Xiaoxiao, a Free Children Clinic, Milan

The clinic Xiaoxiao treats only children, with paediatric tuina and acupuncture, and it is run for the 4° year, once every week, in Milano, Italy.
In the first 3 years it led 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 current pilot-study is designed for children who do not sleep well or are hyperactive.
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).
From November 2005 to June 2008, during school time, we treated 58 children, from 2 months to 12 years old, for a total of 392 sessions (45 children for prevention and cure of respiratory disorders, of which 39 have completed the 8 sessions).
From October 2008 to January 2009 we treated 27 children, for a total of 104 sessions (40 sessions for respiratory disorders, 41 for hyperactivity or sleep disorders, 26 for other problems, as infant abdominal pain, nocturnal enuresis, dermatitis, intestinal disorders, growing problems).

By June 2009 35 practitioners will be trained through a basic or advanced paediatric course.

Data were 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 it was important to get information through a semi-structured interview in June 2007 and 2008 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 preliminary results can be read on the Journal of Chinese Medicine (n.85, October 2007).