MD, PhD, FMedSci, FSB, FRCP, FRCPEd

Alternative medicine has the image of being gentle and risk-free; it is therefore frequently used for children. German experts have just published an important article on this rather controversial topic.

They performed a systematic synthesis of all Cochrane reviews in paediatrics assessing the efficacy, clinical implications and limitations of alternative medicine use in children. The main outcome variables were: percentage of reviews concluding that a certain intervention provides a benefit, percentage of reviews concluding that a certain intervention should not be performed, and percentage of studies concluding that the current level of evidence is inconclusive. A total of 135 reviews were included – most from the United Kingdom (29), Australia (24) and China (24). Only 5 (3.7%) reviews gave a recommendation in favour of a certain intervention; 26 (19.4%) issued a conditional positive recommendation. The 5 positive recommendations were:

1) Calcium supplements during pregnancy for prevention of hypertension and related conditions

2) Creatinine supplements for treating muscular disorders

3) Zinc supplements for prevention of pneumonia

4) Probiotics for prevention of upper respiratory infections

5) Acupuncture for prevention of post-operative nausea and vomiting

Nine (6.6%) reviews concluded that certain interventions should not be performed. Ninety-five reviews (70.3%) were inconclusive. The proportion of inconclusive reviews increased over time. The three most common criticisms of the quality of the primary studies included were: more research needed (82), low methodological quality (57) and small number of study participants (48).

The authors concluded: Given the disproportionate number of inconclusive reviews, there is an ongoing need for high quality research to assess the potential role of CAM in children. Unless the study of CAM is performed to the same science-based standards as conventional therapies, CAM therapies risk being perpetually marginalised by mainstream medicine.

As it happens, we published a very similar review two years ago. At the time (and using slightly different inclusion criteria), we identified a total of 17 systematic reviews. They related to acupuncture, chiropractic, herbal medicine, homeopathy, hypnotherapy, massage and yoga. Results were unconvincing for most conditions, but there was some evidence to suggest that acupuncture may be effective for postoperative nausea and vomiting, and that hypnotherapy may be effective in reducing procedure-related pain. Most of the reviews failed to mention the incidence of adverse effects of the alternative treatments in question. Our conclusions were as follows: “Although there is some encouraging evidence for hypnosis, herbal medicine and acupuncture, there is insufficient evidence to suggest that other CAMs are effective for the treatment of childhood conditions. Many of the systematic reviews included in this overview were of low quality, as were the randomised clinical trials within those reviews, further reducing the weight of that evidence. Future research in CAM for children should conform to the reporting standards outlined in the CONSORT and PRISMA guidelines.”

Treating children with unproven or dis-proven therapies is even more problematic than treating adults in this way. The main reason is that children cannot give informed consent. Thus alternative medicine for children can open difficult ethical questions, and sometimes I wonder where the line is between the application of bogus treatments and child-abuse. Examples are parents who opt for homeopathic vaccinations instead of conventional ones, or paediatric cancer patients who are being treated with bogus alternatives such as laetrile.

Why would parents not want the most effective therapy for their children? Why would anyone opt for dubious alternatives? The main reason, I think, must be misinformation. Parents who use alternative medicine are convinced they are effective and safe because they have been misinformed. We only need to google ALTERNATIVE MEDICINE to see for ourselves what utter nonsense and dangerous rubbish is being promoted under this umbrella.

Misinformation is the foremost reason why well-meaning parents (mis-) treat their children with alternative medicine. The results can be disastrous. Misinformation can kill!

14 Responses to Alternative medicine for kids: when is it child-abuse?

  • Unfortunately the amount of misinformation seems to far exceed available valid information. Often it is presented in clear, easy to understand messages. It is a great advantage to be able to employ imagination unencumbered by facts or science. This is often the standard for people advertising a product. One would expect higher standards from, ethics boards approving studies of questionable treatments on children. Unfortunately it is not just the general public that has been taken in by CAM misinformation. It would be nice to see some accountability. Sadly when it comes to CAM there usually is none.

    • uncritical thinking, it seems to me, is not just easier than critical thinking, in the realm of alt med, it also is more lucrative, more trendy, more “patient-centred” and it might even get you a gong, if you are really good at it.

  • Gan Mao Ling for cold. Yin Qiao and or Guna Flu for flu. Arnica Montana for bruising. Acupuncture for any number of reasons from tension and stress to pain relief from chronic injuries to immediate pain relief of injuries.

    And the list goes on.

    Sort of funny how my wife and I have the healthiest and most intelligent child of any of my friends or any of the people we know—by leaps and bounds—and all of our friends needed Western medicine to even get pregnant. We gave birth at home, in a spa tub with only a singoe midwife in the entire house with us. Our child has never knowingly or wittingly eaten any GMO product or any non organic foods–her entire life now at 5. It is not easy to do.

    No vaccines, no Western meds AND OUR DAUGHTER IS HEALTHIER THAN ANY KID YOU WAMT TO MEASURE HER AGAINST.

    PUT YOUR MONEY WHERE YOUR MOUTH IS AND LET’S GET THE TESTS DONE RIGHT NOW ON THIS TEST SUBJECT COMPARED TO ANY AND ALL OF YOUR SUPPOSEDLY HEALTHY VACCINE CONCOCTED, WESTERN MEDICINE (BANDAID) FED MEDICINE, GMO FED FREAKS YOU CAN MUSTER.

    MY CHILD COMPARED TO ANY PERSON ON THIS PLANET THAT FITS YOUR IGNORANT MODEL OF PERFECTION.

    SO, TELL ME WHERE TO BE OR SHUT UP.

    • I take it you don’t like vaccinations very much!
      not surprised at all that your kid is the most intelligent around – with such a father!!!

  • Btw, what is “proven”about requiring 6month old children to get vaccinated?

    Oh yeah, we want to absolve parental responsibility by making it acceptable, and so-called “safe”, for them to drop their kids into a pool of other kids. The cess of which requires of us to inject into such tiny little bodies, unformed as of yet and unable to handle the toxic soup of drugs cobbled together in order to allow…government to take care of our kids, and us for the rest of our lives.

    Thank you edzard ernst for being the lapdog to big government.

    • I guess you have no idea how wrong you are with me being pro BIG G.

      • No answer to why a 6 month old should be forced to have a cocktails of disease injected into their bodies…and for what reason?—in order to make them able to be around all of the other babies of all of those responsibility free parents dropping their 1 year olds off at the head start program.

        Nope…no big government in your bones whatsoever.

      • Please answer….why 6 months old? Why cant you wait until these kids are 5 or 6 years old?

        Do you have any science on the fragility of a 6 month old babies immunity?

  • Since your “95% of all alternative medicine is bunk” keeps being bandied about and the only reference is to some long lost magazine article. I wonder if you could be a dove and do publish some interesting expose on that percentage.

    I would love to know, particularly, how you have fractioned the 100% into the various forms of alternative medicines and what part of the whole does acupuncture and herbal medicne (TCM) takes of the whole whereby you render up to 5% of the whole as having any value.

    Do the science behind your specious and oft cited claim.

    • the 5% figure originates from counting which alt med is evidence-based for which condition as reviewed in one of our books . it is almost certainly an over-estimation because, for our book, we selected the most encouraging topics. I estimate the true figure to be less than 1%, but this is purely an estimate.

  • So, you are guessing as to the efficacy of acupuncture which certainly bears a large proportion of the total into alternative medicine.

    You suppose that only 1% of ALL alternative medicine has any value thereby determining that 99% is “total bunk”.

    I have only one reference to your stated “scientific” conclusion, that being a stale magazine article. Kindly show me the book reference now.

    Now, for over 5, 000 years, countless billions of Chinese-amongst others-have all been being fed snake oil?

    What is empirical if not founded in fact and observation? What is science if it is not empirical?

    Oh I guess it is guessing at figures of 1% or even 5% without quantifying or naming anything.

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