Is echinacea safe and effective for kids?

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A common use for echinacea is to stimulate the immune system to fight off viral infections, such as the common cold or flu, or bacterial and fungal infections. People also use it on the skin to treat wounds and skin conditions.

However, studies have not found strong evidence to support these uses, and there is a lack of research into echinacea use for children.

Other uses for echinacea include:

• anxiety
• migraine
• headaches
• indigestion
• skin rashes
• bee stings

Read an overview of echinacea.

Research into echinacea’s benefits is mixed. In an older 2014 review of studies into echinacea use for adults and children, the authors concluded that it does not significantly reduce the duration of colds. However, It may have a small benefit in preventing colds.

According to a 2021 study, echinacea may reduce the need for antibiotic use in some children.

Echinacea may decrease the number of secondary bacterial complications resulting from viral respiratory infections.

Doctors prescribe antibiotics to treat bacterial infections rather than viral infections. However, sometimes viral respiratory infections suppress a child’s immune system, so they also develop a bacterial infection. An example is bacterial pneumonia, which doctors often treat with antibiotics.

In the 2021 study, researchers gave echinacea or vitamin C supplements to children ages 4–12 years. They wanted to compare the effectiveness of the supplements in preventing viral RTIs and secondary bacterial complications.

The researchers found that children taking echinacea experienced fewer viral and bacterial infections than those taking vitamin C. This led to a 76.3% reduction in antibiotic prescriptions.

Even when someone requires antibiotics, echinacea may increase their efficacy, according to a 2020 study on recurrent tonsillitis in children. The study found that echinacea combined with the antibiotic Azithromycin (AZT) was more effective than AZT alone at reducing the frequency and severity of tonsillitis recurrence.

More research is necessary to understand echinacea’s benefits and mechanisms of action.

Read about the side effects of antibiotics.

Echinacea is available in different forms, some of which include:

• tincture (concentrated liquid extract)
• lozenges
• tea
• chewable tablets
• gummies
• syrup
• capsules
• powder

Many products have additional ingredients that caregivers should be aware of, including sugars, colors, flavors, and preservatives.

Echinacea may feature in products designed to strengthen the immune system alongside other nutrients, such as zinc and vitamin C. It may also be part of a herbal blend. Research is necessary into how effective such products are.

It is important to follow the dosage instructions on package labels and avoid exceeding the maximum dosage.

According to a 2020 study, echinacea may be safe for some children ages 4–12 years up to a maximum of 2,000 mg per day.

The researchers gave children 3 or 5 echinacea tablets daily for 10 days. Both groups required fewer antibiotics, and those taking 5 tablets daily experienced shorter cold duration than those taking 3 tablets.

The study assessed the safety margin of echinacea using 400 mg Echinaforce Junior (EFJ) tablets.

Participants were randomly assigned to a cold and flu treatment regimen of either 3 EFJ tablets each day (with a daily maximum of 1,200 mg) or 5 tablets (with a daily maximum of 2,000 mg).

The cold episodes treated with EFJ lasted an average of 7.5 days. The 5-tablet treatment shortened the average cold duration by 1.7 days compared to the 3-tablet regimen.

To assess tolerability, the researchers asked caregivers, children, and physicians to rate the treatment. The table below shows the tolerability ratings:

Echinacea belongs to the drug class of herbal and dietary supplements. The Food and Drug Administration (FDA) offers the following cautionary notes for such supplements:

• Supplements may interfere with medications, lab tests, and even surgery.
• The FDA does not approve the labeling, safety, or effectiveness of supplements before they are available for sale to the public.
• A company can introduce a supplement product to the market without notifying the FDA.
• The responsibility for product safety lies with the supplement company.

Herbal products like echinacea can sometimes cause unwanted side effects or interact with medications. Caregivers can check with a pediatrician to see if echinacea use is appropriate for a particular child.

Supplements such as echinacea should not replace prescription medication from a child’s doctor.

The safety of long-term echinacea use is unknown.

Echinacea may not be safe for people of any age with certain medical conditions, such as:

• tuberculosis
• leukemia and similar conditions
• multiple sclerosis
• collagen disorders
• autoimmune diseases
• AIDS and HIV infections
• any condition requiring the use of immunosuppressant drugs

A 2017 study examined the prevalence of children’s allergic reactions to herbal medication. Echinacea purpurea was the third most reported suspected allergy trigger.

An older study from 2008 examining echinacea use for ear infections found that it did not help and may increase the chance of another ear infection in the 6 months following treatment.

Echinacea may cause skin rash in children, according to older research from 2003 involving subjects ages 2–11 years. The study also found that echinacea was ineffective in treating upper respiratory infections.

The National Center for Complementary and Integrative Health states that the most common echinacea side effects are digestive tract issues such as stomach pain or nausea.

Echinacea is an herb that some people take to improve immune system function. It may be beneficial for preventing and treating respiratory infections in some children, but more research is necessary.

Although generally safe, people with certain medical conditions, such as leukemia or an autoimmune disease, should not take it.

Echinacea may cause allergic reactions, such as rashes, nausea, or stomach pain.