Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.
Acupuncture is safe for children when given by a trained acupuncturist, and with their parent present. If they are unable to tolerate needles, acupressure or moxibustion can be used on the relevant points.
Research and Resources on Acupuncture for Children:
A scholarly search of the available research papers on the terms “acupuncture” + “paediatric OE “pediatric” yields over 35,700 papers, and narrowing this to “RCT” to identify Randomised Controlled Trials, gives over 3,970 results; of which 40% have been carried out since 2017 (Google Scholar). This suggests that acupuncture is being used traditionally and currently in this area, leading to a body of research being carried out, the pace of which has increased in recent years, indicating increased recognition that it is worthy of scientific appraisal regarding its potential role.
Interpreting the research:
When reading health research, it is important to know that Systematic Reviews or Meta Analyses of a large number of high-quality research studies are the very best way to be able to say to what extent a given treatment can address a condition, symptom, or set of symptoms. The next best level of evidence is the individual Randomised Controlled Study (RCT) which uses a systematic technique to compare two or more groups of patients receiving different treatments (or a treatment against a “control”, or no treatment). In acupuncture trials, the nature of the control group is of particular interest as it is hard to blind a patient to whether they are having a needle inserted or not, and even more challenging to blind the researcher/team to this.
The means and quality of how research is carried out varies considerably from country to country, and in terms of how an intervention is compared to another intervention (or a control). Of note is the fact that “sham” acupuncture (where needles are placed in apparently inert locations rather than traditional acupuncture points) is not really an inert process as it has physiological effects, so that comparing sham and “true acupuncture” may therefore not give a clear picture alone; but and form a part of a research body where acupuncture versus no treatment, vs conventional treatment or vs a different approach/modality also form part of the evidence base.
The n= figure (where quoted in research) tells you how many people were participants in the study, and usually the larger a study (when it is of good quality and design), the more likely it is to be reliable and applicable to larger populations. When (statistical) “significance” is discussed in view of studies it has a very particular meaning – it is the confidence in the data (using statistical tests) that tells us how likely a result could have just come about by chance. The lower the possibility of a chance result, the more likely it is due to the intervention in the experiment. When you are reading a trial/study, the “p” is the number telling us of significance, and this must be under 5% (or p less than 0.05) to mean we can say it is a (statistically) “significant” result.
The Research:
Research has looked at acupuncture in a number of areas including paediatric pain, nausea, and post-operative symptoms. Research and information on post-operative pain in an adult population is here.
In the hospital setting, acupuncture reduces postoperative nausea and vomiting (PONV) in children, particularly during the first 4 hours after surgery and was most effective when performed before anaesthesia (Veiga-Gil at al, 2017, systematic review of 16 RCT, n=1773). More information on acupuncture, nausea and the research is here.
Azarfar et al’s (2017) systematic review of 7 trials showed promise in the area of nocturnal enuresis (bedwetting) in children, many of the studies used low level laser acupuncture in lieu of needling. The positive trend limited by the small number of trials available to the researchers at the time, warranting further large RCT trials of quality. Research and mechanisms of action on the urinary system are here.
Stadler et al’s systematic review concluded acupuncture may have a role in neonatal pain, (2019) although they also pointed out that the number and quality of trials available was low, meaning more research is warranted. More on the pain research in the adult population, and the research is here.
A systematic review has also found that acupuncture appears “safe and effective for the treatment of migraine in children” (Doll et al, 2019). More information on acupuncture research for headache and migraine is here
In the area of allergic rhinitis (hayfever), there is already some research evidence for adult populations with acupuncture (see our specific page), and a forthcoming systematic review will examine this in children (protocol: Li et al, 2021).
A systematic review has drawn tentatively positive conclusions in trends in the fields of autism spectrum disorder (Lee at al, 2018, 27 articles, n=1736); however it is of note the quality of the available studies examined was low and therefore further high quality trials are needed.
A systematic review protocol was put forward in 2021 for an examination of the efficacy and safety of acupuncture for the treatment of children with attention deficit hyperactivity disorder (Lin et al, 2021), so it will be of interest to see the forthcoming publication of this.
Regarding Your Individual Condition and Symptoms:
Whilst the scientific studies are of great interest to researchers and acupuncturists in terms of comparing protocols, for the patient not versed in research they are less accessible, which is why when we asked “can acupuncture work for my (condition or symptom) we are not able to give a simple yes or no response. We are able to tell you what experience we have had in our decades of experience in practise, of the types of outcomes we have seen in similar cases, and give you an idea of our level of experience and knowledge in that area, and how this could relate to your own individual situation. For this, we recommend booking a free telephone consultation where we can answer any questions you have and give a realistic appraisal of what acupuncture may be able to provide.
References:
Azarfar, A., Ravanshad, Y., Aval, S.B., Khamnian, S. and Mehrad-Majd, H., 2017. A systematic review and a meta-analysis of using acupuncture for the treatment of nocturnal enuresis. Journal of Nephrology & Therapeutics, 7(2), pp.292-297.
Doll, E., Threlkeld, B., Graff, D., Clemons, R., Mittel, O., Sowell, M.K. and McDonald, M., 2019. Acupuncture in adult and pediatric headache: a narrative review. Neuropediatrics, 50(06), pp.346-352.
Lee, B., Lee, J., Cheon, J.H., Sung, H.K., Cho, S.H. and Chang, G.T., 2018. The efficacy and safety of acupuncture for the treatment of children with autism spectrum disorder: a systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine, 2018.
Li, J., Liu, L., Jiao, L., Liao, K., Xu, L., Zhou, X. and Xiong, J., 2021. Clinical acupuncture therapy for children with allergic rhinitis: A protocol for systematic review and meta analysis. Medicine, 100(3).
Lin, Y., Jin, H., Huang, B., Zhao, N., Li, Z., Mao, J., Chen, C., Xu, J., Zhang, J. and Shuai, B., 2021. Efficacy and safety of acupuncture on childhood attention deficit hyperactivity disorder: A protocol for systematic review and meta-analysis. Medicine, 100(5).
Stadler, J., Raith, W., Mileder, L.P., Schmölzer, G.M. and Urlesberger, B., 2019. Invasive and non-invasive acupuncture techniques for pain management in neonates: A systematic review. Acupuncture in Medicine, 37(4), pp.201-210.
Veiga-Gil, L., Pueyo, J. and López-Olaondo, L., 2017. Postoperative nausea and vomiting: physiopathology, risk factors, prophylaxis and treatment. Revista Española de Anestesiología y Reanimación (English Edition), 64(4), pp.223-232.
Helen