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Complementary therapies and children

Hope springs eternal in the human breast. It is understandable that families resort to complementary and alternative therapies (CAM) when and where conventional medicine appears to offer little. Gastro-oesophageal reflux and constipation are generally regarded as self-limiting conditions usually of nuisance value by gastroenterologists, and the therapies prescribed are palliative and served up with lashings of reassurance. In this context, it is both natural and not surprising that parents, especially mothers, desire to speed things up and seek assistance elsewhere. Complementary medicine has been with us since primitive times and despite the railings of doctors, community acceptance of these therapies has never been more robust. In this issue of the Journal Andrew Day describes the use of complementary and alternative therapies and probiotic agents in 92 children attending gastroenterology outpatients at Sydney Children’s Hospital. 1 A questionnaire explored the use of five specific therapies and asked about whether patients had been receiving others. Thirty-six per cent of children were either using a complementary therapy or had recently used a complementary therapy. Given that 78% of parents said they were happy to administer alternative therapies if they thought benefit would result, it is quite likely that the lifetime exposure to CAM in these children is much higher than the 36% reported. These figures are very similar to the 41% reported to use CAM in an Anglo-American study in paediatric inflammatory bowel disease clinics. 2 In this study, only 6% used probiotics, as opposed to 22.3% in the Australian study. This difference is surprising, particularly as probiotics have been reported to be beneficial in inflammatory bowel disease. 3 The three previous studies of CAM in Australian children have all been small and disease-specific. Studies in asthmatic children and oncology patients in Adelaide showed a 55% and 46% prevalence of use, respectively, and a study of attention deficit hyperactivity disorder (ADHD) children from Western Australia showed a usage prevalence of 64%. 4–6 These figures are similar to those shown in the adult population in the South Australian Health Omnibus Survey, where 48.5% of South Australians over the age of 15 had used at least one CAM. 7