Autheem therapy for young Saudi infants: the whys and the impacts

In Saudi Arabia, primigravida or multigravida mothers might seek complementary medicine for their infants. When an infant struggles with colic or poor feeding, a mother will do anything to help her baby including traditional therapy. Traditional healers use a maneuver called "Autheem- عظيم" based on a common belief among the Saudi public of needing to manipulate soft palates for struggling infants.

This study is a retrospective cohort study adopted to recruit children at the age of 36 months who underwent "Autheem" therapy and those who did not as controls. Mothers in the waiting area at the general pediatrics clinics in Riyadh, Saudi Arabia were approached to answer a pre-structured survey. The "Ages and Stages Questionnaire" study tool was used to assess their children's development.

The study enrolled 84 well-educated mothers (74% with college degrees in the control group and 58.5% in the study group). The main sources of information about Autheem and its indications were grandmothers and family elders. Poor feeding followed by responding to grandmothers' pressure were the main reasons to seek this therapy. The majority of mothers (71%) admitted that if they found a solution in modern medicine, they would not have explored this therapy. Mothers noted that most healers do not wash their hands. Over one-third of mothers (36.6%) documented lethargy in the first 24 h post-therapy. One in five mothers was offered cautery therapy at the time of Autheem therapy. There was a significant difference in development between children exposed to Autheem therapy in comparison to healthy controls. Autheem exposed children were 10 times more likely to be delayed in gross motor skills. Furthermore, notable delay was documented in fine motor and problem solving despite lack of statistical significance.

Concern about infant feeding is the main reason for seeking "Autheem." The association of developmental delays might indicate safety concerns of this therapy on growing brains. Future advocacy should focus on elders in the family to avoid Autheem therapy until better safety data is available.