Source: the New York Times December 11, 2008
Many Children Now Rely on Alternative Remedies
By RONI CARYN RABIN
One of every nine children under age 18 practices yoga, goes to a chiropractor, takes a supplement like fish oil or uses some other alternative treatment, according to a new government survey that for the first time included questions regarding children’s use of complementary medicine.
Natural, non-vitamin products are the most common alternative therapies used by children, with almost 4 percent taking a supplement like echinacea, fish oil, flaxseed oil, herb pills, prebiotics or probiotics, according to the survey, conducted by the National Center for Complementary and Alternative Medicine.
Almost 3 percent of children see a chiropractor or an osteopath for manipulation, 2.2 percent do deep breathing exercises and 2.1 percent do yoga.
“It’s a substantial amount of use in children, given that children tend to be healthier than the adult population,” said Richard L. Nahin, acting director of the center’s division of extramural research and co-author of the report.
But some experts say the figures may be even higher and that as many as 40 percent of healthy children and more than 50 percent of children with chronic health conditions are using alternative therapies.
Dr. Lawrence D. Rosen, a pediatrician who has also researched use of these therapies by children said the survey results may depend on how questions were asked and how alternative therapy is defined.
“This is a wake-up call,” said Dr. Rosen, who practices integrative medicine in Oradell, N.J. “The main thing pediatricians and patients need to recognize is that we all need to be talking about this. Parents need to be comfortable discussing it, and pediatricians need to feel comfortable bringing it up.”
The survey’s findings will help shape research initiatives, Mr. Nahin said, adding that many products, especially dietary supplements, have not been rigorously tested in clinical trials in adults or children even as their use has become more widespread.
“In most cases, there is no clear recommendation one can make whether a child should use a product or not,” Mr. Nahin said. The survey results are based on data from more than 23,000 interviews with American adults and more than 9,400 interviews with adults on behalf of children in their households. The survey was conducted in 2007 as part of the annual National Health Interview Survey.
It included questions about 36 common alternative therapies, including 10 that are provider-based, like chiropractic care, and 26 that do not require a provider, such as meditation. The last such survey of adult use of alternative therapies was conducted in 2002.
Use of complementary therapies among adults has remained fairly steady in recent years, with 38 percent of adults using some form of alternative medicine in 2007, up from 36 percent in 2002.
But while adults tend to rely on alternative therapies for chronic conditions like back or neck pain, children more often use them for both chronic problems, like attention deficit hyperactivity disorder, and acute illnesses, like headaches and colds.
Adult use of complementary medicines for colds appears to have dropped significantly, to 2 percent in 2007 from 9.5 percent in 2002, while use of yoga, massage, acupuncture, meditation, deep breathing exercises and naturopathy has increased.
The single most influential factor driving children’s adoption of alternative therapies appears to be whether their parents also use them. Children whose parents or relatives use alternative therapies are five times more likely to use them than children whose parents do not.
Teens were more likely to use alternative therapies than younger children, with 16.4 percent of adolescents ages 12 to 17 using these therapies, compared with 10.7 percent of children ages 5 to 11 and 7.6 percent of children ages 4 or younger. White children were twice as likely as black children to use alternative therapies, the survey found.
But the lines separating the therapies considered mainstream from those considered alternative is constantly shifting, said Dr. Kathi Kemper, chair of the American Academy of Pediatrics section for complementary and integrative medicine and a professor of pediatrics at Wake Forest University in Winston-Salem, N.C.
“They included fish oil in this survey, but I’ve been asking psychiatrists if they use fish oil and it looks like 80 percent of psychiatrists are recommending it, as are cardiologists,” Dr. Kemper said. Massage for newborns, hypnosis and acupuncture for pain are also going mainstream, she added.