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THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINEVolume 18, Number 8, 2012, pp. 1–2
ª Mary Ann Liebert, Inc.
High Frequency of CAM Use Among Children in Germany
Anne Weissenstein, Alexandra Straeter, Gloria Villalon, Elisabeth Luchter, MD, and Stefan Bittmann, MD
The numerous studies on the use of complementary and
alternative medicine (CAM) among children carried out in
various countries indicate a prevalence of CAM use in chil-
dren with acute conditions of 12%–23%1,2 and 44%–54% for
children with chronic illnesses.3 So far, no studies about the
frequency of CAM use in children have been conducted inGermany. As possible side-effects4 and interactions with
other drugs may occur, it is necessary to further analyze
which types of CAM are the most frequently used. With the
intention of assessing the prevalence and the exact sub-
stances of CAM that are currently being used by children, we
Our survey was distributed to 185 parents visiting our
pediatric day center in Epe (Germany) between September
and November 2011 with their children. The main questions
in our survey addressed the frequency of CAM use in chil-dren and the substances that were used. Furthermore, it was
Each used by 1 patient with 0.75% of CAM: inhalation, etheric oils,
inquired whether the physician knew about this.
compresses, olive oil, belladonna, quirk cough syrup, schuesslersalts, chamomile, iron supplements, cottage cheese, potatoes, thyme,
Of 185 questionnaires distributed, 115 were returned
(62.2%). As a result of our evaluation, it was found that75.7% of all children treated at our pediatric day centerhave received CAM from their parents. Most children
natural products, with no side-effects and therefore
(58.4%) received a combination of CAM and conventional
harmless, the use of CAM has been reported to affect
medicine, while 15.6% used CAM alone and 26.0% used
treatment outcomes adversely.4 Few physicians know that
only conventional prescribed medications. The physician
the use of honey may cause infant botulism,5 that herbal
knew in only half of the cases (50.6%) that his patient
teas such as chamomile contain coumarins and could
takes CAM, and less than half of the parents (43.6%)
therefore cause bleeding,6 or that nonprescribed vitamins
know that interaction between prescribed drugs and
when used in the wrong dosage can be hepatotoxic.7 De-
CAM is possible. The substances that were used are
spite all side-effects and interactions of CAM, it is probable
manifold, mainly herbal teas or other herbal supplements
that the highest risks occur when conventional medicine is
(30.8%), honey (26.3%), and nonprescribed vitamins
stopped or altered in favor of complementary medicine.4
(11.3%) were used. Furthermore, various other remedies
That is why it is of utmost importance for the parents to
such as homeopathy, onions, or globuli have been given
communicate with the doctor and inform him about pos-
sible treatment alterations or supplements of their children.
The prevalence of CAM use among children is about
The physician, on the other hand, should be aware that
three quarters (75.7%), much higher than other studies
CAM is used very often and he should encourage the
have indicated,1–3 and in half of the cases (50.6%) the
doctor is oblivious about this. As numerous side-effects of
However, when used in a well-modulated manner and in
herbal remedies and possible interactions with conven-
accord with the physician, CAM can significantly improve
tional medicine exist,4 the discrepancy between CAM use
the child’s health.8 CAM could be further integrated in
and the doctor’s knowledge about the consumption of al-
ternative remedies may possibly result in endangering the
doctor is indispensable along with good parent–doctor
child’s health. Despite the general belief that CAM use
Ped Mind Institute, Gronau, Germany.
6. Vaes LP, Chyka PA. Interactions of warfarin with garlic,
ginger, ginkgo, or ginseng: Nature of the evidence. Ann
No competing financial interests exist.
7. Haslam RH, Dalby JT, Rademaker AW. Effects of megavita-
min therapy on children with attention deficit disorders. Pe-
1. Ottolini M, Hamburger E, Loprieato J, et al. Complementary
and alternative medicine use among children in Washington,
8. Riley D, Fischer M, Singh B, et al. Homeopathy and con-
DC area. Ambul Pediatr 2001;1:122–125.
ventional medicine: An outcomes study comparing effec-
2. Smith C, Eckert K. Prevalence of complementary and alter-
tiveness in a primary care setting. J Altern Complement Med
native medicine and use among children in South Australia. J
Paediatr Child Health 2006;42:538–543.
3. Shenfield G, Lim E, Allen H. Survey of the use of comple-
mentary medicines and therapies in children with asthma. J
Paediatr Child Health 2002;38:252–257.
4. Lim A, Cranswick N, South M. Adverse events associated
with the use of complementary and alternative medicine in
children. Arch Dis Child 2011;96:297–300.
5. Kumar R, Lorenc A, Robinson N, et al. Parents’ and primary
healthcare practitioners’ perspectives on the safety of honey
and other traditional paediatric healthcare approaches. ChildCare Health Dev 2011;37:734–743.
AUTHOR QUERY FOR ACM-2012-0398-VER9-WEISSENSTEIN_1P
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