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CBD for Children: What do Parents Need to Know?

Now that hemp-derived CBD is decriminalized at the federal level, many parents have questions about the safety and effectiveness of CBD for children.

In this article, we’ll cover some of the main questions that parents and healthcare practitioners may have about CBD for kids, including:

This article will look at the most recent research on CBD, so that you will have the benefit of the most up-to-date information available.

We also asked a nationally renowned cannabis educator, Dustin Sulak, D.O., to weigh in with his views on using CBD for kids.

Ultimately, you’ll be ready to talk to your child’s healthcare provider about whether CBD is right for your child. Or, you may also decide to hold off for now and wait for more placebo-controlled, double-blind clinical trials.

Either way, you’ll be ready to make an informed decision.

How Does CBD Work?

CBD seems to correct a lot of different mental and physical imbalances. It does this by working in relationship with the endocannabinoid system (ECS).

The ECS is a network of molecules and signaling pathways in our bodies. It uses neurotransmitters called endocannabinoids that target receptors on cell walls to communicate. 

In short, this system’s job is to create balance, or homeostasis, in the body.

While endocannabinoids are produced naturally inside our body, there are plant-derived molecules known as phytocannabinoids that can also interact with the ECS.

CBD is one of these phytocannabinoids, and it works by mimicking and augmenting what the endocannabinoids do.

There is a growing collection of data indicating that CBD, in conjunction with the ECS, can cause positive changes in some pediatric illnesses.

Keep reading to learn more about the latest research in this area.

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CBD for Kids: What Does the Research Say?

If the child was ill or has a preexisting challenge that they have to overcome, and they want to maintain a good level of health, could CBD be helpful? I think it could be.
— Dr. Dustin Sulak
The clinical research on using CBD for different medical conditions is in its early stages. But there have already been some studies looking specifically at CBD for pediatric conditions.

When pediatric, youth and adolescent patients with epilepsy or autism spectrum disorder (ASD) take CBD as part of observational studies, they tend to experience improvement in a range of symptoms. According to caregivers’ responses to surveys and questionnaires, these include:

For example, a promising study out of Israel shows holistic improvement in anxiety and behavioral problems in children with autism who participated in the observational study.

But does CBD help get to the root of the problem, or is it better for managing symptoms? Let’s take a look at the research on CBD for specific pediatric health conditions.

CBD for Children With Seizure Disorders

The rapidly increasing mainstream acceptance of CBD is largely due to the story of one child.

In 2013, CNN reported on the story of Charlotte Figi. Charlotte experienced her first seizure at three months old, and her seizures increased in intensity and frequency as she grew older. At two years old, she was diagnosed with Dravet Syndrome, a form of epilepsy that is severe and resistant to treatment.

By the age of five, Charlotte was near death, and her parents decided to try cannabis as a last resort.

On the low-THC, high-CBD formula that her parents chose, Charlotte experienced significant reduction in seizure frequency. She also began to regain lost physical, verbal and cognitive skills. Presently, she continues to thrive on a consistent CBD regimen.

Media exposure surrounding Charlotte’s experience created pressure to inform the public and to provide legal access to CBD for children in the treatment of epilepsy.

How does CBD help with seizures?

Based on current research, it appears that CBD helps with seizures in two main ways. First, it helps to prevent them. Then, when seizures do occur, it helps to protect the brain so that it can recover more quickly.

So, how does it work?

CBD decreases and sometimes eliminates seizure activity by correcting imbalances in the brain. These imbalances can trigger a damaging process known as excitotoxicity.

CBD also helps after a seizure by halting that excitotoxicity before it injures or kills surrounding brain cells. This is how CBD provides neuroprotection that reduces post-seizure recovery time.

What do parents need to know about using CBD for seizures?

Using CBD for epilepsy requires professional guidance. That’s because CBD can raise levels of certain anti-epileptic medications in the blood. In addition, there are reports that CBD can actually promote seizure activity in some children with epilepsy.

This is why parents interested in CBD for pediatric epilepsy should work with a medical professional who has studied the endocannabinoid system and is knowledgeable about the medical use of CBD.

CBD for Children With Autism

The dramatic results of CBD for epilepsy has been encouraging for parents of children with autism spectrum disorder (ASD). That’s because ASD and epilepsy have intersecting areas of disorder, as well as cross symptoms.

The Centers for Disease Control and Prevention (CDC) characterizes ASD as a neurodevelopmental disorder. In 2018, one in 59 children have ASD, and its numbers are on the rise. ASD was once thought to be strictly inherited, but through recent research an environmental contribution is becoming apparent.

As part of an ASD treatment program, providers at the Soroka University Medical Center in Israel collected data from 188 pediatric ASD patients treated with medical cannabis between 2015 and 2017.

Their results, which they reported in January 2019, suggest that high-CBD, low-THC cannabis oil does cause positive change in ASD patients.

Data from the study indicates a decline in some of the most distressing symptoms of ASD: restlessness, self-injury, rage attacks, agitation, and sleep problems.

Overall, more than 80% of the parents reported a significant or moderate improvement in their child’s global assessment score.

While these are extremely promising improvements, the researchers noted that there were limitations to their study. Specifically, because it was an observational study, there was no control group. Still, this is a first step toward demonstrating the need for more clinical trials.

What do parents need to know about using CBD for ASD?

According to pediatrician Bonni Goldstein, MD, there are some risks regarding CBD use in ASD. She says that CBD alone can be overstimulating for some children with behavioral conditions and/or autism, and low doses may worsen hyperactivity.

For these reasons, if you think that your child with ASD would benefit from CBD, dosing efforts and cannabinoid ratios should be monitored by a professional.

CBD for Children With Anxiety and Heightened Behavioral Responses

We feel that CBD is safe based on the all the reports and widespread use, but I wouldn’t start with CBD. I would start with lifestyle changes, exercise, time in nature, amount of sleep, boosting endocannabinoid levels with diet, and avoiding toxins.
— Dr. Dustin Sulak
If your child experiences anxiety or behavioral outbursts, you’ll surely be interested in a plant-derived, safe supplement that quiets neurotoxic excitability states. And if your child deals with higher-than-average levels of anxiety, but they don’t have a diagnosis attached to their symptoms, you may be wondering whether CBD could help.

One study of 93 children with ASD and 93 children without ASD showed differences in their brains. The ASD brains had decreased levels of the endocannabinoid anandamide.

Disrupted levels of our endogenous cannabinoid anandamide are also implicated in anxiety disorders. CBD may have therapeutic potential as an anxiolytic by keeping anandamide around longer.

Also, CBD may inhibit anxiety-provoking hormones at the serotonin target receptor. When CBD inhibits activity at the serotonin receptor, the action is to quell behavioral responses, quiets neurotoxic excitability states and decrease stress reactions in the brain.

The ECS is heavily involved in forming brain cells and reorganizing synaptic pathway connections. This is called neuroplasticity, a process of growth inherent in active learning, yet also necessary for acquiring more balanced emotional responses to the world at large.

Should Parents Use CBD as a Supplement for Their Kids?

Prior to now, a family with a chronically ill child typically decided to use phytocannabinoids for their child after all conventional medical options had failed.

Now it is easy to obtain CBD, and we have more information at hand regarding safety and efficacy. But if you’re thinking of adding CBD to your healthy child’s regimen of supplements, you should be aware that we still don’t know whether it is prudent to jump to external supplementation.

During a webinar hosted by Healer.com, I spoke to Dustin Sulak, D.O., an integrative medicine practitioner and cannabis educator.

Dr. Sulak offered valuable advice for parents who are interested in giving CBD to their healthy child as a general wellness supplement.

“I would start by saying, we don’t know much at all about CBD as a general wellness supplement in children and I would always use more caution in children. I think what we know about CBD makes me feel like it’s very safe. Even at super high doses, [in studies] it is safe. And to use CBD as a tonic at low doses would probably also be safe. But if I were counseling a parent on general wellness approaches I would not be starting with CBD

“We feel that CBD is safe based on the all the reports and widespread use, but I wouldn’t start with CBD,” he said. “I would start with lifestyle changes, exercise, time in nature, amount of sleep, boosting endocannabinoid levels with diet, and avoiding toxins.”

“We live in a toxic environment, chemical toxins, electromagnetic fields, social toxins, and stressors at school. But still, I would do supplements last, and I would probably choose Vitamin D, magnesium, or Omega 3 supplements over CBD.”

Dr. Sulak acknowledges that this is a sensitive subject, and we don’t have information to provide a definitive answer to this question. Ultimately, though, he believes in parental health sovereignty and transparent discussion with your health provider.

“If the child was ill or has a preexisting challenge that they have to overcome, and they want to maintain a good level of health, could CBD be helpful? I think it could be. And I would not hesitate to give low doses to someone who needed it. I would supplement CBD at a very low dose of 1 to 5 milligrams,” he said.

“Another option would be to supplement as a tea. Hemp flower tea has CBDA, CBD and THCA and a tiny little bit of THC. This might be a nice approach, as well as a gentler approach.”

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CBD Concerns for Kids

The endocannabinoids that the body produces naturally are safe enough to be found in breast milk. There, they are imperative for growth and development.

Endocannabinoids occur naturally in the body, and children are exposed to external sources of cannabinoids through foods.

In recent years, pediatric providers are finding they are treating more children using phytocannabinoids like CBD. So, what do we know about the safety of CBD in pediatric use?

In a 2018 letter to the DEA, the FDA’s Assistant Secretary for Health Brett Giroir wrote, “There is little indication that CBD has abuse potential or presents a significant risk to the public health.” But as of yet, there are no regulated dosage guidelines for CBD. Nor are there effective therapeutic dosing guidelines of CBD for any particular medical condition.

And CBD is not necessarily without side effects. In clinical studies, some patients have reported nausea, fatigue and irritability while using CBD.

But while we have little information regarding long-term use of CBD, children with seizure disorders have been taking CBD for years. We do not seem to have serious adverse events coming from this population of patients.

We do know that CBD can affect the levels of certain other medications in your blood by competing for the enzymes that metabolize them. Talk with your provider about this if your child is taking any other medication and you want to add CBD.

Another concern that arises for parents is CBD’s genetic ties to THC, an intoxicant. Fortunately, CBD never met the criteria for the same classification as THC. It does not intoxicate nor cause cravings. Stopping CBD does not cause withdrawal symptoms, and starting CBD will not create a dependency.

How to Talk to Your Pediatrician About CBD for Kids

Parents, you can take the information you have learned about CBD’s validity and safety, and speak to your practitioner about potential treatments.

You may discover practitioners who consider CBD a passing fad and who question its medicinal value. They are concerned by limited scientific research on its use.

Cannabis prohibition stymied medical research in the US for most of the twentieth century. But in the meantime, researchers continued to conduct cannabis pharmacology studies and clinical trials in other countries. This body of research points to the validity and efficacy of CBD’s health benefits.

If you speak to your child’s healthcare provider and your ideas fall on deaf ears, don’t dismay. There is a growing field of practitioners who are willing to take a more holistic approach to your child’s needs.

Find a provider who has knowledge of the endocannabinoid system, cannabinoid receptors, cannabinoids, CBD pharmacology and the research associated with the medical use of CBD, and go from there.

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The Author

Maureen Smyth

Maureen Smyth

Maureen Smyth, RN, BSN, teaches the basics of the endocannabinoid system, cannabinoid receptors, cannabinoids, cannabis pharmacology, and the research associated with the medical use of cannabis. Her goal is to dispel myths and extend the reach of the health and safety messages about cannabis medicine.

She is certified by the Global Medical Cannabis Institute and is a member of the American Cannabis Nurses Association. Her work has also appeared in Cannabis Industry Journal.