A holistic approach to child health care

The health of your child comes down to a million little moments. (Fruit for lunch? A long nap? Stress over a math test?) A holistic approach considers them all.

Sometimes a kid’s health comes down to a simple formula: Fever? Pass the ibuprofen. But when matters are more complicated—for instance, when there’s a chronic condition, like asthma, or a stress-related ailment, like migraines—popping a pill may not be enough. According to the holistic approach to pediatrics, the best way to get a kid healthy, and keep him that way, is to consider every aspect of his lifestyle—his diet, his environment, his way of handling stress.

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Jack Maypole, the director of pediatrics at the South End Community Health Center, in Boston, and an assistant professor at the Boston University School of Medicine, is one of a growing number of doctors who are integrating holistic methods into their mainstream practices. Real Simple asked him to explain the “whole kid” philosophy and describe how it can complement traditional medical care—without replacing it.

How is a holistic approach different from the usual trip to the doctor’s office?

It’s not just about medicating symptoms, which is what medical schools have traditionally taught doctors to do. We’ve come to think of illness as a catalog of problems to be solved. This can be cool and makes for great TV—shout-out to Dr. House here. But we tend not to think enough about wellness. In many cases, you have to take a 360-degree look at a patient to get to the root cause of an issue. That’s what a holistic approach really is—it’s not necessarily whale songs and scented candles. (Not that there’s anything wrong with whale songs and scented candles.)

What is an example of holistic medicine at work?

Consider one of my patients, Rolland (this name has been changed to protect the patient’s privacy)—he’s 12. He had been having severe asthma attacks and was taking more and more medication, but he was still wheezing all the time. He was also gaining weight. So I asked him and his mom some questions to get the bigger picture. Rolland said his wheezing was worse at home, and as it turned out, his house had some mold issues. He had been inside a lot because his mom was understandably concerned that running around outside would make his wheezing worse. He got bored and anxious, so he ate more. Weight gain makes it harder to treat asthma. Vicious-circle city! We all agreed it was time for a shift. His family addressed the mold issues. His mom, quietly and heroically, began transforming her grocery-shopping habits—no more junk food. Rolland started a martial-arts class, which helped him head off the anxiety that had once made him wheeze. One change built upon another. Now Rolland is at a healthier weight, he’s at the park again playing hoops, and we’ve been able to reduce some of his medications.

So holistic medicine isn’t about cutting out the traditional stuff.

It’s about being a “both/and” problem-solver rather than an “either/or” type. For a patient with strep throat, I might prescribe amoxicillin, and his mom might also be delighted to know that slippery-elm tea might take the sting out of his throat. When possible, it’s about letting natural remedies and mind-body treatments, like meditation, complement mainstream medicine.

Where do mind-body treatments come in?

Pediatrics, like parenthood, is a risk-benefit analysis, and if there’s quality evidence to support that a complementary treatment is safe and effective, then I’ll recommend it. And there is sound clinical research to support some of this stuff. Massage therapy, for instance, can reduce symptoms in kids who have anxiety or eczema—a condition that may not be caused by stress but is made worse by it. There are also a number of studies that indicate acupuncture can be effective for kids with conditions like headaches or pain. On the other hand, I wouldn’t suggest a homeopathic remedy for an ear infection—not because it will hurt anything but because it’s not clear that it will help. And parents have to be wary about the lack of regulation around the manufacture of herbs and dietary supplements. Caveat emptor! Stick with what you can get from companies known for selling quality products, like Trader Joe’s and Whole Foods.

Are most kids’ health providers receptive?

You may be surprised. Studies have shown that we mainstream docs are increasingly aware of complementary treatments. I urge parents to test the waters by asking their child’s doctor about gentle herbal remedies, like chamomile for colic and aloe for burns. A source I recommend for initial research is NaturalDatabase.com, which lists conditions and gives you conventional medicines and natural remedies, along with information about what the clinical evidence supports. Whatever you decide, it’s important to loop in your child’s primary-care provider, because she knows your child and may be in the best position to understand whether a particular therapeutic approach makes sense or is safe. A child is not a little adult. Kids have a unique physiology that changes as they grow, so we can’t necessarily administer pharmaceutical or natural products known to work safely for grown-ups and assume they’ll be OK for a child.

Do you learn from the parents?

Absolutely. Doctors can offer clinical experience, risk analysis, and compassion. But parents give us our reality checks and present us with new therapies to consider and chances to learn—and they help keep our eyes on the prize, which is a healthy kid. Parents also hold the inestimable powers of love, hugs, and chicken soup.

The Scoop on Holistic Pediatrics

Holistic pediatrics is a growing field: The American Academy of Pediatrics (AAP) Section on Complementary and Integrative Medicine has quadrupled its membership since 2005. But there isn’t yet a certified subspecialty in complementary medicine for pediatricians and family practitioners, so “holistic pediatrician” is a loose term. It might describe that doctor’s philosophy, or it might mean the doctor attended an academic program that offers specialized training. There are a few such training programs, most notably at the Beth Israel Medical Center’s Continuum Center for Health & Healing, in New York City, and at the University Medical Center of the University of Arizona, in Tucson. Also, the National Center for Complementary and Alternative Medicine at the National Institutes of Health, in Bethesda, Maryland, has a growing roster of research programs. For a list of doctors who identify themselves as holistic, check out the Complementary and Integrative Medicine section of the AAP’s site.

Jack Maypole advises parents who are looking for a new doctor to seek recommendations from a few sources: nearby academic medical centers, local or regional parenting sites, and, of course, other parents.