medicine for children
Transcription
medicine for children
MEDICINE FOR CHILDREN Homeopathy and anthroposophic medicine in paediatric use EDITORIAL 2 EDITORIAL The birth of a child completely changes the lives of the new parents. Among the many questions and decisions facing first-time parents, one of the most important is: how do I help my child to become healthy and which therapeutic approach is the right one? At this point, many parents decide in favour of complementary, alternative medicine. Besides expecting efficacy and safety, they also wish for a gentle and well tolerated form of medicine offering therapeutic treatments and remedies attuned to the specific physical and mental requirements of their child. Samuel Hahnemann, the founder of homeopathy, was already searching as long ago as 1796 for a naturopathic remedy to save his own children from an epidemic of scarlet fever, and discovered that belladonna is effective against this childhood disease. In the early 1850's, the first homeopathic paediatricians became established, such as Foubustier in London, and were joined by increasing numbers of paediatricians of the homeopathic and anthroposophic school of medicine throughout Europe (e.g. Imhäuser, H. Michael Stellmann and von Linden). At present, more than 50,000 homeopathic and anthroposophic practitioners are active prescribers in the European Union. More and more people are deciding in favour of alternative medicine: a Dutch study dating from 2001, commissioned by the Royal Association of Homeopathy of the Netherlands (KVHN), shows that 41% of the parents surveyed prefer homeopathic remedies for the medical treatment of their children, while 43% favour allopathic medicines. Children currently account for more than 40% of patients treated in anthroposophic Practices in Germany. 3 Despite their high success rate, alternative therapies and medicines have been viewed very critically by many allopathic physicians. A large number of clinical and experimental studies evaluating the efficacy of alternative medicine are now available . 1 A study in the Netherlands in 175 children suffering from recurrent infections of the airways has shown that fewer recurrences are seen on homeopathic treatment and that the consumption of antibiotics is lower than in the placebo group, although the difference was not statistically significant . 2 Children also appear more receptive to homeopathy than adults. A pilot study showed that homeopathic treatment was most successful in children between 2 and 11 years old, followed by children aged between 12 and 17 years. Treatment outcome was less favourable in the corresponding conventional treatment group . 3 4 Parents not only wish to combat diseases, but also to enhance their children's general health condition. This is why they are more and more requesting a pluralism of methods, i.e. the freedom to choose between different diagnostic and therapeutic forms. Only when allopathic and alternative medicine are accorded an equal status and can be applied alongside each other child centred paediatrics will be able to adjust to the special needs of these small patients. Sabine Backes-Aghte (for the editorial team) 1 2 3 4 4 See e.g. several studies of Dr. Helmut Kiene de Lange de Klerk, E.S.M., Blommers, J., Kuik, D.J., Bezemer, P.D., Feenstra, L Effect of homoeopathic medicines on daily burden of symptoms in children with recurrent upper respiratory tract infections, 1994. van Berckel Smit, J.A.C.M., A pilot study evaluating the efficacy of homeopathy in daily practice, Brit. Hom.J. 82: 9-15 (1993) Riley, D, Fischer, M, Singh, B, Haidvogel, M, Heger, M,: Homeopathy and conventional medicine: an outcomes study comparing the effectiveness in a primary setting. J Alternative Compl Med. 7: 149 – 159 (2001) PAEDIATRICS TODAY When we consider the rate of infant and child mortality that still existed in our grandparents' days, it is evident that paediatric medicine has made enormous progress. The improvement in hygienic conditions and the discovery of penicillin are milestones along this road. From the moment the infant first glimpses the light of day, its path is flanked through early childhood and on into school age by a comprehensive system of medical care and supervision. Conventional medicine offers a rich programme of medicines and therapies. But changed living conditions and the special health constitution of our children are increasingly calling for this medicine to be supplemented by complementary, alternative forms of therapy attuned to the child's body. But what exactly is holistic paediatrics? Is it concerned only with the cure and management of diseases? Or do these ailments, and especially childhood diseases, rather have to be viewed and interpreted in a broader way as they are closely related to the individual child's development ? Fact is: the maintenance of children's health therefore should be placed at the centre of all paediatric endeavours with the aim of preventing future illnesses ? 5 6 5 6 Tautz Christoph, Kinderkrankheiten – Krankheiten im Kindesalter! Stuttgart 2000 Glöckler, Michaela, Kindsein heute. Stuttgart 2003 5 HOW TO COPE WITH DISEASES? All parents are familiar with this stage in their child's development: at the latest when their child first walks through the kindergarten gate, infections and childhood diseases increasingly find their way into the family home. Whether cold, cough, middle ear inflammation or gastrointestinal catarrh, infections like these may be expected to crop up on an almost monthly basis, especially during the cold seasons. How helpful and reassuring is the visit to the familiar children's doctor who provides the desired relief by prescribing the necessary medications. And this is indeed the most fundamental purpose of paediatrics: coping with and warding off disease. Exactly at this point complementary paediatrics take the child itself (and not just the disease) with all its unique personal characteristics into the focus of medical treatment. This holistic approach thus creates an overall picture of the physical and mental-psychological situation and – in case of of illness – identifies deficits and imbalances in the child . Based on this, it offers an individualised treatment approach tailored to the patient's own personal potentials, in which the child is always perceived as an independently acting human being. 7 CHILDREN’S DISEASES AS A CHANCE TO DEVELOP AND STRENGTHEN THE CHILD’S BODY In paediatric practices there are not only the above mentioned infections, but also the usual childhood diseases. Complementary, alternative paediatrics view typical children's diseases from a new perspective: Are these really childhood diseases and to be equated with asthma, bronchitis or rheumatism? Or aren’t childhood diseases rather experiences or stages along the child's path of self-development? Aren’t they rather to be seen as a further step towards the child developing immunocompetence, in other words a strengthening and concentration of childhood immunity ? In fact, children regularly emerge strengthened and more mature from childhood diseases. 8 7 8 6 Tautz Christoph, Kinderkrankheiten als Weg zur Immunkompetenz in Der Merkurstab – Pädiatrie, Sonderheft IV Tautz Christoph, Kinderkrankheiten DEVELOPMENT OF SUSTAINABLE HEALTH OF CHILDREN Classical paediatrics is mainly concerned – as already mentioned above – with gaining control over of the disease and its etiologic agents. However, paediatrics can go into action even before the disease develops by investigating and preserving the child's original health. What – on the other hand – makes children "healthy children" and how can this health be maintained ? This concept, named salutogenesis, was invented by the medical sociologist Aaron Antonovsky (1923 – 1994) and attempts to elicit a conclusive answer to the question "Why are people healthy?". The WHO defines health as a state of complete physical, mental and social well-being . Antonovsky goes even further and speaks of a sense of coherence, the ability to experience and perceive oneself as part of the world . In this way, understanding and experiencing the deeper sense of one's own actions and facing the world with self-confidence and a sense of belonging become the fundamental pillars of health. However, this also makes parents and physicians the co-architects and custodians of children's health. 9 10 11 With an interplay of all three components, coping with and warding off disease, perceiving disease as a developmental step in the child's biography and a means of strengthening the personality, paediatrics as an interaction of conventional and alternative medicine can now point the way towards a new approach. 9 10 11 Glöckler Michaela, Kindsein heute Koch Ulrich, Impfen im Kindes- und Erwachsenenalter – Ein kritischer Ratgeber aus homöopathischer Sicht, Nr. 16, Page 12 Gleide Corinna quoted according to Antonovsky Aaron: Salutogenese. Zur Entmytifizierung der Gesundheit, Tübingen 1997 in die Drei 8/9 2004 7 PAEDIATRICS REQUIRES CHILD CENTRED MEDICINE In contrast to adults, the child's body is not (yet) fully formed, certain organs only reach maturity in adolescence or adulthood and many processes are still in the process of completion. The entire body is busy with its self-creation and maturation. It concentrates its forces inwards and is thus unable to respond in the same way as the fully grown body to external influences. What could be more appropriate, therefore, than to administer to the growing person gentle remedies containing natural substances that are both effective and well tolerated and are practically free from adverse reactions. A further important aspect is to promote the body's intrinsic activity and involve the sick child as an independently acting being in the various therapeutic procedures. Illness can then be overcome through the individual's own resources by stimulating the body's self-healing powers . 12 12 8 Soldner Georg und Tautz Christoph in Der Merkurstab, Pädiatrie, Sonderheft IV COMPLEMENTARY MEDICINE IN PAEDIATRICS The efficacy and only slight side effects of homeopathic and anthroposophic medicines can be traced back and verified over many centuries. Today they are subject – like allopathic medicines – to complex and strict rules of testing. Effectiveness, safety and quality are evaluated very rigorously. Complementary medicines are compositions of purely plant derived substances, but also include components of plant, mineral and animal origin. Particularly their effectiveness and low rate of side effects are persuading increasing numbers of parents to provide health care for their children using alternative medicines. For example, homeopathy and anthroposophic medicine often achieves remarkable positive results in children with asthma, allergies and neurodermatitis where allopathic medicine has reached the limits of its effectiveness. The child's active participation in the therapy as well as healthy food and lifestyle are accompanying the therapy in a positive way. Conventional medicine still views alternative medicine as placebo medicine. Yet especially in paediatrics, this claim is untenable. How otherwise to explain that infants and children are cured when in their case the thesis "Homeopathy is only effective because people believe in it" is completely inapplicable . And this claim is disproved not least by the fact that an increasing number of physicians trained in conventional general medicine are embracing homeopathy as a supplementary specialisation and are publishing credible reports of successful homeopathic cures . 13 14 13 14 Dellmour, Friedrich: Homöopathische Arzneiwirkung oder Placebo? Wirknachweise in der Homöopathie Dellmour, Friedrich: Homöopathische Arzneiwirkung oder Placebo? 9 AN INTEGRATED APPROACH CONVENTIONAL MEDICINE AND COMPLEMENTARY PAEDIATRICS It is becoming increasingly apparent that an excess of conventional medicine can also be harmful. A growing number of chronically ill children and the enormous increase in allergies are now being seen as linked to the increasingly widespread use of antibiotics and interpreted as reactions to multiple vaccinations . Nevertheless, conventional medicine is indispensable and confers many benefits. It is here that complementary paediatric medicine takes up the challenge and, as a supplementary discipline with a holistic approach perceives the child as an independently acting being. With its veritable richness and variety of gently acting, well proven natural remedies, it offers a well tolerated and child oriented medicine with a much lower rate of side effects. Awareness of this fact also relieves parents of some of their worries and anxieties. And together with their child and the treating physician they can take an acceptable course of action which never loses sight of the fact that the patient is a child. 15 15 10 Soldner Georg in Der Merkurstab, Pädiatrie, Sonderheft IV Georg Soldner is a paediatrician in Munich, Germany. He published several books and numerous articles in international medicinal journals on paediatrics and complementary medicine. ECHAMP How can complementary paediatrics broaden the scope of conventional paediatrics? Soldner “Complementary paediatrics sees the child primarily as a developing organism, capable of learning and with its own independent spirit. Providing it with external stimulation can place it in a position where it can overcome diseases by its own resources. As an acting person, it passes through and develops learning processes during the illness which can cure it and also protect it against future diseases (e.g. immunity): every disease overcome by the organism itself thus permanently strengthens the health of the body. On the one hand, modern paediatrics needs conventional medicine, for example to gain control of severe bacterial infections and keep them at bay through external interventions and treatments. On the other hand, it also needs complementary medicine to stimulate the body's own healing forces from within, promote detoxication processes and support the child in its endeavours to recover its health by its own efforts.” ECHAMP What specific successes can be achieved with complementary medicine in paediatrics? Soldner “A study from 1999 (Lancet. 1999 May 1;353 (9163):1457-8) published in the internationally respected medical journal The Lancet has shown that if children are consistently treated with complementary medicine from the beginning, the rate of allergies is much lower during school age 11 or later childhood. The frequency of neurodermatitis, asthma and hay fever in this comparative study was up to 70% lower on a complementary medical regimen combined with biological-dynamic diet than when the children received conventional treatment and nutrition.” ECHAMP For which therapeutic indication complementary treatment is most suited? Soldner “Neurodermatitis and acute infections heal much more quickly with homeopathic and anthroposophic preparations. Also, there a fewer side effects and the patient remains sustainable healthy.” ECHAMP What experience have you gathered as regards the well-being and satisfaction of patients and their parents during the therapy? Soldner “At the start of an alternative therapy, quite heavy demands are placed on both children and parents; often it is necessary to endure 1-2 days of high fever. Since it is not immediately suppressed by antipyretics or similar medications, but rather the body overcomes the illness by drawing on its own resources, this "threshold" first has to be crossed. After a few days the patient feels much better. Late complications are also much more rare. Parents are happy to accept this situation; only few decide to terminate the therapy.” 12 ECHAMP Why do parents decide in favour of complementary therapy? Soldner “Parents often have a strong aversion to toxic medicinal products and wish to avoid their children being chronically exposed to these agents. This is why they prefer a gentle, well tolerated medicine with few side effects. Experiences such as permanent skin damage during the long-term use of cortisone ointment in neurodermatitis have shown that the use of allopathic medications can involve risks. In my 19 years as a paediatrician I have not observed a single threatening adverse reaction for children due to the intolerability or side effects of an alternative medicine.” ECHAMP Does the continuous administration of allopathic medicines encourage chronic diseases? Soldner “Especially in the prosperous industrialised countries in which a vast range of conventional medications is continuously available and industrially processed foods are often served up on a daily basis, the rate of childhood asthma has doubled. Lifelong diabetes (Type 1) in children under 4 years of age is increasing by 6% annually: in the period from 2000 to 2020 the number of diabetic children will have doubled. And this although it is now proven that this is not for genetic reasons but is exclusively attributable to changed environmental conditions, particularly diet and medical treatments including vaccinations. The use of antibiotics is leading to an increase in the number of children with allergic diseases. This development is not observed in children treated exclusively by complementary medicine.” 13 ECHAMP Is today's paediatrician tomorrow's geriatrician? Soldner “There are studies which show that the risk of arteriosclerosis, and most likely also the risk of developing cancer, differs during adulthood depending on nutrition and medical treatment during childhood: for instance, prolonged breast feeding protects against vascular calcification in the second half of life. Unfortunately the suppression of fever is still given first priority among standard therapeutic interventions in paediatrics; however, the presumed benefits of this approach are not substantiated by any scientific research. On the contrary: viral infections, for example, remit faster and better during high fever, and even the incidence of febrile seizures is not influenced by antipyretic therapy! This puts the paediatrician's activity in a completely new light. The scope of modern paediatrics must be broadened by integrating this holistic view and acknowledging its true status as the cornerstone of the human biography.” 14 ECHAMP What development do you see in paediatrics? Soldner “At present I see the situation in paediatrics as resembling the "national debt". The more we use conventional medicine during childhood – including for non-life-threatening diseases – and the less children learn to overcome acute diseases themselves with the aid of complementary medicine and their parents' care , the more chronic diseases will manifest among children and later on in adulthood. The costs of treating these diseases will rise to dizzying heights. Yet this situation is not inevitable, particularly not in childhood! But it can only be reversed if we all take upon ourselves more mental and physical activity. We should accept acute illness as a challenge on which it is worth concentrating on our strength in order to overcome it with our own resources. And we must also expect children to embrace this process, naturally only to the extent where it involves no risk. Complementary medical paediatrics, and especially anthroposophic medicine and homeopathy, offer many ways for children to engage in this independent healing process. Conventional medicine based paediatrics has so far proved helpless in the face of the growing incidence of bronchial asthma, diabetes mellitus and eating disorders. In view of these major challenges to paediatric prophylaxis, medicine will no longer be able to manage without complementary approaches. Combating disease has to be backed up by a conscious promotion of health; this is the message with which we should enlarge conventional paediatric medicine.” The interview was done by Sabine Backes, Munich, March 2005. 15 CHILDREN DISEASE CHILDHOOD DISEASES AND THEIR SIGNIFICANCE A sick child often plunges the parents into a maelstrom of worries and questions. This is where paediatrics has to provide support for parents and children, point out methods of treatment and create a basis of trust in order to overcome the disease. CHILDHOOD DISEASES At all times, children's growth and development have been accompanied by diseases. Although a cause of concern to parents, illnesses when overcome are seen to have brought about a change in the child. Suddenly it has acquired new abilities, its personality has matured, and it has gained a new, more intense quality of perception. Furthermore, the child usually also acquires lifelong immunity by having overcome the illness . Childhood diseases thus also confer added health benefits and at the same time provide new impetus for the child's development . 16 17 16 17 16 Tautz Christoph, Kinderkrankheiten als Weg zur Immunkompetenz Tautz Christoph, Kinderkrankheiten – Krankheiten im Kindesalter ES FEVER The way in which fever is perceived has changed fundamentally during mankind's history: while Hippocrates still saw fever as the body's attempt at self-preservation and Paracelsus as an intrinsic activity of the body for combating disease, fever is now regarded mainly as a health hazard to be countered by giving medications . The multiplicity of antipyretic agents of the kind now to be found in almost every home bears testimony to this view. Clinical observations have shown that children given antipyretics recover slower from ailments like smallpox than non-medicated children. The same observations have been made for viral diseases: children overcame the illness faster without antifebrile drugs. Fever can therefore be seen as an intrinsic activity and an expression of the body standing up for itself, and not solely as a pathological disorder that can lead to severe health impairments. However, temperature has to be observed carefully and if necessary, lowered by simple physical methods (e.g. cold leg compresses) 18 INFECTIOUS DISEASES Infections like common colds, middle ear inflammation or diarrhoea are constant companions throughout childhood. Very often, antibiotics and antipyretics are already prescribed at the first signs of illness. And yet by giving gentle medications, the immune defence processes taking place in the child's body can be stimulated and supported. The frequent occurrence of infectious diseases requires a natural, gentle therapy which strengthens the body and immune system in the long-term. 18 Tautz Christoph: Kinderkrankheiten als Weg zur Immunkompetenz 17 18 WHAT PARENTS SAY... I discovered complementary medicine for myself and for my family from that moment on when we had children. (Ceilith Rowe, Bristol, United Kingdom) I feel good giving homeopathy to my children because I experienced those remedies as very effective, easy to apply and the children love their “beadlets”! (globules) (Bettina Appel, Brussels, Belgium) Since I treated my children with homeopathy they are stronger and their constitution is more resistant to infections. (Edwige Burkart-Nourrichard, Strasbourg, France) On holidays I always take for my family the homeopathic travel case with us. (Joana Matos, Lisbon, Portugal) In our family Arnica and Calendula are the most frequently used first aid treatments. We couldn't do without it! (Mary Stoorvogel, Bergen, The Netherlands) Parents are nowadays fully empowered and active partners of the physician. Increasing transparency both in medical and pharmaceutical / pharmacological respects, has created this situation. But also a close analysis of disease and the requirements of the child's body which is different from that of adults. For their children, who are in a phase of both physical and mental development, parents desire safe, reliable medicines which expedite recovery but which also and above all must be well tolerated. For acute and chronic diseases, the risk of side effects for the child should be excluded to the greatest possible extent. 19 Aware of their responsibility and obligation of care, parents demand a free choice of therapeutic approach for their child. Neither governmental nor ideological constraints must be allowed to interfere in these choices. The medical treatment should always have first priority in the interest of the child's well-being. Both cooperation with physicians and disclosure of the individual therapeutic measures is a major concern of parents. However, this also means not to regard illness only as a threat. Rather, parents should place trust in the therapeutic methods employed by the paediatrician and in the abilities and strengths of their child. 20 "NICE FOLKS" Based on an interview with Tosia Kossakowski, homeopathic paediatrician based in Amsterdam " Children, nice folks" that’s how Tosia Kossakowski characterised her patient clientele. Although initially reluctant to choose paediatrics, this medical specialisation became her daily profession, rather than psychiatry or surgery which were originally her first choices. Dr. Kossakowski studied medicine at Nijmegen University. She has now been a medical doctor and registered paediatrician for 20 years. She is a down-to-earth doctor, a practical "doing" person. The interview took place in her Amsterdam office. A cosy working room, with the usual doctors’ gadgets, large chairs, a little stool, dolls and a Donald Duck on the desk. She first made contact with homeopathy during her clinical rotations in a Lelystad hospital, where she witnessed the swift recovery of a child suffering from high fever following an insect bite after being treated with the homeopathic medicine Apis. This experience and the lectures of Alphons Geukens, a prominent Belgian homeopathic physician, stimulated her interest and decided her to enrol in a post graduate training course in homeopathic medicine. The impressive, fully documented case of how a child suffering from severe Osteogenesis imperfecta (an extremely fragile bone structure) was brought to a state of cure and well-being convinced her to concentrate on homeopathy. 21 THE CHILD AS A PA The child as a young human being often presents a clearer case to the doctor than an adult. This is probably because it is less constrained by conventions and expectations and is able to express its primary reactions more directly. Usually the parents take the initiative in seeking homeopathic advice, although some of Dr. Kossakowski's patients also come on referral from other colleagues and specialists. Parents usually decide to see a homeopath when regular treatment fails to deliver the expected results or simply because they consider it to be the best possible option for their child. The first consultation usually takes an hour to an hour and a half. Besides taking a detailed homeopathic history, the doctor also performs a normal physical examination. A prescription is given for the pharmacist and the case is documented in the required manner. "A lot of paperwork!" "It's often amazing what comes out during these interviews and what children remember from their early childhood. Not only about their own situation but also the general family situation. Frequently, parents are astounded to hear their child describing its situation and its observations". Evidently events during the first few years of life play a significant role in everyone's health history. Many illnesses seem to have their roots in events during these primary years. 22 ATIENT The data are also recorded for pooling in outcome studies. Dr. Kossakowski is a member of the HARP project, in which a large number of Dutch homeopathic physicians participate and which aims to propagate and publicise the effectiveness of homeopathy. The growing size of the practice is an indicator of patients' satisfaction. There is good contact between doctor and patient. When therapy was successful, patients don't return. Sometimes patients return after ten years just to mention they recovered after the first homeopathic treatment and so there was no reason to come back earlier. TYPICAL CHILDREN’S AILMENTS Besides the typical children’s illnesses, the conditions most commonly encountered by paediatricians are eczema, respiratory tract diseases, behavioural and developmental disorders, as well as digestive complaints and allergies. Homeopathy has a good track record in treating anxiety, fear and depression, although these are mainly the domain of child psychiatrists. Since great restraint should be exercised in prescribing antidepressants to children, homeopathic remedies can be an excellent solution in such cases. 23 24 REGULAR MEDICINE Dr. Kossakowski takes a pragmatic view of conventional medicines. "We should be grateful for the existence of antibiotics". Nevertheless they should be prescribed and taken with common sense. "When a child is receiving allopathic and homeopathic medicines concurrently, I will always make sure that the conventional medicine is taken as it should be – for example by providing a prescription for penicillin". And she adds with confidence: "Moreover, when the right homeopathic remedy has been chosen, it will have its beneficial effects anyway." VACCINATION As regards vaccination, different areas of responsibility need to be distinguished. Governments clearly have a different type of responsibility than an individual doctor. Depending on the individual child's constitution, it might be wise in some cases to adapt the vaccination procedure to suit the child's personal needs. Homeopathic physicians are by no means hostile to vaccination. On the contrary, homeopathy offers good resources for alleviating the adverse effects of vaccination. REWARDING Homeopathy is a very rewarding therapy. "It is good to see that after a homeopathic treatment, the child has acquired a better balance. It has become more mature. What used to be a behavioural problem in the past is now suddenly no longer a problem". Spectacular results are sometimes also achieved in more severe cases. She is not discouraged by the fact that opponents of homeopathy dismiss her successes as "serendipitous". "Body follows mind" – more basic research needs to be done, since the solution to the homeopathic enigma is to be found in physics and not in chemistry. Apparently Dr. Kossakowski is not alone in her opinion, although at present it is still controversial. The interview was done by Frank Bech, Amsterdam, March 2005. 25 CONCLUSION In a time of rapidly changing circumstances and habits, but also of new developments in health policy, modern paediatrics can point the way in a new, groundbreaking direction. Although children – especially in Europe – live under the most advanced conditions, a widespread lack of physical and mental-emotional exercise, dietary deficits and an excess of allopathic medicines can be deleterious to children's health. Illness also needs to be redefined and not merely accepted as an adverse situation. Illness offers the child a chance to become healthy by using its inherent abilities, exercising its own initiative and developing its personality. The child thus becomes the exclusive focus of all medical endeavours. Its individuality must be the physician's starting point for finding the appropriate form of therapy. Perceiving the child as an independently acting person, and not merely as a patient to whom medicine is administered from outside and who is treated from outside, must be the initial point of approach to all therapy. This paediatric medicine must continue to be based on the use of child-appropriate medicines of a potency suited to the needs of the child's body and which support conventional medicine at the critical points. Paediatrics must also increasingly be understood as a health promoting discipline: wherever health exists, it must be maintained and should be seen as the basis of the child's further development. When it takes all these aspects into account, paediatrics can fulfil all the requirements both of medicine and of parents themselves. 26 27 ECHAMP European Coalition on Homeopathic and Anthroposophic Medicinal Products E.E.I.G. Avenue Livingstone 33 1000 Brussels Belgium Phone +32-2-235 09 81 Fax +32-2-235 09 82 Email [email protected] http www.echamp.org ECHAMP gratefully acknowledges the achievements of the editing team (Sabine Backes-Aghte with Frank Bech and Christine Wild). 1st edition, April 2005 Illustrations: Our sincere thanks to Biologische Heilmittel Heel GmbH, Dr. Peithner KG nunmehr GmbH & Co, VSM Geneesmiddelen BV, WALA Heilmittel GmbH and Weleda AG for the pictures used in this brochure, as well as the private pictures and drawings received from the families Appel, Backes-Aghte, Bech, De Decker and Zupan. Layout: International Graphics & Productions Copyright 2005 by ECHAMP E.E.I.G., Brussels, Belgium. All rights reserved. Except for the explicitely by law mentioned exceptions, nothing from this brochure may be duplicated, saved or published on any way, without the explicitely preceding and written confirmation from ECHAMP E.E.I.G.