And nothing comes.

And then the frustration sets in, and before you know it, you're onto some other task that has to be done.

I've discovered a simple hack for creating written content that can save you a ton of time!

If you prefer to tell someone their content or speak it aloud, you can use Otter.ai, a voice to text app on your phone. 

It's way better than the dictation app that comes standard on most computers. 

Here's what Otter.ai does:

• It records your voice.
• Creates a time-stamped transcript.
• You can go in and edit it.
• Then copy and paste it. 
• If you keep your recording under 40 minutes, you can use the free version.
  

If it helps to create your content through conversation, talk to your friend as you explain what you want to share in the content you're creating. 

Sometimes, when I'm trying to figure out how to explain something, I'll tell my husband my ideas and record them with Otter.ai. His feedback helps gain clarity, and it's much faster to edit the transcript of our conversation to create the content. 

Best of all, those brilliant ideas you say aloud and then promptly forget are recorded!

If you're ready to delegate...

Have a copywriter or member of your staff edit your transcript and transform it into a blog post, newsletter, and/or social media post for you. Try and take one content idea and use it on multiple platforms. 

If you're wearing all the hats...

Set aside a few hours each month and talk out your content. Then in another session, edit and prep for the different platforms.

I know you have so many great ideas inside you! Don't let writer's block stop you from sharing them with your patients and social media followers.

Check out Otter.ai

Epidemics are exceptional patterns of chaotic qi and wind; Chinese medical theory was created to respond to the flow of qi and the earth provides the medicines that tonify the immune system and expel wind.

Prophylactic formulas are recommended for daily use plus having an “expel wind” formula for immediate use at the very first symptom experienced. The expel wind formulas are far more effective if taken at the very onset, of viral infection. Take the formula every 2 hours for at least the first 24 hours.

Here are their recommendations for adults for the best outcome: 

Preventative Stage

These formulas are used in lower doses, not more than 4-6 tabs per day.

Herbal Sentinel Yang- with Yang deficiency

Herbal Sentinel Yin- with Yin deficiency 

Children’s Sentinel- dampness

Biocidin Throat Spray- very effective anti-viral, anti-bacterial herbal spray. Use often during the day and especially when going out.

Early Stage

During this period increase dosage, up to 12 tabs per day.

Expel Wind Cold- slight fever, more chills, symptoms predominate in the nose, eyes with thin secretions.

Expel Wind Heat- fever and chills, sore throat, head and body aches.

Clear Metal- more severe immediate symptoms of wind heat with cough of yellow mucus.

Middle Stage

Middle dosage between 6 and 12 tabs per day.

Clear Metal- continued symptoms, clears lung and stomach heat

Expel Toxic Heat- acute severe toxic heat symptoms, use with Clear Metal.

Limpid Sea- profuse phlegm use with Clear Metal.

Later Stage

We follow the cycle back to preventive dosage 4-6 tabs per day.

Ringing Metal- resolve lingering cough with phlegm-heat 

Limpid Sea- profuse phlegm use with Ringing Metal

Jade Spring- dry cough, thirst, night sweats

Olivirex- Olive leaf extract with kidney tonics

Shop Now

Pediatric feeding disorder (PFD) is impaired oral intake that is not age-appropriate and is associated with medical, nutritional, feeding skill, and/or psychosocial dysfunction (Goday, 2019) The incidence of children of children with problematic feeding is on the rise. It is estimated that 2.3 million children five years old and younger in the United States (Manikam, 1996) are affected by PFD. 

Primary care for these children generally includes Physician(s), Occupational and/or Speech Therapist, Nutrition/dietitian, and in some cases Behavior support. The physicians monitor health status, medications, Western medical tests, labs, and possible surgery if a g-tube or other procedures are needed.

Occupational therapists may work on seating, positioning, sensory processing, oral motor skills and adaptive equipment for feeding, as well as developmental skills in other areas.

Speech therapy will work on oral motor skills, monitoring swallow, provide support for thickeners or food texture, and cognition and communication in general.

Nutritionist/dietitian will provide diet education and support, (especially if special diets like Ketogenic, Atkins, allergen-free, etc are an issue), monitor the child’s weight, schedule oral and non-oral feedings as appropriate.

Behavior intervention can be helpful in managing the psycho-social dynamics in the family related to eating.  In current practice, acupuncturists are not generally part of the team.

However, as acupuncturists, our ancient medicine has much to offer young children struggling to eat enough or unable to eat at all. 

Spleen (SP)/Stomach (ST) Imbalance

In simple cases, a lack of appetite is the limiting factor. These children usually have no other medical diagnosis. Addressing the TCM pattern, which is often either clearing SP/ST excess or tonifying SP/ST deficiency is enough to motivate young children to eat. In these cases, tuina or shonishin can be very beneficial. Don’t forget to train the family to do tuina at home! If massage with skin-to-skin contact is a problem, try doing the massage with a hedgehog ball. Kids who don’t tolerate touch often enjoy a hand-free massage with a ball.

Another common issue with children with PFD is Reflux.

Treating the Reflux per the TCM pattern is essential. I like to use a combination of tuina, or other manual therapy, to address the alignment of the diaphragm, rib cage, and musculature around the thorax as well as more traditional TCM or tuina treatment strategies.

Working with herbs and diet can be very useful if the team is open to exploring these options. Sometimes just changing a formula can significantly reduce Reflux. Personally, I like to get kids on the most whole-food-based diet possible.

PFD usually has a significant musculoskeletal component, especially in children with no other medical diagnosis. Often these kids had a difficult birth. Perhaps breathing or other vitals were not impaired during delivery, but the baby suffered from neck or other strain in the birthing process that is often not considered by the medical team. 

How do you know if anatomical malalignment (AKA channel obstruction) is a factor in PFD?

To assess physical alignment as a contributing factor to PFD, look for any anatomical asymmetry in the body or the head.

Is there cranial asymmetry?

Plagiocephaly, of asymmetry of the cranium, is known to cause neurological impairments in children. I especially notice issues with the coordination of chewing and swallowing with plagiocephaly. 

Is there cervical extension or torticollis?

Often babies with PFD, have “no neck”. Dysfunction anywhere in the cervical region affects the function in the other structures, including swallowing.

Palpate under the jaw. Children with PFD often have spasticity at the attachments of the tongue, palpable at the inside edge of the mandible. Roll the skin along the spine (Nie Jie Fa) and palpate for areas of restriction. Identifying these restrictions go a long way to determining which muscles and Zang Fu organs are involved.

For example, if the upper lumbar is restricted, look for Kidney patterns, but also look for psoas, diaphragm, rib cage, paraspinal, Quadratus Lumborum, and latissimus dorsi issues. 

Treating the baby’s neck for trauma can go a very long way to improving her feeding.

Just as in adults, severe pain interferes with a baby's ability to concentrate and learn new things. When traumatic pain occurs at birth, it can impair a baby’s ability to learn to feed and attain other milestones. Both channel theory and Western musculoskeletal style treatments can be very useful for both assessing and treating very young babies with PFD.

If the baby is generally grumpy and disagreeable, please consider that they are in chronic pain and treat the pattern accordingly.

For those comfortable with hands-on therapies, the Speech and Swallowing Disorders protocol from Integrative Manual Therapy is phenomenal. 

Given that this incidence of PFD increases to 80% in developmentally delayed children (Manikam, 2000), often the baby's needs go beyond just stimulating the appetite or treating musculoskeletal trauma. Of course, these cases require a team of professionals addressing the needs of the family.

For these children, treating the musculoskeletal structures as well as the presenting TCM patterns is essential. TCM can be extremely useful in managing the GERD, asthma, allergies that are often comorbidities with PFD, and preventing pneumonia that often occurs with swallowing dysfunction.  

PFD Case study: 

Manuel is an 8-month-old boy that was born prematurely at 33 weeks. He was in the NICU for 1 month but was released home with no additional services and no medical diagnosis. His mother was referred to Early Intervention (birth to 3) services when he was having difficulties feeding, he was not rolling, he was not bearing weight in the feet and he was significantly falling behind with his milestones. 

Manuel’s only service provider is an Occupational Therapist/Acupuncturist. He presented with plagiocephaly, and significant fascial restrictions along the length of the spine.

He had very little active neck or spine rotation.

He was spilling formula from his mouth when he took a bottle, was unable to tolerate textures or finger feeding, and couldn't use his hands to hold his bottle.

He was not rolling over or tolerating tummy time. He had no Western Medical diagnosis.

His TCM diagnosis is Channel Obstruction with underlying SP and KD deficiency. The first treatment mother was trained to do the “basic four” tuina massages: 

1. Pinching and pulling the spine 
2. Acupressure to ST36 
3. Circle rubbing on the Abdomen
4. Supplementing the SP on the thumb (Fan Ya-li, 1994)

Following the first treatment, Manuel had more active movement at his neck and his sitting balance started to improve. In the following 10 treatments, the focus was on the Integrative Manual Therapy protocol for Speech and Swallowing Disorders and addressing channel obstruction in his pelvis, neck, and face.

His mother was trained to do acupressure on the ST 4, 6, 7, and GB 8 to release Buccinator, Masseter, and Temporalis muscles in order to address the Plagiocephaly.

These points were extremely tender as first and very gentle pressure was needed to gently release them. She was also given tuina and acupressure strategies to support Manuel’s SP and KD during the week per the clinicians pattern assessment. 

[Before]

The therapy outcome was very good.

Manuel stopped dribbling when taking a bottle. He started actively use his hands for play and finger feeding. He started tolerating more texture in his food, including finger foods. He began tolerating tummy time and eventually rotating on his tummy during tummy time. His head became significantly less flat in the back. He became much more aware of his environment and much more social with his family.

[After]

Using the techniques described above can significantly improve PDF outcomes and improve family dynamics. 

About Emily Hall 

Emily Hall, OTR/L, L.Ac. of Good Beginnings Wellness www.goodbeginningswellness.com

Emily studied Biology and Occupational Therapy at Concordia University-WI. Emily's career began as an Occupational Therapist with experience across many treatment settings, but a strong interest in pediatrics. After personal success with Traditional Chinese Medicine and manual therapy, Emily pursued her Acupuncture degree at the New Zealand School of Acupuncture and Traditional Chinese Medicine and extensive training in Manual Therapies and osteopathic techniques. Emily currently works in Denver, CO. Her practice is divided between Early Intervention (primarily with children with feeding and swallowing disorders) and in her private Acupuncture practice, Good Beginnings Wellness. She is licensed as both an Acupuncturist and Occupational Therapist.

References

Bass, N.H. and Morrell, R.M. The neurology of swallowing. In: M.E. Groher (Ed.), Dysphagia, Diagnosis and Management. Butterworth–Heinemann, Boston, MA, 1992, pp. 1–29. 

Callison, Matt. Motor Point Index: An acupuncturists guide to locating and treating motor points. AcuSport Seminars. 2007; 12-27

Fan Ya-li. Chinese Pediatric Massage Therapy: A parent’s and practitioners guide to the treatment and prevention of childhood disease. Blue Poppy Press. 1994; 141-143.

Goday PS, Huh SY, Silverman A, Lukens CT, Dodrill P, Cohen SS, Delaney AL, Feuling MB, Noel RJ, Gisel E, Kenzer A, Kessler DB, de Camargo OK, Browne J, Phalen JA. Pediatric feeding disorder: consensus definition and conceptual framework. JPGN 2019;68(1):124-129. 

Manikam R, Perman JA. Pediatric feeding disorders. J Clin Gastroenterol. 2000;30(1):34-46. 

Reau NR, Senturia YD, Lebailly SA, Christoffel KK. Infant and toddler feeding patterns and problems: normative data and a new direction. Pediatric Practice Research Group. J Dev Behav Pediatr. 1996;17(3):149-153.

Reau NR, Senturia YD, Lebailly SA, Christoffel KK. Infant and toddler feeding patterns and problems: normative data and a new direction. Pediatric Practice Research Group. J Dev Behav Pediatr. 1996;17(3):149-153.

Essential oils are an easy, fun and effective way to support children physically, mentally and emotionally.  Applying essential oils to acupuncture points activates the qi of the points and has the added therapeutic benefit of the oil itself.

I use these products every day in my home and office and wanted to share five oils to keep kids happy, healthy and parents sane during the school year.

Top Five Essentials Oils To Recommend to Your Patients

1. Ginger

Ginger is an amazing oil to address digestive distress including nausea, stomach upset, vomiting and constipation. Nerves before a big presentation? Apply ginger to the wrists. It is also a strong oil for immune support fighting off colds, flu, congestion and cough. Ginger also encourages proactiveness in life and empowers individuals to take responsibility for their actions.
Channels:  LU, SP, ST, KD
Points Options: LU5, PC6, Ren12, SP6   

2. Lavender

Lavender is always a go-to favorite because it has so many benefits! Rid away stress and anxiety, sleep deeper, treat burns and blisters, as well as headaches when applied to the temples. Lavender promotes emotional honesty and can be very helpful applied to you and your middle schooler when communication is in breakdown.
Channels:  HT, PC, LV, LU
Points Options: yin tang, tai yang, Ren 22, ST36

3. Lemon

Lemon is a detoxifying oil both physical and emotionally. It rids the body of toxic overload due to environmental factors keeping the immune system healthy, while also cleansing the mind of negative thoughts. Lemon increases energy and focus, while also a strong remedy for permanent marker stains, sticky goo problems and with a spoonful of honey will alleviate a sore throat.
Channels:  LV, GB, ST, SP
Points Options: LV3, GB20, GB40, LI4

4. Roman Chamomile

Roman Chamomile has been used for centuries to clear the mind and boost courage. It promotes restful sleep and can aid in simmering childhood tantrums. Roman Chamomile treats diaper rash as well as panic attacks. Mom can apply as a floral perfume behind the ears to promote calm during the challenging high school years.
Channels:  LV, HT, SP
Points Options: SP3, GB40, Du20, HT5

5. Tea Tree (Melaleuca)

Tea Tree (Melaleuca) is my hand sanitizer. Great for killing germs and treating cuts, wounds and skin irritations. Tea tree is also a natural remedy for strep throat and tonsillitis. For older children, apply to the heart to protect their energetic boundaries. Kids are constantly in an anxious and excitable environment. This oil will clarify what is their experience versus their peers. Mix with eucalyptus to prevent or rid a child of lice.
Channels: LU, KI, ST
Points Options: LU7, UB13, Ren17, ST9

Safety & Application

Essential oils are a very powerful healing tools and if applied incorrectly can be dangerous. Following these safety tips and application guidelines will build your confidence in applying oils.  With advanced application of essential oils, practitioners can learn oil protocols for TCM patterns.

1. Ensure the oils are pure, potent and therapeutic grade.  Most over the counter oils are adulterated and unsafe for medical use.  I chose doTerra because of the Certified Pure and Therapeutic Grade testing that is performed on all oils and oil-based products. This gives me the confidence needed to safely apply and prescribe oils to patients.
2. If ingesting oils or oil-based products, they MUST have a supplement fact label just like multivitamins. I recommend when taking oils orally, patients consult an essential oil practitioner.
   
   
   
   
3. For children age 11 and under, be sure the oils are properly diluted to protect the skin. 
   a) For newborns and infants, mix1 drop of essential oil with 2 tablespoons of carrier oil and apply to feet.
   b) Age 1 through 5, mix 2 drops of essential oils with 1 tablespoon of carrier oil and apply to feet or points.
   c) Age 6 and up, 2 drops to essential oils with 1 teaspoon of carrier oil and apply to points.
   
   
4. Diffusers are another safe way to use oils with kids. Under the age of 5, add only 1-2 drops of oils and use the intermittent function.

About Devon

I am Dr. Devon Vernetti, a licensed acupuncturist who specialized in pediatrics and family medicine located in Oakland, CA.  My passion is to provide safe, natural and effective wellness options for parents to combat illness and support healthy physical and emotional development in their children. Incorporating essential oils into my practice has provided at-home tools to empower patients in their own healing process, as well as, an opportunity to work with families that do not have access to a pediatric acupuncturist.  I also assist healthcare practitioners in quickly and effectively use oils and oil-based products in their clinics.

Need More Support?

If you want to learn more about essential oils, I’d love to help. Click here to sign up for a free Essential Oils 101 introduction.

Looking for a pediatric acupuncturist or wellness mentor, set up a discovery consultation to see if working with me would be a good fit.

Let’s make this school year the happy and healthiest ever! I am here to help.

Millions of children have "steroid resistant" or difficult asthma that doesn't respond to inhaled corticosteroids on montelukast (Singulair).

These children suffer daily and have few options to control their illness! Chinese medicine offers safe, effective solutions when Western medicine isn't enough.

Cara and I will be discussing how Chinese herbal medicine can play in role in easing asthma symptoms and breaking the cycle of frequent illness and asthma.

The three formulas we cover are:

1. Pulmasoothe - for all patterns of asthma, treats Lung deficiency
2. Easy Exhale - for asthma with phlegm, loud, wet cough
3. Wheeze Ease - for asthma with dry, hacking, spasmodic cough

These formulas are available at China Herb Co after you sign up for a professional account, click on Shop Products --> Little Fishes and you can purchase these formulas.

Register for Robin's Upcoming Webinar

Use this link to register: https://www.acupuncturepediatrics.com/asthmawebinar

How many acupoints should you treat? How many for infants vs. toddlers vs. young children?

If you can't assess tongue or pulse, how do you know which points to use?

Have you ever had trouble explaining Chinese medicine to them? Have their eyes ever glazed because they’re confused?

Or maybe you're just looking for a simple system to explain what you do that instills confidence? 

That’s what this video all about. 

I'll teach you how to use the 5-Elements to give your patients the 30,000-foot view of Chinese medicine. They'll be able to see how everything their child struggling with is connected. Your patients will see how Chinese medicine takes a systematic approach and that by healing the root of one issue many other issues will resolve, too.

Click Here to Download the 5-Element Questionnaire & Diagnostic Test

Do you ever find it challenging to work with kids? Is it difficult to manage family dynamics? What about interacting with the different personalities of the parents and their children? 

Are some kids bouncing off the walls while others barely talk to you? Do you have a hard time balancing getting the treatment done while also diagnosing, treating, and prescribing home care?

That's where the 5-Elements can help!

In this video, you'll learn how you can use the 5-Elements to create more ease and flow in your pediatric treatments.

Last week was our monthly Pediatric Q&A. This is a Facebook Live event where you can ask me anything about pediatrics!

Here are some questions we covered in the last Q&A session:

• How do you start a pediatric practice when you're mainly treating adults?
• What do you do when a child is embarrassed about their symptoms, and the parent doesn't want you to discuss them in front of the child?
• What do you do when you have more new patients than you can accommodate?
• How do you respond to parents who say their kids will NEVER take the herbs you prescribed?
• How do you present a treatment plan to your patients, and what does that look like?
• How long are your treatments?
• How do you chart, and how much time should you spend on charting?
• What's a good place for Pediatric CEUs Online?

If you want to know my answers to these questions, be sure to watch the video above.

And if you're not a member of The Pediatric Acupuncturist Community on Facebook, please consider joining!

It's a great place to connect with other pediatric practitioners. I love moderating this group because it gives me the opportunity to teach, coach, and help acupuncturists reach the next level in their practice. Join now!