Regarding the infant use of pau d'arco for thrush:

Do not think that pau d'arco should be given to babies - 1. general principles
that one avoids direct feeding of herbs to baby, especially given the safer
alternatives for treatment.  2. controversy surrounding the toxicity of pau
d'arco - side effects are very dose-related.  Dose is tricky with babies.

Tabebuia various species ( common names: taheebo, lapacho, ipe roxo, pau
d'arco) - tree native to tropical Brazil. (Bignoniaceae family) - bark (
sometimes leaf) is part used.  Historic and current traditional use by
Brazilians.

 Active constituents:  Tabebuia bark "contains three anti-yeast compounds
-lapachole, beta-lapachone( the strongest in tests), and xyloidine - that show
anti-fungal activity against Candida albicans and other problematic fungi."
Lapachole is not the strongest anti-fungal phytoconstituent of Tabebuia but
tests have shown it "comparable in strength to ketoconazole ( Nizoral)". (
Duke Green Pharmacy 1997).  Getting real pau d'arco ( standard product
available) is one problem.  Controlling the dose impossible using tea form of
the product.

Toxicity:  "At high oral doses, lapachol causes nausea, vomiting, and a
reversible prolongation of the prothrombin time, the latter effect possible
due to lapachol's structural similarity to Vitamin K. "  (Duke 1985).  Have
found a therapeutic dose in an experimental cancer study where 20-30 mg/kg.
lapachol was used orally with occasional nausea/vomiting the only side effect
and some degree of success( Murray ).

The American Herbal Products Association "Botanical Safety Handbook"(1977)
classes Tabebuia bark as class 1: "Herbs that can be safely consumed when used
appropriately". [I.e. no safety concerns identified in their review of the
literature for pregnancy or lactation].  Assumes appropriate use is possible
here - internal dose for adults with candida is not
studied/established/reported though sure that many have opinion on this -
infant dose?????

Duke's medical syllabus has more info on toxicity:

"SEC: Side effect may include GI distress and nausea. Guiraud et al (1994)
note that lapachol and beta-lapachone, though active against Candida, could
be harmful). Multiple doses of oral lapachol at 500 mg/kg caused death with
severe histopathological changes. In clinical trials, oral lapachol induced
anticoagulant effects, nausea and vomiting. After 6 doses at 9 mg/kg.
Beta-lapachone caused death, following anorexia, diarrhea and weight loss." [
Isolated constituent information; whole extract effects would differ].

Definitely not for baby.  Maybe for mother but there are safer alternative
alternatives!  With a blind mother especially, it would seem that treating the
mother should be the focus rather than herbal treatments requiring direct
feeding of baby.

Eyebright - Varro Tyler thinks this one is a waste of time.  Weiss reports
clinical success for eye conditions.  German Commission E - use not
recommended due to hygenic concerns when used in eye and lack of proof of
efficacy. ( From Leong & Foster).

Going no-mail and off the British Columbia to see family - back after the
28th.

Sheila Humphrey
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