Painting by Mary Cassat
Constipation should be considered when a baby or child is moving their bowels less frequently than normal, or the stools are small and hard. There can be pain and fear about going to the toilet.
There are many possible causes of constipation including:
Frequency of Feeding
In Traditional Chinese medicine the Middle Jiao is the area generally below the heart to the pubic bone. All Middle Jiao issues revolve around the transformation and transportation of food and fluids. We can include the Stomach, the Intestines, the Spleen, the Liver, the Bladder and the Uterus in the Middle Jiao.
When we think about Constipation we mainly look at the Spleen, Stomach, Liver and Gallbladder as the main organs that affect how food is transformed into energy and excreted.
Unlike Western Medicine the Spleen plays a vital role in processing food. The Stomach is considered the Hearth of the body and has the name the “Hundred Degree Soup”. The Spleen functions better with regularly spaced meals, cooked foods and easily digested foods. The Spleen needs to be able to turn the food into rapid energy and then send the waste to the colon for excretion.
How things get “slowed” down:
Most babies and toddlers graze a lot throughout the day. Often snacks keep them happy temporarily but can affect the amount of “proper” food eaten at a meal.
Eating abundance of cold, raw foods:
Cold raw food (including an excess of raw vegetables, fruits, ice cream, cold drinks) can affect the digestive powers of the Middle Jiao.
External and Internal Stress:
New environments can create an interruption in bowel movements such as travel and/ or school. Additionally potty training and issues around that can create constipation.
Traditional Chinese Medicine typically breaks down symptoms into clusters to strategize the best treatment.
Constipation generally falls into two specific categories: Excess and Deficiency.
Excess Type Constipation / Accumulation
- Swollen abdomen
- Stools can be very hard and smelly
- Stools can fluctuate hard and loose
- Often the cheeks are red or flushed
- Strong Child
- When they yell you are forced to take notice
- Green or yellow nasal discharge
Deficient Constitution / Weakened Spleen and Stomach Qi:
These children often do not have the energy or Qi to properly move their bowels.
Prone to more frequent illnesses
Weak or floppy looking
Possibly a challenging childbirth
Bowel movement infrequent, possibly hard
Not particularly odorous bowel movement
Acupuncture and Acupressure Treatment Strategies:
For the child who has Accumulation Issues we use acupuncture, Shoni shin massage and dietary therapy to help relieve constipation. This pattern is typically revolved around clearing heat and stimulating the colon to move. The colon is essentially bogged down and needs a bit of help passing the accumulated food through.
Children typically respond very quickly. *Do not be alarmed if the bowels move very suddenly!
Acupuncture needles are generally not retained for children under the age if seven years old. Typically a pin is placed and removed quickly before the child even sees it. Shonishin pediatric massage is utilized to stimulate the Stomach, Gallbladder and San Jiao meridian. Often the acupuncturist will leave press tacks in points that are particularly effective including St 36 or St 25.
What you can do at home:
Gently massage the abdomen in a circular fashion over the umbilicus.
Massage Stomach 36 with a tapping motion.
Children with a weaker Constitution are treated similarly but the emphasis is less on draining excess food but warming and strengthening the middle to process food more effectively. We often utilize moxabustion to tonify the digestive strength.
Similarly pins are not retained for children under the age of seven.
Klaire Labs and Jarro make great powdered probiotics that can be seamlessly added to just about any food.
More cooked, easily digestible foods like grains, millet, quinoa, rice, sweet potato, root vegetables,
Fewer sugary foods and drinks
Congee is a type of rice porridge that is popular in many Asian cultures. Congee is easily digested which makes it a popular dish when one is sick or constipated.
Grains are generally cooked in a 6-1 (water to grain) dilution until the grain disintegrates. You can add a bit of meat or scallion and soy sauce for a savory congee or honey or maple syrup for a sweet congee. Traditionally rice is the most commonly used grain or you can try millet or quinoa.
Epsom salt baths:
A few times a day place your child in a warm bath with enough water to cover most of the abdomen. This often works to loosen things up. It tends to relax the body, which is particularly useful with kids who hold stool in. Some kids will allow you to gently massage their belly while they soak in the bath. Adding about 1/2 cup of epsom salts, which contains magnesium and sulfates that are absorbed through the skin, can also help ease constipation.
Shonishin pediatric massage is a Japanese treatment that uses small tools to tap, rub, press, scratch and stroke the body’s skin. Shonishin translates to “Children’s Needle” although primarily used for children, Shonishin massage can be applied to anyone.
Traditional Shonishin pediatric massage became widely popularized in the 20th century in Japan. Unlike traditional acupuncture, Shonishin focuses on massage rather than needle insertion. Shonishin tools made of silver, stainless steel, bronze and even gold. Many of the tools have cute names and resemble objects like the “bug” and the “rake”.
Shonishin massage is a pragmatic system of treatment with minimal theory needed to apply treatment. Children are highly receptive to treatment and love it! Since the treatment is harmless, I usually let the children apply a bit of massage to themselves and even to me.
Other treatments that are used in conjunction with shonishin massage are the application of light cupping on the body to release stuck energy and/or heat. Cupping was popularized in America by in image of Gwyneth Paltrow wearing a backless gown exposing purple colored circles on her back. Unlike Ms. Paltrow’s treatment cupping on children is very gentle and leaves little to no markings.
To supplement the massage a practitioner may insert a few acupuncture pins. Depending on the child’s age the pins are usually not retained rather the pin is inserted and withdrawn in a painless way that the children barely know what happened. Additionally, ear seeds little gold or silver balls backed with tape or tiny press tacks can be left on the acupressure points for up to 48 hours to strengthen the treatment.
Painless Press Tacks placed on San Jiao 5, for earache (left). San Jiao 17 and Gallbladder 20 for earache and congestion (right).
I started my search into Shonishin massage because I was on the hunt to find a non-invasive way to treat my daughter’s enlarged tonsils. She contracted mononucleosis in Pre-K and since then her tonsils remained enlarged. Although she didn’t report feeling sick she failed her hearing test in Kindergarten. An ENT suggested surgery or hearing aids. I was devastated and I felt terribly guilty that I let her catch mono in the first place!!! (No one said being a mom came with rational thinking).
Before embarking on surgery I decided to do 30-Day intense treatment that included acupressure, neck massage, acupuncture, homeopathy, dietary changes, moxibustion and castor oil packs on her neck. Her hearing completely improved and she did remarkably well on her hearing test. Overall, she is stronger and more resilient. Her pediatrician was impressed.
One of the greatest elements of Shonishin pediatric massage is the ability to teach parents how to continue treatment at home. This not only expedites the healing process but can help parents feel more connected to recovery.
In the clinical setting and at home Shonishin pediatric massage is a great complimentary therapy for any child. Please have all children evaluated by their pediatrician first as Shonishin provides an excellent complimentary treatment to Western medicine. Children love treatment and you may find yourself getting a little massage yourself from your little one!
Tapping # 1 Back of the Body
Tapping # 2 Front of Body
Stroking #3 Front and Back