European Journal of Pediatrics

, Volume 173, Issue 11, pp 1413–1428 | Cite as

Patterns of Complementary and Alternative Medicine (CAM) use in children: a systematic review

  • Salvatore Italia
  • Silke Britta Wolfenstetter
  • Christina Maria Teuner


Utilization of Complementary and Alternative Medicine (CAM) among children/adolescents is popular. This review summarizes the international findings for prevalence and predictors of CAM use among children/adolescents. We therefore systematically searched four electronic databases (PubMed, Embase, PsycINFO, AMED; last update in 07/2013) and reference lists of existing reviews and all included studies. Publications without language restriction reporting patterns of CAM utilization among children/adolescents without chronic conditions were selected for inclusion. The prevalence rates for overall CAM use, homeopathy, and herbal drug use were extracted with a focus on country and recall period (lifetime, 1 year, current use). As predictors, we extracted socioeconomic factors, child’s age, and gender. The database search and citation tracking yielded 58 eligible studies from 19 countries. There was strong variation regarding study quality. Prevalence rates for overall CAM use ranged from 10.9–87.6 % for lifetime use and from 8–48.5 % for current use. The respective percentages for homeopathy (highest in Germany, United Kingdom, and Canada) ranged from 0.8–39 % (lifetime) and from 1–14.3 % (current). Herbal drug use (highest in Germany, Turkey, and Brazil) was reported for 0.8–85.5 % (lifetime) and 2.2–8.9 % (current) of the children/adolescents. Studies provided a relatively uniform picture of the predictors of overall CAM use (higher parental income and education, older children), but only a few studies analyzed predictors for single CAM modalities. Conclusion: CAM use is widespread among children/adolescents. Prevalence rates vary widely regarding CAM modality, country, and reported recall period.


Complementary therapies Homeopathy Phytotherapy Child Drug utilization Socioeconomic factors 



This work was supported by the Munich Center of Health Sciences (MC-Health) at Ludwig-Maximilians-Universität (LMU) München. The authors want to thank Prof. Helmut Brand, Professor of European Public Health at Maastricht University, for his contribution and support. In addition, we would like to thank PD Dr. Björn Stollenwerk and Dr. Matthias Hunger for their statistical advice and support.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

431_2014_2300_MOESM1_ESM.doc (316 kb)
ESM 1 (DOC 316 kb)
431_2014_2300_MOESM2_ESM.xls (38 kb)
ESM 2 (XLS 38 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Salvatore Italia
    • 1
    • 2
  • Silke Britta Wolfenstetter
    • 2
  • Christina Maria Teuner
    • 2
  1. 1.Department of International Health, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life SciencesMaastricht UniversityMaastrichtThe Netherlands
  2. 2.Institute of Health Economics and Health Care ManagementHelmholtz Zentrum München, German Research Center for Environmental HealthNeuherbergGermany

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