Children and Essential Oil Safety

“Smell is a potent wizard that transports us across thousands of miles and all the years we have

lived”

Helen Keller

Essential oil use is becoming increasingly popular. Every day we see companies opening across the country and on the internet. From small entrepreneurs, mlm (multi-level marketing) and larger companies, many say that they offer pure “therapeutic grade” essential oils, unlike any other company. However, there is no actual recognized grading system for essential oils. The term “therapeutic grade” was coined by a company (with others following suit) and has no meaning in the aromatic industry. Unless the company provides Gas Chromatography/Mass Spectrometry (GC/MS) reports that analyze the oil’s components, there is no guarantee of its purity. The analysis not only breaks down the chemical constituents of an oil, it also will pick up any synthetic ingredients present within the oil. Essential oils are a complex mixture of 20-200 organic compounds. Most reliable companies have these readily available on their site. Many have them upon request. By gaining a few key terms, these reports can help guide you in making informative safe decisions.

Essential oil molecules are made up of chemical families and within the chemical families are the chemical components. As previously mentioned, GC/MS reports will show the breakdown of the chemical families and the constituents within these chemical families. There are chemical families and constituents that sends up red flags for children as well as elderly, those with sensitive skin and on medications or other health issues. Chemical families and components of concern that I call “red flagged” include Phenols (eugenol, thymol, and carvacrol), Aldehydes (neral and geranial), Ethers (methyl eugenol and methyl chavicol), Ketones (camphor, carvone, and menthone components) and Oxides (cineole). Essential oils are composed of several or more chemical families, but when these particular component categories (listed above) are dominant, it becomes a concern. However, as long as the suggested safety cautions are followed, these types of essential oils can be useful for certain individuals. Some of the essential oils that fall under these chemical families, and in this case, specifically Phenols include Clove bud Eugenia Caryophyllata)and Thyme Thymus vulgaris ct. thymol, Oregano Origanum vulgare, Cinnamon leaf Cinnamomum zeylanicum, Cinnamon bark Cinnamomum zeylanicum and tulsi (Holy basil) Ocimum sanctum ct eugenol.

For aromatherapists, the essential oil analysis report is important in regard to the essential oil components and for aromatherapy blending. Many aromatherapists blend essential oils based on the chemical constituents shown in the analysis reports. Purchasing essential oils from a reliable company/supplier, always look for those with an ethical reputation as well as research their stance on sustainability for the plants. There are also watchdog groups on Facebook such as Essential oil Consumer Reports and other resources (including aromatherapy and herbal organizations) that provide both educational information and sources for reputable essential oil companies/suppliers. Finding a wide range of researched scientific based information ensure you are getting the best and purest essential oil for your money and family.

One of the most concerning things in the aromatherapy profession that is of concern is the lack of safety information with the sales of essential oils, especially pertaining to use with children. Essential oils are 50-100 times more potent than its original plant form. So, if the rind of the lemon tends to burn your lips a little, imagine 50-100 times more potent with the use of lemon essential oil.

Many people are told or under with the impression that you can use essential oils undiluted topically, leaving a path of injuries behind. (ref. 8,9). For some using milder essential oils, there may be none or very little reaction but for some the reaction is red, irritated, or burned skin. There are some essential oils that if used on the skin without being properly diluted, can cause mucous membrane and dermal irritation, burning and/or blistering. The main principal reactions to essential oils are contact urticarial (immediate hypersensitivity), allergic contact dermatitis (delayed hypersensitivity), and photosensitivity/photo toxicity (with phototoxic type oils). With this in mind, one can only imagine the damage to tender mucous membranes.

The second safety issue is the suggestive use of ‘drinking’ essential oils in water. The molecules of essential oils will not bind to water which means the essential oils and water do not blend. I’ve had people respond that they have done this practice for years with ‘no problem’. But what if the reaction or damage has not become apparent yet? Drinking water with essential oils such as peppermint with menthol, eucalyptus with 1,8-cineole or cinnamon bark with cinnamaldehyde can possibly lead to mucous membrane damage.

This is not to say internal use is not done. However, this practice should be done safely and effectively with the direction of a Clinical Aromatherapist with additional education/training in this method. More importantly, why would we if we do not have the proper education in safety, especially with our little ones? So the question is, do we really want to take a chance with our children’s tender skin or the mucous membranes inside their little bodies? Let’s review “why we don’t use undiluted essential oils” or “drink” essential oils and then discuss how you can use these oils safely.

Taking a brief look at the chemistry of essential oils is necessary to understand the need to follow safety recommendations. The word “essential” in essential oils (also known as volatile oils) is indicative of the nature or essence of essential oils. Because essential oils are insoluble, they do not form a homogeneous mixture (because they are not of the same element) when added with water, and for this reason, they are referred to as an oil. Essential oils are made of molecules. One drop of unadulterated essential oil contains approximately 40 million-trillion molecules. Considering that it only takes one molecule of the right kind to open a receptor site and communicate with the DNA to alter cellular function, you can see why even a small amount of oil can have profound effects on the body, brain, and emotions. This relationship helps explain why smells often trigger emotions. Knowing this, we can hypothesize how the use of essential oils can have very profound physiological and psychological effects. Of our seven senses, smell is the only one wired directly to the brain. Molecules are a collection of even smaller ingredients-neutrons, protons and electrons. The neutrons and protons live in the nucleus of the atom in the center. Neutrons have no weight or charge whereas the protons have a positive charge and electrons are the outer particle that spins around the atom. The word atom in Latin means “basic building block”. Molecules are made of 2 or more atoms. Heat will break this bond which is why we need to keep our essential oils stored in a cool environment. On a side note, the best solution is in a temperature-controlled refrigerator. Some essential oils are fine at room temperature. However, oils such as those that are phototoxic do not do well when exposed to heat sources. If you leave your essential oil in the heat, it can go from being a chemical composition of 3 carbons and 6 hydrogens (C3H6) to 3 carbons and 8 hydrogens (C3H8). This is the result of the bond being broken between the first and second carbons. Oxygen zipped into the bond with carbon, and it grabs a hydrogen atom to hold onto, because oxygen always makes two bonds. Once heat and oxygen hit those molecules the chemistry has now changed. This degrades the essential oil and now it’s unclear what the composition is unless you have the oil retested. Oxidation also effects the potency or stability of the oil. Tisserand noted that Orafidiya (1993) tested oxidized lemongrass oil and it had lost much of its antibacterial activity. Other studies are noted. Keeping essential oils at a temperature of 65 degrees, with lids tightly closed will help to achieve their shelf life. Shelf life varies with essential oils.

Changes to

Essential oils each have their own unique set of carbon compound, mainly carbon and hydrogen (hydrocarbon) with one or more functional groups attached. Hydrocarbons can vary in size.

That is why, for example, rose essential oil has a different aroma than eucalyptus. A long time ago in a faraway place (I like that line), alchemists gave way to chemists and they eventually found the “basic building blocks” of all life. And these basic building blocks apply to essential oils as well.

The lack of knowledge or belief that essential oils involves chemistry is why we continuously see an increase in injury reports involving the misuse of essential oils. When we refer to chemistry when speaking of essential oils, generally the first response is “what does chemistry have to do with it. They are natural”. Although true, nature, in all its glory, involves chemistry. Having the basic knowledge of the chemistry of essential oils allows you to make smarter, safer decisions when using them. This little bit of knowledge also will allow one to blend more efficiently and more effectively.

Research has documented time and again that some essential oils can irritate the skin, especially the young tender skin of a child. If you use oils such as peppermint (with menthol), clove (with eugenol) or similar oils they can cause irritation, sensitization, or worse, burn the skin. Yet some sources will say that these essential oils and others can be used undiluted. I’ve heard the “myth” that if you react, it is your body detoxing. That simply is not true. Essential oils do not detox the body. Diluting protects the body and did you know that diluting with a carrier oil increases the effectiveness of the essential oil? It’s true.

Essential oils will bind to what is referred to as a carrier oil (fixed oil) and since essential oils are volatile (they evaporate quickly), blending with a fixed oil slows down the evaporation rate and this in turn allows more essential oils to enter the skin to the stratum corneum then to the dermis and travel into the bloodstream, across the blood brain barrier, then into the tissues throughout the body. The blood-brain barrier (BBB) is a physical barrier that prevents entry of large and potentially toxic molecules into the brain, thus separating the central nervous system and systemic circulation. It is formed by tight junctions between brain endothelial cells, which selectively prevent the diffusion of hydrophilic molecules and pathogens such as bacteria from entering the brain parenchyma. It’s remarkable that essential oil molecules can cross this barrier. The sense of smell is remarkable. In 2007, a study at the University of Chicago, research demonstrated the importance of smell as a means for people to gather information from their environment. Smell is often an undervalued sense because people are more aware of the visual aspects of their perceptions. We are used to our visual senses and we forget about smell. If we consciously use that sense of smell, it’s remarkable how it can affect our other senses, even making our visual sense more enhanced as we inhale the aroma.

The carrier oil serves as a protective shield between the essential oil and the skin. However, even with a carrier, Tisserand suggests maximum dosing or blending percentages per each essential oil based on the components within each individual oil.

With this knowledge and this approach, people may have the desire to blend because it becomes apparently clear that you can get more benefits from the oils with proper dilution.

Taking a scientific approach may spark a different light in people and how they use essential oils.

Carrier oils (aka fixed oils) are derived from plants and include nuts, seeds, or fruits sources. They aren’t volatile like essential oils are, but they do have remarkable therapeutic effects and pair well with essential oils. They tend to be heavier than essential oils and are very safe for the skin. Carrier oils include cold pressed vegetable oils and jojoba oil (a liquid wax), as well as other bases such as: hydrosols, herbs, sea salt, sugars (as an exfoliant), milk powders, clays and muds.

While using essential oils topically, we are simultaneously inhaling them and in turn both applications stimulate the brain to trigger a reaction and this supplies the therapeutic benefit of the essential oil. Essential oils work in the same manner as, for example, topical creams that you buy over the counter to ease pain, or antibiotic ointment or hormonal cream that is topically applied and enter the skin.

Carrier oils do not enter our skin but do a great job making sure as much essential oil as possible has time to enter our skin before evaporating. The solubility in the various aqueous and fatty body compartments largely effects and determines the distribution of substances through the body.

Similarly, the relative lipid and water solubility is what effects the substances reaching the bloodstream from tissue distribution via the site of administration.

There is much more that occurs within the body. But most importantly, ‘diffusion into the brain’ (Tisserand, EO Safety, pg.51) means the substance needs to be lipophilic to pass the blood brain barrier. Essential oils constituents are able to penetrate that barrier.

How does this effect the safety of children and essential oils? Children, especially under the age of five years old, are the most vulnerable and although essential oils can have a positive impact on their health when used accordingly, this also means that if used unsafely on a child, some oils can have a negative impact.

To clarify the positive therapeutic actions of an essential oil as well as the negative reactions of an essential oil, we’ll look at peppermint (Mentha x piperita). The cooling effect of peppermint is from the component menthol. Menthol serves as a pain reliever (analgesic), anti-inflammatory, and antibacterial. It’s cooling when used in low doses and warming in higher doses and has several other benefits. It also comes with a host of safety cautions and contraindications. If you are taking calcium channel antagonists, use caution, it can be a concern with peppermint. Calcium channel blockers, also called calcium antagonists, treat a variety of conditions, such as high blood pressure, migraines and Raynaud's disease. Peppermint essential oil is a calcium channel blocker and may alter the effects of these drugs. Peppermint may potentiate this type of medication. Peppermint should be avoided if you have been diagnosed with or suspect you may have GERD, gastro esophageal reflux disease. Menthol-rich essential oils should also be avoided if they are listed to avoid their use with the following medications: antimalarial, sulfonamides, chloramphenicol, streptomycin or aspirin. Peppermint essential oil should be avoided with children younger than 5 years of age because of the possibility of neurotoxic effects. With such safety concerns, it should be apparently clear as to the effects of peppermint essential oil with its use (topically or internally) with a small child, topically or internally.

With the use of essential oils that have the potential to cause irritation (skin and mucous membranes) even when diluted, be aware of this factor when trying new essential oils with yourself or when introducing to your family or friends, always do a small skin patch test prior to topical use. A skin patch test is simply applying a small amount of the diluted essential oil/s to the thin skin of the inside of the wrist. If no reaction appears within 10 minutes it should be safe to use the oil/blend. In regards to what is considered “safe” essential oils for children, I use no more than a maximum 2% dilution (18 drops per one ounce of carrier oil) for acute or chronic issues; this is also dependent on the age and health of the child. However, it’s always better to start with less to find the strength needed without overdoing. Less is more. With all this in mind, how do we safely use essential oils with our children?

Diffusion

There are many diffusers available these days that are especially made for essential oils. Diffusion works by distributing essential oil molecules through the air. Once in the air, they are inhaled and come into contact with nerves that send them directly to the brain. This is a quick and safe way of letting the essential oils go to work for you. You can either use a diffuser or direct inhalation. Inhalation plays a huge role in aromatherapy and presents a very low risk to most people. During inhalation, odor molecules travel through the nose and affect the brain through a variety of receptor sites, one being the limbic system, which commonly is referred to as the emotional brain. The limbic system is directly connected to those parts of the brain that control heart rate, blood pressure, breathing, memory, stress levels, and hormone balance (Higley & Higley, 1998). This relationship helps explain why smells often trigger emotions. With this information, we can hypothesize how inhaling essential oils can have some very profound physiological and psychological effects. Also while inhaling, the oils pass down the trachea and into the bronchi, and down into the lungs. More details on this process can be found in Tisserand and Young, Essential Oil Safety, 2nd ed. pg. 49. After essential oils reach the bloodstream, they enter the central nervous system (CNS) quite easily. With this being the case, it’s imperative that we safely use essential oils since this easy access to the CNS can also pose serious issues and complication when essential oils with cautionary concerns are ignored, especially with our little ones.

On diffusion and children, Tisserand states, (2nd Ed. Essential Oil Safety, pg. 658) “A few drops of essential oil in a burner, vaporizer or in a steam inhalation is virtually risk-free. However, prolonged inhalation (more than about 30 minutes) of concentrated essential oils vapors (e.g. steam inhalation, or direct from a bottle) can lead to headaches, vertigo, nausea, and lethargy. In certain instances more serious symptoms might be experienced, such as incoherence and double vision. For children of 5 years old or less, direct inhalation should be avoided. Direct inhalation includes inhaling essential oils from the hands, a cotton ball, a nasal inhaler, a bowl of hot water or similar. Indirect or ambient inhalation, is safe for young children, and includes any method that vaporizes essential oils into the air”.

On page 9, Tisserand continues “perhaps 10 minutes or more” break between diffusions would be advisable. Although this is a safe method of application, Tisserand states it excludes premature babies, (Tisserand and Young, EO Safety, pg. 659) as well as the health of the child, i.e.; medications, asthma, etc. The diffusion method doesn’t erase the importance of the individual oil safety precautions. Some essential oils, no matter what method, are not safe for children so please seek advice from a reputable source on essential oil safety.

I’ve worked my way through Tisserand and Young’s 2nd Edition of Safety of Essential Oils book; the one book I refer to when it comes to safety for children. If you purchase this book, I encourage you to read through it first. Not one section, chapter or page will have all the information in one place that is needed to accurately and safely use your essential oils. I used various highlighters and highlighted and tagged the pages on everything for children. I suggest this because I personally have seen a sentence taken as an answer, although had the person researched further, there was more specific information that was of importance and relevance to the final outcome. Research is key.

I asked Robert for a more definitive answer on diffusion with the little ones. From Robert Tisserand: "I think after 3 months is OK, so long as diffusion is not too intensive. I know that's vague, but air concentration of volatiles is hard to pin down, and even if we could - there's no clear guideline."

I feel that inhalers would fall under “direct inhalation” and should be avoided for those 5 and under.

With this and since each child is an individual with their own weight, health and age, apply your Mommy instincts for your own child/children.

Topical/Dermal Use

A great deal of caution should be used with topical application on infants since their skin does not mature until around three months; excluding premature infants. Infant’s skin is not only more sensitive to essential oils but the absorption rate is higher because the skin is more permeable.

Bathing children with essential oils requires great caution, however it can be done safely. Use 1 ounce of a water-soluble medium to blend with (jojoba oil is a favorite for this purpose) and 9 drops of lavender (Lavendula angustifolia). Add to bath salts and then add ½-1 tablespoon to bath, depending on how full you run the bath. Then your little one can enjoy a relaxing bath before nighty night time. Lavender serves so many purposes and it really is a perfect essential oil for children. However, even with lavender, it’s still important to do a skin patch test since there has been noted an occasion of irritation from lavender. With multiple therapeutic properties including anti-inflammatory, anti-bacterial, analgesic, sedative, respiratory support and more, this is my go to for children.

For topical use, Tisserand suggests the following:

“Age-related recommended and maximum concentrations of essential oils for massage”

Age

Essential Oil Dilution Rates for Children

Recommended (%) Maximum (%)

Premature infant 0 0

Up to 3 Months 0.1 0.2

3-24 months 0.25 0.5

2-6 1.0 2.0

6-15 years 1.5 3.0

15 + years 2.5 5.0

Tisserand states that these concentrations aren’t researched based. These are, however, safety suggestions from one of the top experts in the industry.

Different factors can affect the absorption of essential oils through the skin. Warming the area up first with either a warm cloth (if wet, dry thoroughly) or heating pad, then massage the area, will increase the circulation to that area which in turn will allow more absorption of the essential oils.

As to how much is absorbed into the body is determined by several factors. First how much is used and the total dilution rate. The next thing to consider is how they are dispersed, what is the overall area of the body being applied to, the health of the skin and the age of your client. As mentioned above, the temperature also effects the absorption, and this can increase by adding a warm cover over the skin after oils are applied. And of course, what essential oils you choose affects the final outcome.

Once again, apply your Mommy instincts. Always look up individual safety guidelines for each essential oil as some are not meant to be used topically on children or require more of a dilution rate.

You can find other useful information and guidance at NAHA (National Association for Holistic Aromatherapy) at http://naha.org.

A big thank you to Kelly Holland Azzaro, RA, CCAP, CBFP, LMT for encouraging words and guidance.

Resources

Essential Oils and the Detox theory; (2016, November 22). Retrieved May 17, 2017, from http://tisserandinstitute.org/essential-oils-and-the-detox-theory.
Essential Oil Composition Summary, pg. 21; Tisserand, R., & Young, R.; Essential Oil Safety, 2nd Edition. Churchill Livingston
Toxicity, pg. 38, Tisserand, R. & Young, R.; Essential Oils Safety, 2nd Edition (2014), Churchill Livingston
Dermal Dosing, Infants and Children, pg. 47; Tisserand, R. & Young, R. 2nd Edition (2014), Churchill Livingston
The Skin; pg. 97; Tisserand, R. & Young, R. 2nd Edition (2014), Churchill Livingston
Safety Information. (n.d.). Dermal Dosing. Retrieved May 17, 2017, from http://naha.org/explore-aromatherapy/safety/.
Peppermint https://pubchem.ncbi.nlm.nih.gov/compound/6850741#section=Top
University of Chicago. "Brain Processes Sense Of Smell Better Than Previously Thought." ScienceDaily.30 April 2007. <www.sciencedaily.com/releases/2007/04/070428094824.htm>.
Adverse Reaction Reports (n.d.). Retrieved March 6, 2017, from http://www.atlanticinstitute.com/.
Adverse Reactions Database; (n.d.). Retrieved March 6, 2017, from http://tisserandinstitute.org/safety/adverse-reaction-database/.
Safety Guidelines; (n.d.). Retrieved April 2, 2107, from http://tisserandinstitute.org/safety/safety-guidelines/.
TC USA Inc. (n.d.). Retrieved May 17, 2017, from http://www.zenitech.com/ Toxicity_of_essential_oils_p1.pdf
Essential Oils are Poisonous when misused, (n.d.). Retrieved May 17, 2017, from http://www.poison.org/articles/2014-jun/essential-oils.