CBD for Children: Is It Safe?
From Healthline.com. Medically reviewed by Karen Gill, M.D. — Written by Corey Whelan on November 21, 2019
CBD, short for cannabidiol, is a substance extracted from either hemp or marijuana. It’s available commercially in many forms, from liquid to chewable gummies. It’s become very popular as a treatment for multiple conditions, including some that occur in children.
CBD doesn’t get you high. Although CBD is usually obtained without a prescription, EpidiolexTrusted Source, a medication made from CBD, is available with a prescription from your doctor.
Epidiolex is prescribed for two severe, rare forms of epilepsy in children: Lennox-Gastaut syndrome and Dravet syndrome.
Parents sometimes use commercially manufactured CBD to treat some conditions in children, such as anxiety and hyperactivity. Caregivers may also use it for children on the autism spectrum to try to reduce certain symptoms of autism.
CBD hasn’t been tested extensively for safety or for effectiveness. While there’s promising research about CBD, especially for seizure control, much is still not known about it. Some parents are comfortable giving it to their children, while others are not.
What is CBD oil?
CBD is a chemical component inherent in both marijuana (Cannabis sativa) plants and hemp plants. CBD’s molecular makeup is the same, once it has been extracted from either plant. Even so, there are differences between the two.
One of the main differences between hemp and Cannabis sativa is the amount of resin they contain. Hemp is a low-resin plant, and marijuana is a high-resin plant. Most CBD is found within plant resin.
Resin also contains tetrahydrocannabinol (THC), the chemical compound that gives marijuana its intoxicating properties. There is much more THC in marijuana than there is in hemp.
The CBD derived from marijuana plants may or may not have THC in it. This is also true of hemp-derived CBD, but to a lesser extent.
In order to avoid giving THC to your children, always opt for isolate CBD rather than full-spectrum CBD, whether it’s hemp derived or marijuana derived.
However, other than Epidiolex, which is a prescription medication, there’s no way to be certain a CBD product is THC-free.
Forms of CBD
CBD oil is available in a wide range of forms. One popular form is commercially prepared baked goods and beverages. This can make it difficult to know how much CBD is in any product.
Other than using prescription products like Epidiolex, it’s difficult, if not impossible, to control the amount of CBD administered to any child using these products.
Other forms of CBD include:
- CBD Oil. CBD oil may be labeled in multiple potencies. It’s typically administered under the tongue, and can also be purchased in capsule form. CBD oil has a distinctive, earthy taste and an aftertaste that many children may dislike. It’s also available as a flavored oil. Before giving CBD oil to your child, discuss all the possible risks with their pediatrician.
- Gummies. CBD-infused gummies can help you override taste objections to the oil. Since they taste like candy, make sure that you store the gummies somewhere your children can’t find them.
- Transdermal patches. Patches allow CBD to penetrate the skin and enter the bloodstream. They may provide a consistent levelTrusted Source of CBD over a period of time.
What is CBD oil used for?
CBD oil is used for several conditions in children. However, the only condition it’s been approved by the Food and Drug Administration (FDA) for is epilepsy.
The FDA approved a medication made from CBD to treat difficult-to-control seizures in children with Lennox-Gastaut syndrome and Dravet syndrome, two rare forms of epilepsy.
The medication, Epidiolex, is an oral solution made from purified CBD that’s derived from Cannabis sativa.
Epidiolex was studied in three randomized, double-blind, placebo-controlled drug trialsTrusted Source, which included 516 patients that had either Dravet syndrome or Lennox-Gastaut syndrome.
The medication was shown to be effective at reducing seizure frequency, when compared with placebo. Other researchTrusted Source has yielded similar results.
Epidiolex is a carefully manufactured and administered medication. There’s no scientific evidence to indicate that store-bought CBD oil in any form will have the same effect on seizures. However, any CBD oil product you buy may have the same risks as Epidiolex.
This medication can cause side effects and is not without risk. You and your child’s doctor should discuss the benefits of Epidiolex versus its potential risks.
Side effects may include:
- feeling lethargic and sleepy
- elevated liver enzymes
- diminished appetite
- feeling weakness in the body
- issues with sleep, such as insomnia and poor sleep quality
Serious risks are less likely, but they may include:
- suicidal thoughts or actions
- aggressive behavior
- panic attacks
- injury to the liver
Several studiesTrusted Source that have analyzed the use of medical cannabis or CBD oil in children with autism have suggested there could be an improvement in symptoms of autism.
One studyTrusted Source looked at 188 children on the autistic spectrum, aged 5 to 18 years old. Study participants were given a solution of 30 percent CBD oil and 1.5 percent THC, placed under the tongue, three times daily.
An improvement was seen in most of the participants, for symptoms including seizures, restlessness, and rage attacks, after 1 month’s use. For most study participants, symptoms continued to reduce over a 6-month period.
Reported side effects included sleepiness, lack of appetite, and reflux. During the study, the children continued to take other prescribed medications, including antipsychotics and sedatives.
The researchers indicated that their results should be interpreted with caution, as there was no control group in place. This prevented them from determining causality between the use of cannabis and the reduction of symptoms.
Other studies are currently underway around the world, which may help to determine if there are safe and effective doses of CBD for children with autism.
Some animal and human studiesTrusted Source indicate that CBD oil may help reduce anxiety, although this claim hasn’t been tested sufficiently in children.
Preclinical evidence indicates that CBD oil may have a place in the treatment of anxiety disorders, including social anxiety disorder, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD).
A studyTrusted Source of one 10-year old patient with PTSD found that CBD oil improved her feelings of anxiety and reduced insomnia.
Attention deficit hyperactivity disorder (ADHD)
There’s little research on CBD oil’s benefits or risks for children with ADHD. Anecdotally, some parents report a reduction in their children’s symptoms after CBD oil use, while others report no effect.
Currently, there isn’t enough evidence to confirm whether CBD oil is an effective treatment for ADHD.
What are the risks of using CBD oil for children?
Marijuana has been used for hundreds of years, but CBD oil use is relatively new. It hasn’t been extensively tested for use in children, and no longitudinal studies on its effects have been done.
It also may produce significant side effects, such as restlessness and issues with sleep that may be similar to the conditions you’re trying to treat.
It may also interact with other medications your child is taking. Much like grapefruit, CBD interferes with some of the enzymes needed to metabolize drugs in the system. Don’t give CBD to your child if they’re taking any medication that has a grapefruit warning.
CBD oil is unregulated, making it difficult, if not impossible, for parents to have complete confidence about what’s in the product they’re purchasing.
A study published in JAMATrusted Source revealed labeling inaccuracies among CBD products. Some products had less CBD than stated, while others had more.
Is it legal?
The laws around CBD purchase and use can be confusing. CBD oil that’s derived from hemp is legal to buy in most places — as long as it has less than 0.3 percent THC. Even so, some states restrict possession of hemp-derived CBD.
CBD that’s derived from marijuana plants is currently illegal on the federal level.
Since any product containing CBD oil could contain some amount of THC, and giving THC to children is illegal, the legality of giving CBD oil to children remains a gray area.
The laws about marijuana use and CBD oil use are constantly changing, and they continue to vary from state to state. However, if your doctor prescribes Epidiolex for your child, it’s legal for them to use, no matter where you live.
Is CBD Legal? Hemp-derived CBD products (with less than 0.3 percent THC) are legal on the federal level, but are still illegal under some state laws. Marijuana-derived CBD products are illegal on the federal level, but are legal under some state laws. Check your state’s laws and those of anywhere you travel. Keep in mind that nonprescription CBD products are not FDA-approved, and may be inaccurately labeled.
Choosing a CBD product
CBD oil is manufactured by many companies around the world, and there’s no easy way for consumers to know exactly what’s in a particular product. But here are a few tips to help you find a reputable CBD product:
- Read the label. Look for the amount of CBD per recommended dose.
- Find out where the product is manufactured. If the CBD comes from hemp, ask if it’s grown in organic soil that’s free of pesticides and toxins.
- Search for CBD oil that’s undergone third-party testing and has lab results you can verify. These products will have a certificate of analysis (COA). Look for COAs from labs with certifications from one of these organizations: the Association of Official Agricultural Chemists (AOAC), the American Herbal Pharmacopoeia (AHP), or the U.S. Pharmacopeia (USP).
The bottom line
CBD oil has been shown to be effective for the treatment of seizures in children with certain rare types of epilepsy. But it isn’t FDA-approved for any other health condition in children.
CBD oil is manufactured by a vast number of companies. Since it isn’t federally regulated, it’s hard to know whether a product is safe and providing an accurate dose. CBD oil can sometimes contain THC and other toxins.
CBD oil hasn’t been significantly researched for its use in children. It may show promise for conditions such as autism. However, the products you buy online or off a shelf doesn’t necessarily parallel those supplied medically or used in research.
Anecdotally, many parents have reported that CBD oil is beneficial for their children. However, when it comes to your child, take a buyer beware approach. Always talk to your child’s pediatrician before starting any new supplements or medications.