Skip to main content

Advertisement

SpringerLink
Log in

Patterns and perceptions of complementary/alternative medicine among paediatricians and patients' mothers: a review of the literature

  • Review
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

For many families and their children, the use of complementary/alternative medicine (CAM) is an accepted adjunct or alternative to conventional therapy, even if data available in the literature regarding risks and adverse drug reactions (ADRs) pertaining to childhood populations are scarce. Moreover, despite widespread and increasing use of CAM, there are limited data on how paediatricians communicate with mothers and/or patients about CAM. Therefore, we report the studies available in the literature in the paediatric field and summarise what is known about ADRs and risks of CAM, taking into account in particular problems related to interactions between phytotherapy and conventional medicines and to counselling. Conclusion:from the analysis of the literature, some interesting aspects emerge: (1) the extent of CAM use in the paediatric field is increasingly sought by parents of children with chronic illnesses; (2) most parents who choose CAM medicine for their children believe that these therapies are "natural" and thus "safe" and (3) physicians often feel to know too little about CAM and wish to learn more for different reasons including "to dissuade whether the alternative method is unsafe and/or ineffective". Therefore, paediatricians should be prepared to discuss alternative therapies with parents, since talking about CAM may help to minimise the risks and to restrain parental misconceptions and doubts. Educational interventions for parents should also be performed to bring about a more aware use of traditional and alternative medicines.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

ADR :

adverse drug reaction

CAM :

complementary/alternative medicine

References

  1. Abebe W (2002) Herbal medication: potential for adverse interactions with analgesic drugs. J Clin Pharm Ther 27: 391–401

    Article  CAS  PubMed  Google Scholar 

  2. Andrews L, Lokuge S, Sawyer M, Lillywhite L, Kennedy D, Martin J (1998) The use of alternative therapies by children with asthma: a brief report. J Pediatr Child Health 34: 131–134

    CAS  Google Scholar 

  3. Anonymous (1986) Pancreatitis following ingestion of a homeopathic preparation. N Engl J Med 314: 1642

    Google Scholar 

  4. Anonymous (1994) Quincke's oedem bij gebruik van oester-extract in Ostrin plus GTZ 611. Gebu Prikbord 28: 67

    Google Scholar 

  5. Anonymous (1995) Propolis-recalled because of lead contamination. WHO Pharm Newslett 1: 3

    Google Scholar 

  6. Armishaw J, Grant CC (1999) Use of complementary treatment by those hospitalised with acute illness. Arch Dis Child 81: 133–137

    CAS  PubMed  Google Scholar 

  7. Awang DVC (1991) Maternal use of ginseng and neonatal androgenization. JAMA 266: 363

    CAS  Google Scholar 

  8. Bakerink JA, Gospe SM, Dimand RJ, Eldridge MW (1996) Multiple organ failure after ingestion of pennyroyal oil from herbal tea in two infants. Pediatrics 98: 944–947

    CAS  PubMed  Google Scholar 

  9. Bensoussan A (1999) Complementary medicine. Where lies its appeal? Med J Aust 170: 247–248

    CAS  PubMed  Google Scholar 

  10. Bouraoui A, Toumi A, Bouchacha S, Boukef K, Brazier JL (1986) Influence de l'alimentation epicee et piquante sur l'asorption de la theophylline. Therapie 41: 467–471

    CAS  PubMed  Google Scholar 

  11. But PPH (1994) Herbal poisoning caused by adulterants or erroneous substitutes. J Trop Med Hyg 97:371–374

    CAS  Google Scholar 

  12. Canduela V, Mongil I, Carrascosa M, Docio S, Cagisgas P (1995) Garlic: always good for the health? (letter). Br J Dermatol 132: 161–162

    CAS  PubMed  Google Scholar 

  13. Chavis L (2001) Pharmacy-based consulting on dietary supplements. J Am Pharm Assoc 41: 181–191

    CAS  Google Scholar 

  14. Chen MF, Shimada F, Kato H, Yano S, Kanaoka M (1991) Effect of oral administration of glycyrrhizin on the pharmacokinetics of prednisolone. Endocrinol Jpn 38: 167–175

    CAS  PubMed  Google Scholar 

  15. Chow RC (2000) Complementary medicine impact on medical practice. Curr Ther 7: 77–79

    Google Scholar 

  16. Clark RF, Strukle E, Williams SR, Manoguerra AS (1996) Selenium poisoning from a nutritional supplement. JAMA 275: 1087–1088

    CAS  Google Scholar 

  17. Corbin-Winslow L, Shapiro H (2002) Physicians want education about complementary and alternative medicine to enhance communication with their parents. Arch Intern Med 162: 1176–1181

    Article  PubMed  Google Scholar 

  18. D'Arcy PF (1994) l -Tryptophan (Optimax): limited availability for resistant depression. Int Pharm J 8: 56

    Google Scholar 

  19. Day AS (2002) Use of complementary and alternative therapies and probiotic agents by children attending gastroenterology outpatient clinics. J Pediatr Child Health 38: 343–346

    Article  CAS  Google Scholar 

  20. De Smet PAGM (1992) Giftige metalen in homeopathische preparaten. Pharm Weekbl 127: 125–126

    Google Scholar 

  21. De Smet PAGM (1995) Health risks of herbal remedies. Drug Saf 13: 81–93

    PubMed  Google Scholar 

  22. Dietary Supplement Health and Education Act (1994) Publication nr. 103–417, 108 Stat 4325

  23. Donnelly WJ, Spykerboer JE, Thong YH (1985) Are patients who use alternative medicine dissatisfied with orthodox medicine? Med J Aust 142: 539–541

    CAS  PubMed  Google Scholar 

  24. Eisenberg DM (1997) Advising patients who seek alternative medical therapies. Ann Int Med 127: 61–69

    CAS  Google Scholar 

  25. Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL (1993) Unconventional medicine in the United States. N Engl J Med 328: 246–252

    CAS  PubMed  Google Scholar 

  26. Ernst E (1995) The risks of acupuncture. Int J Risk Safety Med 6: 179–186

    Google Scholar 

  27. Ernst E (1999) Prevalence of complementary/alternative medicine for children: a systematic review. Eur J Pediatr 158: 7-11

    CAS  PubMed  Google Scholar 

  28. Ernst E (2000) Risks associated with complementary therapies. In: Dukes MNG, Aronson JK (eds) Meyler's side effects of drugs, 14th edition. Elsevier, Amsterdam, pp 1649–1681

  29. Ernst E, De Smet PAGM (1996) Risks associated with complementary therapies. In: Duke MNG (ed) Meyler's side effects of drugs, 13th edition. Elsevier Science, Amsterdam, pp 1427–1454

  30. Ernst E, Dixon M (1997) Talking about the alternatives. Update 7 May: 632–634

    Google Scholar 

  31. Ernst E, White A (2000) The BBC survey of complementary medicine use in UK. Complement Ther Med 8: 32–36

    CAS  PubMed  Google Scholar 

  32. Ernst E, Resch KL, Mills S, Hill R, Mitchell A, Willoughby M, White A (1995) Complementary medicine – a definition. Br J Gen Pract 45: 506

    PubMed  Google Scholar 

  33. Ernst E, Resch KL, White AR (1995) Complementary medicine. What physicians think of it: a meta-analysis. Arch Int Med 155: 2405–2408

    Article  CAS  Google Scholar 

  34. Fisher P, Ward A (1994) Medicine in Europe: complementary medicine in Europe. BMJ 309: 107–111

    CAS  PubMed  Google Scholar 

  35. Fugh-Berman A (2000) Herb-drug interactions. Lancet 355: 134–138

    CAS  PubMed  Google Scholar 

  36. Fusco F, Sambugaro D, Bozzetti R (1998) La mamma colta sceglie una strada alternativa. Occhio Clinico Pediatria 9: 24–26

    Google Scholar 

  37. Garty B (1993) Garlic burns. Pediatrics 91: 658–659

    CAS  PubMed  Google Scholar 

  38. Goldbeck-Wood S, Dorozynski A, Lie LG, Yamauchi M, Zinn C, Josefson D, Ingram M (1996) Complementary medicine is booming worldwide. BMJ 313: 131–133

    PubMed  Google Scholar 

  39. Gordon J (1998) SSRIs and St John's wort: possible toxicity? Am Fam Phys 57: 950–953

    CAS  Google Scholar 

  40. Haines AP, Sanders TAB, Imerson JD (1986) Effects of fish oil supplement on platelet function, homeostatic variables and albuminuria in insulin-dependent diabetics. Thromb Res 43: 643–655

    CAS  PubMed  Google Scholar 

  41. Hernandez-Reif M, Field T, Krasnegor J, Martinez E, Schwartzman M, Mavunda K (1999) Children with cystic fibrosis benefit from massage therapy. J Pediatr Psychol 24: 175–181

    Article  CAS  PubMed  Google Scholar 

  42. Heuschkel R, Afzal N, Wuerth A, Zurakowski D, Leichtner A, Kemper K, Tolia V, Bousvaros A (2002) Complementary medicine use in children and young adults with inflammatory bowel disease. Am J Gastroenterol 97: 382–388

    Article  PubMed  Google Scholar 

  43. Horowitz RS, Gomez H, Moore LL, Fulton B, Feldhaus K, Brent J, Stermitz FR, Beck JJ, Alessi JR, De Smet PAGM (1993) Jin Bu Huan toxicity in children. Colorado 1993. Mor Mortal Wkly Rep 42: 633–636

    Google Scholar 

  44. Huang WF, Wen KC, Hsiao ML (1997) Adulteration by synthetic therapeutic substances of traditional Chinese medicines in Taiwan. J Clin Pharmacol 37: 344–350

    Google Scholar 

  45. Hylck EM, Heiman H, Skates SJ, Sheehan MA, Singer DE (1998) Acetaminophen and other risk factors for excessive warfarin anticoagulation. JAMA 279: 657–662

    CAS  PubMed  Google Scholar 

  46. Karliova M, Treichel U, Malago M, Frilling A, Gerken G, Broelsch CE (2000) Interaction of Hypericum perforatum (St John's wort) with cyclosporine A metabolism in a patient after liver transplantation. J Hepatol 33: 853–855

    Article  CAS  PubMed  Google Scholar 

  47. Kerr HD, Saryan LA (1986) Arsenic content of homeopathic medicines. Clin Toxicol 24: 451–459

    CAS  Google Scholar 

  48. Ko RJ (1998) Adulterants in Asian patent medicines. N Engl J Med 339: 847

    Article  CAS  Google Scholar 

  49. Koopman H (1937) Tödliche Schöllkraut-Vergiftung ( Chelidonium majus). Vergiftungsf lle 8: 93–98

    Google Scholar 

  50. Lewis T (2001) Dear health professional colleague-letter. Rockville, MD: US Food and Drug Administration. Available from:http://www.fda.org/medwatch/safety/2001/kava.htm

    Google Scholar 

  51. Lininger SW, Gaby AR, Batz F, Yarnell E, Brown DJ, Constantine G (1999) A-Z guide to drug-herb-vitamin interactions. Prima Publishing, Rockline

  52. MacLennan AH, Wilson DH, Taylor AW (1996) Prevalence and cost of alternative medicine in Australia. Lancet 347: 569–573

    CAS  PubMed  Google Scholar 

  53. Mangione-Smith R, McGlynn EA, Elliott MN, Krogstad P, Brook RH (1999) The relationship between perceived parental expectations and pediatrician antimicrobial prescribing behavior. Pediatrics 103: 711–718

    CAS  PubMed  Google Scholar 

  54. Mason S, Tovey P, Long AF (2002) Evaluating complementary medicine: methodological challenges of randomised controlled trials. BMJ 325: 832–834

    Article  PubMed  Google Scholar 

  55. Menniti-Ippolito F, Gargiulo L, Bologna E, Forcella E, Raschetti R (2002) Use of unconventional medicine in Italy: a nation-wide survey. Eur J Clin Pharmacol 58: 61–64

    Google Scholar 

  56. Miller LG (1998) Herbal medicinals: selected clinical considerations focusing on potential herb-drug interactions. Arch Int Med 158: 2200–2211

    Article  CAS  Google Scholar 

  57. Miller LG, Hume A, Harris IM, Jackson EA, Kanmaz TJ, Cauffield JS, Chin TW, Knell M (2000) White paper on herbal products. Am Coll Clin Pharm Pharmacother 20: 877–891

    CAS  Google Scholar 

  58. Nebel A, Schneider BJ, Baker RK, Kroll DJ (1999) Potential metabolic interaction between St. John's wort and theophylline. Ann Pharmacother 33: 502

    CAS  PubMed  Google Scholar 

  59. Oepen I (1983) Kritische Argumente zur Homoopathie. Dtsch Apoth Ztg 123: 1105

    Google Scholar 

  60. Roulet M, Laurini R, Rivier L, Calame A (1988) Hepatic veno-occlusive disease in a newborn infant of a woman drinking herbal tea. J Pediatr 112: 433–436

    CAS  PubMed  Google Scholar 

  61. Rowin J, Lewis SL (1997) Spontaneous bilateral subdural hematomas associated with chronic Gingko biloba ingestion. Neurology 48: 1775–1776

    Google Scholar 

  62. Shenfield G, Lim E, Allen H (2002) Survey of the use of complementary medicines and therapies in children with asthma. J Pediatr Child Health 38: 252–257

    Article  CAS  Google Scholar 

  63. Sibinga E, Ottolini M, Duggan A, Wilson M (2000) Communication about complementary/alternative medicine use in children. Pediatr Res 47: 226A

    Google Scholar 

  64. Simpson N, Roman K (2001) Complementary medicine use in children: extent and reasons. A population-based study. Br J Gen Pract 51: 914–916

    CAS  PubMed  Google Scholar 

  65. Sorisky A, Robbins DC (1989) Fish oil and diabetes. The net effect. Diabetes Care 12:302–304

    CAS  PubMed  Google Scholar 

  66. Southwood TR, Malleson PN, Roberts-Thomson PJ, Mahy M (1990) Unconventional remedies used for patients with juvenile arthritis. Pediatrics 85: 150–154

    CAS  PubMed  Google Scholar 

  67. Spigelblatt LS, Laine-Ammara G, Pless IB, Guyver A (1994) The use of alternative medicine by children. Pediatrics 94: 811–814

    CAS  PubMed  Google Scholar 

  68. Taylor RFH, Al-Jarad N, John LME (1992) Betel-nut chewing and asthma. Lancet 339: 1134–1136

    CAS  PubMed  Google Scholar 

  69. Thompson RJ, Gustafson KE, Hamlett KW, Spock A (1992) Psychological adjustment of children with cystic fibrosis: the role of child cognitive processes and maternal adjustment. J Pediatr Psychol 17: 741–755

    PubMed  Google Scholar 

  70. Trapani G, Barbato C, Zanino L, Del Giudice A, Liverani A (2002) Uso delle medicine non convenzionali nella popolazione pediatrica dell'Italia nord-occidentale. Available from:http://www.smbitalia.org/ricercaepidemio.html

    Google Scholar 

  71. Vaes LPJ, Chyka RA (2000) Interactions of warfarin with garlic, ginger, gingko or ginseng: nature of the evidence. Ann Pharmacother 34: 478–482

    Article  Google Scholar 

  72. Westendorf J (1992) Anthranoid derivatives – general discussion. In: De Smet PAGM, Keller K, Hansel R, Chandler RF (eds) Adverse effects of herbal drugs, vol. 2. Springer, Heidelberg Berlin New York, pp 105–108

Download references

Author information

Authors and Affiliations

  1. Department of Medicine and Public Health, Section of Pharmacology, University of Verona, Policlinico G.B. Rossi, P.le LA Scuro 10, 37134, Verona, Italy

    Laura Cuzzolin, Silvana Zaffani & Giuseppina Benoni

  2. CESPER, Centre for Research Study and Education of Family Paediatricians, University of Verona, Verona, Italy

    Vitalia Murgia, Michele Gangemi, Giorgio Meneghelli & Giampietro Chiamenti

Authors
  1. Laura Cuzzolin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Silvana Zaffani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Vitalia Murgia
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michele Gangemi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Giorgio Meneghelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Giampietro Chiamenti
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Giuseppina Benoni
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Laura Cuzzolin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cuzzolin, L., Zaffani, S., Murgia, V. et al. Patterns and perceptions of complementary/alternative medicine among paediatricians and patients' mothers: a review of the literature. Eur J Pediatr 162, 820–827 (2003). https://doi.org/10.1007/s00431-003-1313-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00431-003-1313-9

Keywords

Search

Navigation