TCM for Children: Tui Na, Herbs and Safety

Urgent safety first

If a child may have swallowed a herbal product, pills or liquid, call Poison Help at 1-800-222-1222 in the US right away, or see Poisoning: what to do first. A US poison center report described three children who developed life-threatening neurologic and cardiovascular problems after a single ingestion of a Chinese herbal product, jin bu huan. The report noted the highly concentrated tablets, no childproof packaging and a package that misidentified the ingredients. [1] Keep all herbal products out of reach, like medicines.

What the official sources say

NCCIH advises that if you are thinking of using TCM to treat a child, you should be especially sure to consult the child's health care provider. [2] The NHS states that herbal medicines are not recommended for children because not enough is known about their safety. [3] For general guidance see children and teens and therapies for children and older adults.

Pediatric tui na

Pediatric tui na uses manipulative techniques on specific parts of the body, chosen for a child's particular characteristics. [4] See tui na and tui na evidence by use.

Trials of hands-on treatments cannot easily hide from the family which treatment a child receives, so expectation may play a part.

Acupuncture and acupressure in children

A systematic review of 37 reports found 279 adverse events in children treated with needle acupuncture. Most were mild, such as pain, bruising and bleeding, with a mild event rate of 11.8% of patients. Twenty-five were serious, including infections, thumb deformity and rare organ injuries. The authors concluded that many serious events might have been caused by substandard practice and that acupuncture appears safe when performed by appropriately trained practitioners. [6] See acupuncture side effects and precautions.

Herbs and patent medicines

Reasons for caution:

• Safety evidence in children is limited, which is why the NHS does not recommend herbal medicines for them. [3]
• NCCIH notes some Chinese herbal products have been contaminated with toxic compounds, heavy metals, undeclared drugs such as warfarin, or incorrect herbs, some of which have caused organ damage. [2]
• Herbal products can interact with medicines a child takes, and the NHS advises checking with a pharmacist first. [3]

See Chinese herbal products: quality and interactions and herbs with known safety concerns.

Who should see a doctor first

Seek prompt medical care for fever in a baby, trouble breathing, dehydration, persistent vomiting or diarrhea, seizures, a child who is unusually sleepy or hard to wake, or symptoms that are severe or getting worse. Complementary care should never delay diagnosis or stop prescribed treatment. The NHS advises not to stop any prescribed medicine without talking to your doctor. [3]

Choosing a practitioner

Qualifications vary by place. In England, the NHS says complementary therapists and herbal medicine practitioners do not need to be registered by law, and suggests choosing one registered with a professional organisation accredited by the Professional Standards Authority. [3] In the US see how to choose a TCM practitioner. Ask whether the practitioner has experience treating children. This site does not list practitioners.