March 2008

A recent report written by an Indian pediatrician and indexed by PubMed details a child’s severe injuries from the accidental ingestion of neem oil. Beyond that horrible tragedy, however, there are several important facts that the article does not include:

·         First and most importantly, no American manufacturers recommend that neem oil be used internally.  Neem leaf and bark are very safe products taken internally as directed -- but even they are not recommended for small children except under the direction of a healthcare professional.

·         Secondly, the accidental ingestion was actually a force-fed dose of 8 ml – more than a tablespoon – of oil. The father confused neem oil with another medication and gave a large dose to an already-sick 30-pound child. The article implies that a healthy child found the neem oil and chose to drink enough to cause a severe injury. This is not the case. We can’t imagine any child intentionally consuming that much neem oil.

·         Additionally, there is no mention of why the child was being medicated or the possibility that another illness may have been at least partially to blame for the injury.  Our follow-through emails with the article’s author include the comment:  “The preparation was not indicated for oral use and father gave it in confusion with another medicine.”  

·         The article also made a series of statements about the dangers of using neem internally without attributing them to published sources.  Neem oil (along with the recommended doses of bark and leaf) has been used internally in Indian tradition for thousands of years, much as America grandmothers dosed sick children with cod liver oil. A review of literature over the past 50 years shows very few reports of injuries considering its widespread use.

·         The authoritative book on neem (Neem: A Tree for Solving Global Problems) published by an arm of the US government reports that other tests show that a concentration of 5,000 mg per kg resulted in no toxicity in animal studies. It seems possible, those researchers say, that the contaminants in the oil caused the problems in cases where children were harmed, not the oil itself.

·         No information on the source of the oil taken by the Indian child is available and it may have been extracted with petroleum-based solvent like hexane that could be toxic in high concentration.

As a group, American manufacturers of neem have requested that the publication print a clarification to this article, detailing the source, dose and cause of that accidental ingestion and attributing all the statements in the article.

We’ll keep you updated as we work through that formal process.