Tuesday, 20 February 2007

What's the alternative?

Today I have an article in the Guardian about alternative therapies and the boom in using them to treat young children.
To read it online, click on http://www.guardian.co.uk/g2/story/0,,2016867,00.html
Otherwise, read on....

Risky alternative?
More and more parents are taking their children to complementary therapists. But just how safe and effective are such treatments? Sarah Ebner reports

There's a baby boom in the world of complementary medicine. Therapists are treating more and more infants, as many parents abandon long waits at the doctor's surgery in favour of costly visits to alternative practitioners.
"There's much more of an awareness of what we do," says June Tranmer, who specialises in paediatric acupuncture at the Healing Clinic in York. "We have had hundreds of children coming through our doors and the numbers keep going up."

Probably the most popular treatments are baby massage and yoga - the infant Leo Blair was reputedly taken to baby massage sessions run by beauty therapist Bharti Vyas - as well as homeopathy and even acupuncture, kinesiology (which claims to diagnose imbalances through analysing movement) and chiropractic. But why is the next generation having these treatments? Alternative therapists usually spend longer with their patients and claim remarkable results. So for parents with money and initiative, they are an attractive option.

Caroline Hind took her twins, Corem and Jaimie, to see Tranmer at the end of last year. The boys, who turn two at the end of this month, had whooping cough. "There was nothing the doctor could do, as it was really a nursing issue," says Hind. "We suffered broken nights with the boys coughing so much they were sick." Tranmer spent an hour with the family, before carrying out acupressure and cupping treatments. "It was a really calming experience for them, and for us," says Hind. "Everything was so gentle. Afterwards both babies slept through the night." The whooping cough didn't go away completely, but Hind is sure the treatments helped. "I suppose you never know for sure, but it did seem to make a difference," she says. "I think doctors are very good at serious illnesses, but for allergies, migraines and the sorts of things where they're at a bit of a loose end, this is a good option. Medicine is so reliant on drugs. This is a gentler alternative."

Many medical professionals, however, disagree. "I remain sceptical until there's good evidence," says paediatrician Jethro Herberg. "My antagonism is proportional to the degree of harm they can do. At best they are benign and, at worst, can do an awful lot of harm. Herbal remedies are littered with case studies where they have done damage. People have an inconsistent view ... If they go to the doctor, they demand an extremely high level of proof that what they're getting is efficient and not harmful. But they'll go and see an alternative practitioner, with no idea whether it could be harmful, or not."

Tranmer admits there is not a "huge body" of research, but questions who would finance it. "You can't do research for nothing, and drug companies won't fund us," she says. "Anyway, if you see a child screaming in pain, and they're better after you treat them, how do you deny it is working?"

Edzard Ernst, professor of complementary medicine at the Peninsula Medical School in Exeter, agrees that more evidence is needed. "Without proof, we only have hearsay and clinical experience, which can be misleading," he says. "Little children are very fragile and, to me, there is an ethical imperative to find more evidence. The official bodies - the NHS or Wellcome Trust, which have no commercial interest - should fund research."

In the meantime, Ernst is dubious about the benefits of treating infants this way. "Gentle massage is definitely very good for babies, but kinesiology is nonsense," he says. He also believes that acupuncture could be downright dangerous. "Everything is so tiny in a baby. In a jiffy, a needle could be in the heart or lung." Although, as acupuncturist, Vera Wong, points out, actual needles are rarely used on babies. Acupressure is more common: "We use skin rollers, toy tractors and spring-loaded pointers usually used on adult ears," she says.

According to Ernst, the main determinant of whether a child is treated with alternative medicine is whether its parents also use it. However, homeopath Jo Redmond, director of the Health Works clinic in east London, says they are treating more young families and more black and Asian patients. "People think it is only a white, middle-class domain, or only for people who have treatments themselves. We are seeing parents who are fed up with doctors, and don't want endless prescriptions."

Around three quarters of Redmond's 1,000 patients are babies and small children. Ruqiyah Henry is one of those. She was seven months old and suffering from severe eczema when her parents, Aa'isha Henry and Abdul Raheem, took her to the homeopath. "She was scratching all the time," says Henry, "waking up in the night and she was so distressed. It was awful to see her unhappy."

The doctor had prescribed hydrocortisone cream and antibiotics. "The cream was so strong I was concerned about putting it on her face. The eczema came back each day ... I didn't want her to be on a steroid cream for ever." When one of Henry's friends suggested homeopathy, she decided to give it a go. Interestingly, her health visitor also recommended it. "The doctor said there was no cure ... she would have to grow out of it. The homeopath said she could be cured," she says.

After two monthly sessions, during which Ruqiyah was given homeopathic pills nearly every day, her eczema cleared up. "Her skin is so soft and smooth," says Henry. "I can't believe the results." With treatments at around £30, Henry wishes it was available on the NHS. "We're not rich at all," she says, "but it is worth it."

Despite these results, homeopathy has not been proved clinically effective. Ernst, who has just published a review of homeopathic trials, claims "there is no good evidence" it works for children.

And while Herberg sympathises with parents "driven to distraction" by a difficult baby, "it shouldn't surprise anyone that children get better," he says. "A lot of these alternative therapies treat the mother rather than the baby, and placebo also has a measurable effect."

Redmond naturally disputes that view. "How does the placebo effect work with babies and animals?" she asks. "Colds and skin problems can't clear up just because mum's calmer and happier".

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