Learn About the Benefits of Needle-free Acupuncture for Babies & Children, Tui Na Massage & Shoni Shin Treatment–An Interview with Melanie Katin, L.Ac., Professor and Clinician of Pediatric Chinese Medicine with Juliette Aiyana, L.Ac., Creator of HealthyStuff U.com
JA: A slew of positive media reports about the efficacy of acupuncture and tui na massage for kids is popularising parental interest in this natural treatment. Yet, many parents remain hesitant to bring kids in for acupuncture because babies, toddlers, kids and even the parents themselves may be frightened of needles. With that, how does your pediatric practice stay so busy?
MK: When people learn that I am a pediatric acupuncturist, they open their eyes wide when inquiring if I really use needles on children. The answer is yes, depending on a combination of the health issue, the parents’ consent, and the child’s willingness. However, in the pediatric clinic, there are several other methods of treatment beyond needling that are comfortable for the child, and easy to teach parents so that they can continue treatments at home, when necessary.
JA: Chinese medicine uses medical massage as a stand-alone, or as an adjunctive therapy to acupuncture. How well do children take to needle-free therapies?
MK: In Chinese medicine, massage is called Tui Na (twee-naa). For infants and small children under 6, this is always the first line of treatment in my office. One of the best things about the health of children is their ability to heal quickly. They generally have rapid shifting of symptoms, however intense they may seem at the moment.
In Chinese medicine, we say that infants, babies and toddlers are yang in nature, meaning that they grow and learn fast, get sick quickly, with fast resolution of their illness, and tend to have more hot, feverish illnesses. When children are sick, there is disorder in their Qi (chee), and it is part of the goal of my treatments to restore order to the qi using gentle and tolerable treatments. The Qi is superficial, and is easily accessed on the skin, which is why massage is one of the best tools to use for children.
JA: How does pediatric tui-na massage differ from therapeutic massage for grown-ups?
MK: Pediatric tui na massage is different from standard adult massage in many ways. First, is the fact that warm water is used as the substrate, instead of oil or creams. Adult massage employs oils because they help sedate and calm during the massage. But because children have yang tendencies, sedating or calming them with oils and creams is usually contraindicated. We want their discomfort to move out of their bodies rapidly, therefore water allows for fast hand motions during the massage without creating any friction on the skin, which may be uncomfortable.
Also different from adult massage are the techniques. The hand movements are specific to the goal of treatment: for instance, for a child experiencing a cough, we would administer tui na massage the sternum or breastplate in a downward direction only, to encourage the body to stop having the upward movement of the cough. If a child is experiencing constipation, the abdominal massage is done in a clockwise direction, because the large intestine moves in this direction, and the massage helps direct the peristalsis. Conversely, for a child with diarrhea, we would massage in a counter-clockwise direction.
JA: Can parents learn tui-na massage techniques to continue therapy at home with their children?
MK: Yes. Since the techniques are very easy to learn, I ensure that the parents have a good grasp on how to do 2-3 techniques so that they can continue the treatments at home. With most illnesses it is important that the treatment be performed sometimes several times a day, so caregiver involvement is essential.
JA: It always amazes me how effective tui-na massage is when I use it with my son at home. And, yes, we’ve noticed that if we don’t use the techniques several times per day the treatments are not successful. We commit the time to his health, which isn’t hard, because the tui-na only takes a few minutes each time. My son and I love the bonding time that massage creates for us. Which other needle-free methods do you use?
MT: A second modality we use is called Shoni Shin. This is a technique of gently tapping and scraping the skin with small instruments. There are specific shoni shin tools that are usually made from copper or stainless steel. This technique is used both as a preventative measure by maintaining the flow of qi to stay consistent when the child is healthy, but also as a way to inform the neurological system of the proper flow when the child is ill.
JA: When I was searching for stock photos to accompany this interview, my son peeked at my computer screen as I found the photo below, of a boy receiving shoni-shin. He recognized the shoni-shin tools and exclaimed, “That boy is getting massage, mommy”!
MT: Children love shoni shin tools! Especially the roller, which is always the first one to be picked up and played with. It is important that the children become comfortable with the tools, and we create a game with them during the treatment. Often, slightly older children will make up stories about each tool. However, I have found that children who have had many experiences with surgeries or hospital visits are wary of shiny, strange looking objects coming near their skin. For these wee ones, I have used more recognizable household items, such as buttons, spoons, sea glass or seashells: in other words, friendly and familiar.
JA: That is brilliant. And these are items which kids are likely familiar with. I have also used a coin as a tool. Shoni-shin has a neat history. Please tell us about that.
MK: Shoni shin was a technique developed in Japan in the 17th century, and more recently popularized in modern clinics. In Japan, the Chinese medical clinics will raise a flag of a different animal each month, around the full moon. This signals parents in the neighborhood that it is time to bring in the children for their monthly wellness visits for shoni shin. I strongly encourage parents to consider bringing their kids in to see me when they are not currently sick to receive shoni shin. This way, they can meet me, learn about shoni shin and massage, and develop a level of comfort at my office, so that when they are actually sick and fussy, they will not have the added fear of something and someone new, but will be familiar with the procedure.
JA: And monthly visits can help strengthen kid’s immune systems and refresh the parents memory about techniques to use, along with learning new ones.
So, what about acupuncture for kids? When do you use needles?
MK: It is not always necessary to needle small children, because they can benefit greatly from the two modalities described here. However, for some instances, neither tui na nor shoni shin can be employed well, either due to intolerance of touch, or for those little ones who have just learned how to walk, and just cannot sit still. For these cases, sometimes a couple needles are faster and easier to use.
Once you find a competent pediatric specialist, you should discover that your child may not even notice that they have been needled. One way I have discovered to avert the fear aspect of needles is to call them something else! One little 3-year old I know calls them “piques,” which sounds a lot like “peek,” so this is usually my word of choice, to remind the child of a game of peek-a-boo.
JA: I love it! My son is still nervous to receive acupuncture, but each time after I treat him, he always looks me right in the eyes and sincerely thanks me. I bet your patients and their parents are grateful too. We are certainly grateful when we come to see you! How can parents outside of the New York City area find a practitioner of Chinese medicine who specializes in pediatrics?
MK: My advice on how to find a practitioner in your area is to search a couple of online resources, both www.nccaom.org, which is the national certification agency for all licensed practitioners of Chinese medicine, and also www.acufinder.com. Both of these will yield practitioners in your area. Another suggestion is to see if there is a local Chinese medical school in your area. They might have a low-cost clinic where your child can be treated, or have alumni information available. Once you’ve found a few practitioners, start calling and ask if they have experience treating children. They might be able to point you in the right direction if they are not able to help you directly.
JA: I also send people to www.tcmdirectory.com. Thank you so much for all of this valuable information about Chinese medicine for kids. I hope it is useful for parents!