The well-worn cliché that children are not little adults reminds us in medicine that we must think rather differently about our little patients. At the very least, this means adjusting the dosing of both medications and supplements to decrease the chance of overdosing. Besides this obvious difference, we must also consider different illnesses in some situations, different effects of the same illness, and even different effects of the same medicine. While any therapy must consider short- and long-term effects, this is especially true with treating children. Ultimately, we do a lot of extra work in caring for children because a lot more lifetime is at stake, with the potential that an ounce of prevention can be worth pounds of cure.
The science behind the need for different dosages in kids goes much farther than just their size and how concentration is the real determinant of effect, not overall amount. For a start, children’s growth rates mean that different therapies impact their metabolisms differently than in adults. Children’s stage of life also includes a different hormonal balanced, which requires a slightly different approach and can be less tolerant than the adult equivalent. Children’s longer life expectancy then increases the chance that a delayed adverse effect may actually occur, where an adult might not live long enough decades to see the down sides of a therapy, making the short-term benefits worth it. All theses reasons are just the start of what impacts dosing in children.
As we care for children, we can diagnose many genetic conditions for the first time and must think of possibilities that never need cross our minds when caring for adults. For some conditions, diagnosis will almost never occur in adulthood because every case is found in childhood. For some conditions, the patient just does not survive into adulthood. For come conditions like PANS/PANDAS, the condition mostly fizzles out in early adulthood and doesn’t show up afterwards.
With some conditions, the actual symptoms change from childhood to adulthood, and we have to approach them differently. In treating mold toxicity, a parent may report very different symptoms in their child versus the adults in the same house. While the child may have bed wetting, nightmares, mood changes, schoolwork challenges, insomnia, and weird food reactions, the adults may experience thyroid imbalances, multiple chemical sensitivities, chronic fatigue, fibromyalgia, headaches, and other issues the kid doesn’t. Post-COVID in children may cause more neuropsychiatric symptoms, while adults may have more chronic fatigue, cancer, and immune issues.
Furthermore, when treating children, we have to consider how some therapies may affect children differently than they affect adults. There are medications that we do not give to children because they might affect growth hormone or bone growth or brain growth. In adults we can get away with lower cholesterol, but in children the same low cholesterol could harm their brains. Some children are more sensitive to everyday meds like antihistamines and get hyper reactions to these over-the-counter drugs. For the youngest of our patients under 1 year, we avoid the supplement quercetin, as it can cause jaundice (high bilirubin due to liver effects). The list could go on for pages.
As stated before, children are not little adults, which is why the whole field of pediatrics deserves its own training and recognition. Knowledge and wisdom in applying their knowledge of these differences enables pediatric providers to avoid costly missteps in caring for children. While I acknowledge that mainstream pediatrics does endorse or practice some bad views in important areas like parental autonomy and insufficiently tested therapies, pediatric providers have a critical role in helping children of the upcoming generations to pursue healthier, more abundant lives. This article covers just some of the ways that such committed providers at Sanctuary change the world, one child’s life at a time.
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Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.
Dr. Eric Potter graduated from Vanderbilt Medical School and then went on to specialize in internal medicine (adult) and pediatric care, spending significant time and effort in growing his medical understanding while caring for patients from all walks of life.
