Cambodian parents are commonly using medicinal balms and oils such as “Tiger Balm” on their newborn children despite potentially toxic effects, according to a new report.

The report in the Journal of Tropical Pediatrics questioned 27 mothers on using products containing camphor, eucalyptus oil and menthol and observed four more using the products. “Tiger Balm”-like products are not recommended for children under 2 years old “because of the potential for accidental ingestion and the danger of over-absorption through vulnerable skin”, the report said.

“Numerous case reports describe infant morbidity, and even mortality, resulting from exposure to camphor and terpenic oil products . . . Despite significant potential for toxicity in children, these products remain widely available and popular.”

The study also highlighted that warnings are often written in Chinese, Thai or English instead of Khmer.

Report author Alessandra Bazzano, from the Tulane University School of Public Health and Tropical Medicine, cautioned: “It’s important not to draw too many strong conclusions since we’re looking at only case reports and qualitative data.”

She said the main danger would likely come from accidental ingestion.

The report found mothers used balms for health reasons – to mature or firm up the skin on the head or stomach, or to prevent diarrhea.

Mother Leang Eng, 29, yesterday said she used balms on her 1-year-old and had never been informed the products might be dangerous. “I put the balm on the belly to make it not bloat, and on the head to make it stronger,” she said.

Nov Vanna, who operates Pharmacy Dararaksmey in Phnom Penh, said she did not know if customers used the products on their infants, although some queried which were suitable for infants. “I don’t know which types are safe for children. I just sell it,” she said.

Cambodian-American doctor Mengly Quach said the practice had “become a part of the culture” and community education was needed. “It rarely causes any fatalities but there are long-term effects – a kind of desensitisation to strong medications,” he said. “It has a psychological remedy, placebo effect. It’s become a norm.”