Neem leaf extracts and teas appear to be very safe at recommended intake levels with no significant reports of problems. Neem seed oil is more problematic and should be kept out of reach of children because of a report of Reye's syndrome–like symptoms in a few infants who consumed 5 ml of the oil and ultimately died.²⁰ No deaths have been reported in adults, but because of the potential for severe adverse effects, the amount of neem used should not exceed the amount that has been safely used in research studies. Adults may sometimes have diarrhea, nausea, or stomach upset when taking neem oil.²¹ Neem should be avoided in pregnancy until its safety is demonstrated.