• AAP Section on Integrative Medicine,
• National Center for Complementa-
ry and Integrative Health, pediatrics
• Academic Consortium for Integrative
Medicine & Health, http://bit.ly/2h
Focus on prevention,
blending of therapies
PIM describes an approach that
blends complementary and evi-dence-informed conventional therapies
with a patient-centered focus. The field
is important in pediatrics for two main
reasons: its high prevalence of use, especially in children with chronic illness,
where one in two are estimated to use
complementary therapies; and the emphasis on modern preventive health.
Children and adolescents face serious health challenges and stressors
in today’s society. Integrative medicine seeks to promote a comprehensive approach to healthy nutrition,
physical activity, stress management
and coping skills, sleep and judicious
use of complementary therapies that
can help children and their families
reduce risk of preventable chronic illness across the lifespan.
Patients’ use of
Data from the 2007 and 2012 Na-
tional Health Interview Survey show
complementary approaches in children
were used to treat specific conditions
rather than to promote general well-be-
ing. They were used most commonly
for back or neck pain, head or chest
colds, other musculoskeletal conditions,
anxiety or stress, and attention-deficit/
hyperactivity disorder. Therapies used
most frequently were nonvitamin,
nonmineral dietary supplements (such
as herbal medicines or probiotics), os-
teopathic or chiropractic manipulation,
and yoga, tai chi or qi gong.
While use of complementary therapies was about 12% in children under
age 18 years for both 2007 and 2012,
it rose to 50% in children with chronic
Adolescents are more likely than
younger children to use complementary therapies. Teens turn to them
most often to help treat chronic illnesses such as inflammatory bowel
syndrome and mental health conditions. They also use supplements like
ginseng, zinc, Echinacea, ginkgo and
creatine in hopes of reducing weight,
increasing energy or improving body
image or athletic performance.
Not all families feel comfortable
disclosing the use of complementary
therapies. The report says pediatricians can help guide families in safe
use with awareness of the field and by
encouraging an open exchange of information. Clinicians should respect
the family’s perspectives, values and
cultural beliefs while monitoring the
patient’s response to treatment in case
therapy needs to be re-evaluated.
• Pediatricians are encouraged to advise and counsel patients and families about relevant, safe, effective and
age-appropriate health services and
therapies, whether they are considered conventional or complementary.
• Pediatricians should inquire regularly about all therapies a family is using
for their children.
• Pediatricians should seek continued
and updated knowledge about available therapeutic options.
• Policy and health insurance coverage
should evolve to provide fair coverage for patients and equitable payment for physicians.
Dr. McClafferty, a lead
author of the report, is
immediate past chair of
the AAP Section on Integrative Medicine Executive Committee.