The Use of Complementary and Alternative Medicine in Pediatrics

Abstract

The American Academy of Pediatrics is dedicated to optimizing the well-being of children and advancing family-centered health care. Related to these goals, the American Academy of Pediatrics recognizes the increasing use of complementary and alternative medicine in children and, as a result, the need to provide information and support for pediatricians. From 2000 to 2002, the American Academy of Pediatrics convened and charged the Task Force on Complementary and Alternative Medicine to address issues related to the use of complementary and alternative medicine in children and to develop resources to educate physicians, patients, and families. One of these resources is this report describing complementary and alternative medicine services, current levels of utilization and financial expenditures, and associated legal and ethical considerations. The subject of complementary and alternative medicine is large and diverse, and consequently, an in-depth discussion of each method of complementary and alternative medicine is beyond the scope of this report. Instead, this report will define terms; describe epidemiology; outline common types of complementary and alternative medicine therapies; review medicolegal, ethical, and research implications; review education and training for complementary and alternative medicine providers; provide resources for learning more about complementary and alternative medicine; and suggest communication strategies to use when discussing complementary and alternative medicine with patients and families.

Complementary and Alternative Medicine in Autism: An Evidence-Based Approach to Negotiating Safe and Efficacious Interventions with Families

“…It is nonetheless important to realize that some CAM therapies will eventually be proven to be effective and some conventional therapies will eventually be proven to be ineffective. 3 Families typically want physician input about CAM to be given in a nonjudgmental manner. When families experience negative responses from their pediatricians regarding CAM, they are more likely to seek alternative care without consulting their pediatrician, 141,142 thus increasing the risk that complementary care will become alternative care.…”

“…In 2007, the Centers for Disease Control and Prevention (CDC) estimated that 11.8% of U.S. children had used some type of CAM therapy in the preceding 12 months, 23 with considerably higher use in children with special health care needs or chronic health conditions. 3,24 Prevalence of CAM use in children with ASD is among the highest of any population, with reported use between 52% and 95%. 1,9,25,26 CAM use for children with ASD has been reported to be elevated in families with higher socioeconomic status, especially when at least one parent has completed a 4-year college degree.…”

“…Evidence must be stratified, based on the likelihood of excluding bias, and producing accurate results, with strongest support for systematic reviews and metaanalyses of randomized controlled trials (RCT) and individual RCTs, followed by well-designed (nonrandomized) controlled and uncontrolled (case-control and cohort) studies, and finally descriptive case reports. 42 When evaluating CAM studies, it is important to note in terms of publishing bias that CAM studies with negative results are more likely to be published in mainstream journals in English, whereas CAM studies with positive results are often published in other languages or in less prestigious journals, 3,43 despite the fact that the quality of randomized controlled trials and meta-analyses of CAM have been equal or superior to the quality of trials for conventional medicine. 44,45 Responsible, ethical, and legally defensible decisions about CAM use can be made through evaluating the evidence that supports the treatment's efficacy and potential for harm or injury and then discussing this evidence with patients in a format that they can understand.…”

Complementary and Conventional Medicine Use Among Youth With Recurrent Headaches

“…45 Based on clinical and populationspecific studies, adolescents most commonly use biologically based dietary approaches (both avoiding dietary triggers and taking dietary supplements) and mind-body practices, many of which can be implemented at costs lower than CAM modalities requiring professional assistance. [46][47][48][49] The efficacy of acupuncture, thermal biofeedback, and hypnosis for children with HA has been documented.…”

Safety, Efficacy, Regulations and Bioethics in Herbal Medicines Research and Practice

“…On the other hand, medical professionals including the clinicians have the task of preventing others from getting harm as a way of ensuring positive beneficence. Moreover, it is expected that the safety and evidence based efficacy of the management strategy has to be determined before they can be applied on the patient [84].…”