Over the years, Echinacea has become one of the most popular herbal remedies in pregnancy primarily due to its medical indications. Used both systematically and topically, it has been reported to improve the body's defenses against viral and bacterial infections, as well as to prevent and treat common cold/flu season illnesses, all of which are very common ailments during pregnancy (Melchart et al., 1994; Hoheisel et al., 1997; Grimm and Muller, 1999). The three major groups of constituents among several responsible for these effects are alkyl amides, caffeic acid derivatives, and polysaccharides (Facino et al., 1995; Combest and Nemecz, 1997).
Recommendations for Echinacea use are most frequently obtained through nonmedical sources, including word of mouth, friends, and family members (Gallo et al., 2000). Consequently, the quality and accuracy of information provided on product type and pattern of use may not always be reliable.
Its broad range of reported medical applications appeal to many pregnant and lactating women, who often opt for this herb over manufactured drugs because they believe it to be safer. Although anecdotal evidence may support this use, sound scientific knowledge surrounding the wide array of supplement choices is lacking (Lepik, 1997; Therapeutic Research Faculty, 2000).
There appears to be a common misconception among patients and some practitioners alike that the terms "safe" and "natural" are interchangeable (Boon et al., 1999). Consequently, many women are inclined to believe that natural remedies are safer than pharmaceutical drugs (O'Hara et al., 1998). This perceived safety of natural products over manufactured drugs could increase the potential for adverse effects in both the mother and her developing fetus. This is due to the fact that many women initiate treatment with supplements such as Echinacea without obtaining medical advice; they either self-prescribe or take the advice of others. An added potential for concern is posed by the fact that many consumers may be unaware that unlike conventional medications, herbal products such as Echinacea are not under enforced regulations by the Food and Drug Administration. To further complicate matters, every country differs in their regulatory laws regarding these products. For example, minimal regulation exists in the United States, given that herbal products are classified as dietary supplements (Tsui et al., 2001).
Echinacea has been reported to be the most common herb used prior to knowledge of pregnancy and continued throughout (Tsui et al., 2001). In light of the fact that it is not subject to regulations normally applied to pharmaceuticals, it is vital for women of reproductive age to exercise both common sense as well as caution with use.
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