In this, my newest series of blogs, I want to discuss the growing interest in alternative medicine among adults that has now carried over to children and into the offices of pediatricians and family physicians.
If a parent is taking echinacea, should it be given to a child with a runny nose? (Echinacea is a popular remedy for preventing colds that we consider to be scientifically unproven though apparently safe for many adults.)
Is garlic oil a better eardrop than commercial products made specifically for children?
What about acupuncture for children with cerebral palsy, or megavitamin or nutritional therapy for children with Attention Deficit/Hyperactivity Disorder (AD/HD)?
A national survey published in 2004 found that 87 percent of pediatricians had been asked questions about complementary and alternative medicine (CAM) by parents or children in the previous three months.
Two-thirds of the pediatricians in the survey believed CAM therapies could be beneficial, and one-third said they or an immediate family member had used them in the previous year.
However, three quarters were concerned about possible side effects, and another three-quarters believed CAM use could delay conventional care.
According to the Association of American Medical Colleges, in 2005, three-quarters of the nation’s 125 medical schools required some kind of CAM coursework. Yet fewer than 5 percent of practicing pediatricians felt very knowledgeable about CAM therapies, and most wanted more CAM information.
It’s no wonder only about one-third of parents tell doctors they are using alternative therapies with their children.
The use of CAM may even be more popular with parents for their children than for themselves.
When parents were surveyed at pediatricians’ offices in the United States, one-third reported using CAM with their children in the previous year. The most popular therapies were infant massage, massage therapy, vitamin therapy, and herbal remedies.
A survey found that CAM was used with about half of the children at a large Australian children’s hospital. The most commonly used remedies were multivitamins, vitamin C, and echinacea; the most common therapies were chiropractic and aromatherapy.
When the same survey was conducted at a large children’s hospital in Wales, 41 percent of the children were reported to have used CAM in the previous year. There, the most commonly used remedies were multivitamins, herbal remedies, and dietary supplements; the most common therapies were aromatherapy and reflexology.
These surveys often use such a broad definition of alternative medicine that the numbers are inflated.
The study in the United States found that by far the most popular “therapies” parents used with their children were prayer (47 percent) and exercise (19 percent).
These researchers did not include these in their report of overall CAM use, though other researchers have.
No parents in that study had used therapies such as acupuncture, acupressure, or hypnosis with their children in the previous year, and use of other alternatives was relatively small: herbal remedies (7 percent), homeopathy (3 percent), and chiropractic (2 percent).
Why Parents Use Alternative Medicine with Children
The most common reason parents give for using CAM with healthy children is that they use CAM themselves.
Parents give children herbal remedies because they believe they are cheaper and safer than conventional treatment and have little risk of side effects.
When children have chronic or incurable conditions, fear of conventional medicine’s side effects becomes a bigger issue.
A survey was conducted with children diagnosed with AD/HD attending an Australian outpatient clinic. CAM was being, or had been, used by two-thirds of the children, who most commonly used modified diets, vitamins, and dietary supplements.
Children with cancer are commonly given CAM. Several studies in the United States between 1997 and 2003 found that between 46 and 84 percent of these children were given CAM, a huge increase from the 1980s.
Children with cancer most commonly used what researchers called “spiritual/mental strategies.” These included prayer, faith, and guided imagery.
We have concerns about listing prayer and faith as “therapies,” but that is how these (and many other) researchers classify them.
The second most popular category was physical strategies (e.g., acupuncture or massage), followed by herbal remedies.
Many children with cancer use CAM to relieve pain or chemotherapy side effects but do not report this to those providing chemotherapy. While they or their parents may believe they are receiving the benefits of both approaches, interactions between the two can have detrimental effects.
Most parents would have been shocked to hear Cora Collette Breuner tell pediatricians at the 2005 American Academy of Pediatrics meeting, “Some widely available supplements can sicken or kill kids.”
Evidence Is Lacking but Growing
A number of university hospital programs are now experimenting with aspects of alternative medicine for children.
While much remains inconclusive at this writing, some therapies are starting to show some positive results.
Many of these are ways to help children relax as they learn to cope with chronic or serious illnesses.
Others represent ways to include good nutritional strategies and vitamin therapy within conventional care.
As mentioned earlier, the vast majority of pediatricians (and, we suspect, family physicians who care for children) would welcome more guidance on CAM for children.
Randomized controlled trials (RCTs) provide the best evidence of effectiveness, and almost all the pediatric CAM RCTs have been published in mainstream medical journals.
The number of studies investigating CAM for children is increasing, but the quality of many of these has been found to be particularly poor.
There are signs of improvement, but still over three-quarters of all CAM trials with children mentioned nothing about adverse effects.
This leaves parents and doctors without clear guidance on this crucial issue.
Few systematic reviews of this research are available, but these reviews have been found to be of the same quality as those of conventional therapies.
Such developments are to be welcomed. Some CAM procedures may be relatively harmless for children to try.
Acupressure and acupuncture are felt by many practitioners to be generally safe for children, though their effectiveness for many children’s problems remains questionable.
It must be stressed that much remains unknown about whether CAM is effective or safe for children.
However, some popular CAM approaches are more controversial and even raise some concerns.
In future articles, we’ll examine the use of the following in children:
Here’s the entire series:
You can read more about this topic in my book, Alternative Medicine: The Christian Handbook, which is endorsed by the Christian Medical and Dental Associations.