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Thank you all for your kind responses. and thanks to my patientīs mother who initiated my request. More than explaining her clinical studies, I was explaining to her the placebo effect as in homeopathy and other alternative therapies. She was reluctant to believe that homeopathy could get a kid better only by the placebo effect. Thatīs when I mentioned the examples previously mentioned, like the placebo effect of pacemakers <http://www.ncbi.nlm.nih.gov/pubmed/10190407>, or the better results with four pills over two pills, etc. When she mentioned children I cited the "proxy effect" but I decided to go a little further, as sometimes the "proxy effect" might not be the only factor, as in double blind studies of neonates with sucrose or placebo (water) for pain relief. Undoubtedly the placebo effect as we know it requires higher cognitive process to take place as in the examples previously cited. The reason or explanation on how it works in children and even in neonates is speculative and most likely explained by the "proxy effect" when parents or caretakers perceive and report an improvement. I would like to hear more about studies and examples in babies (like the pacemaker example). In my searches I havenīt found much examples, but Iīll keep trying and I īll let you know. ...on other question (same topic) Citing the first systematic review by Rheims: Placebo effect is twice in children as in adults & I quote "Such a difference, if ignored, could well result in an underestimation of the placebo response and type II errors in paediatric RCTs." Should we as "Evidologists" consider this effect when appraising pediatric trials? evenmore, when conducting one? Have a nice weekend! -- Carlos A. Cuello-García, MD