A mother drops her four-year-old off one morning and tells you that she is administering a “homeopathic remedy” for his chronic ear infections. You hesitate to question the mom about this alternative to traditional medical care. You do not want to sound skeptical about the wisdom of her decision. But what do you need to know about this treatment while the child is in your care?

“Alternative medicine” is an umbrella term for a wide variety of healing practices, treatments, and remedies that are not part of conventional medicine. They neither are widely taught in medical schools nor used frequently by mainstream health providers. Typically, alternative medicine emphasizes healing and disease prevention techniques that treats the mind, body, and spirit as equal factors in any personal health problem.

Most of these alternative therapies are not covered by medical insurance because there is too little scientific evidence of their effectiveness. Nevertheless, alternative therapies are more popular than ever. In fact, a recent survey revealed that 36 percent of U.S. adults used some form of alternative medicine. Prayer, natural herbal products and supplements, meditation, and chiropractic care are the most common forms of alternative medicine utilized today.

Some forms of alternative medicine are known as “whole medical systems.” This means that they are complete systems of theory and practice that have evolved independently from or parallel to conventional medicine. Examples of whole medical systems include:

• Acupuncture--the practice of stimulating points on the body to promote healing.
• Oriental medicine--the treatment of disturbances of energy in the body that are thought to be the cause of health problems.
• Homeopathy--treating health problems with very small amounts of diluted substances believed to be out of balance in the body.
• Ayurveda--ancient holistic healing methods from India.
• Naturopathy--a system of healing that views disease as a change in the processes by which the body naturally heals itself.

While adults are the major consumers of alternative therapies, many parents use these methods on their children. Studies show that mothers who use alternative therapies for their own care are much more likely to use them for their children’s care. Parents of children with chronic health needs frequently report using alternative therapies. Despite widespread use, there is very little research on the positive or negative effects of alternative therapies on young children.

Given the growing popularity of alternative medicine, how should the childcare provider respond to the parent who is treating his or her child with alternative medical treatments? Many parents use alternative therapies with the best intentions for their child and should be supported in their efforts as long as the treatment causes no harm to the child. Methods such as prayer, massage, and meditation are generally considered safe complements to regular medical treatment.

Some alternative therapies, particularly herbal products and dietary supplements, might harbor risks. Unlike prescription and over-the-counter medicines, herbal products and supplements are not fully regulated by the government. In addition, these products are heavily marketed and promoted often without sound scientific evidence supporting their health-enhancing claims. Parents may be misinformed about the effects, beneficial or otherwise, of herbal products and supplements and unaware of their potential to cause harm.

Many people consider these products “safe” because they are deemed to be “natural.” Quality control and truthful labeling of herbal products and supplements can be extremely variable. Depending on where and how an alternative medication was produced, there might be other substances such as plant matter, drugs, pesticides, or even heavy metals mixed in with the primary substance.

In addition, some herbal products can interfere with the effectiveness of prescription and over-the-counter drugs. For example, when certain herbal substances like gingko, ginseng, and red clover are combined with non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin) or naproxen (Aleve), it may have a negative effect on blood flow and increase blood-clotting time.

Questioning the parent who is using alternative therapies can be successful if it is done in a confidential, non-confrontational, and non-judgmental fashion. When parents feel comfortable talking about their choice of alternative therapies, it is possible to openly discuss the therapy’s safety and effectiveness in children.

Parents should be encouraged to discuss their use of alternative therapies with the child’s health care provider if they have not already done so. Many studies have revealed that parents who use alternative therapies for their children usually do not discuss them with the child’s health care provider. A parent’s use of alternative therapies does not necessarily mean that they are dissatisfied with conventional forms of medicine.

Many cultures rely heavily on “folk remedies” to treat illnesses. The range of such different cultures represented in the U.S. population, and in childcare, is increasing rapidly. In general, folk remedies usually are not passed on for generations unless the people who use them believe that they are effective. However, the fact that they seem to work for the purpose intended does not mean that they are completely safe.

For example, Azarcon, a bright orange powder used in many Hispanic cultures to treat diarrhea, contains substantial amounts of lead and has been implicated in cases of childhood lead poisoning. Parents who choose to utilize alternative medicine or folk remedies for their children have made a personal choice based on their personal experience, cultural beliefs and attitudes. It can be very helpful for childcare providers to become familiar with a variety of common culturally-based folk remedies before they initiate conversations about them with parents.

It is important to maintain a supportive atmosphere where communication with parents is open and nonjudgmental, but this should always be balanced against ensuring that every child’s health and well-being is regarded first and foremost.

Elaine Abrams
Certified Health Education Specialist and Public Health Professional

American Dietetic Association, 120 South Riverside Plaza, Ste. 2000, Chicago, Illinois 60606-6995; 800-877-1600; www.eatright.org/food.pdf

National Center for Complimentary and Alternative Medicine, NCCAM Clearinghouse PO Box 7923, Gaithersburg, MD 20898; 888-644-6226; http://nccam.nih.gov

U. S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5600 Fishers Lane, Rockville, Maryland 20857; 888-INFO-FDA; www.cfsan.fda.gov/~dms/supplmnt.html