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Thursday, August 31, 2017

Pediatric Integrative Medicine - American Academy of Pediatrics Clinical Report

From the American Academy of Pediatrics

By Hilary McClafferty, Sunita Vohra, Michelle Bailey, Melanie Brown, Anna Esparham, Dana Gerstbacher, Brenda Golianu, Anna-Kaisa Niemi, Erica Sibinga and Joy Weydert
August, 2017


The American Academy of Pediatrics is dedicated to optimizing the well-being of children and advancing family-centered health care.

Related to this mission, the American Academy of Pediatrics recognizes the increasing use of complementary and integrative therapies for children and the subsequent need to provide reliable information and high-quality clinical resources to support pediatricians.

This Clinical Report serves as an update to the original 2008 statement on complementary medicine. The range of complementary therapies is both extensive and diverse. Therefore, in-depth discussion of each therapy or product is beyond the scope of this report.

Read the complete AAP report HERE.

Instead, our intentions are to define terms; describe epidemiology of use; outline common types of complementary therapies; review medicolegal, ethical, and research implications; review education and training for select providers of complementary therapies; provide educational resources; and suggest communication strategies for discussing complementary therapies with patients and families.

  • AAP — American Academy of Pediatric
  • ACIMH — Academic Consortium for Integrative Medicine and Health
  • ADHD — attention-deficit/hyperactivity disorder
  • CAM — complementary and alternative medicine
  • DO — Doctor of Osteopathic Medicine
  • DSHEA — Dietary Supplements Health and Education Act
  • FDA — Food and Drug Administration
  • IBS — irritable bowel syndrome
  • NCCIH — National Center for Complementary and Integrative Health
  • NHIS — National Health Interview Survey
  • NIH — National Institutes of Health
  • OMT — osteopathic manipulative treatment
  • RCT — randomized controlled trial
  • TCM — traditional Chinese medicine

The National Center for Complementary and Integrative Health (NCCIH) of the National Institutes of Health (NIH) (1) defines complementary therapies as evidence-based health care approaches developed outside of conventional Western medicine that are used in conjunction with conventional care.

Examples of complementary care include the use of acupuncture to treat migraine headache (2) and clinical hypnosis to improve symptoms of irritable bowel syndrome (IBS). (3)

The term integrative health describes the blending of complementary and conventional therapies by the practitioner to include all appropriate therapies in a patient-centered and evidence-informed fashion. In an integrative approach, evidence-based complementary therapies may be used as primary treatments or used in combination with conventional therapies.

In contrast, alternative therapies are not evidence-based, are used in place of conventional care, and are not covered in this report.

Interest in the field of pediatric integrative medicine is driven by a number of factors, including the prevalence of use in children living with chronic illness, (4,5) the desire to reduce frequency and duration of pediatric prescription medication use, and the need for more effective approaches to preventive health in children. (6,7)

To date, consumer interest in and use of complementary therapies has outpaced training options in pediatric integrative medicine, leaving pediatricians with a desire for more training and familiarity with resources. (8)

For example, a 2012 survey of academic pediatric training programs revealed that only 16 of 143 programs reported having an integrative me (dicine program. (8) National initiatives to introduce pediatric integrative medicine into conventional pediatric residency training include programs such as the Pediatric Integrative Medicine in Residency program through the University of Arizona, initiated in 2012. (9)

Other teaching initiatives are underway through the American Academy of Pediatrics (AAP) Section on Integrative Medicine and through academic institutions affiliated with the Academic Consortium for Integrative Medicine and Health (ACIMH), a prestigious organization of more than 65 medical schools that offer integrative medicine research, education, and clinical initiatives (eg, Harvard, Yale, Duke, Stanford). (10)

This Clinical Report serves as an update to the original 2008 statement on complementary medicine. (11)

Download the complete report HERE (PDF; 23 pages).

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