CAM in Pediatrics
The use of complementary and alternative medical (CAM) therapies in children is less well-studied and researched than in adults. Perhaps this is because children have fewer chronic illnesses and their parents are reluctant to use unproven remedies on them. An excellent book on the topic is “The Holistic Pediatrician” by Kathi Kemper MD; a physician who is residency trained in pediatrics and has taught at the University of Washington School of Medicine. Much of this information is from her book. She takes a very pragmatic approach and only recommends treatments that have some evidence for effectiveness and safety.
Holistic medicine is an approach that considers all the parts of a human being – physical, emotional, mental and spiritual. Disease can be caused by a combination of factors and never occurs as an isolated happening. Our food, lifestyle, family, friends, school, job and environment all have an impact on our health and well-being. Dr. Kemper uses a model based on the imagery of a therapeutic mountain. The summit of the mountain represents optimal health and the four sides are different approaches to achieve that goal. The side with biochemical therapies includes medication, herbs and nutritional supplements. Use of herbs in children has not been studied much so caution is in order. Using herbs known to be safe in adults and in low doses is prudent. Many chronic illnesses of children require supplementation of various vitamins, minerals and supplements. A practitioner with experience treating children is your best guide.
The side with biomechanical therapies includes massage, physical therapy, spinal manipulation (chiropractic and osteopathic), and surgery. Massage in definitely indicated in infants and children because it is safe and effective when done properly. Physical therapy is usually done for injuries of the muculoskeletal system and is really a mainstream treatment. Spinal manipulation has proven effective in clinical studies of many adult problems but research in children is very limited. Surgery in children is best performed by a surgeon with two extra years of training in pediatric surgery.
The side of the mountain with bioenergetic therapies includes acupuncture, homeopathy, prayer, Therapeutic Touch, Healing Touch, Reiki, Qi Gong, and laying on of hands. Studies in children using acupuncture are limited but when done by a licensed acupuncturist or well trained Medical Doctor, it is safe and may be effective in a variety of disorders. Homeopathy is a system of healing widely used in Europe and it is quite safe since the remedies used are very dilute solutions of different substances. It takes a lot of skill and training to choose the proper remedy so seek out a practitioner with a license and training credentials if you intend to trust your child’s health to them. Reiki, Therapeutic Touch and other purely energetic treatments use the healer as a conduit to channel subtle energy into the patient. A small amount of research has been done that shows these methods have a positive effect on general well-being. The degree of training each of these modalities differs widely so ask a practitioner about their training. Prayer as a healing modality has been studied recently and studies show a significant positive benefit, even to people in intensive care who did not know they were being prayed for.
The last side includes nutrition, exercise, environment and mind-body therapies. These are all mainstream treatments except physicians still often overlook the mind-body connection. Meditation, hypnosis, biofeedback and relaxation techniques are all very useful in children. Many of their chronic complaints are due to emotional distress and family dysfunction.
A trusted family physician or pediatrician who is knowledgeable about CAM therapies is a good initial resource to consult when your child is not responding to standard treatments or if you prefer to use alternative therapy as the initial treatment. A thorough evaluation by a licensed medical doctor is a good idea to rule out more serious medical conditions before embarking on a prolonged trial of alternatives.
Daniel Blodgett MD