Hiding info from pediatricians could be risky for young patients, report authors say
By Alan Mozes
TUESDAY, Aug. 29, 2017 (HealthDay News) -- Parents often try unconventional treatments -- such as acupuncture and herbal products -- when their kids are sick, but many don't tell their pediatricians about it, a new report shows.
Such omissions could be risky, especially when these young patients are already taking traditional medications, the report authors said.
"The point we're making in this report is that many of our young patients are already using these [complementary] therapies," said lead author Dr. Hilary McClafferty. "And much of that use is driven by the consumer, by parents looking for additional help for their children.
"But a lot of parents are not necessarily disclosing this use to their child's pediatrician, for fear of censure or ridicule," McClafferty explained. "That can be a problem, because while we are really excited about some of the advances in the field of complementary medicine and research, it is also important to discuss with parents the need for safety and proper use.
"So, what we are saying here is that it's very important to encourage pediatricians to become well-informed about complementary medicine and about what the research shows. And to discuss all of this openly with parents," McClafferty added.
She is an associate professor at the University of Arizona's Center for Integrative Medicine.
The report was published online Aug. 28 in the journal Pediatrics.
According to federal statistics from 2012, roughly 12 percent of all American children used complementary therapies over the past five years, mostly to treat back and neck pain, head or chest colds, anxiety, stress, musculoskeletal issues, and/or attention-deficit/hyperactivity disorder (ADHD).
That figure rose to more than 50 percent among children struggling with chronic health issues, including epilepsy, migraines, asthma, respiratory illness, celiac disease, and a wide range of stomach and heart disorders.
But while nearly three-quarters of pediatricians surveyed back in 2001 believed they should offer patients information about all available treatments, they admitted having little to no knowledge about complementary medicine, the researchers noted.
As of 2012, just 16 of 143 academic pediatric training programs in the United States offered coursework on such therapies.
That could be a recipe for trouble, the report warned.
For example, because the federal government classifies dietary herbs and supplements as food products rather than as drugs, they do not come under the scrutiny of the U.S. Food and Drug Administration. "And in many areas of supplements, the body of research is still lacking," McClafferty added.
Previous research has found potential benefits with supplements, particularly with fish oil and probiotics. But the new report cautions that the dosage, content and purity of supplements remains questionable, with some products laced with dangerous heavy metals, including lead, mercury and arsenic.
What's more, mixing supplements with prescription meds can trigger toxic interactions, dramatically weakening or strengthening a prescription drug's impact. For example, St. John's wort is often taken to address moderate depression, but it may undermine the effectiveness of oral contraceptives and some heart medications, the study authors said.
Lorenzo Cohen, director of the integrative medicine program at MD Anderson Cancer Center in Houston, agreed that "drug-herbal interactions is a big concern."
And, he added, "with supplements, there is very little quality control. So, what this very well-balanced report is saying is that while acupuncture, meditation and yoga all fall into the category where we know they're safe and there's a good evidence base to support their efficacy, there are complementary treatments for which we don't have good evidence and which may not be safe."
According to Cohen, "Discussing all this needs to be part of the standard of care in terms of dialogues between informed physicians and parents. The days are over where physicians can just say, 'Well, I don't know much about it.' They need to find out, and they need to talk about it with their patients," he stressed.
Visit the U.S. National Center for Complementary and Integrative Health for more on complementary medicine.
SOURCES: Hilary McClafferty, M.D., FAAP, associate professor, department of medicine, Center for Integrative Medicine, College of Medicine, University of Arizona, Tucson; Lorenzo Cohen, Ph.D., director, integrative medicine program, MD Anderson Cancer Center, Houston; Aug. 28, 2017, Pediatrics, online
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