CAM are used by some dairy farmers in the UK but there is limited evidence about their use and which products and practices farmers consider to be CAM. The study found that dairy farmers think of a wide range of treatments and practices as CAM and vary in how and why they use CAM.
 
Most vets consider CAM to be counter to evidence-based practice. The Royal College of Veterinary Surgeons does not endorse CAM use where there is no scientific evidence of efficacy (RCVS, 2017) and the British Veterinary Association defines CAM as “treatments that fall outside of mainstream veterinary care” (BVA, 2018). This exploratory research aimed to step aside from the debate around CAM efficacy to understand what underpins CAM use in dairy herd health management and how that might influence antibiotic use.

Twenty-four farmers were interviewed from 20 farms, 16 of which were visited to collect observational data such as photographs and fieldnotes. The participating farms represented a range of management systems (15 organic; 9 conventional) and herd sizes, and supplied milk to a range of processors under different certification standards.

What farmers think of as CAM

What farmers thought of as CAM varied and included a wide range of products and practices, the use of which was motivated mainly by their desire to provide care for their animals. These included herbal remedies (such as commonly used topical udder creams, including Uddermint®) homoeopathy, distant healing, environmental enrichment, observation methods, food products used for ingestion or external rubs, and shop-bought products. Not all participating farmers considered all of these products or approaches to be CAM. Some farmers used multiple approaches or products which they viewed as CAM whilst others just used Uddermint®, and did not regard this as CAM at all. 

Conceptualisations of CAM

CAM was often seen as part of a wider ethos which encompassed a range of practices to manage animal health on dairy farms, rather than as one particular product, medicine or therapy. CAM was thought of by some as a natural and holistic system approach, with products made with natural ingredients that supported animals’ natural healing processes. It also formed part of a wider philosophy regarding holistic farming more broadly with regards to land use and avoiding overuse of antibiotics. Farmers’ main motivation for using CAM was a desire to do something to support the health of their animals when other approaches were not available or appropriate. 

Farming approaches associated with CAM use

The use of CAM was linked to organic farming and production without antibiotics (PWAB) contracts as both restrict antibiotic use, which meant that some farmers were trying different approaches to support herd health. Farmers consulted a range of advisors and resources to guide their CAM use, including veterinary support specifically relating to CAM and antibiotic use.

Dr Kayleigh Crouch, lead author who conducted the research for her PhD at the University of Bristol, said: “This is the first study to explore CAM use on dairy farms in a UK context. It is important for vets and advisors to acknowledge and discuss what herd health management approaches are used and explored by farmers. More open discussion surrounding the use of specific CAM practices and products on dairy farms would support better collaboration between dairy farmers, vets and other advisors in support of animal health. This would enable further study and work towards co-produced herd health plans that are farm specific and acknowledge farmers’ own goals and values. Further research in this area would be useful to gain a wider breadth of views and practices.

“The discussion about CAM in the veterinary literature often focuses on homeopathy but this does not acknowledge the widely used products such as udder creams/oils or broader approaches such as animal observations or environmental enrichment, which some farmers consider CAM. This study suggests that it may be more helpful to refer to specific products and practices by name, rather than using the term CAM more broadly, to avoid any confusion or negative associations with the term CAM. 

“It is also important to acknowledge the potentially positive impacts of these products and practices, for example where they support reduced use of antibiotics. Research should be conducted into how CAM practices contribute to the One Health approach for antimicrobial resistance impact reduction and how they influence animal housing, management, and interactions to identify potential positive practices.” 

David Barrett, Professor of Bovine Medicine, Production and Reproduction at the University of Bristol and a European Veterinary Specialist in Bovine Health Management, said: “The veterinary profession constantly strives to optimise animal health and welfare through the application of evidence-based veterinary medicine and the pursuit of best practice. Vets have a vital role to play in safeguarding both animal and public health, and through the One Health approach have significantly reduced antibiotic use in the dairy production chain in recent years. However, it has become apparent that many dairy producers are using CAM products and practices without consultation with their vets. While some of these practices might be considered simply good animal husbandry, others are controversial to those seeking an evidence base and, because of this, are not being openly discussed. 

“This study does not seek to establish, or question, the efficacy of all the products and practices considered to be CAM by farmers, but to draw attention to the need for farmers, vets and others to work more closely together to ensure transparency around all the animal health related activities undertaken on a farm.”

Project funding: The study received funding from A Nelson and Co Limited. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article, or the decision to submit it for publication.

Paper: What do complementary and alternative medicines mean to UK dairy farmers and how do they use them? By Kayleigh M. Crouch, Helen Cramer, Gwen M. Rees, Debbie Sharp, David C. Barrett and Christie Cabral. Published in Frontiers in Veterinary Science.