Herbs to Homeopathy—Medicinal Products for Children
Section snippets
Regulation of dietary supplements
Dietary supplements, regulated under the DSHEA, are products designed to “supplement the diet” and include herbal and other botanical products, vitamins, minerals, amino acids, and other dietary substances for use.” The DSHEA allows dietary supplements that were on the market before 1994 to be marketed without the approval of efficacy and safety that the FDA requires for prescription medications. Manufacturers are permitted to claim that the product affects the structure or function of the
Regulation of homeopathy
Homeopathic remedies, on the other hand, have been regulated as drugs since the 1938 Food Drug and Cosmetic Act that defines the term “drug” to mean “articles recognized in … the official Homeopathic Pharmacopeia of the United States … and articles intended for use in the diagnosis, cure, mitigation, treatment, or the prevention of disease in man …. Whether or not they are official homeopathic remedies, those products offered for the cure, mitigation, prevention, or treatment of disease
Trends in pediatric use of dietary supplements
Many children and adolescents use dietary supplements and homeopathy. The prevalence of use of these products depends on population characteristics (healthy versus sick), the age of the child or adolescent, race/ethnicity, and other factors such as methods of data collection (interviews versus surveys) and the extent of the survey (national versus regional).
Recent national surveys indicate that more than 20% to 40% of all young children and 20% to 30% of adolescents in the United States have
Patient use of dietary supplements and homeopathy
In 1996, Vincent [29] identified reasons that patients seek complementary therapies, including dietary supplements and homeopathy. These reasons included a positive value associated with complementary treatment, the ineffectiveness of orthodox treatment for a patient's complaint, concern about the adverse effects of orthodox medicine, concerns about communication with doctors, and, finally, the availability of complementary medicine. Homeopathy patients were most strongly influenced by the
Homeopathy—what is it?
Homeopathy is a popular form of CAM globally and is part of the official health care systems in a number of countries. It is 200 years old, and its core is based on the idea of “treating like with like” (Similia similibus curentur), aiming to stimulate self-healing processes. This principle also is applied in some areas of conventional medicine, such as allergy desensitization. The doses used in homeopathy range from those that are similar in concentration to conventional medicines to very high
Research background
Hierarchies for the evaluation of evidence of clinical research usually give the greatest weight to systematic reviews of controlled trials, followed by randomized, controlled trials. Other forms of evidence also are used to establish the effectiveness and safety of a therapy. The World Health Organization and many regulatory agencies use the hierarchy in Box 1 for evaluating evidence [38].
Research in homeopathy
Currently more than 130 randomized, controlled clinical trials of homeopathy have been published in the peer-reviewed medical literature. Of those, more than 15 have focused on the pediatric population.
Dietary supplement research
This section gives examples of commonly used pediatric dietary supplements. Vitamins and minerals that can be obtained from food or supplements include vitamin A, B, C, D, E, calcium, and iron. Survey data clearly indicate that multivitamins are the most commonly used supplements. The question arises: should all children take a vitamins and minerals, and, if so, at what age do they begin? There are numerous different opinions and recommendations about vitamins and minerals, but there is no
Patient preference
The use of dietary supplements and homeopathy, particularly in clinical research, often is associated with strong issues of patient preference. When subjects refuse to be randomized, it sometimes is possible to compensate for the challenges of recruitment by using of quasi-experimental designs, but then other methodologic challenges emerge. On the other side of the spectrum of patient preference is parental concern about the safety of nonpharmaceutical and pharmaceutical medicinal products for
Summary
Many pediatric patients and their families, especially those who have chronic or recurrent conditions, use dietary supplements and homeopathy. Families do not always disclose this information to their health care professionals. It is critical that health care practitioners have an open a dialogue with their patients about the use of dietary supplements and homeopathic medicinal products. As part of that dialogue, clinicians must consider what level of evidence or efficacy is acceptable to
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