Xiaoxiao, a free children clinic: a two years experience with paediatric tuina and acupuncture

The clinic Xiaoxiao treats only children, with paediatric tuina and acupuncture, and it is run once every 10 days, since two years, in Milano, Italy.
It leads a pilot-study for the cure and prevention of recurrent respiratory diseases in 0-12 years old children, with 8 sessions free of charge: the first 7 sessions take place every 10 days and the last one around two months after the completion of treatment.
The therapeutic choices are not rigidly set by protocols: they follow the Chinese diagnosis and take into account the complexity and the variability of the patients.
Paediatric Tuina is the main treatment, but we also use acupuncture, moxibustion, cupping, ear-seeds, guasha, plum-blossom needle.
This project is supported by the Federation of Italian Schools of Tuina and Qigong (FISTQ), and it has been developed with the essential contribution of Rossella Cignetti, Letizia Frailich, Ruggero Scaccabarozzi, M.Grazia Terzi, Maurizio Zanghi.

From November 2005 to June 2006, during school time, the clinic opened 42 times.
We treated 29 children, from 2 months to 12 years old, for a total of 218 sessions.
20 children came for the project about respiratory diseases: of these 17 completed the 7 sessions course and 14 had already done also the 8th session of consolidation and follow-up.
13 practitioners were trained through a basic or advanced paediatric course.
Data are recorded with Microsoft Access, through a specifically designed clinical chart.
The program has been made available to all centres that treat children with Chinese Medicine, with the intention of building a net for gathering and exchanging information. Medical chart layout, data processing method, written issues for parents, legal consent form, all clinical information are accessible – of course within the limits of the privacy rules.

We usually teach the parents the main individual tuina sequence, which will then be applied daily at home. Parents also learn some “emergency” sequences (in case of common cold or cough, fever, constipation, etc.).
The care-givers can also attend a two-days course that takes place twice a year. Here they get a basic knowledge of Chinese Medicine and of specific children physiology, pathology, diagnosis, tuina points and techniques, acquiring the ability to recognise the main clinical patterns and to design and apply a treatment.
The Xiaoxiao clinic also acts as a clinical training centre for tuina practitioners and acupuncturists (in Italy acupuncturists must be MD) who already have a good knowledge of Chinese Medicine and wish to focus on paediatrics.

The study was not intended to gather data for a statistical analysis, but it was designed as a qualitative tool to think about what happens before, during and after treatment of children.
We focused on results concerning the main complaint (frequent fever, cough, otitis, etc.), but we evaluated the general condition as well, the state of qi, which in children shows mainly in sleep, appetite, stools, skin, attitude/behaviour.
We also thought important to get information through a semi-structured interview in june 2007 on the way parents felt in the clinic, how they considered the whole experience, and if they continued to apply tuina after the end of the 8 sessions.

Observations on the results can be read on the next issue of the Journal of Chinese Medicine (n.85, October 2007)