How to Prepare Your Child for Acupuncture Treatment

For the parent of a child with special concerns, whether those concerns are for the child's physical, medical, emotional, cognitive, or behavioral well being, there is little literature available that thoroughly addresses the use of Complementary and Alternative Medicine (CAM) in pediatric patients. As the clinic coordinator of a medical acupuncture service in a major pediatric hospital, the physicians I work with and I are striving every day to provide information to parents and to other health care providers, in order that we might achieve our goal of de-mystifying the use of CAM in the care of children. Acupuncture is one of the most commonly utilized, yet least understood forms of CAM.

What is Complementary and Alternative Medicine?
Complementary and Alternative Medicine refers to therapies or treatments that fall outside the scope of conventional Western Medicine. When people think of CAM, they typically think of acupuncture, Reiki, guided imagery, massage, and the use of herbal medicine. However, many other therapies fall into the CAM category. Prayer therapy, for instance, is one of the most prevalent forms of CAM utilized, as well as music therapy, pet or animal therapy, and even chiropractic care.

What is Acupuncture?
Acupuncture, a commonly utilized form of Complementary and Alternative Medicine, is a treatment that has been practiced for over 2,000 years. First used in China, acupuncture employs the use of hair-fine needles inserted into strategic points throughout the body. The points are known as "acupuncture points." These points work together with one another, interconnected by systems called "meridians," to help unblock the energy, known as "qi" (pronounced "chi") in the body and restore balance and energy to the entire system.

Sound a little too numinous? Many Western patients and medical practitioners might think so. However, I will say this: the strongest force of the physical nature of the human being would also fall into that category. The energy, the spirit, the soul, if you will, is an intangible, yet indisputable part of our workings as animated beings. We all know it's there, however we choose to categorize it, although we have never seen it and do not know how to definitively characterize it. Treating the energy when it ails is, in Traditional Chinese Medicine, as obvious a need for the well being of the patient, as medical therapies are for treating the physical symptoms of disharmony in the body. Because all the systems in the body are interconnected, greater physical well being can be achieved by addressing the blockages of energy caused by physical distress in the body.

Can Acupuncture Be Used in the Care of Children?
One of the most positive things about the use of acupuncture as a complementary therapy is that there are virtually no adverse effects. Sometimes a small amount of bruising, redness, or swelling might occur around the needle site, but responses such as allergic reactions, respiratory problems, or significant negative medical reactions of any sort are rare almost to the point of unreported, with over 2,000 years of experience from which to gather report.

So, if acupuncture is so safe, why do many acupuncturists shy away from treating children? Frankly, the reason for this is that the system of a child is so vastly different from the system of an adult. Children are still developing, their bodies changing and most acupuncturists have no experience in the care of pediatric patients, and so they wisely decline to treat them until they are at least well into their teenage years. Many acupuncturists won't treat a patient at all until they are 18 years old. This is not for fear of harmful consequences to the patient, but rather, due to concern for the treatments' effectiveness if the practitioner is inexperienced in treating children.

That being said, acupuncture is a safe and effective method of treatment for pediatric patients, under the skill of a practitioner accustomed to working with children. In the service I coordinate, we specialize in pediatric acupuncture. Our physician acupuncturists are pediatric anesthesiologists with years of experience controlling the analgesic effects in children, who are also highly trained medical acupuncturists.

What Is the Difference Between an Acupuncturist and a Medical Acupuncturist?
As I stated, the acupuncturists practicing in our service are medical acupuncturists. What is a "medical acupuncturist" as opposed to an "acupuncturist?" Quite simply, a medical acupuncturist is a physician acupuncturist. In the United States, in order for a non-physician to become an acupuncturist, he or she must complete a three-year acupuncture course at an accredited school of acupuncture, and pass a certification test. Medical Acupuncturists must also complete acupuncture training, although the laws about what type of training and the numbers of course hours required vary state by state.

But My Child Is Afraid of Needles!
The first hurdle the acupuncturist must tackle in the care of any patient, child or adult, is needle phobia. No one spends their time figuring out how to get more needles into their lives. Most people have a strong dislike of them, and many experience a full-blown terror. It is also not uncommon for patients to experience what is called a "vasovagal" response to the insertion of a needle into their hand or arm, which refers to sick, dizzy feeling and may even lead to loss of consciousness (fainting).

Acupuncture needles are very different from any sort of needle you or your child has ever come into contact with, as I will describe more thoroughly in a moment. Many of our patients choose to call them "wires" or "hairs." We even have one patient who prefers the phrase "magic sticks" to refer to the acupuncture needle. Because the needles are only inserted into the outer layers of the skin, the vasovagal response is not triggered, even in the most sensitive of patients.

How Do I Prepare My Child for Acupuncture?
I speak everyday on the telephone with parents who think that acupuncture would be beneficial to their child, but they cannot get the child to agree to even consider the treatment. I think we can all appreciate the child's trepidation. As mentioned earlier, most people, and children especially, are afraid, to some degree, of needles. In the service we provide, this is particularly true. Any service provided in a hospital setting tends to attract patients who are integrated into that setting, that is to say, they're sick. Most of our patients have, quite frankly, already had way too many needles in their lives, and will continue to have way too many needles in their lives. The idea of voluntarily seeking a treatment that will employ the use of still more needles is out of the question, in their opinion. A large part of my job is spent trying to give parents some information and a framework for their discussion with their children about the possibility of trying to gain some relief of their pain or symptoms of illness through acupuncture.

I begin by explaining the needle to the parent in terms a child can understand. I do not tell the parent that the needle is 0.12mm-0.30mm in diameter (depending on gauge), as that would mean nothing to the child. What I say, instead, is that the needle is about the size in diameter as one of their child's hairs. Something as innocuous as a hair provides the parent with an accurate, and much less threatening image to present to their child.

The next image I dispel for the parents of the potential acupuncture patient is the idea of the needle being inserted into the body like a blood draw or injection needle. As noted previously, the acupuncture needles only penetrate the outer layers of the skin, with the majority of the needle, hair, or "magic stick" sticking out above the surface of the skin. I share that many of our patients like to bring along siblings or friends to watch the treatment, because they look so "cool" with the needles sticking out of them. I also reassure the parent that they can, in good conscious, tell their child that acupuncture is not painful, and that it is not uncommon for one of our physicians to have two or three needles in place before the patient has realized that anything has happened.

The second most significant reason, after the minute size, that the acupuncture needle is so much less painful than other needles is due to the solid nature of the needle. Most people do not realize that when they experience blood draws or injections, it is actually the hole in the center of the needle (the hole that allows blood to be drawn, or medication to be injected) that causes a great deal of the pain. That hole provides some resistance during the insertion of the needle, sort of like a stopper effect, and causes the stinging we are all so familiar with. Tiny and solid, the acupuncture needles can be placed in the body with almost no disruption to the skin or soft tissue beneath it.

And, most importantly, I impress upon the parent how thorough a job we are going to do making their child comfortable and ready for the acupuncture experience before a single needle is placed. I am happy to share with the parents and encourage them to share with their child the fact that I am one of those unlucky individuals who experiences a vasovagal response to needle insertion, and yet I happily receive acupuncture regularly. If the lady who runs the office is afraid of needles, maybe it's not so bad after all? Once the child arrives for his or her first appointment, we are happy to demonstrate just how easy and comfortable the experience will be. Before beginning, our physicians will often place a needle in their own hand, in my hand, in Mom or Dad's hand, so that we can be scrutinized for any signs of flinching or discomfort.

We try very hard in our service to remove the sterility of the usual hospital experience from the experience the child will have during his or her visits. Acupuncture is a continuing therapy, like physical therapy or chiropractic care. We develop relationships with our patients, and try to maintain a casual, relaxed environment that our pediatric patients look forward to coming to. Most importantly, we let the patients know that we fully expect them to feel better when they leave our clinic than they did when they arrived.

What Will My Child Experience During An Acupuncture Treatment?
The acupuncturist will first come in and talk to you and your child together, and get a full account of your child's symptoms and medical history. He or she will examine your child, including checking the pulse and examining the tongue for signs of imbalances in the system. Your child will lay down on an acupuncture table (much like a massage table), either face up or down, depending on whether the practitioner wants to treat the front or the back of your child. Then, needles will be placed. Each disposable, one-time-use needle comes in a little plastic tube, which is just a little bit shorter than the needle itself. The tube is placed over the acupuncture point, so that the sharp end of the needle is resting against the skin, and the blunt end is jutting out just above (about 3mm) the top of the plastic tube. The acupuncturist then taps the top of the blunt end of the needle, until the plastic tube stops the finger. This safe, smart mechanism erases any concern that the needle will be inserted any more deeply into the patient than needed, and virtually eliminates human error during needle insertion. The acupuncturist then removed the plastic tube and twirls the needle a little bit to stimulate the flow of energy around the acupuncture site.

When all the needles are in place, the lights will be turned down low, soft music will be played, and the acupuncturist will leave the room, allowing your child to rest and relax, while the needles do their work. This quiet period can last anywhere from 5 to 20 minutes, depending on how much energy work the system needs. The practitioner will then return, and remove the needles from your child.

How Many Needles Will the Acupuncturist Use, and Where Will They Be Placed?
The number of needles used for any acupuncture treatment will depend on what is being treated, and what is happening in the system. It varies from patient to patient, and will often vary from visit to visit in the same patient. Once the acupuncturist examines your child, he or she will have a better idea of what that day's treatment will involve. Acupuncture can often be as effective with one needle as with twenty, depending on the state of the body's systems. The same can be said for the location on the body the where the needles will be placed. Will a patient with a headache have needles in his or her head? Perhaps. However, the needles may also be placed nowhere near the head. As mentioned earlier, the network of acupuncture points known as meridians allow the practitioner to gain access to channels causing disruption to the system from various sites on the body.

My Child Still Refuses to Discuss Needles, Can You Still Help?
On occasion, we come across a patient who is strong of character and simply knows that he or she is not going to allow someone so stick any more needles in him or her, and that is that. Are there other ways to utilize the theories of acupuncture to provide some benefit to the child? Absolutely. Although acupuncture treatment employing the use of needles is often the most effective method of providing relief to the patient, needle insertion is not the only method of utilizing the acupuncture points and meridians. Magnets, lasers, and the simple application of pressure to the acupuncture points with the fingers (known as acupressure) can also achieve the desired effect.

However, as the children come in for their treatments, we find that, almost without exception, they begin to become more comfortable in the setting of the clinic and with the benefits they are experiencing from the non-needle treatments and will at some point, allow needles to be utilized in their treatment. Once this hurdle is overcome, they often see a difference in the amount of benefit they receive from the acupuncture treatments, and the fear of the acupuncture needles quickly dissipates.

What Can Acupuncture Be Used to Treat?
Acupuncture can be a beneficial therapy to address any disruption to the body's system. Pain, whether caused by illness, injury or chronic pain conditions, can be treated by acupuncture. Non-painful conditions that cause the patient distress can also benefit from acupuncture. Some of these conditions treated in our clinic include enuresis (bed wetting) and hair loss.

Can acupuncture be used to help heal a broken arm? Yes and no. Acupuncture cannot do anything to directly heal the fracture, but it can help to reduce the pain experienced as a result of the injury. This in turn, will allow the patient to be able to perform more beneficially in other therapies that will help to strengthen the arm, for instance, physical therapy. Therefore, a stronger and better-healed arm is the result.

Can acupuncture be used to be treated diseases like cancer? Again, acupuncture is not a treatment for cancer, or other disease, but it is a treatment for the symptoms of the disease. It can be used to effectively treat the pain the disease may cause, or the nausea and vomiting, or other side effects caused by the medications used to treat the disease, and to bolster the immune system.

But We Don't Know Why My Child Has Pain
One of the most helpful aspects of the benefits of acupuncture treatment is that a diagnosis is not necessary to effectively treat what the patient is experiencing. If a child has headaches, the acupuncturist does not need to know what is causing the headaches. If a patient has back pain, and the orthopedist cannot find the source of that pain, it does not matter from an acupuncturist's point of view whether that pain is being caused by a pinched nerve or a slipped disc, or simply by being slept on "wrong." The acupuncturist is treating the pain itself and the body's response to that pain.

Acupuncture is an ancient practice, and yet, despite the advancement of Western medical techniques, is still considered a viable, effective treatment for most conditions in large parts of the world. And, here in the United States, it is growing in popularity and acceptance by patients, and medical personnel alike. Due to the safety of the procedure and its minimally invasive nature, acupuncture is an excellent form of treatment for pediatric patients when practiced by a practitioner experienced in the care of children.