Acupuncture without needles for children

Are you one of those people who close their eyes as soon as the needle approaches when they have their blood taken by the doctor? Then you are not alone. I'm at least as anxious as you are. Or even more anxious. That's why acupuncture was never an option for me - until I met Christina Aubert.

The Traditional Chinese Medicine (TCM) therapist from Zurich was literally my last resort when my pregnancy nausea (known as «hyperemesis gravidarum» in technical jargon) was so severe that I was waking up at night because of it.

I have never forgotten my very first encounter with acupuncture. After taking my medical history and pulse, I had to stick my tongue out at Christina Aubert - something that is forbidden even to small children in our western world is a must for a diagnosis in Chinese medicine.

TCM therapists see the tongue as the mirror image of the body, a kind of counterpart to Western medical imaging techniques. Disorders in the body's mechanism manifest themselves in the tongue in the five aspects of colour, shape, coating, moisture and spirit.

A healthy tongue, they say, moves freely, does not tremble, is slightly moist and shiny, has a thin, white, even coating, has no spots and the body of the tongue has a beautiful, slightly reddish colour. As you can imagine, my tongue looked completely different: whitish, flaccid and cracked, in short: out of kilter. The TCM specialist had that famous look, which you can imagine doesn't bode well. Her verdict: «Oh dear.» My body was out of balance. In TCM terminology, this means: yin and yang in disharmony.

When the heat is missing

Yin and yang are designations for universal principles of order. Both must be in balance. If they are not, complaints and illnesses manifest themselves. Yin does not exist without yang; according to the philosophy behind it, everything that exists and changes is created through the interplay of yin and yang. In Chinese phonetic transcription, yin represents a hill with a shady side, while yang represents a hill with a sunny side. Although yin and yang characterise opposites (shadow / light, cold / heat, water / fire), they are not mutually exclusive but complement each other.

Disorders of yin and yang form the foundation of TCM. If the person affected has too little yang, they feel cold and need a lot of warmth to compensate - especially in the form of warm rather than cold meals. As this was exactly what I suffered from, I had to change my diet. So soup instead of salad for lunch and porridge instead of Bircher muesli for breakfast, plus a special herbal tea. Exercise was also very limited.

An improvement occurred after the first treatment.

The various needles - five to seven fine disposable stainless steel needles at specific points - remained in my body for 20 minutes. I started to feel better after the first treatment and after four weeks I was able to manage with just one weekly session. I had long since got used to the pricking of the needles. The only unpleasant thing was the pain. I then found the subsequent resting phase very pleasant.

Pins instead of needles?

Being treated with needles every week as an adult is one thing. Having children needled is another. There is a gentle alternative for children from newborn to adolescence (and also for adults who are afraid of needles): Japanese paediatric acupuncture Shōnishin. Shōnishin is derived from the two Japanese words shōni = child and shin = needle / needling.

Shōnishin is also practised in Switzerland by TCM therapists with the appropriate training and further education - for example by Beatrice Barmettler from Bern. She says: «Shōnishin is a form of paediatric acupuncture that has been practised in Japan for centuries.» It has a long tradition there. Shōnishin is used there as immunisation, self-enhancement and health prophylaxis immediately after birth or given as a gift to new parents, explains Beatrice Barmettler. «The idea behind this is that the child must first arrive in the world and find its place outside the womb. Shōnishin is a means to this end.»

How does Shōnishin work?

Unlike acupuncture for adults, Shōnishin is non-invasive. Instead, the children are gently stroked with various instruments, including a small stick with a round head.

TCM therapist Beatrice Barmettler uses it to treat certain reflex zones, meridian sections and acupuncture points on the surface of the skin. She strokes, taps or lightly presses certain points so that, as in classic adult acupuncture, the life energy Qi (pronounced «chi», literally translated: «food vapour») flows, the autonomic nervous system is harmonised and Yin and Yang are balanced.

Everything so that the life energy Qi, which flows through the body in invisible pathways, can flow smoothly again. The meridians are the pathways of this energy. If they are disturbed, we speak of disharmony patterns in the body. Because, according to TCM, the meridians connect the inside of the body with the outside, it is assumed that a disturbance in the meridians can be corrected from the outside.

«It feels as if the skin is being lightly stroked.»

Beatrice Barmettler works as a TCM therapist

«This basic treatment only takes a few minutes and is very pleasant for the children,» says Barmettler. «It feels as if the skin is being lightly stroked.» There are numerous areas of application for Shōnishin. Vegetative disorders, especially sleep and digestive disorders, loss of appetite and, in babies, three-month colic are among them, as well as bedwetting and susceptibility to infections. Allergies such as hay fever or asthma can also be treated, as well as psychological problems such as anxiety, concentration problems or test anxiety.

Similar to osteopathy?

The number of studies on acupuncture with children and Shōnishin is thin, as is generally the case in paediatrics, as Eveline Roth from the Professional Association of TCM Therapists explains on request. It is ethically unacceptable to «abuse» children for studies. However, there is one observational study: it concerns KiSS syndrome. KiSS stands for «upper cervical joint-induced symmetry disorder», which indicates a dysfunction in the upper cervical spine and causes the baby's head and neck to be asymmetrical. The upper cervical joint is blocked and the baby often holds its head at an angle or lies on one side, which is why this syndrome is often colloquially referred to as «torticollis». The study was conducted by German doctor and Shōnishin pioneer Thomas Wernicke and published in the Journal of Acupuncture.

Traditionally, KiSS babies are treated with manual therapy - using chiropractic, osteopathy or craniosacral therapy. «In around 20 to 25 per cent of babies, a recurrence of this blockage was observed after two to four weeks,» says Thomas Wernicke. «It was only after the Japanese paediatric acupuncture Shōnishin was integrated into the treatment concept around ten years ago, in addition to manual treatment, that a decrease in the recurrence rate was recorded.» Wernicke subsequently examined 40 six to twelve-week-old babies with KiSS syndrome and treated them with Shōnishin alone.

57.5 per cent of the treated babies no longer showed any blockage in the head area after three Shōnishin treatments at one-week intervals, around 75 per cent of the previously crooked babies no longer showed any asymmetry and there was an improvement in the accompanying vegetative symptoms such as excessive crying or sleep disorders. «This allows us to conclude,» says Wernicke, «that Shōnishin is an effective treatment method.»

Rapid improvement after just a few treatments

Beatrice Barmettler is also convinced of its effectiveness. She is always surprised at how well and quickly children respond to Shōnishin. «Children only need gentle stimuli to stimulate their bodies in a targeted way. Three basic treatments are often enough, but almost all children improve significantly after just one treatment.» According to Barmettler, several sessions are sometimes necessary for persistent complaints.

If the symptoms do not improve or do not improve enough with basic treatments, specific meridian circulations are used or one or more points are treated specifically depending on the symptoms. In TCM, there are around 365 acupuncture points on the various meridians, and each point has its own therapeutic significance. Some children also receive sprays with a herbal mixture.

Who responds to a Shōnishin treatment?

Not only babies and toddlers, but also schoolchildren and teenagers can be treated with Shōnishin, says Beatrice Barmettler. Diffuse anxiety, test anxiety or general school anxiety are common. According to TCM, children who are under stress often have liver qi stagnation and are tense. This tension leads to muscle tension, but also to heat in the heart meridian - which, according to TCM, is responsible for mental strength and its coordination. As a result, the child finds it difficult to concentrate and sleeps badly. The so-called «Shen», the spirit in the heart, is also impaired.

Depending on the other symptoms, treatment would therefore calm the liver qi and eliminate the heat. At the same time, the kidney energy often also needs to be strengthened in order to balance the heart axis and build up the centre. «A detailed medical history is very important to determine all of this precisely,» explains Beatrice Barmettler.

TCM qualifies rather than quantifies.

This TCM language sounds strange to many people. While Western science and medicine are based on maths and physics, TCM is more about qualifying than quantifying, instead of measuring with numerical scales, it observes and seeks correspondences with natural laws.

This is precisely why critics of TCM like to question the effectiveness of these therapies, criticise the lack of rationality or argue that acupuncture only works for acute pain and has a kind of placebo effect for psychological problems.

Other, predominantly German voices counter this - such as Ulrich O. H. Frieling, a doctor of internal medicine and TCM therapist. According to his observations, acupuncture has a clear effect on exam anxiety in particular, he says.

Does acupuncture also work for ADD and ADHD?

The German-Chinese paediatrician and TCM specialist Helen Wai-Ngan Schreiber treats ADD/ADHD children in her practice with alternative acupuncture and has been able to prove its effectiveness in an observational study.

Hyperactivity is a symptom that the Chinese call restlessness of the mind and restlessness of the body. According to Helen Wai-Ngan Schreiber, the aim is to find out where the greatest imbalance has arisen in order to provide an impulse for equalisation. She treats several children who were previously taking psychotropic drugs and who, according to her, improved as a result of TCM treatment.

And in a pilot study at Lincoln Hospital in New York in 1999, ADHD children were treated with small magnetic and gold-plated steel beads («pearls») that were stuck to the back of both ears in the form of sticking plasters - a simple form of acupressure. These plasters were not stimulated and were replaced weekly. The mothers were involved in the treatment.

After just a few weeks, the psychiatrists saw significant effects in the children in terms of reduced restlessness, improved concentration and better test results.

The Tuina massage

Tuina massage is also an option for some children. This has been used for more than 2,000 years and, like acupuncture and Chinese herbal medicine, is part of thousands of years of empirical medicine. Tuina is made up of the Chinese words «tui» (to push, press) and «na» (to grasp, pull), as these manual techniques do not require needles. A special form of tuina is used in paediatrics.

Evidence-based studies have yet to show how successful TCM therapies are for ADHD in particular. Overall, however, it is not wrong to speak of a boom in the use of complementary medical treatments.

According to the Institute of Complementary Medicine in Bern, the number of registered TCM research papers has risen sharply in recent years. In 2011 alone, 148 articles on acupuncture were listed in journals in the Pubmed medical database by the end of November.

The healed journalist

«The West loves TCM,» summarises sinologist and expert on the original literature of Chinese medicine, Paul Unschuld. This is remarkable in that TCM has only been known in the West since 1971. Legend has it that a journalist named James Reston accompanied Henry Kissinger, who was security adviser at the time, on a trip to China. Reston suffered appendicitis and had to be operated on, writes Paul Unschuld in his book «What is Medicine?».

When Reston woke up, he saw the doctors treating his post-operative pain with acupuncture. This impressed him so much that he wrote an article shortly afterwards, which the «New York Times» published on 26 July 1971 under the title «Now, about my operation in Peking» - on the front page. According to Unschuld, this was the trigger for his fascination with traditional Chinese medicine in the West.