The Use of Complementary and Alternative Medicine (CAM) in NICU

 

Reviewed by Carl Kuschel
with advice from ADHB Legal Services
March
2005
Clinical Guidelines Back Newborn Services Home Page
Background Summary References

Background

Having a baby in the NICU is a stressful experience for parents.  For some parents, conventional medicine may not fit well with their framework of personal, health, and spiritual beliefs.  Occasionally, parents will request that their infant receives complementary and alternative medicine (CAM) care (for example, naturopathy, osteopathy, or homeopathy).

The prevalence of CAM in NICUs is not widely reported. 1 Some interventions that have previously been regarded as “complementary” 2 (for example, kangaroo care, and music therapy) have moved more into mainstream “conventional” care within the bounds of some developmental care practices.  For older children, there is evidence that CAM use is relatively prevalent. 3  In an Australian paediatric gastroenterology outpatient setting, 36% of children were using or had recently used CAM, and 78% of their parents indicated that they would use CAM if they thought it would be beneficial. 4  Similarly, 18% of children were receiving CAM treatments at the time of hospitalisation for acute illness in a New Zealand paediatric inpatient unit. 5  Many parents of children in a paediatric ICU suggested that they would appreciate the opportunity to provide CAM therapies, and those that were using CAM were reluctant to discuss this with conventional medicine providers. 6

The Health and Disability Code of Rights states that “every consumer has the right to be provided with services that take into account the needs, values, and beliefs of different cultural, religious, social, and ethnic groups”. 7  Whilst the code is geared more for adults who are able to make autonomous decisions, there is potential conflict where parental beliefs may conceivably place their infant at risk by not providing appropriate conventional care or by exposing the infant to risk from untested or dangerous therapies (particularly medications that may interact with conventional medicines).  The legal position of the Auckland District Health Board is that Newborn Services is responsible for the care of infants in NICU and under paediatric care in the postnatal wards.

Summary

References

1 Mark JD, Barton LL.  Integrating complementary and alternative medicine with allopathic care in the neonatal intensive care unit.  Alternative Therapies in Health and Medicine;2001;7:134-6.
2 Jones JE, Kassity N.  Varieties of alternative experience: complementary care in the neonatal intensive care unit.  Clin Obstetr Gynecol 2001;44:750-68.
3 Ernst E.  Prevalence of complementary/alternative medicine for children: a systematic review.  Eur J Pediatr 1999;158:7-11.
4 Day AS.  Use of complementary and alternative therapies and probiotic agents by children attending gastroenterology outpatient clinics.  J Paediatr Child Health 2002;38:343-6
5 Armishaw J, Grant CC.  Use of complementary treatment by those hospitalised with acute illness.  Arch Dis Child 1999;81:133-7.
6 Moenkhoff M. Baenziger O, Fischer J, Fonconi S.  Parental attitude towards alternative medicine in the paediatric intensive care unit.  Eur J Pediatr 1999;158:12-7.
7 The HDC Code of Health and Disability Services Consumers' Rights Regulation 1996.Clause 2, Code 1.  Available online at http://www.hdc.org.nz
8 Cohen MH, Kemper KJ.  Complementary therapies in pediatrics: a legal perspective.  Pediatrics 2005;115(3):774-80.
9 Anonymous.  Guidelines on complementary, alternative or unconventional Medicine.  Medical Council of New Zealand.April 1999.  Available online at http://www.mcnz.org.nz/portals/1/Guidance/guidelines%20on%20complmentary%20medicine.pdf