Author: DB

This author has written 44 articles

Children and exercise: can they have too much of a good thing?

Children and exercise: can they have too much of a good thing?

DB February 3, 2020

Conventional wisdom says that exercise is good for children.  Period.  With rising obesity rates, and leisure time increasingly being filled with screen-based activities, it is understandable and right that children are encouraged to exercise.  Having a range of different physical activities is a crucial prerequisite for healthy growth and development.  But how much and what type of exercise is right for children?  And is there a point at which exercise may become a cause of problems rather than something that prevents them? 

The Jin dynasty scholar wrote:

 ‘The body should always be exercised…yet even in exercise do not go to extremes.’  

From an immunological perspective too, there is a dose response to exercise.  The right amount helps to reduce inflammation.  Too much or too little may encourage inflammation. 

A generation or two ago, physical activity was woven into the fabric of life in a way that it is not in the modern, developed world.  It was often the norm for children to walk or cycle to school.  A large proportion of spare time was spent playing outside.  Children were expected to help with the physical work involved in running a household.  

Nowadays, parents find themselves having to consciously create opportunities for their children to exercise.  It may become something that the child should do, or needs to do and therefore potentially something they rebel against.  Exercise often becomes about seeking an adrenaline rush or, in older kids, a way of trying to attain the ‘perfect’ body.  In schools, sport is often about competition and winning which, for some kids, can take the fun out of it.  One outcome of this is that many children lose the ability to sense what level and type of exercise their body needs.  

From the Chinese medicine perspective, children have an abundance of yang energy, which means that they express themselves through movement and need to move frequently.  They also have immature yin which means that they need to rest often and take regular breaks.  In Chinese texts, the flesh and ligaments of children are described as being not yet fully formed or ‘firm’.  So much of a child’s qi fuels their rapid growth and development.  If they are exercising excessively too, this can lead to depletion or injury. 

So, how do we decide what is the appropriate level of exercise for our children?  In general,

  • Young children thrive off short bursts of activity, interspersed with periods of rest
  • For the first six or seven years of life, frequent walking, running around, climbing and generally larking about is probably enough exercise for most children
  • Most children are not constitutionally suited to intensive training in their chosen sport until their growth has slowed down, after the intense growth of puberty
  • If a child is training in their chosen sport, making sure they train a maximum of every other day can help to prevent injury or depletion
  • If a young child’s mood changes after intensive exercise (e.g. they become tearful or aggressive) it is a sign that the exercise is excessive for them
  • If a young child is tired and less able to function for more than an hour or so after exercise, it is a sign they have probably done too much

Every child has a different sweet spot when it comes to exercise.  Depending on their constitution, some will thrive on more exercise than others.  The best thing we can do for our children is guide them in finding their sweet spot.  We can help them to listen to their bodies.  We can support them to stop when they need to rest, or encourage them to do more when they are suffering from the effects of inactivity.  We can help them understand that what is right for another child may not be right for them, and that it’s ok that we all have different limits.

Once again, the simple yet profound principle of yin-yang is applicable.  A child should have a balance of rest (yin) and activity (yang) and this balance will be slightly different for every child.  

The hidden link between sleep and digestion in babies and toddlers

DB January 21, 2020

There are as many different reasons why babies and toddlers don’t sleep as there are approaches to help them to sleep better.  I have seen parents losing their minds trying to work out why their baby sleeps well one night and not the next.  I have seen strong, capable and calm mothers and fathers cry in desperation at yet another broken night.  Theories abound as to why a particular infant is not sleeping – they are too hot, too cold, teething, don’t like the dark, slept too much in the day, didn’t sleep enough in the day…. However, one thing rarely gets mentioned, and that is the link between sleep and the digestive system. 

When a baby is born, their digestive system goes from being completely dormant (in the womb the baby receives all its food via the umbilical cord) to working overtime.  Babies usually double their birth weight in the first five or so months of life.  In order to do this, they need to ingest and digest an enormous number of calories.   Assuming their basic needs are being met, how a baby manages this task dictates more than anything else how they will feel.  If their digestive system is working well, they are likely be happy and settled. If it is not, they are likely to be grouchy and unsettled.

One of the most common ways for things to go awry, is for food (which includes breast milk) to accumulate somewhere in the baby’s digestive tract.  In Chinese Medicine paediatrics, this is known as Accumulation Disorder.  The baby or toddler simply does not have enough digestive qi to keep the food moving through, so it lingers around and festers.  When this happens, the food starts to ferment and generates extra heat in the body.  This heat rises up and affects the shen, which is often translated as ‘mind’ or ‘spirit’ and which governs the ability to sleep.  

In adults, the equivalent is what I call ‘Great Uncle John on Christmas Day syndrome’.  After eating an enormous meal, much of it rich, heavy food, not moving around and with some heightened emotions added into the mix too (family all together having not seen each other all year), Great Uncle John will start burping, farting and becoming irritable, and will often not sleep well that night.  He may complain of gripey pains in his stomach and feel much better after he’s taken some antacids and then had a good evacuation of his bowels.  This is similar to how a baby or toddler with Accumulation Disorder feels.  Unlike Great Uncle John however, due to his immature digestive system, an infant is prone to this on a daily basis, not just Christmas day. 

In order to minimise the chances of Accumulation Disorder developing, there are a few general dietary guidelines that should be followed:

  • The baby/toddler should have gaps between feeds and/or meals, even when solely breastfed.  This is to make sure they have fully digested one feed without running the risk of ‘overloading’ their system with the next.  Every child is different, but a rough guideline is to allow 2 hours minimum between the end of one feed and the start of the next.
  • The baby/toddler should not eat too many raw, rich, heavy or greasy foods.  They will be better able to digest foods that have been cooked, such as rice congee.  This is so that the first part of the digestive process has been done for them, during the cooking process, and their immature digestive systems do not have to work quite so hard.  
  • Some kids have eyes that are bigger than their stomachs!  While it goes against most people’s instincts to limit what a baby eats, some robust types do not know when to stop (to read more about this, take a look ‘Is your toddler a robust or sensitive type?).  This means they cannot process the amount of food they take in, and their system becomes clogged up.  So making sure the child does not over-eat will lessen the chances of Accumulation Disorder developing.
  • Try to ensure that the baby or toddler is as relaxed as possible when they are feeding or eating, and that the environment is calm.  In Chinese medicine, we talk about good digestion needing the ‘smooth flow of qi’ to the stomach and intestines.  Being relaxed helps this. 

The Chinese have a saying that goes ‘if the stomach is not harmonised, sleep will not be restful’.  Of course, there can be other reasons for poor sleep, but this is one that should be considered and is often ignored.  Look out for more blogposts on sleep in babies, children and teenagers! 

Is there a therapeutic element to thumb sucking?

DB January 18, 2020

The perceived wisdom is that children suck their thumb in order to feel secure and as a way of soothing themselves.  For many children this is obviously true but there may be another reason why certain children are drawn to sucking their thumbs.

From the perspective of Chinese medicine paediatrics, the thumb relates to the digestive system.  There is a mode of treatment commonly used on children in China called xiao er tui na which loosely translates as paediatric medical massage.  One of the moves in this system is to rub the pad of the thumb in a circular motion or to stroke repeatedly down the radial (outside) edge of the thumb.  Each of these techniques strengthens the baby or young child’s digestive system.  A child’s digestive system is considered to be undeveloped and immature until the age of about 7 or 8.  This is why babies and young children are so prone to colic, reflux and other digestive symptoms.  

So, doctors of traditional Chinese medicine consider that when a baby or child sucks their thumb a lot, they do so instinctively in order to massage and stimulate their digestive system.  Whilst you could say this is rather clever of them (the babies and children that is), we also know that habitual thumb sucking once the teeth come through can create problems.

So, if you are concerned that your child is becoming a habitual thumb sucker, you could try either rubbing the pad of the thumb in a circular motion or stroking downwards along the radial edge of their thumb, as shown in the video below.  You could do this two to three times a day, for up to two minutes each time.  At best it may reduce their need to suck their thumb.  But at the very least, you will actually be helping their digestive system to become healthy and strong!

Click on the link below to see the video:

Chinese medical thumb massage to strengthen the digestion

Snow plough parenting – what is it and what is its effect?

DB January 15, 2020

It’s official.  Snow ploughs are the new helicopters!  Until earlier this week, I was aware that parents could be described as ‘helicopters’ (when they have a tendency to hover over their children) but I didn’t know they could be snowploughs.  Let’s be clear.  None of us get parenting exactly right and that’s OK.  We should hold on to Winnicott’s concept of the ‘good enough’ parent, in this age of perfectionism.  

However, even though these rather derogatory sounding clichés can be overly simplistic, it can also be interesting to reflect on the ideas at their heart.  Snowplough parents are those who have a tendency to remove all obstacles that might get in the way of their child’s progress and success.  With the best of intentions, they try to make their child’s life as easy as possible.  A common example is a parent doing their child’s homework to make sure they get a good grade.  Another is a parent who tries to make sure their child does not experience ‘difficult’ emotions.  I remember being asked by a parent to make sure her child did not take part in ‘pass the parcel’ at my daughter’s birthday party.  The parent was concerned that her child would feel upset if she did not win. 

This concept reminds me of a Chinese proverb.  A farmer wants his crop of sprouts to grow as tall as possible as fast as possible.  So he decides to pull them up through the soil himself.  As a result, his crop dies.  The farmer does not trust his sprouts in their ability to work their way up through the soil in their own time, and in trying to do their work for them, he kills them. 

From a Chinese medicine perspective, all aspects of a child’s physical, mental and emotional self grow strong through being used.  Muscles become strong through being exercised and waste away when they are not used.  But so do other aspects of a child.  If a child is always removed from any source of anxiety, they won’t learn that they can manage the emotion.  If they experience anxiety for the first time as a teenager, when their parents can no longer shield them from it, they are more likely to be overwhelmed by the emotion.  If a child has always been allowed to spend their time doing only enjoyable activities, they may find that when they have to do things they don’t want to do, their willpower fails them.  

Psychologists talk of a concept called ‘stress inoculations’. Children build resilience through small, repeated exposures to stress during childhood.

Life inevitably involves challenges.  The Wood Element within us enables us to react to obstacles that we meet with flexibility, to find a way through rather than give up.  The Water Element also gives us the drive to push through all manner of difficulties    If these two Elements are not exercised during childhood, by being faced with challenges and obstacles, they will not enable a person to face difficulties in adulthood in a robust and resilient way. 

As with almost everything, balance is the key.  Of course, a parent would not want to artificially create challenges for their child.  But supporting a child to deal with challenges that naturally arise, rather than snow ploughing them out of the way, may be the kindest approach in the long run.  

What is the unspoken harm of screen time for children?

DB January 11, 2020

There are many documented reasons why excessive screen time may be harmful for children.  Those most commonly cited are its negative impact on sleep and its contribution to rising obesity levels, as well as educational and/or behavioural problems.  While these are all valid issues, a far more detrimental effect is rarely mentioned. 

When children spend a lot of time on screens, they miss the opportunity to go inwards and find out how they are feeling.  A bus journey that might have been spent gazing out of the window and noticing how they feel, may now be spent catching up with the latest posts on Instagram.  Instead of sitting with feelings of anger induced by an argument with a sibling, a child now often escapes this feeling by turning straight to their phone.  I have often seen teenagers pick up their device because something made them feel anxious.  By turning their attention to watching YouTube videos, they can escape the discomfort that their anxious feelings cause. 

Why is this such a problem?  Since Socrates implored people to ‘know thyself’ and Aristotle proclaimed that ‘knowing thyself is the beginning of all wisdom’, it has become widely accepted that good mental health involves developing a certain level of self-awareness.  From a Chinese medicine perspective, emotions become a cause of disease when they are prolonged, intense or repressed.  When a child loses themselves online to escape a feeling of sadness, for example, the sadness does not go away.  On the contrary, it will most likely fester inside them and have a negative impact on their flow of qi.  This can lead to physical symptoms.  But it can also create the unwelcome situation of the child not feeling content or well in themselves, but not really knowing why.  This disconnection from emotions means that the spirit of the young person is no longer thriving.

It is not helpful to demonise screens.  If we do that, we risk destroying rapport with our children, for whom screens are a part of the fabric of their lives.  But when they become a means by which a young person avoids or detaches from the wide range of emotions that are a necessary part of being human, they begin to do real harm.  As Proust said in A la Recherche du Temps Perdu, ‘We are healed of our suffering only by experiencing it to the full.’  

Are you missing the signs of tiredness in your child?

DB January 8, 2020

The simple fact is that growing and developing is extraordinarily hard work.  For this reason, children very easily become tired.  Yet I believe that we often miss the signs of tiredness in our children.  Many physical symptoms, emotional patterns and behavioural tendencies arise from or become exacerbated when a child is tired.  I have seen many children in my clinic whose symptoms go away when they start getting an hour’s more sleep each night, or when their hectic daily schedule is reduced.  And fatigue can look different in a child to how it might look in an adult.  In this blogpost, I am going to focus on pre-teen children and I will discuss teenagers in another post.

Tiredness and energy levels

One of the key ways in which a young child’s tiredness may manifest differently to that of an adult is that it does not necessarily mean that they want to sit around and do nothing.  Young children are hard-wired to please their parents, on whom they entirely depend for their survival.  If a child knows, albeit unconsciously, that their parents approve of them doing lots of sport or pushing themselves hard to learn an instrument, it is easy for them to ignore any signals their body may be sending them that what they actually need to do is rest.

It is also easy for parents not to recognise the signs of tiredness in their children.  Children’s bodies are rather like batteries.  They may give no obvious signals that they are about to run out until they moment they do.  One minute they keep going on full pelt; the next minute they are completely flat.   

Tiredness and hyperactivity

Many toddlers and young children become more hyperactive the more tired they are.  They find it difficult to be still and resist anything that might require them to stop moving (e.g going to bed!).  Their emotions are often expressed more strongly when they are tired and it can feel to the parent as if everything ‘ramps up’. Ironically, tired children can be exhausting to be around because adults often experience them as being especially frenetic.  

There is a clear reason for this in Chinese medicine terms.  The balance of yin (calming energy) and yang (active energy) is different in children than it is in adults.  Children’s yin is ‘insubstantial’ and has not yet fully matured.  At the same time, a young child has an excess of yang energy.  The more tired a child becomes, the less yin there is available to ‘root’ their abundant yang.  If yang is not rooted, it rises up to the head.  This causes agitation, intense expression of emotion and the child may feel as if they have just had a strong coffee!

Tiredness and sleep

Ironically, the more tired a child is, the worse they may sleep.  This is for the same reason that children become more hyperactive when tired too, as described above.  An overtired child may take longer to get off to sleep in the evening, have more disturbed sleep during the night and wake up earlier in the morning.  

Other signs of tiredness in a young child

There are of course many other ways in which a child may reveal their fatigue.  Some of the most common are:

  • being grumpy 
  • saying ‘I’m bored’ 
  • heightened emotions of any kind, for example becoming more anxious, more fearful, more worried or more angry. 
  • saying ‘I don’t feel well’ or ‘I’ve got a tummy-ache’ 
  • increased clinginess: young children do not only feed off their mother’s milk. They rely on the qi of their main caregivers in order to keep going.  This is because their own qi system has not yet fully-developed.  When a child becomes tired they then rely on another’s qi even more in order to keep going.  This is often the root of a child’s clinginess.

So, of course we should not put everything down to tiredness, but it may help both parents and children to be able to more accurately spot the ‘hidden’ signs of tiredness in a child.  I have heard many a parent say that their child just does not seem to need much sleep.  The reality is that the child has become so tired that they just cannot sleep, and they are ‘running on empty’.  Looking at how to promote sleep in children will be the subject of another post.  In the meantime, if you think your child is chronically tired, a first simple step can be to start putting them to bed half an hour or an hour earlier in the evening.  You may be surprised at just what a difference it can make!

Why we need to slow down the pace of our children’s lives

DB January 5, 2020

Many children today live extremely busy lives.  Term time, especially, is often a blur of activities.  After a taxing day at school, many children then have hours of after school and weekend activities.  I hear many parents talk about their children ‘hanging on in there’ or ‘just about holding it together’ as they near the end of a term at school.  We seem to live in a society where ‘doing’ is valued and ‘being’ is not.  Children often grow up deriving their self-esteem from their external achievements.  So, unless they are busy achieving out in the world, they do not know how to feel good about themselves.  This drives them to do more and more. 

But does this matter?  Many people would say that children today are lucky to have so many opportunities to play different sports, learn instruments, do martial arts, learn extra languages, take dance classes or pretty much anything that takes their fancy.  And, of course, on one level they are.  However, as with most things in life, balance and timing are the key. 

One of the most influential Chinese doctors of all time was Sun Simiao, who lived approximately 1500 years ago.  He wrote:

‘The way of nurturing life is to constantly strive for minor exertion but never become greatly fatigued and force what you cannot endure.’

Ironically, in the 21st century, many of us feel that unless we are greatly fatigued and really ‘digging deep’ that we are simply not working hard enough!  Sun Simiao’s words, however, are especially important for children.  

Children’s yin is said to be ‘immature’.  It is still in a state of development until a child stops growing which, for most children, is some time in the mid-teens.  Yin is essential for the physical body to become strong and for stamina.   Yin also underpins good mental health.  Without it, it is hard for us to feel calm and to be resilient against life’s challenges.  Too much activity depletes the yin energy of the body.  And because children’s yin is not yet fully developed anyway, lots of activity is especially detrimental for them. 

Pushing a young child to become proficient in mandarin, an Olympic gymnast or a highly-skilled musician when they cannot endure it*, is like decorating a house before building strong foundations.  Childhood should be about building the foundations so that they are as strong and robust as possible.  A child then has the rest of their lives to develop refined skills or, as it were, to put the decorations on their house.  

So, if as a parent you feel that your child is constantly tired, or that they have very little opportunity to just ‘be’, it might be worth reflecting on how their schedule can be reduced.  Not only might it help them to grow up physically and mentally strong, it will also teach them an important lifelong lesson.  If, as children, we do not learn how to be still, quiet and reflective at times, we have little hope of doing this as an adult.  

*How to spot the signs that a child may not be enduring what is being asked of them will be the subject of my next blog post.  

Is your toddler a ‘robust’ or ‘sensitive’ type?

DB December 15, 2019

It barely needs stating that every single child in the world is a complete individual, with their own unique combination of traits, tendencies and quirks.  It is important to be mindful of this fact whenever we start talking about types or categories of children.  Although I am about to describe two broad categories of young children, please bear in mind that within each category there are an infinite number of nuances!

Chinese medicine understands that children may be born with one of two constitutional tendencies.  Neither type is ‘better’ or ‘worse’ than the other.  Children in both categories will have their own set of challenges and strengths.  However, understanding which type your child is, may help to guide you in how you parent them.  This is most applicable in  children up to the age of about four.  

The robust child

The robust child is born with a surplus of qi.  They will look physically robust, often have red cheeks and a huge appetite.  They perceive the world as a place that needs exploring.  Every new place they go or new person they meet is a wonderful opportunity to express their natural inquisitiveness.  They make their presence strongly felt and are often impossible to ignore!  

The robust child will thrive off having a full and varied daily routine, with lots of stimulation and activity.  They will hate being constrained and will often show a strong level of independence for their age. 

When they become ill, they tend to have strong symptoms and high fevers.  They may be very ill but throw off the illness as quickly as they succumbed to it.  

The sensitive child

The sensitive child is born with not quite enough qi.  They will often be physically slight or thin, have a pale complexion and tend to eat small amounts of a smaller range of foods.  They may need time and the support of an adult to adjust to new places or people.  They may need to ‘warm up’ before revealing their true nature in situations that they are not entirely familiar with. 

The sensitive child will thrive off having a quieter lifestyle.  They will need a balance of activity and stimulation, with rest and downtime.  They may rely on the presence of a parent to help them feel secure when they are going to a new place or doing a new activity.  

They tend to get mild illnesses, that may last a while but rarely amount to anything.  

Some children fall very clearly into one category, whilst others seem to sit somewhere in the middle of the two.   This way of classifying children has some overlaps with the system developed by paediatric health researcher William Boyce.  He differentiates between ‘dandelions and orchids’.  He writes that dandelions are able to thrive in a wide variety of environments, whereas orchids need a more specific environment in which to thrive.  I would say that the kind of society most children in urban environments are brought up in does indeed favour the robust type child.  This is unfortunate, as the majority of children born in the West today are the sensitive type (the reasons for this will be the subject of another post!).  Below are some tips that might help parents, who clearly identify their child as being strongly one type or other, meet their needs.  

Robust children need:

  • A lot of movement and physical activity (although rest of course too)
  • Opportunities for lots of exploration and adventure
  • Sometimes help with knowing when they are full 
  • Guidance to know when to step back and allow other children to take centre stage!
  • Lots of love (of course) but firm, clear boundaries

Sensitive children need:

  • Smaller amounts of activity interspersed with rest
  • Encouragement to explore and try new things
  • Encouragement to eat a wide range of food
  • To be allowed to take their time to feel their way into new situations or relationships
  • Lots of love (of course) and a gentle, tender approach

It is very easy, as a parent, to be concerned that our child is a particular way.  For example, we may worry that our really robust child dominates when playing with other children and that this means as an adult they will be perceived as over-bearing or bossy.  Or we may worry that our sensitive child is never going to make their mark in the world and will be over-looked.  But this worry is usually misplaced.  Both robust and sensitive children, as they grow and mature, will have the ability to find a path in life where they can express their true nature and excel.  If we try to turn a child into something they are not, we are likely to cause them harm.  If we respect their individuality, and meet their needs accordingly, they are likely to emerge into adulthood with the confidence to manifest their true nature in the world.  

Nurturing the Young webinar: coming up this Saturday

DB December 12, 2019

I wanted to alert you to my upcoming webinar this Saturday.  It is a three hour webinar for practitioners, but also interested parents, titled “The Importance of Nurturing the Young to raise healthy, happy children.”  This short introduction interview with Lorne Browne, of Healthy Seminars (who are hosting the webinar) will tell you all you need to know about it.

Routine: to have or not to have, that is the question!

DB December 10, 2019

For my mother’s generation, deciding how to manage the first months of a baby’s life was comparatively straightforward.  There was one book out there to be guided by – Dr Spock’s Common Sense Book of Baby and Childcare which, according to some sources, is considered to be the second best-selling book after the Bible!  Nowadays, parents are faced with a multitude of different books, advocating a multitude of different approaches.  At one end of the spectrum, there is the Gina Ford philosophy of putting a strict routine above all else.  At the other end, there is Jean Liedloff’s the Continuum Concept advocating a completely ‘baby-led’ approach to child-rearing. 

What does Chinese medicine have to say on the matter and can it help us to see beyond these approaches to find a little more balance?  Can it help parents respond to their individual baby’s needs whilst simultaneously not losing sight of their own?

Chinese medicine is very clear that young children are, by their very nature, full of yang energy.  This means that they have a need to move a lot, a certain exuberance and often volatility.  Whilst this abundance of yang is physiological, rather than pathological, and is necessary to fuel their extraordinarily rapid growth, it also can easily become ‘out of control’.  Therefore, it needs tempering.  The best way to temper it, is by creating a strongly yin environment.  

A yin environment is one where there is consistency, predictability and repetition.  Babies and young children have not had time to build an internal sense of structure, and are therefore often comforted and made to feel safe by an external structure.  Having a certain rhythm to their daily routine is often calming and helps to keep the exuberant yang in check.  For many, having meals and going to sleep at around about the same time each day, is a way of creating this rhythm. 

However, we should differentiate between predictability and inflexibility.  Life itself is certainly not completely predictable, and babies and young children will have slightly different needs from one day to the next.  Trying to impose too much routine does not allow for this, and a too rigid approach may create stress or conflict for both parent and child.  A toddler who has no flexibility in their schedule may struggle to develop the resilience necessary to cope with the unpredictable nature of life.  

Another consideration is that stress, in either child or parent, is one of the most common reasons for yang energy to rise up in the body.  When this happens, children may display more intense emotions, be inclined towards digestive disturbances and sleep less well.  Therefore, it’s probably not worth rushing home in a fluster purely to make sure we can get our baby off to sleep on the dot of 7pm. The anxiety this may induce is most likely more detrimental than going to bed slightly later than usual.  

The vast majority of children will benefit from having some rhythm and routine in their life most of the time.  Beyond this basic premise, each parent and child must find a way through the first years of life which creates the most ease for both of them.  Pronouncements about one approach being ‘right’ and another ‘wrong’ are missing the point.   A more helpful way to look at it is to assess the unique needs of each parent and child, and to respond to that as best as possible.  

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