Feeding of Dietary Botanical Supplements and Teas to Infants in the United States
ABSTRACT To describe the use of dietary botanical supplements and teas among infants, the characteristics of mothers who give them the specific botanical supplements and teas used, reasons for use, and sources of information.
We used data from the Infant Feeding Practices Study II, a longitudinal survey of women studied from late pregnancy through their infant's first year of life conducted by the US Food and Drug Administration and the Centers for Disease Control and Prevention between 2005 and 2007. The sample was drawn from a nationally distributed consumer opinion panel and was limited to healthy mothers with healthy term or near-term singleton infants. The final analytical sample included 2653 mothers. Statistical techniques include frequencies, χ² tests, and ordered logit models.
Nine percent of infants were given dietary botanical supplements or teas in their first year of life, including infants as young as 1 month. Maternal herbal use (P < .0001), longer breastfeeding (P < .0001), and being Hispanic (P = .016) were significantly associated with giving infants dietary botanical supplements or teas in the multivariate model. Many supplements and teas used were marketed and sold specifically for infants. Commonly mentioned information sources included friends or family, health professionals, and the media.
A substantial proportion of infants in this sample was given a wide variety of supplements and teas. Because some supplements given to infants may pose health risks, health care providers need to recognize that infants under their care may be receiving supplements or teas.
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ABSTRACT: The survival of Salmonella on dried chamomile flowers, peppermint leaves, and green tea leaves stored under different conditions was examined. Survival and growth of Salmonella was also assessed after subsequent brewing using dried inoculated teas. A Salmonella enterica serovar cocktail was inoculated onto different dried tea leaves or flowers to give starting populations of approximately 10 log CFU/g. The inoculum was allowed to dry (at ambient temperature for 24 h) onto the dried leaves or flowers prior to storage under 25 and 35°C at low (<30% relative humidity [RH]) and high (>90% RH) humidity levels. Under the four storage conditions tested, survival followed the order 25°C with low RH > 35°C with low RH > 25°C with high RH > 35°C with high RH. Salmonella losses at 25°C with low RH occurred primarily during drying, after which populations showed little decline over 6 months. In contrast, Salmonella decreased below detection after 45 days at 35°C and high RH in all teas tested. The thermal resistance of Salmonella was assessed at 55°C immediately after inoculation of tea leaves or flowers, after drying (24 h) onto tea leaves or flowers, and after 28 days of storage at 25°C with low RH. All conditions resulted in similar D-values (2.78 ± 0.12, 3.04 ± 0.07, and 2.78 ± 0.56, at 0 h, 24 h, and 28 days, respectively), indicating thermal resistance of Salmonella in brewed tea did not change after desiccation and 28 days of storage. In addition, all brewed teas tested supported the growth of Salmonella. If Salmonella survives after storage, it may also survive and grow after a home brewing process.Journal of food protection 04/2015; 78(4):661-7. DOI:10.4315/0362-028X.JFP-14-508 · 1.80 Impact Factor
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ABSTRACT: To evaluate the effectiveness of an educational intervention to decrease pediatric emergency department (PED) visits and adverse care practices for upper respiratory infections (URI) among predominantly Latino Early Head Start (EHS) families. Four EHS sites in New York City were randomized. Families at intervention sites received 3 1.5-hour education modules in their EHS parent-child group focusing on URIs, over-the-counter medications, and medication management. Standard curriculum families received the standard EHS curriculum, which did not include URI education. During weekly telephone calls for 5 months, families reported URI in family members, care sought, and medications given. Pre- and post-intervention knowledge-attitude surveys were also conducted. Outcomes were compared between groups. There were 154 families who participated (76 intervention, 78 standard curriculum) including 197 children <4 years old. Families were primarily Latino and Spanish-speaking. Intervention families were significantly less likely to visit the PED when their young child (age 6 to <48 months) was ill (8.2% vs 15.7%; P = .025). The difference remained significant on the family level (P = .03). These families were also less likely to use an inappropriate over-the-counter medication for their <2-year-old child (odds ratio, 0.29; 95% confidence interval, 0.09-0.95; 12.2% vs 32.4%, P = .034) and/or incorrect dosing tool for their <4-year-old child (odds ratio, 0.24; 95% confidence interval, 0.08-0.74; 9.8% vs 31.1%; P < .01). The mean difference in Knowledge-Attitude scores for intervention families was higher. A URI health literacy-related educational intervention embedded into EHS decreased PED visits and adverse care practices.PEDIATRICS 04/2014; 133(5). DOI:10.1542/peds.2013-2350 · 5.30 Impact Factor
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ABSTRACT: Introduction Pediatric use of natural health products (NHPs) is common, although conventional health care providers frequently do not attempt to manage them due to limited knowledge and lack of confidence. The aim of this review is to synthesize available guidance given to pediatric health care providers on how to manage NHPs in clinical practice. Methods An integrative review of the literature was conducted. Key search terms were NHPs, dietary supplements, herbal medicines, CAM, pediatrics, decision-making, guides, management, safety, parents, and medical providers. Expert organizations and databases from CINAHL, PubMed, Embase, and the Cochrane Collaboration were searched. Fifty-two articles were chosen for inclusion based on appraisal using the Johns Hopkins Nursing Evidence-Based practice tool for research and non-research. Themes for NHP management were identified through integrating repeated expert guidance. Results: Three themes emerged from the literature regarding clinical management of NHPs: product regulation and its impact on safety, communication deficits, and limited provider knowledge. Despite guidance on NHP management from well-known organizations such as the American Academy of Pediatrics and the NIH National Center for Complementary and Alternative Medicine, considerable heterogeneity was discovered in management guidelines. Discussion This is the first known review to synthesize NHP clinical management guidance. Identified themes led to development of six key principles to help guide clinician NHP management. More research is needed to evaluate if this guidance is effective in promoting clinician confidence and competency with NHP management. Conclusions This is the first known review to synthesize NHP clinical management guidance. Identified themes led to development of six key principles to help guide clinician NHP management. More research is needed to evaluate if this guidance is effective in promoting clinician confidence and competency with NHP management.European Journal of Integrative Medicine 01/2013; DOI:10.1016/j.eujim.2013.12.020 · 0.65 Impact Factor