Dec. 23, 2010 - The growing numbers of parents who turn toward complementary and alternative medicine (CAM) to treat their children’s illnesses may often assume that “natural” means safe and harmless.
But new research in the Archives of Childhood Diseases suggests that many complementary and alternative remedies can have significant -- even fatal -- side effects.
Complementary and alternative medicine includes vitamins, herbs, and special diets.
Alissa Lim, MD, a pediatrician at the Royal Children’s Hospital in Melbourne, Australia, and colleagues tracked and analyzed all CAM-related adverse events reported to the Australian Paediatric Surveillance Units from January 2001 through December 2003.
There were 39 reports of such events, including four deaths that occurred among children age from birth to 16 years. The greatest risks were seen among infants who were put on restrictive diets and children with chronic illnesses who were treated with complementary and alternative medicine (CAM) instead of conventional medicine. For example, a child with epilepsy died after being treated with alternative therapies instead of anticonvulsants, the study showed.
“Parents should be aware that, like any other treatments and medicines, adverse effects can be associated with CAM use,” she tells WebMD in an email. “They should talk with their doctor before changing prescribed medications or restricting their child's fluid or diet.”
According to Lim, “the take-home message for families is to be aware of potential side effects from the use of CAM [and] weigh up the benefits and risks of any treatment they use for their children."
Lawrence Rosen, MD, a pediatrician at the Whole Child Center in Oradell, N.J., and chairman of the American Academy of Pediatrics Section on Complementary and Integrative Medicine, says that the types of complementary and alternative medicine used vary from country to country, as to how and when such therapies are used.
Rosen does not think that the new findings apply to the U.S. “Most studies in the U.S. show that the use of these therapies is done in complement to conventional medications, not as an alternative,” he says. Restrictive diets in infants such as those cited in the new report are rarely used here, he says.
What’s more, many of the adverse effects seen in the new report occurred when these therapies were used in lieu of conventional, proven treatments.
“If you have a child with a chronic illness or a complex illness, do not stop conventional therapy to use alternative without discussing it with your physician,” he says.
“Talk to your doctor about everything you give your children,” he says. “Are there going to be adverse events? Yes. Do we need to do a better job monitoring them? Yes.”
Lim agrees that such surveillance is important to get a better handle on the risks associated with these therapies.
Communication About CAM Is Key
John Dorsey, MD, an attending pediatrician at Beaumont Hospital in Royal Oak, Michigan, urges parents to stay in touch with their child’s pediatrician even if they choose to seek care from an alternative medicine provider.
“There could be hazards to what you are doing,” he says. “Collaboration is essential because people may do this on their own and these therapies should be supervised by a conventional doctor.”
“It is absolutely vital that parents and health care providers communicate with one another about the use of CAM,” says Adam Rindfleisch, MD, an assistant professor at the University of Wisconsin in Madison and director of the Academic Integrative Medicine fellowship program there.
“Many parents don't report its use, because they feel either their provider won't be familiar with the forms of treatment they are using, or because they fear criticism,” he says in an email.
But “open communication and trust can go a long way in enhancing the safety of care, be it with CAM approaches, medications, surgery, or any intervention,” he says.
More research is needed, he says. “The body of CAM research is increasing, but very little of this has to do with CAM in children,” he says. “Every treatment -- CAM or otherwise -- can have its dangers in some circumstances.”
“To decide how dangerous it is, we have to ask how dangerous other approaches are as well,” he says. “Medications are not without their side effects, and there is a reason that many parents hesitate when it comes to giving them to children.”
Safe Supplement Use in Kids
Duffy MacKay, ND, vice president of scientific and regulatory affairs at the Council for Responsible Nutrition, a trade association that represents the supplement industry, urges caution in interpreting the new findings, at least as they pertain to dietary supplement use in kids.
“Many supplements are safe when they are used as directed and under the advice of a professional such as a pediatrician or integrative medicine provider,” he says. In terms of avoiding overdose, “treat all home health care products and cleaning products the same way -- lock ‘em up and keep them up high.”