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Wednesday, 09 July 2014 11:56

Can acupuncture help a six year old child who has a daytime wetting issue?

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A: We were asked a question about nocturnal bedwetting some time ago, and answered:

There is some evidence that acupuncture may be of benefit in treating bedwetting in children

http://www.ncbi.nlm.nih.gov/pubmed/15791606

but as is the case with a great deal of the research which is conducted in China, it often falls below the standards required for acceptance in the west. Invariably authors of systematic reviews such as this will make generally encouraging noise about meriting further research, but until and unless major funding is provided for such studies the evidence will remain thin.

However, Chinese medicine has been dealing with problems such as this for over two thousand years, and operates from an entirely different theoretical base in understanding how the body functions. This is expressed in the concept of energy, 'qi', and its balance in and flow around the body, and uses concepts such as 'yin' and 'yang' which we're sure you've come across. There will be a number of ways of understanding the balance of the functional relationships in the body which might explain the symptoms, and the practitioner's skill is used to ensure that the treatment not only resolves the symptom but tries to deal with underlying patterns of imbalance to stop their recurrence.

One note of caution is that although we do not recognise 'experts' in treating particular diseases or patient groups, there is no doubt that children are not simply 'little adults', and the consensus is emerging that some of the diagnostic conclusions and ways of treating are slightly different from the adult versions of the same problems. A growing number of members now seek postgraduate training in paediatric acupuncture, and while we would not say that someone without this training may not be able to help you, we believe that we are fast approaching the point where we say to a prospective patient that we would expect someone who focuses their work on children to have made the effort to undertake further study, be it in the form of a course or a programme of self-study.

Our best advice is to ask a BAcC member local to you whether they or someone they know focuses their work on treating children, and failing that to use 'google' and search under 'acupunture treatment of children' alongside where you live. Many of our members now have their own websites, and usually mention their areas of primary focus (children, pregnancy and fertility, if they have them.

However, most of the research and discussion is about nocturnal wetting, not daytime wetting. In theory, from a Chinese medicine perspective the factors in play would be understood in a similar kind of way. The inability to hold back the flow of water, or to be unconscious of its passing, is evidence of a functional disturbance, and a practitioner will look carefully at the whole system to see what is driving this. The daytime nature does also open up the possibility that there is an emotional component. Here again, acupuncture treatment may be of value, and the standard textbook on the treatment of children with acupuncture lists a number of emotional problems which the authors believe are susceptible to treatment. However, as Clint Eastwood was wont to say in his movies, 'a man has got to know his limitations', and the counselling of children is an expert skill which would not form a normal part of a practitioner's training. The wise practitioner will refer on if they feel this is out of their depth.

Subject to these caveats, though, children, when they respond to treatment, do seem to respond very well, so if one of our members believes that acupuncture may be of benefit, there is some hope that they may well be able to help.

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Sandy Williams

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