Pediatric palliative care is a specialized, growing area of medicine that focuses on providing comfort and improving the quality of life of children with serious or life-threatening illnesses. It addresses the emotional and physical symptoms of patients with severe conditions – from the time of diagnosis of the illness and throughout the course of treatment. Pediatric palliative care specialists also provide resources to families to help them cope with the stresses of their child’s condition and treatment.
From Nemours' KidsHealth
- Palliative Care
- End-of-Life Care for Children With Terminal Illness
- Relaxation Techniques for Children With Serious Illness
- Taking Care of You: Support for Caregivers
- How Can Spirituality Affect Your Family's Health?
- Helping Your Child Deal With Death
- Caring for a Seriously Ill Child
- Alternative Medicine and Your Child
Alternative Medicine and Your Child
About Alternative Medicine
The phrase "alternative medicine" might make you think of pungent herbal teas, poultices, chanting, or meditation. In fact, both herbal remedies and meditation, as well as dozens of other treatments, fall under the heading of complementary and alternative medicine (CAM).
Although there is no strict definition of alternative medicine, it generally includes any healing practices that are not part of mainstream medicine — that means any practice that is not widely taught in medical schools or frequently used by doctors or in hospitals.
But the boundaries of alternative medicine in the United States are constantly changing as different types of care become more accepted by doctors and more requested by patients. A few practices (such as hypnosis) that were dismissed as nonsense 20 years ago are now considered helpful therapies in addition to traditional medicine.
So, are any alternative medicines right for your family?
Types of Alternative Care
In the United States, the lead agency that's charged with scientific research into CAM is the The National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health (NIH).
NIH classifies four general areas of complementary and alternative care:
- Mind-body medicine. This includes practices such as meditation, prayer, Tai Chi, and music therapy, which are intended to develop the mind's ability to affect physical symptoms. It focuses on the mind's role in conditions that affect the body.
- Biologically based practices. This includes substances such as herbs, foods, vitamins, and dietary supplements that are geared to help heal the body. Herbal remedies include a wide range of plants used for medicine or nutrition. They are available in grocery stores, over the Internet, in health food stores, or through herbalists and are often in the form of teas, capsules, and extracts. The U.S. Food and Drug Administration (FDA) does not regulate these.
- Manipulative and body-based practices. These practices are based on the manipulation or movement of body parts. It includes methods like massage therapy and therapeutic touch, which manipulate and realign body parts, to help alleviate symptoms. You've probably heard of chiropractors, who focus on affecting the nervous system by "adjusting" the spinal column.
- Energy medicine. This area of medicine is based on the theory (which has not been proved scientifically) that certain energy fields surround and penetrate the body. This includes practices such as Reiki, qi gong, and therapeutic touch. Also included are therapies based on bioelectromagnetics, the theory that electrical currents in all living organisms produce magnetic fields that extend beyond the body.
In many cases, there is overlap between each of these areas. Acupuncture, for example, is a healing practice that originates in traditional Chinese medicine. It involves stimulating different points in the body, mostly with thin solid metallic needles, in order to balance Qi, certain energy pathways. In addition, NIH classifies medicine systems, such as homeopathic medicine and Ayurveda, which may include elements from several of these four different areas.
How CAM Differs From Traditional Medicine
Alternative therapy is frequently distinguished by its holistic methods, which means that the doctor or practitioner treats the "whole" person and not just the disease or condition. In alternative medicine, many practitioners also address patients' emotional and spiritual needs. This "high touch" approach differs from the "high tech" practice of traditional medicine, which tends to concentrate on the physical side of illness.
Most alternative practices have not found their way into mainstream hospitals or doctors' offices, so your doctor may not be aware of them. However, new centers for integrative medicine offer a mix of traditional and alternative treatments. There, you might receive a prescription for pain medication (as you might get from a traditional health care provider) and massage therapy to treat a chronic back problem. Such centers usually employ both medical doctors and certified or licensed specialists in the various alternative therapies.
Despite the growth of the field, the majority of alternative therapies are not covered by medical insurance. This is largely because few scientific studies have been done to prove whether the treatments are effective (unlike traditional medicine, which relies heavily on studies). Rather, most alternative therapies are based on longstanding practice and word-of-mouth stories of success.
What Are the Risks?
The lack of scientific study means that some potential problems associated with alternative therapies may be difficult to identify. What's more, almost all of the studies that have been done involved adults as test subjects; there is little research on the effects of alternative medicine on children. Although approaches such as prayer, massage, and lifestyle changes are generally considered safe complements to regular medical treatment, some therapies — particularly herbal remedies — might harbor risks.
Unlike prescription and over-the-counter (OTC) medicines, herbal remedies are not rigorously regulated by the FDA. They face no extensive tests before they are marketed, and they do not have to adhere to a standard of quality. That means when you buy a bottle of ginseng capsules, you might not know what you're getting: the amount of herb can vary from pill to pill, with some capsules containing much less of the active herb than stated on the label. Depending on where the herb originated, there might also be other plants, even drugs like steroids, mixed in the capsules. Herbs that come from developing countries are sometimes contaminated with pesticides and heavy metals.
"Natural" does not equal "good," and many parents don't realize that some herbal remedies can actually cause health problems for their kids. Medicating a child without consulting a doctor could result in harm. For example, certain herbal remedies can cause high blood pressure, liver damage, or severe allergic reactions.
Consider these examples:
- Ephedra, also called ephedrine and often sold as the Chinese herb ma huang, was on the market for years until it was linked to several deaths in people with heart problems. The FDA decided the health risks associated with ephedra were too great, and banned it in December 2003.
- Alone and in combination with prescription drugs, several dietary supplements — such as chaparral, comfrey, germander, and ephedrine — have been linked to severe illness, liver damage, and even death.
Parents might also give their kids much more of an herb than recommended, thinking that because it's natural, higher doses won't hurt. But many plants contain potent chemicals; in fact, approximately 25% of all prescription drugs are derived from plants.
Choosing a practitioner can pose another problem. Although many states have licensing boards for specialists in acupuncture or massage, for instance, there is no organization in the United States that monitors alternative care providers or establishes standards of treatment. Basically, almost anyone can claim to be a practitioner, whether he or she has any training.
Perhaps the greatest risk, however, is the potential for people to delay or stop traditional medical treatment in favor of an alternative therapy. Illnesses such as diabetes and cancer require the care of a doctor. Relying entirely on alternative therapies for any serious chronic or acute conditions can jeopardize a child's health.
Can Alternative Care Help Your Child?
Many parents turn to a cup of chamomile tea or ginger as first-line treatment against the flu or nausea. Anxious kids can learn to relax with the help of meditation or yoga. Some alternative therapies may be helpful for a child when used to complement traditional care.
If you want to try alternative medicine for your child, you should first talk with your doctor or pharmacist to make sure it is not dangerous and will not conflict with any traditional care your child receives. Your doctor also can give you information about treatment options and perhaps recommend a reputable specialist.
By coordinating alternative and traditional care, you don't have to choose between them. Instead, you can get the best of both.
Reviewed by: Steven Dowshen, MD
Date reviewed: October 2010