Thursday, December 23, 2010

"Complementary" medicine 'can be lethal for children'

Using complementary medicine on children can be fatal, experts warn today. Parents can be misled into believing treatments such as homeopathy are more ‘natural’, with fewer side effects than conventional drugs. But they may have direct dangerous effects, and even lead to death, when substituted for effective conventional medicines, according to a study.

It found the deaths of four children could be blamed on parents failing to use orthodox treatments for illness and using alternative remedies instead.

The study team from the Royal Children’s Hospital in Melbourne, Australia, used data from 2001 to 2003 showing 39 separate incidents of side effects in children up to the age of 16 thought to be linked with complementary treatment, whether used as a substitute or alongside conventional medicine.

In three-quarters of cases the issues were ‘probably or definitely’ related to complementary medicine. In 25 cases (64 per cent), the adverse effects were rated as severe, life-threatening or fatal. In almost half of cases, including the four deaths, the patient was harmed by a failure to use conventional medicine.

One involved an eight-month-old admitted to hospital with malnutrition and septic shock following naturopathic treatment with a rice milk diet from the age of three months for constipation.

‘Another death involved a ten-month-old with septic shock following treatment with homeopathic medicines and dietary restriction for chronic eczema,’ said the report in the journal Archives of Disease in Childhood.

The third death was sudden in a child who had presented with multiple seizures. ‘A number of different complementary and alternative medicine therapies had been used instead of anti-convulsant therapy due to concerns about potential drug side effects,’ the report said.

The fourth death was of a child who needed blood-clotting drugs but was given complementary medicine instead.

Other reactions to complementary medicines included constipation, pain, seizures, vomiting, infections and malnutrition.

The report said: ‘Many of the adverse events associated with failure to use conventional medicine resulted from the family’s belief in complementary and alternative medicine and determination to use it despite medical advice.’

Alternative treatments are not subject to pharmaceutical testing as they are classified as food supplements. In the UK, homeopathy has been funded on the NHS since 1948. The Commons Science and Technology Committee earlier this year criticised state funding, saying it conferred scientific legitimacy.

Doctors at the British Medical Association’s annual meeting voted 3-1 in support of removing ‘scarce’ NHS funding for homeopathy, despite protests from patients.

Professor Edzard Ernst, from the department of complementary medicine at Peninsula Medical School in Exeter, said parents must be very careful. ‘The ethics of using alternative remedies in children are complex,’ he added.

Cristal Sumner, of the British Homeopathic Association, said: ‘With millions in Britain using complementary medicines (CAM), this study only emphasises the importance of CAM being integrated into the healthcare system and delivered by statutorily regulated health professionals. ‘Most of the risks from CAM come from the failure to responsibly integrate therapies appropriately rather than a direct risk from treatments.’


Will Mrs. Obama Downsize Your Kid?

The first lady got a bit of a bum rap last week when some on the right wrenched her comment on the new school lunch program out of context. Justifying an expanded federal program to feed kids healthy breakfasts and lunches at school, Michelle Obama said, "We can't just leave it up to the parents." Some radio shouters let fly at her for that. But immediately before that statement, Mrs. Obama had said, "I meet parents who are working very hard to make sure that their kids are healthy ... They're trying to teach their kids the kind of healthy habits that will stay with them for a lifetime. But ... it's clear that we as a nation have a responsibility to meet as well. We can't just leave it up to the parents."

This is not to suggest that Mrs. Obama's initiative, which will cost an additional $4.5 billion over the $13 billion we're already spending, is a good idea. The thrust of the new federal law is to bring the wisdom of the federal government to the task of helping kids become healthier. The terms "wisdom" and "federal government" make uncomfortable sentence mates. Certainly, there is a problem to be addressed. Some 31 percent of children and teens, reports the CDC, are overweight or obese, triple the rate of 30 years ago. It isn't even crazy to suggest, as Mrs. Obama has, that when "one in four young people are unqualified for military service because of their weight, childhood obesity isn't just a public health threat, it's not just an economic threat, it's a national security threat as well." And yet, it requires a certain kind of stubborn obtuseness to ride into battle carrying the flag of subsidized school lunches when the problem was partly created by ... subsidized school lunches!

Mrs. Obama is correct that school meals are loaded with saturated fat, salt, and sugar. She notes that children receive half of their daily calories from school lunches. Most kids don't eat breakfast at school, which means that school lunches are larded up with calories.

How did this happen? Was it just that before the Obamas came to town, the feds were misguided about what was good for kids? Or was it something about the way government operates?

Is it an accident that school lunches are so heavy on cheese and meat? No. The National School Lunch program, enacted in 1946, was devised with two goals in mind. The first was to subsidize farmers by purchasing huge blocs of "excess" commodities in order to keep prices up. Only secondarily did the government intend to help feed hungry children. Subsidies are, to paraphrase Ronald Reagan, the closest thing to immortal life in this world. So while America's children were getting heavier and heavier, particularly low-income children, federal programs continued to heap pizza, French fries, and cheeseburgers onto their plates.

There have been episodic and quixotic efforts to kill the subsidies. In 2007, Rep. Jeff Flake, R-Ariz.; and Ron Kind, D-Wis., offered an amendment to the farm bill that would have reduced subsidies for unhealthy commodities like meat and cheese, cut subsidies to millionaire farmers, and increased funding for nutritional services to poor children. But Speaker Pelosi, fearing that her farm state members would pay a political price, urged a "no" vote.

Some 30 million American children (about 83 percent of the total) eat subsidized school lunches in America's schools, though only 17.4 million are low income. Mrs. Obama's reform will increase spending on the grounds that healthy foods are more expensive than unhealthy ones. But $2.2 billion of the $4.5 cost of the new program is to be offset by reductions in the Food Stamp program. Bad idea.

The amount of all of this food that winds up uneaten in the trash can only be guessed at (though anecdotal evidence abounds). Wouldn't it make more sense, economically, nutritionally, and (importantly) socially to eliminate school lunches altogether? Parents can pack a highly nutritious turkey, tuna, or peanut butter sandwich with an apple or an orange. Poor parents can afford to do this with help from the Food Stamp program. The older kids can pack their own lunches. (A child who repeatedly showed up at school without lunch would receive attention from child protective services.) Most of the parent-supervised lunches would be superior in nutrition and taste to anything the government could serve (some kids might even find an affectionate note from mom or dad in their lunch boxes). But more importantly, the principle that parents are responsible for their children would be ratified.


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