From the Guidelines
Pesto-basil (not pesto-bishop) does not need to be avoided in children due to its salicylate content, as the amounts present in normal dietary consumption are generally too small to cause problems in most children. While basil does contain natural salicylates, only children with specific salicylate sensitivity or those on strict low-salicylate diets for medical reasons would need to avoid basil and pesto 1. For the average child, pesto can be a nutritious food that provides beneficial nutrients like vitamins and healthy fats. If your child has a known salicylate sensitivity, unusual reactions to foods, or is on medication that interacts with salicylates (like certain anticoagulants), consult with their healthcare provider before including pesto in their diet. Otherwise, pesto can be safely incorporated into a child's balanced diet in moderate amounts. The concern about salicylates in foods is often overstated for most children who don't have specific sensitivities or medical conditions requiring their restriction.
Some key points to consider:
- The amount of salicylates in pesto is generally not a concern for most children 1
- Children with specific salicylate sensitivity or those on strict low-salicylate diets for medical reasons should avoid basil and pesto 1
- Pesto can be a nutritious food that provides beneficial nutrients like vitamins and healthy fats
- Consult with a healthcare provider before including pesto in a child's diet if they have a known salicylate sensitivity or are on certain medications 1
In terms of salicylate toxicity, extracorporeal treatment is recommended in severe salicylate poisoning 1. However, this is not relevant to the normal dietary consumption of pesto in children. The available literature does not confidently identify patients with salicylate toxicity for whom extracorporeal treatment is likely to favorably influence the more meaningful outcomes of morbidity and mortality 1.
From the Research
Salicylate Toxicity in Children
- Salicylate toxicity can occur in children due to ingestion of salicylate-containing products, including medications and certain foods 2, 3, 4, 5.
- The risk of salicylate toxicity in children is a concern, as it can cause severe symptoms, including hematemesis, tachypnea, hyperpnea, dyspnea, tinnitus, deafness, lethargy, seizures, unexplained lethargy, or confusion 2.
- Ingestion of more than 150 mg/kg or 6.5 g of aspirin equivalent, whichever is less, warrants referral to an emergency department 2.
- Oil of wintergreen (98% methyl salicylate) is particularly hazardous, and ingestion of greater than a lick or taste by children under 6 years of age and more than 4 mL by patients 6 years of age and older could cause systemic salicylate toxicity and warrants referral to an emergency department 2.
Pesto-Bishop and Salicylate Content
- There is no direct evidence in the provided studies regarding the salicylate content of pesto-bishop or its potential toxicity in children.
- However, if pesto-bishop contains salicylates, it is possible that consumption of large amounts could lead to salicylate toxicity in children, similar to other salicylate-containing products 2, 3, 4, 5.
Recommendations for Children
- Due to the potential risk of salicylate toxicity, it is essential to be cautious when consuming products that may contain salicylates, including pesto-bishop, especially in children 2, 3, 4, 5.
- Parents and caregivers should be aware of the potential risks and monitor their children's consumption of products that may contain salicylates.
- If a child ingests a large amount of pesto-bishop or exhibits symptoms of salicylate toxicity, it is crucial to seek medical attention immediately 2.