‘Homeopathy is only for the kids,’ is a common misunderstanding among the public. But there are several reasons for this wrong notion, and hence, many of our clients are pediatric cases. The reason for the parents to choose Homeopathy is not due to the children’s interest to have sweet pills, and also it is not due to their option to avoid painful injections and bitter tabs, but due to the positive results they had from our medicines, that too with no side effects. We can even easily make out the kids under the care of homeopathy just by observing their alertness and energy levels. Usually, when one family decides to try homeopathy, the first one to approach for treatment will be their child. The adults usually prefer homeopathy only when they notice some positive response from the treatment given to the kids. Hence, successful management of pediatric cases is most important, especially for beginners to develop their practice.
Managing a pediatric case is not so easy due to various reasons. We do not get the subjective symptoms to prescribe, and we will have to manage the case mainly on the basis of our observatory findings and the words told by the family members. Some times, the information given by the family members may be misguiding. Amongst them, the mother is the best one to give the true picture of her child. The other family members may not be able to give more details; hence their words should be treated with caution. It is also a must to have a direct interaction with the child. In this busy world, often father alone comes for medicine for his child. We can’t easily prescribe homeopathically under such situations since the father can’t give more details regarding the case, except the common symptoms and the name of the disease. Hence, many Homeopaths are forced to prescribe climatic remedies, specifics or combinations that can’t give genuine results. Remember, there is no excuse for a failure of the case even if prescribed without direct interaction with the child. Hence, it is compulsory to educate the public regarding homeopathic case taking and clinical examination of the child for the selection of a correct remedy.
We often get confused while doing remedial diagnosis. Some times, the case does not improve even after repeating the indicated drug. Nowadays people are not ready to wait for a re-case taking, they need immediate symptomatic relief of the presenting complaints, or else they will keep on changing doctors (doctor shopping). Under such situations, we will have to use some near specifics for managing the case as a last resort. When a case fails, people often consider this as the failure of Homeopathy; they do not know that it was due to the failure of one particular homeopath to select the true simillimum. Hence our system is always blamed for the mistakes we do in our day-to-day practice!
Here are a few clinical tips that helped me on several occasions:
Crying baby: There are various reasons for a continuous cry of a baby, which should be identified by observation, clinical examination and the details told by the parents. Next comes the remedial diagnosis and management. When a crying baby is brought to us, we can consider drugs like Chamomilla. If it does not work, consider Cina. The absence of normal cry is also significant since it is common in certain infections like meningitis.
Milk vomiting: Little amount of milk eructation is common, especially when the baby is not burped enough after feeding. Aerophagia is common while feeding and thumb sucking; hence carrying the baby and patting gently can help to burp the air. I have noticed that burping even before feeding the baby helps to reduce flatulence. There are many homeopathic remedies effective when indicated. Drugs like Aethusa, Valeriana, Ipecac, Rheum, etc helped me on several occasions.
Colic: When a baby cries continuously, it is often diagnosed as colic. When we keep the palms on the abdomen, we can notice some babies stop crying, and they often respond well to Colocynth. Some kids do not even allow us to touch, and then think about Chamomilla or Ant crud. When the tongue is milky white coated, consider Ant crud. If it is due to overeating/feeding and gas, consider Nux mos. If we cant observe any findings to prescribe, then try Mag phos. In some cases of flatulent colic Cataria Nepeta Q has helped me.
Indigestion: It may be due to any change in the diet or over sensitivity of the stomach. Since it is a natural mechanism to throw away the unwanted items, feeding the same kind of food should be avoided. Easily digestible food items like gruel should be given. Overfeeding has to be avoided since over distention of stomach can initiate vomiting reflex. Water balance should be maintained by giving fluids rich in electrolytes. Small amount of food and water, little by little, causes less irritation to the stomach. The commonly indicated drugs for indigestion include Nux vomica, Ant crud, Pulsatilla, Rheum, Ipecac, Ars alb, Chamomilla.
Diarrhea: Diarrhoeal diseases are one of the common reasons for infant mortality allover the world. Our medicines have saved hundreds of children from the brim of death. Commonly indicated drugs are Podophyllum, Chamomilla, Sulphur, Ars alb, Aloes, Nux vomica. One drug I often use when the case is about to fail is Elaterium 3x as suggested by late Dr N. K. Jayaram. On rare occasions, I have come across children having profuse diarrhea, still no weakness, then Acid Phos helped me. ORS is often useful, but the flavored ORS available in the market often doubles the vomiting, hence try to get the plain ORS supplied only through the government PHCs. ORS given little by little can maintain the electrolyte and water balance of the body. Unfortunately, ORS is rarely suggested by most of the hospitals since they prefer administration of expensive IV fluids due to obvious reasons!
Constipation: We rarely get any Indian patient saying that the bowel movements are regular! Hence the word ‘constipation’ has to be considered cautiously. Same thing is applicable when a mother says that the child’s bowels are not regular. For the actual constipation among children, drugs like Nux vomica, Alumina, Opium, Bryonia, Sulphur, etc helped me on several occasions. Each drug has got its own indications, which has to be looked for in every case. It is easy to differentiate Nux vom and opium, in Nux vom, there is urging to pass stools, whereas Opium has no desire to pass. When each remedy fails one after the other, I had prescribed Senna Q as a last attempt. Absolute constipation (no feces and flatus) should be managed cautiously, especially when it is associated with vomiting as we see in bowel obstruction. In constipation, the most important point to tell the mother is to given proper toilet training to the child. If they are encouraged to visit the toilet regularly, most of them will have normal bowels. But the common mistake done is, the children go only when they get uncontrollable urge to defecate. Most of the kids usually hesitate to defecate regularly, hence the stools gets harder due to the absorption of water, which in turn creates painful stools, finally leading to fissures in the anal orifice. Also water intake should be encouraged to make digestion and bowels movements smooth. You might have noticed many mothers saying that their children usually bring back the water they carry in their school bags. This can lead to constipation and urinary tract infection, which is very common among schoolgirls.
Worm troubles: When the child is infested with worms, it often creates troubles, even in the behavior. Drugs like Teucrium, Sabadilla, Spigelia, are some useful drugs. For umbilical pain with worm troubles, Spigelia works like magic. Drugs like Cina works for the ailments from worms. Chelon Q is useful in failed cases. Once the acute stage is over, single dose of Sulphur is found very beneficial.
Adenoids: Even without an investigation, we can diagnose adenoids from the facial expression (adenoid facies), nasal tone, poor school performance and the recurrence of infections. Medicines like Baryta carb, Iodum, Hepar, Silicea, etc helped me on several occasions. Agraphis is often prescribed when the indicated drug is not working. When associated with milky tongue, Kali mur has helped me. Nosodes like Tuberculinum has helped me in some difficult cases.
Otitis media: In breast fed babies, otitis media with discharge is very common. Usually the infection starts in the Eustachian tube and spreads to the middle ear. This is common when the breast-feeding is given in lying down position, by which the milk enters the Eustachian tube and favors infection. You might have noticed good results when breast-feeding is given in sitting position, so that no milk accumulates in the orifice of Eustachian tube. Drugs like Pulsatilla, Hepar sulph, Silicea, Psorinum are some of the commonly indicated drugs. Kali mur, Tellurium, etc are also useful. Always ask the mother to close the baby’s ear with sterile cotton before giving a bath. While traveling, it is also useful to use ear-cover to protect cold wind. Excess use of oil on the scalp and direct exposure to sun can always aggravate troubles affecting the ear.
Tongue-tie (Ankyloglossia or short frenulum): This is one of the common reasons for poor communication among children. They often feel difficult to spell certain words that need the upward movement of the tongue tip. Due to the prominence of frenulum, they are unable to do so. Surgical correction is mandatory, preferably before start attending schools.
Stammering: This can also seriously affect the social contacts of the child. Why should we bother about stammering when we have drugs like Belladonna, Cicuta, Bovista, Stramonium and many other drugs? Apart from moral support, speech therapy is also needed for certain cases.
Respiratory troubles: Asthmatic bronchitis is common among children. Indicated medicine followed by the constitutional medicine often works in most of the cases. Drugs like Natrum sulph, Ant tart, Hepar, Spongia, Bryonia etc are useful. Some tinctures to handle emergency situations are: Blatta Q, Grindelia Q, Pothos Q, Eridiction Q, Sambucus Q.
Fever: Fever is actually a defense mechanism, but the public often considers it as a grave sign. So it is very essential to educate them before managing the fever cases. In my practice, I have good result from prescribing placebo along with a few doses of the indicated remedy. Whenever I receive phone call from the panic-stricken mother saying the temperature is increased, I often suggest giving the pills (second best remedy!) very frequently. That’s enough to manage the fever as well as the tension among the family members. But this should be possible only when we are very sure about the remedy we have given, and also we should make sure that the increased temperature is not due to any complications. Drugs like Belladonna, Bryonia, Chamomilla, Rhust tox, Tuberculinum, etc are beneficial. When a case of fever with vomiting comes, I often consider Sarcolactic acid. On rare occasions I had to prescribe Baptisia Q or Veratrum virid Q. Fever cases with history of febrile convulsions should be given special consideration. I have often found drugs like Belladonna, Cicuta and Stramonium useful to prevent convulsions. For children with recurrent fevers, we should consider nosodes like Tuberculinum and Aviare.
Hand and foot and mouth disease: HFMD cases are very easy to diagnose just by looking at the mouth, palms and soles. A few years back, we had an epidemic of this viral disease affecting many children. We even had many failed cases from the hands of allopaths, which responded very nicely to our medicines. Most of the cases presented with symptoms of Bryonia, Hepar and Rhus tox. Single dose of Sulphur also helped in some cases.
Bed-wetting and UTI: I have seen many mothers hesitating to give sufficient amount of water to their children due to this habit. This will in fact make other serious health issues like UTI. Along with medicine, psychological support is highly necessary. Children should not be scolded or criticized, especially in the presence of others. Usually bed-wetting is common among the elder child when the new sibling arrives in the family, which is an attention-seeking tool. Mind often plays in almost every health issues, hence our medicines that can act on the mental level is the best option. Our drugs like Causticum, Kerosotum, Sepia, Medorrhinum, Psorinum, Sulphur etc are very useful. When the case is not responding I have used Equisetum H in tincture form. UTI is also common among school children, mainly due to less water intake and lack of toilet facility at many schools. Drugs like Cantharis, Apis, Pulsatilla, Copaiva are very commonly indicated. Among the tinctures, Uva ursi Q has helped me in difficult cases. Sarsaparilla Q is also beneficial.
Pains: Pains can be anywhere in the body. Most of our midnight patients come under this category, and the usual cases include earache, toothache and abdominal pain. Painful condition in a child is more painful for the family. Hence the selection of a suitable remedy is the challenge before us. Before prescribing, we should rule out dangerous conditions like intestinal obstruction, intussusception, torsion of testes, injury to any deep structures etc. Non-specific and psychogenic pains (psychalgia) are also common among school children. Growing pains are encountered mainly in girls. It is more severe among those who regularly take chilled soft drinks, and those who walk barefoot on marble floors. Indicated medicines with restrictions can often work like magic.
Mental and emotional issues: Since our medicines act on mental, emotional and physical planes, we have more scope than any other system of medicine. The only necessity is we should use our tools properly. Conditions like School phobia, Adjustment disorders, ADHD, Autism, Behavioral problems, Learning disorders and other childhood psychiatric disorders often respond well to our medicines. Tobacco and other addictions are now seen among the children. Snorting of whitener has been identified in many school children. Child abuse is one of the common reasons for a number of troubles, but unfortunately it is not disclosed while causal case taking. Hence counseling is needed to dig out the hidden pains inside their mind. It is mandatory to master the counseling techniques to manage such cases successfully. Once the cause is identified, our drugs like Staphysagria, Ignatia, Carcinocin, Natrum mur, Arnica etc. can do wonders.
Cartoon addiction: Nowadays it is an addiction since our children can sit for the cartoon for hours together, even by skipping their meals and other routines. Parents, especially working parents, often ignore this tendency since they do not have much time for their children. Such parents should be taught about the hazards of cartoon addiction. Cartoons can result in ADHD, poor school performance, and an even behavioral problem since ‘killing the enemy’ is the main theme in most of the cartoons and computer games!
Nail biting: We have wonderful remedies to get rid of this habit. Nail biting often indicates some issues related with the mentality and confidence levels. Repeated suggestion is needed, but children should never be punished.
Impetigo: Impetigo is common when the baby starts crawling on the floor, and when the child joins the nursery. Drugs like Rhus tox, Rhus venenata, Dulcamara, Hepar sulph, Gun powder, Echinacea, etc helped me on several occasions. The most important point to be considered is to avoid frequent repetition of drugs in skin cases. Recently, I had a case of Bullous impetigo, treated by many doctors including Allopaths and Homeopaths. I prescribed one dose of Steptococcin 200 along with placebo. It worked like magic. Timely use of Nosodes has saved me on several occasions. One more remedy I use in cases where destruction of the skin is more is Calendula 30. When the itching is severe, Mezerium single dose helped me in many cases. Also I consider Echinacea Q externally and internally, mainly in difficult cases.
Pityriasis alba: This is very common nowadays, and most of the mothers often misinterpret that her child is having Vitiligo! Pityriais alba is very easy to manage with homeopathy. Drugs like Sulphur, Sepia, Bacillinum, Silicea, etc are useful as per the indications.
Intertrigo: It is an erythematous eruption on the skin folds and apposed surfaces. It is very common among the kids, especially among those who use tight cloths and diaper continuously for several hours. Nappy rash can be anywhere, but intertrigo occurs in skin folds and apposed parts. Drugs like Sulphur, Bryonia, Calendula, and Petroleum are useful. When the case goes out of control, I have used Calendula Q externally applied with virgin olive oil.
Molluscum contagiosum: This condition spreads very easily when the pulpy nodules are ruptured while scratching. When the lesions are widespread, the parents are forced to go behind the specialists. Since we have tools like Natrum mur, Silicea, Thuja, Bromium, Calcarea carb, etc. with us, we hardly come across failure!
Phimosis: It is often considered as a surgical condition. But I have managed a few cases with one remedy – Nitric acid 200. Any lesion of the mucocutaneous junction, we should consider Nitric acid. If the case is not responding, refer the case for surgical management.
Weight issues: In this materialistic world weight is the major concern for many among us. A sudden weight reduction or significant weight increase or decrease may be important. But, majority of mothers saying that child doesn’t eat well and weight gain is poor may not be much significant. The constitution and the race of the person have to be considered while dealing with weight. Convincing such mothers is often a Herculean task! If there is some nutritional deficiency, we should suggest some natural diet rich in specific nutrients. Always advice the mothers not to get trapped by the fake ads related with food supplements that can only make the babies fatty.
In pediatrics, it is a knack to examine the children without making them uncomfortable. Many kids start crying the moment they notice the stethoscope since it reminds the painful injection they received from the allopaths. Hence, before we start examining the child, we should make them friendly by showing sound making dolls or colorful objects. Once the child is made comfortable, we can start the examination. Better do not touch the affected part immediately, start with a shake hand and then do the general physical examination, and finally local examination. Nature of the tongue is very useful in remedy selection in pediatrics. But if we forcefully open the mouth, the child becomes uncomfortable. Tongue can be easily examined by gently pressing above the mental-protuberance with a finger and gradually opening the mouth, the baby will protrude the tongue automatically.
Identification of causes
Identification of exciting and maintaining causes is very vital for the successful management of cases. The failure to identify the maintaining cause is one of the main reasons for the patients to leave our treatment. A few examples are:
Too much eyestrain and wrong reading posture in headaches and eye troubles.
Reading books in lying down position (especially in dim light) in visual defects.
Wrong sitting posture in neck and back pains.
Stress at the school, bullying, sexual abuse, etc.
Bathing at midday in hot climate predisposes infections.
Too much Jung foods, spices, pickles, sweets, etc.
Artificial coloring agents and preservatives
Fanning from a close distance in respiratory infection.
Mosquito repellents, cosmetics, perfumes, dust, etc.
Exposure to specific allergens.
Cold items in hot days in throat infections.
Too much oil on the scalp in headaches and ear troubles.
Nail biting in worm troubles and indigestion.
Toys painted with lead and other toxic chemicals.
Continued use of habit-forming substances.
Marital disharmony and bad misbehavior of the parents can also be a maintaining cause for many behavioral problems.
Convincing the mother
This is the most important tool for the success of the case. Mother is the final one to decide the choice of treatment, and she often faces forceful suggestions from the family and neighbors to change the physician. Often the disease panic created by the media forces her to keep on changing the physicians. The exact reasons for the disease or condition should be told, along with suggestions and diet restrictions. Also advice the mother not to blame the child in front of others since an emotional hurt often creates more impact than the actual disease. Nowadays family doctors are endangered due to over-importance to the concept of specialization. Hence, we homeopaths are the best to be the family physicians since we go in detail about each and every aspect of our patients.
Referring the failed cases
Since the child is the most important person in most of the nuclear families, we can’t ask them to wait till we try almost all remedies given in our materia medica, one after the other. So better refer the case to another physician and let him observe the case from another angle. It can often save our reputation, and also the name of our system will not be spoiled. No system is cent percent perfect; hence we should be aware of our scopes and limitations. And remember, while referring a failed case; always give a reference letter with the details of the case.
About the author:
Dr. Muhammed Rafeeque, BMHS, Medical officer, Department of Homeopathy, Govt. of Kerala, India, is an international speaker, author of many Homeopathic books and more than 150 articles and a worldwide promoter of Homeopathy. He also serves as the Institutional Review Board Member of the American Medical College of Homeopathy, USA, also the advisor of Homeopathy World Community and IRHFC, Canada.