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Comment & Response |

Placebo Effects in Infants, Toddlers, and Parents—Reply

Ian M. Paul, MD, MSc1
[+] Author Affiliations
1Division of Academic General Pediatrics, Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania
JAMA Pediatr. 2015;169(5):505-506. doi:10.1001/jamapediatrics.2014.3801.
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In Reply We very much appreciate the complimentary letters in response to our article. The Kossowsky and Kaptchuk letter commented that the emotional response to a patient’s treatment could influence subjective complaints. Indeed, parents and health care professionals alike have a difficult time watching an uncomfortable child, perhaps even more so, an uncomfortable infant. Gassiness, perceived formula intolerance, and gastroesophageal reflux are other examples where an uncomfortable infant may have office visits outside of routine care that result in medical interventions that may not be supported by evidence and may not result in objective improvement. Alternatively, intervening commonly satisfies parental and, in many instances, health care professional instincts to help an uncomfortable child. In our study, it was unknown whether infants themselves had a response based on parent behavior as suggested in the text of the Kossowsky and Kaptchuk letter.


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May 1, 2015
Luana Colloca, MD, PhD
1Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore2Department of Anesthesiology, School of Medicine, University of Maryland, Baltimore
JAMA Pediatr. 2015;169(5):504-505. doi:10.1001/jamapediatrics.2014.3795.
May 1, 2015
Joe Kossowsky, PhD; Ted J. Kaptchuk, OMD
1Department of Anesthesiology, Perioperative, and Pain Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
2Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
JAMA Pediatr. 2015;169(5):505. doi:10.1001/jamapediatrics.2014.3798.
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