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More and more, I have families in my practice who are trying out treatments and therapies I didn’t prescribe. Most of the time, it’s absolutely fine. Other times, it’s not.
“Complementary and alternative medicine” is a broad term that refers to treatments that are not generally part of traditional Western medicine. It includes things like herbal remedies, dietary supplements or alternative diets, acupuncture, acupressure, homeopathy, Chinese remedies, Reiki, or hypnosis. It also includes things like yoga or meditation — and chiropractic medicine.
Many of these therapies have become increasingly mainstream. In fact, more than one in 10 US children, and more than half of US children with chronic medical conditions, have used them. As use of these therapies grows, often fueled by what people read on the Internet and social media, it’s important that people get informed and educated, especially if they are going to use them on their children. That’s why the American Academy of Pediatrics (AAP) published a report entitled “Pediatric Integrative Medicine” in the journal Pediatrics.
Here are three things all parents should know about complementary and alternative medicine:
1. Many of them are very useful. It’s not as if Western medicine has the corner on all medical knowledge. Some of these therapies, like acupuncture, have been around for literally thousands of years. The more we study these therapies, the more we learn about the ways they can be helpful. Acupuncture can be very helpful for chronic pain. Probiotics can help fight diarrhea, and docosahexaenoic acid (DHA) found in fish oil helps fetal brain development and may help children with attention problems. Yoga has been found to help youth with attention problems also, as well as those with asthma or irritable bowel syndrome. Our understanding of health and medicine is expanding, and many physicians routinely recommend many therapies that used to be dismissed. But there is a problem…
2. Most of them are poorly regulated. For a drug to be licensed for sale, it has to go through extensive testing. The same is not true of herbal, vitamin, or other “alternative” treatments. Because they are classified as “food” rather than medicine, they aren’t tested or regulated anywhere near as carefully, and they don’t have to prove their claims. If you buy an herbal remedy or a dietary supplement, you have absolutely no way of knowing everything that is in it (some have been found to include dangerous ingredients like lead or arsenic), and no way of knowing if it will do what the manufacturer says it will.
This is also true of practitioners. To be licensed as a doctor or nurse, you have to go to an accredited program, pass national examinations, and prove ongoing competency. That isn’t necessarily the case with many who practice alternative medicine. While there are some licensing boards and ways that practitioners can be accredited, there is currently no comprehensive way to ensure quality of care.
Western medicine also has a tradition of ongoing self-examination, of doing studies to be sure that treatments work and are safe, and an infrastructure to support that tradition. While there have been, and continue to be, many studies of complementary and alternative medicine, there is nowhere near the same tradition and infrastructure. This is something the AAP says needs to change. This is not to say that there aren’t excellent practitioners and excellent treatments. It’s just that it’s much harder to know if the person treating you or your child has the right training and skills and if the treatment is safe, let alone helpful for the condition. Which is why…
3. Parents need to do their homework — and talk to their child’s doctor — before using complementary or alternative medicine with their children. Before you try any treatment, learn about it. The National Center for Complementary and Integrative Health, part of the National Institutes of Health, is a great resource to learn about complementary and alternative medicine and specific treatments. It’s also really important to talk to your doctor. It’s important to be sure that what you are doing won’t interfere with any other treatment. For example, St. John’s wort, an herb that is commonly used to treat depression, can interact or interfere with many commonly prescribed medications. It’s important to check with your doctor to be sure that what you are doing is safe for your child’s particular condition or situation.
Most of all, it’s important that your doctor know about your concerns for your child and why you want to use the treatments in the first place. If you are worried about your child’s growth or appetite, for example, let your doctor be sure there isn’t something more serious going on before you use dietary supplements. While doctors may not know everything about nontraditional treatments (the AAP report says doctors need more education about them), we care very much about your child’s health and want very much to work with you to find all the ways to get and keep your child healthy and happy.