Martini Hospital, Groningen, Netherlands.
University Medical Centre Groningen, Groningen, Netherlands.
Eur J Pediatr. 2021 Jul;180(7):2165-2171. doi: 10.1007/s00431-020-03899-8. Epub 2021 Mar 1.
Pediatric use of complementary and alternative medicine (CAM) in the Netherlands is highly prevalent. The risks of pediatric CAM use are, however, largely unknown. Therefore, a 3-year survey was carried out at the Dutch Pediatric Surveillance Unit. Pediatricians were asked to register cases of adverse events associated with pediatric CAM usage. In 3 years, 32 unique adverse events were registered. Twenty-two of these adverse events were indirect and not related to the specific CAM therapy but due to delaying, changing, or stopping of regular treatment, a deficient or very restrictive diet or an incorrect diagnosis by a CAM therapist. These events were associated with many different CAM therapies. Nine events were deemed direct adverse events like bodily harm or toxicity and one-third of them occurred in infants. Only supplements, manual therapies, and (Chinese) herbs were involved in these nine events. In one case, there was a risk of a serious adverse event but harm had not yet occurred.Conclusion: Relatively few cases of adverse events associated with pediatric CAM usage were found, mostly due to delaying or stopping conventional treatment. Nevertheless, parents, pediatricians and CAM providers should be vigilant for both direct and indirect adverse events in children using CAM, especially in infants. What's Known: • The use of complementary and alternative medicine (CAM) in children is common. • Previous surveillance studies in other countries showed severe adverse events may occur after pediatric CAM usage. What is New: • In the Netherlands CAM-related adverse events are rare but can occur, with variable etiology and severity (from mild to potentially life-threatening) • Most CAM-related adverse events are not directly the result of CAM toxicities but rather are associated with withdrawal from appropriate therapies or with providers unable to recognize health-relevant states and delaying important diagnoses.
荷兰儿童中补充和替代医学（CAM）的使用率非常高。然而，儿科 CAM 使用的风险在很大程度上尚不清楚。因此，荷兰儿科监测单位开展了一项为期 3 年的调查。儿科医生被要求登记与儿科 CAM 使用相关的不良事件。在 3 年内，共登记了 32 例独特的不良事件。其中 22 例不良事件是间接的，与特定的 CAM 治疗无关，而是由于延迟、改变或停止常规治疗、饮食不足或非常受限或 CAM 治疗师的错误诊断。这些事件与许多不同的 CAM 疗法有关。9 例被认为是直接的不良事件，如身体伤害或毒性，其中三分之一发生在婴儿中。只有补充剂、手动疗法和（中药）草药涉及这 9 例事件。在一个案例中，存在严重不良事件的风险，但尚未发生伤害。
与儿科 CAM 使用相关的不良事件相对较少，主要是由于延迟或停止常规治疗。然而，父母、儿科医生和 CAM 提供者应该对使用 CAM 的儿童的直接和间接不良事件保持警惕，尤其是婴儿。
儿童补充和替代医学（CAM）的使用很常见。
以前在其他国家的监测研究表明，儿童 CAM 使用后可能会发生严重的不良事件。
在荷兰，与 CAM 相关的不良事件很少见，但可能会发生，其病因和严重程度不同（从轻到潜在的危及生命）。
大多数与 CAM 相关的不良事件不是 CAM 毒性的直接结果，而是与适当治疗的停药或提供者无法识别与健康相关的状态以及延迟重要诊断有关。
