Supplement use growing among children and adolescents

04/19/04

According to Researchers at Wake Forest University Baptist Medical Center

WINSTON-SALEM, N.C. More than 50 percent of all young children and more than 30 percent of all adolescents in the United States have used a dietary supplement, according to research by a pediatrician at Brenner Children's Hospital and reported in the April issue of Pediatric Annals.

And, she says, the increased use of these alternative therapies brings increased risk.

"Children with chronic, recurrent, and incurable conditions such as attention deficit/hyperactivity disorder (ADHD), asthma, skin rashes, allergies, cancer, inflammatory bowel disease, rheumatoid arthritis and cystic fibrosis have higher complementary and alternative medicine (CAM) and dietary supplement use rates than healthy populations," said Kathi J. Kemper, M.D., a pediatrician at Brenner Children's Hospital. "Parents give their children dietary supplements for health maintenance, treatment of acute and chronic diseases and the prevention of diseases."

However, she said, many parents are unaware of the potential side effects of common supplements and do not discuss their use with their child's pediatrician.

"We surveyed 145 families and 45 percent reported giving their child an herbal product," Kemper said. "Most of these caregivers did not believe or were uncertain if herbal products had any side effects, and only 27 percent could name a possible side effect. We found that more than half of caregivers were unsure or thought that herbal remedies did not interact with other medications," Kemper said. "And of those giving their children herbal products only 45 percent reported discussing their use with their child's primary health care provider."

Health care providers face several challenges when recommending the use of herbs and dietary supplements.

"Efficacy, safety dosage and product recommendation should all be considered before recommending supplement use," Kemper said. "Children have their own unique physiology and metabolize, excrete and absorb supplements differently from adults. Even if a supplement has proven clinical efficacy and safety, the lack of standardization and limited federal regulation of supplements are obstacles in making recommendations."

Studies show some of the more commonly used dietary supplements have been shown to have no benefit whatsoever and have uncomfortable side effects, Kemper said.

For example, Echinacea, which is used to treat colds and upper respiratory and ear infections, has not been shown to be effective. The side effects of the supplement include rashes, hypersensitivity reactions and severe itching.

"The bottom line is that parents should not equate 'natural' with 'safe,'" Kemper said. "Parents should seek expert guidance when considering the use of CAM practices, and they should inform their child's pediatrician of any herb or dietary supplement their children take.

"Unlike drugs, herbal products have not been scrutinized by the FDA, so it is truly a case of buyer beware. Some herbs and plants may have beneficial effects as well as expected toxicity, similar to drugs. It is critical that parents research what is known about the safe and effective use of a supplement when considering giving it to their children."

Kemper is the author of the "The Holistic Pediatrician," a comprehensive resource manual for the many complementary and alternative forms of care available. She is the Caryl J. Guth Chair of Holistic and Integrative Medicine at Brenner Children's Hospital.

Paula Gardiner, M.D., from Children's Hospital at Harvard Medical School in Boston, Mass., is first author of the study. Lana Dvorkin, Ph.D., an instructor at Massachusettes College of Pharmacy and Allied Health Sciences, is second author.

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