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FROM THE AMERICAN ACADEMY OF PEDIATRICS: Kathi J. Kemper, Sunita Vohra, Richard Walls, the Task Force on Complementary and Alternative Medicine the Provisional Section on Complementary, Holistic, and Integrative Medicine The Use of Complementary and Alternative Medicine in Pediatrics Pediatrics 2008; 122: 1374-1386 [Abstract] [Full text] [PDF]

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Clarification on Pediatric CAM Article

Matthew McCoy   (6 January 2009)

Clarification on Pediatric CAM Article 6 January 2009
Matthew McCoy, Associate Professor Life University Send letter to journal: Re: Clarification on Pediatric CAM Article mmccoy{at}life.edu Matthew McCoy	December 23, 2008 Jerold F. Lucey, MD Editor Pediatrics University of Vermont College of Medicine 89 Beaumont Avenue Burlington, Vermont 05405-0068 RE: Kemper KJ, Vohra S, Walls R. The Use of Complementary and Alternative Medicine in Pediatrics. Pediatrics; 2008;122;1374-1386 Dear Editor, The recent article by Kemper and colleagues attempts to thoroughly review the literature on pediatric CAM use and the authors are to be commended for their efforts in this most important area of pediatric care.(1) As the authors point out there is a reverse publication bias in CAM research, and as such, research on CAM may not show up in the usual places. I suspect this is why the authors did not mention the first and largest population based study on the safety and efficacy of chiropractic and pediatrics to date.(2) Alcantara and Ohm report on data derived from a practice based research network that included 53 chiropractors and 1161 pediatric cases. All pediatric patients received chiropractic adjustments at each visit for a total of 10,249 office visits. The average patient age was 6 with 555 females and 605 males. The average number of office visits was 8.83. With respect to treatment associated outcomes, 776 reported experiencing an overall improvement in presenting symptoms with no treatment associated complications and only 17 treatment associated aggravations from 16 patients. The treatment associated aggravations included muscle soreness or stiffness, fussiness post treatment and one report of a worsening in colic symptoms the night after treatment. Of these 1161 clinical cases less than one percent reported minor adverse events while 66% reported improvements in their presenting complaints and another 8% reported improvements unrelated to their presenting complaints. Another area that needs correction is in the area of pediatric training for chiropractors. The authors cite only one source of a 120 hour certification program.(3) However, readers should be made aware that there are others such as the 180 hour program offered by the International Chiropractic Pediatric Association (ICPA) and that this program is the first step in the completion of a 360 hour Diplomate program in chiropractic pediatrics.(4,5) There are Masters programs in chiropractic pediatrics available as well.(6) Finally, the reader should be made aware that the regular curriculum of all chiropractic training programs includes courses and content on the care of pediatric patients both from a primary care and chiropractic perspective.(7) Sincerely, Matthew McCoy DC, MPH Associate Professor Clinical Sciences Life University College of Chiropractic Marietta, Georgia References 1. Kemper KJ, Vohra S, Walls R. The Use of Complementary and Alternative Medicine in Pediatrics. Pediatrics; 2008;122;1374-1386 2. Alcantara, J, Ohm, J. The safety and effectiveness of pediatric chiropractic: results from a practice-based research network. European Chiropractic Union Annual Convention May 2008 Brussels Belgium. 3. International Chiropractors Association Web site. Available at: www.chiropractic.org. Accessed May 15, 2008. 4. International Chiropractic Pediatric Association web site. Available at: http://www.icpa4kids.com/seminars/seminar_program.htm Accessed December 23, 2008. 5. International Chiropractic Pediatric Association web site. Available at: http://www.icpa4kids.com/seminars/ICPA_Cert_Dip_About.htm Accessed December 23, 2008. 6. University of Bournemouth web site. Available at: http://courses.bournemouth.ac.uk/Course.aspx?course=555&code=MSAPPCP Accessed December 23, 2008. 7. Standards for Doctor of Chiropractic Programs and Requirements for Institutional Status January 2007. The Council on Chiropractic Education. Scottsdale, Arizona. Available at: http://www.cce- usa.org/uploads/File/2007%20January%20STANDARDS.pdf Accessed December 23, 2008. Conflict of Interest: None declared