NEW YORK, Mar 07 (Reuters Health) - Use of alternative medicine among children with disabilities or chronic illness is on the rise, according to the nation's largest group of pediatricians.

This means that doctors caring for these children must be aware of non-mainstream therapies and ready to help families sort through the types of care available to them, the American Academy of Pediatrics' Committee on Children with Disabilities writes in the March issue of Pediatrics.

The article sets forth a new policy on complementary and alternative medicine (CAM), in which the committee concludes: "Distinctions among unproven therapies, CAM, and biomedicine may become blurred, presenting special challenges to the pediatrician. To best serve the interests of children, it is important to provide balanced advice about therapeutic options, to guard against bias, and to establish and maintain a trusting relationship with families."

More and more Americans with chronic illness or disability are using CAM to care for themselves, the committee notes. The same is true for families of children with disabilities. "Up to 50% of children with autism in the United States probably are using some form of CAM," the committee points out.

While there is currently little scientific evidence for the effectiveness of various types of alternative medicine, the committee observes, the same is true for many commonly used therapies in conventional medicine. And the placebo response clearly offers benefits of its own.

"Many parents become frustrated with biomedical therapies because of complexity, discomfort, bewildering technology, or uncertainty of cure," the committee writes. "Indeed, for some conditions, biomedicine has little or nothing to offer."

But, they add, CAM is not always benign. "Alternative therapies may be directly harmful by causing direct toxic effects, compromising adequate nutrition, interrupting beneficial medications or therapies, or postponing biomedical therapies of proven effectiveness."

Furthermore, the committee adds, "the Internet has dramatically increased exposure of families to sophisticated marketing, testimonials, and unproven claims. Some parents are attracted to simple explanations of causality, some by an approach perceived to be more 'natural.'"

So the responsibility falls to pediatricians, the authors write, to help parents navigate through the choices offered by both conventional and alternative medicine, and provide the best care to their children. "The pediatrician is in a position to balance a commitment to family-centered care with the ethical responsibility to guard the welfare of children."

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