MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

Many homeopaths will tell you that they like to treat children because they respond particularly well to their remedies. This notion is widely promoted and often is the reason why mothers take their kid to homeopath. Some parents even take it for established wisdom. Yet there is a major problem with it:

IT IS NOT TRUE!

A systematic review and meta-analysis investigated the benefits and risks for oral homeopathic remedies used to treat and prevent acute respiratory tract infections (ARTIs) in children. Extensive literature searches were used to identify all double-blinded randomized trials in children, treated with oral homeopathic remedies versus placebo or conventional treatments for ARTI. Studies were reviewed in duplicate for inclusion, data extraction and risk of bias. Meta-analysis was performed on only 4 outcomes. Other outcomes were reported narratively.

Eight studies (1562 children) were included. Four studies examined treatment and 4 prevention of ARTIs. Four studies involved homeopaths individualizing treatment versus four with non-individualized treatments. Three studies had high risk of bias in at least one domain. All studies with low risk of bias showed no benefit from homeopathy; trials at uncertain and high risk of bias reported beneficial effects. Two individualized treatment studies (N=155) did not show benefit on short-term or long-term cure. Prevention trials showed no significant outcomes: recurrence of ARTIs. No serious adverse events were reported.

The authors concluded that the effectiveness for homeopathic remedies for childhood ARTIs is not supported in higher quality trials.

This paper is the up-date of the current Cochrane review which concluded that pooling of two prevention and two treatment studies did not show any benefit of homeopathic medicinal products compared to placebo on recurrence of ARTI or cure rates in children. We found no evidence to support the efficacy of homeopathic medicinal products for ARTIs in children. Adverse events were poorly reported, so conclusions about safety could not be drawn.

And to prevent errors about conditions other than ARTIs, let me remind you of our systematic review of homeopathy for ANY childhood disease. It concluded that the evidence from rigorous clinical trials of any type of therapeutic or preventive intervention testing homeopathy for childhood and adolescence ailments is not convincing enough for recommendations in any condition.

So, next time you hear a homeopath claim that his/her treatments are especially good for kids, be warned: the claim merely supports his/her income but not your child.

 

4 Responses to The claim that homeopathy is effective for children supports the homeopaths’ income but not your kid.

  • There are several reasons why homeopathy appears to work particularly well in children.

    The main reason is that childhood infections are very common, and in virtually all cases resolve quickly, without any residual problems – so any intervention has the appearance of working wonders, homeopathy included.

    Childhood health problems also exhibit an increase in frequency at certain ages/occasions: from 6 months onwards (after the mother’s antibodies wane and the immune system needs to cope on its own), when teething sets in (also usually at 6 – 9 months of age) – which may give the impression of a sickly child with ‘chronic’ belly problems, ear infections etc., in need of treatment. (Homeopaths quite often attribute these health problems to vaccinations …). And again: just a few weeks of ‘treatment’ usually ‘fix’ these problems.
    Later, when a child goes to daycare, and later still to kindergarten, it is again introduced not only to new friends and playmates, but also to a host of new pathogens. And once again, any treatment ‘works wonders’ to overcome the often unexpected ‘sickly period’ …

    Children are also quite susceptible to the placebo effect and positive human attention – mommy’s kiss is quite often the single most effective intervention for small injuries. A lot of friendly attention from a homeopath without chances of anything unpleasant happening (such as with a real doctor) will make a child often feel better quickly.
    And oh, what happens when a child gets administered homeopathic globuli? Yep: you’re giving it candy, as these homeopathic crumbs are 100% sugar. Which makes almost any child instantly happy.

    Even with more problematic, untreatable conditions such as autism, homeopathy can appear to work if administered for a long enough period (months or even years on end) – as almost all children with ASD will still show some progress over the course of a few years.

    In the end, it boils down to nature doing the work, and homeopaths claiming the success … as usual.

  • Edzard, don’t you get tired of making your own show?

    The meta-analysis you put in isn’t new, it’s just a reproduction of a biased review of the Cochrane, page 8:

    “The review was conducted in accordance with the recommendations of the Cochrane Collaboration. 14 This review has been published as a Cochrane systematic review: Cochrane Database of Systematic Reviews 2018, Issue 9. Art. No.: CD005974.”

    It is not clear why they republished it in a magazine, except that is obvious a thing: the authors are so desperate for the increased use of over-the-counter homeopathy, especially in respiratory problems. The review was debunked by an statician:

    Hawke et al (Cochrane 2018), concluding: “There is insufficient evidence from two pooled individualised treatment studies (N = 155) to determine the effect of homeopathy on short-term cure (OR 1.31, 95% CI 0.09 to 19.54; very low-quality evidence) and long-term cure rates (OR 1.01, 95% CI 0.10 to 9.96; very low-quality evidence).” It appears that meta-analysis of eight trials renders a statistically significant positive effect. Is this evidence corroborated by the remaining evidence for homeopathy? Shang/Egger stated it is not, because of “the biases that are prevalent in these publications, as shown by our study”. However, their study showed higher quality of homeopathy trials (19% higher quality versus 8% for conventional trials). There is only a vague hint of “weak evidence” for homeopathy in ‘larger higher quality trials’ based on an undisclosed subset of eight trials. After disclosure of the missing information this subset appeared to be highly heterogeneous regarding indications, the outcome heavily depending on only one of the eight indications, the for daily practice irrelevant indication ‘muscle soreness after marathon running’. Reconsidering the 21 higher quality trials selected by Shang, disregarding ‘muscle soreness’, it appeared that the whole body of 21 higher quality trials for homeopathy demonstrated a statistically significant positive effect, even if only larger (than median) higher quality trials were considered. [22] What happened here is the opposite of the usual review process: evidence in a subset should be corroborated by evidence in the totality of proof. In the case of homeopathy the totality of evidence in RTI is discredited by small subsets.

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