Posts Tagged ‘Toddlers’

Working with babies, children and young teens

Friday, August 1st, 2014

Treating children with the respect that an adult expects –

Boundaries, guarding behaviors and earning a child’s permission to treat

I treat young people experiencing a wide range in the intensity of their discomfort.  Sometimes its a straightforward orthopedic case – say repeated ankle fractures from skateboarding or muscle strain from athletic training.  They can present as forward looking kids, motivated to get back to the fun and relieved to find someone who says they can help.  Or a bad flu – they are so symptomatic the child is ready to just have all the aches and pains all go away.

Other cases present with more significant issues about how they feel about their bodies and their stress. Sometimes, in a young body having trouble, there is a lot of guarding.  I see guarding presenting in many ways – the child may not want to show me where its hurts, they may switch to ‘wiggle worm’ mode and bounce around the office, they may not want to talk about anything at all.

At this point my first comments are commonly directed towards the embarrassed parent.  I say ‘Look, this behavior is ok.  Its just where they are at, and we’ll start from here.  My first job is to earn their trust.’   I engage with the child to see why they are behaving as they are, before I try to do anything about it.

‘Why is my child not ready to just lie down and receive treatment?’

In many cases of headache or belly pain, I commonly see that I am meeting the child after they have been through a very intense round of biomedical diagnostic procedures.  Scans in loud machines, invasive and painful scopes – it may have all been appropriate at one level (dangerous pathology does of course show up in children and we may need to screen for that), but it was not ok with the child.  With the best intentions, the earlier therapeutic relationships have been a source of wounding.  This is a point where it is often easy to earn trust – I simply promise not to do anything they don’t want me to.  No sudden surprise attacks with acupuncture needles like, say, an earlier vaccine experience.  I will ask a young child where it is alright for me to examine or to do gentle acupressure, and start there.

My most difficult case have rarely needed more than one or 2 sessions before I am trusted to apply any actual therapeutic techniques.  We may start with herbs, we may start with CranioSacral therapy or other bodywork techniques.  But once they experience that I am on their side, the child looks forward to sessions.

‘But what if my child really needs acupuncture specifically?’

Once trust is established, my pediatric training and experience has prepared me to engage with acupuncture in several ways.  Depending on the situation, I may let the child tap a needle into me to show it doesn’t hurt.  I may talk about what to expect, that they may feel a gentle pinch so I let them pinch me and then I pinch them gently to see what its like.  Often, once I have the child’s trust, I can use a needle at a point while I’m talking to them and they usually don’t even feel it.  Needling very young children (I have given acupuncture to young babies, days old) is simply a matter of lots of hand pressure around the area, a quick pop of the needle and then withdraw.  Very different than the adult approach of retaining the needle for 30 minutes and trying to get big stimulation.  With all of my techniques, the child usually loses interest in what I’m doing and falls asleep.

‘Is acupuncture safe for children and babies?’

The mainstream peer-reviewed pediatric journals regard properly performed acupuncture with children to be very safe.  I will discuss the literature in a later post.