This is a big question which Chinese Medicine has more answers to than any other system of medicine I know. Please join me tomorrow (thursday) at 8pm for this free, one hour webinar, hosted by Singing Dragon where I discuss what makes children ill. To register, go to Singing Dragon’s Facebook page here: https://www.facebook.com/SingingDragon. I will be answering questions during the live event tomorrow evening. The recorded version will be available to purchase afterwards. I hope to see you there!
Why do children become ill?
Since the coronavirus pandemic began, I have been contacted by parents who are anxious about the impact the situation will have on their child. Many children will be off school for months, unable to see friends or partake in most of their usual activities. There is no getting away from the fact that this time is throwing up enormous challenges, of many different types and to many differing degrees for almost everybody. This is a difficult time, and it is going to continue to be difficult
In the conversations I have had with parents, we have found it helpful to pare things back to basics. What, of their old lives, can our children really not do without? There may be short term, negative impacts from a few months off school, not seeing friends, no extra-curricular activities or normal leisure pursuits. But how many of these effects will last beyond the short term? Providing a few basics are in place, our children can get through this time unscathed and may even develop resilience and learn some other useful life skills along the way. Perhaps a positive outcome of this challenging time is that we will be reminded of how little we really need to remain physically and emotionally healthy. (It is, of course, also important to remember that there are sadly many children around the world who will not even be able to rely on the basics that are described below.)
Over a thousand years ago the Chinese developed a system of medical massage for babies and young children called paediatric tui na. As well as being extremely effective for the treatment of many common childhood problems, one of its advantages is that it is very practical. It is possible to access the five key functional aspects of a child’s physiology on the hand, specifically on each of the fingers. This means the massage can be done while a baby is breastfeeding or without needing to get an older child undressed.
Each finger relates to a different acupuncture channel and function. Looking at these five functions and, crucially, what they need to remain healthy, shows us what the 5 pillars that support a baby or child’s growth and development are.
Thumb – spleen meridian – nourishment
The thumb relates to the digestive system. In order to maintain health, a baby or child needs adequate nourishment. Although what constitutes adequate nourishment is something which could be discussed all day, it can be stripped back to:
- Enough food or milk
- Gaps between meals or feeds
- A good variety of foods
Index finger – liver meridian – movement
The index finger relates to the flow of qi all around the body, which in Chinese medicine is governed by the liver. This enables the emotions to flow freely and for digestion to be rhythmic and comfortable. In order to maintain health in this area, a baby or child needs to be able to move. For a baby this means first kicking their legs, then rolling, sitting up, crawling and finally toddling. For a child, this means having several opportunities a day to be physically active. If, due to lockdown restrictions, this needs to be done in the home rather than outside, it is still beneficial.
For young children, the key is to move little and often. They need to intersperse more sedentary activities with short bursts of movement, for example, a play in the garden (if they are lucky enough to have one) or some star jumps.
Middle finger – heart meridian – connection
The middle finger relates to the Heart meridian which, in Chinese medicine, governs our emotions. In order for this aspect to thrive, the baby or child needs connection and intimacy. This is more than merely being in the presence of other people. It means having an emotional closeness to them, trusting them, receiving physical touch from them, doing activities together and, for verbal children, having conversations with them. Children may deeply miss seeing friends and extended family, but if they remain connected to those they live with, this will sustain them.
Ring finger – lung meridian – fresh air
The ring finger relates to the Lung meridian which, unsurprisingly, is related to breathing. In order to thrive, the Lung meridian needs a source of relatively clean air. For children who live in cities or whose opportunity to go outside is currently limited, this is probably the hardest basic pillar of health to achieve. If this is the case, simply doing some basic breathing exercises with your child (if they are old enough) can be beneficial.
Little finger – Kidney meridian – rest
The little finger relates to the Kidney meridian which, in Chinese medicine, governs our reserves of energy. In order to thrive, the Kidney meridian needs an adequate amount of rest and downtime. Even if they are not currently going to school and their lives are less busy than usual, we should remember that children are always hard at work behind the scenes with the mammoth task of growing and developing. This consumes a lot of their qi. Getting adequate rest is therefore even more important for children than it is for adults.
If you are aware that your child is struggling in one of these areas (for example, your toddler is going through a fussy phase and refusing to eat anything other than pasta), you can support that function by doing a simple massage on the relevant finger. Simply rub the pad of that finger in a circular motion (it doesn’t matter which direction) for between 1 -2 minutes, twice a day. You don’t need to use great force – just firm contact is enough. As well as supporting that function, the massage can also enable your child to support it better themselves. For example, with the case given above, by massaging the pad of the thumb on a fussy eater, you may well find that by improving their spleen qi, they then start to eat a wider range of foods.
As parents, we are hard-wired to want the absolute best for our children and it can induce anxiety if we feel we are not able to provide that. This extraordinary time, when the fabric of our children’s lives has been temporarily entirely changed, may stir those anxieties. So it is worth reflecting on these 5 pillars of health and reassuring ourselves that if our children have them in their lives, at least to a large degree even if not completely, then they will be getting what they need. Everything else, that is temporarily missing from their lives, is icing on the cake.
Many parents have told me recently that their babies and children are not sleeping as well as usual. This might be due to a combination of heightened anxiety in the household due to the effects of the Covid 19 pandemic, the longer days and the rising yang qi which is resonant of the arrival of spring.
There are as many reasons why babies and children do not sleep well as there are suggestions of how to get them to sleep better. However, these simple, easy-to-learn massages can be used on babies and children of all ages, whatever the cause of their bad sleep. They derive from a system of medical massage called paediatric tui na (xiao er tui na) which has been used in China for approximately 1200 years.
Please click on the link below to learn how to do the massages.
There is a view that we blame everything on teething. When a baby or toddler is grouchy, not sleeping or not eating, it is all too easy to say ‘ah, she must be teething’. But whilst there are, of course, other reasons for our little ones to be unhappy or lose their appetite, the reality is that teething can be a really disruptive process. Chinese medicine can explain perfectly why this is, and give us some clues as to what to do about it.
Firstly, the process by which a tooth works its way up through the gum requires a surge of yang qi (heat) in the body. This is the equivalent to athletes needing to warm up before a race. In order to run their fastest, their body needs to be warm beforehand. In order for a tooth to emerge, a baby must produce some extra heat to provide the motive force for the process. This heat is necessary. However, it can also explain many of the common ‘symptoms’ of teething, such as:
- Red cheeks
- Disturbed sleep
- Restlessness and agitation
- Raised temperature
- Smelly stools
In children who are already a bit too hot, the teething process tends to cause quite a lot of disruption. But for children who are energetically damp or cold, the extra heat in the body can actually be useful. It can enable the body to ‘throw off’ damp that has been lingering. This explains another common teething ‘symptom’ which is:
- Snotty nose
Secondly, the acupuncture meridians (channels) of the Stomach and the Large Intestine both run through the gums. When a new tooth is emerging, the qi in these channels temporarily becomes disrupted and blocked. It can no longer flow smoothly. This explains some other common ‘symptoms’ of teething, such as:
- Loss of appetite
- Loose stools
So, is there anything to be done to help make this transition an easier one? The answer, thankfully, is a definite yes! Here are the most common pieces of advice I give to parents whose children are having a difficult time with teething:
- Trust your child’s instinct to lessen their food or milk intake during this time. It will help to relieve the stagnation in their digestive system, which comes from the tooth cutting through one of the key digestive meridians. Babies and children of this age have an innate instinct for survival. They will make up for it once the tooth has come through!
- Foods should be kept simple and light. This means avoiding red meat and spicy foods, and keeping cheese and sugary products to a minimum.
- Make sure the baby or child has good breaks (ideally a minimum of 2 hours) between meals or feeds, so they have time to digest one before taking in the next.
- Massage the acupuncture point LI 4 hegu on the hand. It really helps to ease the pain of teething.
- If your child has red cheeks, feels hotter than normal to touch and is generally restless and irritable, massage this acupuncture point (known as Kidney 1 yongquan) at the bottom of the foot. It will help to draw the heat down from the top of the body.
- Whilst hot, restless children may need opportunities to run around outside, most children also need more rest when they are teething. In Chinese medicine, teething is seen as an outward manifestation of a strong developmental phase. This means children need to conserve their energy rather than expend it on too many external activities.
Teething may be an unpleasant experience (although, thankfully, one that we don’t remember!) but it certainly does not need to be a tyranny. Having an understanding of the process, and following the simple guidelines above, can enable parents to nurture their children through this developmental stage. We can’t take away the pain, but we can ease it and, most importantly, be alongside our children through it.
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!
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!
This evening, I will be giving a free, live webinar for acupuncturists about treating food allergies in children with acupuncture, hosted by www.treatingchildren.com. It will be a good introduction for anyone who has paediatric patients who have allergies or intolerances to foods. I will outline:
- the main types of food allergies and intolerances
- causes of food allergies
- key pathologies seen in food allergies
- treatment of these pathologies
- practicalities of treating children with food allergies.
If you would like to watch the replay, please go to: https://www.treatingchildren.com/p/rebecca-avern-food-allergies
I have seen several babies and toddlers in the clinic this week who have all been in the middle of what can only be described as ‘outpourings of snot’! They are not ‘ill’, as such, and their parents report that they are happy and energetic. However, they have an almost permanent stream of mucus running from their nose.
It is easy to jump to the assumption that this is inherently ‘a bad thing’, and a sign of ill health in some way, and certainly something that we should try to put an end to. From a Chinese medicine perspective, however, there is another way of understanding this process. The great physician Sun Simiao talked about the fact that babies and toddlers must go through phases of intense growth and development, which both enable them to become more ‘grounded’ in the world and also to throw off toxins that they have been born with. Periods of ‘snotty-ness’, when the child is otherwise well, are often a sign of one of these intense phases of development.
So, rather than reaching for the Calpol and worrying that something is wrong, the best way to help a child through such a phase is to nurture them as best we can, provide them with lots of opportunity for rest and avoid over-stimulating them. Parents often notice that, once this phase is over, their child has made some important developmental leaps. For example, an eight month old baby may start sleeping through the night for the first time, or a three year old may decide they do not want to wear nappies anymore and take to toilet-training easily. An older child may start speaking or engaging with others more confidently.
Growth and development are not linear, constant processes. They happen in fits and starts, with regressions and big leaps forwards along the way. The physical body may become temporarily out of kilter for a time. It’s important to acknowledge and encourage acceptance of this process, rather than to always jump in and try to ‘fix’ it. As practitioners, we can encourage parents to tune in to their intuition, so that they can recognise the difference between illness and development.