botulism occurs when spores germinate in the intestinal tract of infants younger than 52 weeks, making chamomile tea ingestion a documented risk factor 1

Allergic Reaction Risk

• Severe anaphylactic reactions have been documented in children, including an 8-year-old who experienced anaphylaxis after first-time chamomile tea ingestion 2
• Chamomile belongs to the Asteraceae (daisy) family and can cause cross-reactivity in children with allergies to ragweed, mugwort, and other composite pollens 2, 3
• Case reports document allergic reactions ranging from acute rhinitis to life-threatening anaphylaxis 3
• IgE-mediated hypersensitivity reactions can occur even on first exposure due to cross-sensitization from environmental pollens 2

Lack of Safety Evidence

• There are no clinical trials establishing the safety of chamomile tea specifically in children under 5 years 4, 3
• The systematic review of chamomile adverse events notes insufficient data regarding safety during infancy and early childhood 3
• Human studies examining chamomile's effects are limited overall, with virtually no pediatric-specific safety data 5

Guideline-Based Fluid Recommendations for This Age Group

What Children Should Drink Instead

• For infants under 12 months: human milk or infant formula is sufficient to meet all fluid requirements 6, 7
• No additional beverages, including herbal teas, are nutritionally necessary or recommended before 12 months 6
• For children 1-5 years: water and low-fat/nonfat milk are the appropriate beverages 8, 7
• After 6 months, small amounts of water (60-120 ml) can be introduced during meals 7

Why Herbal Teas Are Not Recommended

• The American Academy of Pediatrics does not include herbal teas in recommended fluid sources for infants and young children 8, 6
• Even fruit juice, which is more extensively studied than herbal teas, offers no nutritional benefits for infants under 1 year and should be avoided 8, 6
• The potential hazards of herbal teas in children need greater recognition, as their effects on young children remain largely unknown 4

Clinical Pitfalls to Avoid

• Never assume chamomile tea is safe simply because it is "natural" - natural products can harbor serious pathogens and allergens 1, 2
• Do not recommend chamomile tea for common infant complaints like colic, as safer evidence-based alternatives exist 6
• Be aware that parents may view herbal teas as benign home remedies and fail to report their use unless specifically asked 4
• Unwrapped chamomile sold by weight poses higher contamination risk than tea bags, though neither should be used in young children 1

When Parents Insist on Herbal Remedies

If parents are using chamomile tea despite counseling:

• Screen for allergic history, particularly to ragweed, mugwort, or other Asteraceae family plants before any exposure 2
• Emphasize that allergic reactions can occur on first exposure due to cross-reactivity 2
• Warn about signs of infant botulism (constipation, weak cry, poor feeding, hypotonia) in infants under 12 months 1
• Document the discussion and parental decision in the medical record 4