Thursday, February 23, 2012

Upcoming Specials & Events

New Patient Special:
NEW patients receive HALF OFF
Acupuncture & Chinese Herbal Medicine Initial Consultation
through April 30, 2012
That's a savings of $50!
Schedule your treatment today by calling 510-495-5752.


Low-Fee Acupuncture "Community Clinic:"
In March, I'll begin providing low-fee acupuncture treatments in West Berkeley on the first Sunday of each month.
Sunday, March 4, 2012
10:00am-4:00pm

Sliding Scale: $10-$40
By appointment: Schedule yours today by calling 510-495-5752.

Mini-Workshop:
Chinese Pediatric Massage for Parents & Caregivers

Learn the basic principles of Chinese pediatric massage and a few simple techniques for building your child's immunity and easing symptoms of upper respiratory infections.
Sunday, March 25, 2012
10:30am-12:00pm

Sliding Scale: $0-$30
Infants and toddlers welcome. Let me know if you need childcare for older children so I can make arrangements.
Advance registration required. Enrollment is limited, so book now: Call 510-495-5752 or email stephanie@stephaniedoucette.com.

See Stephanie's articles on Chinese pediatric massge:

Wednesday, February 22, 2012

Sinusitis: Acupuncture, Herbs & Self-Treatment Tips

One of the most unpleasant parts of the winter cold season and the spring allergy season is sinusitis. Sinus congestion can range from acute cold symptom to lingering allergy symptom to chronic sinus infections.

Here are a few tips for dealing with sinus congestion:

Avoid antihistamines & decongestants.
These drugs might give quick relief, but they have the side effect of drying the sinus cavities. Sinus cavities need to be moist to be healthy. Dry sinuses are much more likely to pick up infections.

Avoid antibiotics.
Colds & flu are caused by viruses. There are currently no drugs available that kill cold viruses.

Antibiotics do have an effect on cold viruses, but they have been overprescribed, giving rise to more and more antibiotic-resistant diseases. Also, whenever you use an antibiotic, you're increasing your susceptibility to developing infections with resistance to that antibiotic. These impact not only you, but can be passed on to others.

Antibiotics can help to clear bacterial sinus infections, but they can set people up for repeated infections. The immune system is weakened with each course of antibiotics. Also, the culprit bacteria in sinus infections are often protected by an extracellular biofilm matrix, which protects them from many antimicrobial agents, rendering antibiotics ineffectual.

Alternative Approaches to Sinusitis:

Acupuncture:
Acupuncture is very effective in relieving sinusitis and sinus congestion. It not only provides immediate relief to symptoms, but causes immune boosting blood components to stay elevated for up to three days, providing ongoing relief.

Your acupuncturist will provide gentle stimulation to points on the head and face, as well as on the neck, back, arms and legs, whose meridian pathways run through the sinus area. Points are stimulated using fine filiform needles, glass cups, moxibustion, massage or other techniques.

Here are some good links to illustrate this:

Self-Treatment Using Acupressure:
You can massage points on your body to relieve colds, flus, and sinus congestion.
Here are some helpful links:

Chinese Herbs:
Chinese herbs are superior to antibiotics, decongestants and antihistamine drugs in many ways. A Chinese medicine herbalist chooses from a broad variety of herbs, tailoring each formula to fit the patient's unique constitution, the underlying imbalance causing the symptoms and the nature of the symptoms themselves.

Chinese herbs allow for a multi-pronged approach than antibiotic drugs. Certainly, many Chinese herbs have antimicrobial properties. They are more broad-spectrum and gentler than antibiotic drugs, meaning that they do not weaken the immune system or cause antibiotic resistance. Beyond that, a Chinese herb formula does not consist solely of antimicrobial herbs. It will also likely include aromatic herbs to open the sinuses, herbs that eliminate phlegm and drain damp -many are effective in breaking down the biofilm matrix where pathogens reside-, as well as herbs that clear heat or warm as needed, and boost the patient's immunity.

Herbal Steams:
These are a wonderful, relaxing way of clearing sinus congestion. Put some fresh aromatic (like rosemary, thyme or eucalyptus, even chamomile or mint) herbs in a medium to large pot & cover with water. Bring to a boil & let simmer for 5 minutes (Do not boil for more than five minutes or you'll lose the aromatic quality of the herbs.) (Alternatively heat water and add a few drops of aromatic essential oils.) Remove the pot from heat. Being sure to allow the water to cool sufficiently that you don't burn your face, sit at a table with your head over the steaming pot. Cover your head with a towel. Breathe the warm vapors into your nose & lungs for up to 20 minutes. Enjoy.

There are many wonderful aromatic Chinese herbs that open the sinuses and help clean the lungs of virus, bacteria, environmental irritants, smoke and pollution. Your acupuncturist can make send you home with a package of these for steaming.

Irrigating the Sinuses with Saline Water:
Many find it helpful to irrigate the sinuses with warm saline water in order to wash away mucous with viral, bacterial, and environmental debris. You can use a neti-pot to do this or a simple bulb syringe.

Here's a recipe:
1/4 teaspoon baking soda
1/4 teaspoon salt
8 oz. slightly warm tap water

Using a bulb syringe or nasal rinse bottle, 3 squirts in each nostril while making a harsh "K" sound. Blow nose between squirts and do 2-3 times per day.

Always use clean equipment for to spray inside the nasal cavity. Sterile, distilled or boiled (be sure to cool first!) is recommended to avoid dangerous contaminents.

Nasal Sprays containing Xylitol
Xylitol is a sugar alcohol which breaks up the biofilm protecting bacteria and viruses in the sinus cavity. An OTC nasal spray like Xlear can be helpful in clearing the sinuses, while also helping to keep them slightly lubricated and less susceptible to invasion by pathogens.

Other steps for avoiding sinus problems include getting plenty of rest, staying hydrated, reducing stress and staying warm. See my article on Lifestyle Adjustments for Cold & Flu Prevention for more information along this line.

Monday, February 20, 2012

Antiviral Herb: Isatis / Ban Lan Gen

I wanted to choose one herb to feature in my newsletter on the topic of Cold & Flu treatment in Chinese Medicine.

It quickly occurred to me that choosing one herb for this kind of topic is difficult and kind of silly.

There are so many herbs which can be used to treat colds & flus. For example, there are a range aromatic, pungent herbs which are used to vent pathogens through the skin in the early stages of a cold or flu infection. These include fresh ginger, fresh mint, scallions - to name a few household varieties - and many more. Then, there are a great variety of herbs which ease cold & flu symptoms depending on how they manifest in an individual: herbs for treating body aches, reducing phlegm congestion, bringing down fever, opening the sinuses, clearing the eyes, stopping cough and on and on.

Not to mention, Chinese herbs are almost never used solo. They are combined into formulas; and the sophisticated herbalist will likely add a few herbs for supporting and strengthening the patient's constitution and immune system to a formula that is primarily aimed at fighting a viral infection. So, the task of choosing one herb is a bit of a challenge.

I decided to focus on a plant commonly known as Isatis or, among western herbalists and botanists, woad. It is the plant from which the dye, indigo, is derived. Two species of this plant are used: Isatis tinctoria and Baphicacanthus cusia. Of these, the latter is more medicinally potent, but Isatis is the more common and recognizable name. The root, known in Chinese as ban lan gen, and the leaf, da qing ye, are commonly used medicinally for their broad-spectrum anti-viral and anti-bacterial properties.




Isatis was historically grown in Asia, and has long been used in Indian Ayurvedic and traditional Chinese medicine. Now, it is also being cultivated in the west.

The plant is a favorite among Chinese herbalists practicing in the west and in Asia, because is one of the strongest, most broad-spectrum anti-viral and anti-bacterial herbs in the Asian pharmacopeia. Isatis leaf and root are widely used in Chinese hospitals and clinics in the treatment of influenza, chickenpox, mumps, hepatitis, and viral skin diseases. It has gained popularity during the big flu epidemics and the SARS outbreak of recent years.

Older texts in the Chinese Medicine canon (i.e. Shang Han Lun or Discussion of Cold-Induced Disorders, written around 220 CE) taught that one should treat early-stage colds & flus with warm, spicy herbs which vent pathogens through the skin. In contrast, the use of isatis, which is very cold and bitter, belongs to a later wave of Chinese Medicine theory, the era of the Warm Disease School (1600s). The Warm Disease theorists recognized the phenomenon of infectious diseases that are contracted via the respiratory tract, and propagated the use of very cold, bitter herbs to stem such infections by draining toxic heat (think mumps, smallpox, etc.). It happens that these herbs are anti-viral and often anti-bacterial and anti-fungal. Isatis, then, belongs in this group of cold, bitter toxic-heat clearing herbs. (See my article on Classical Chinese Perspective on Colds & Flus for more historical information.)

In today's TCM clinic in the U.S., it is common for an herbalist to add a small amount of heat-toxin clearing herb like Isatis to any formula for cold or flu because of the anti-viral qualities of the herb. The other herbs in the formula would vary based on the patient's symptoms, constitution and the stage of the infection. (Two of the cold/flu formulas from the Oakland-based company Health Concerns use isatis extract along with other Chinese herbs and western herbs like echinacea and goldenseal.) A small amount of isatis can also be useful in supporting a patient with a lingering low-grade cold to clear the body of infection and regain full health. Small amounts of isatis are also sometimes used as immune regulators in formulas for patients with chronic viral infections, immune-deficiency or autoimmune conditions. Think HIV/AIDS, hepatitis, MS, lupus, etc.

Interestingly, three different parts or aspects of the Isatis or Baphicacanthus plant are used in Chinese Medicine:

1. the root: ban lan gen (transliterated from Chinese into pinyin);
2. the leaf: da qing ye; and
3. a processed powder derived from the leaf, known as qing dai. (The leaf is soaked in lime water until rotten. The foam which rises to the surface in this process is qing dai. It is used either as indigo dye, or medicinally.)

All are antipyretic and antiseptic and are used (in Chinese Medicine terms) to clear toxic heat, cool the blood and reduce swelling. All were historically perceived to be effective against epidemic infectious diseases. (Qing dai was distributed widely in China as a preventative during the SARS epidemic.)

All three derivatives of the isatis plant are particularly useful in cooling a very sore, swollen throat. They are also useful in cases involving bleeding (gums, nose) or skin rash due to infection. Common traditional uses have included - in concert with other appropriate herbs - mumps, hepatitis, dipththeria, jaundice, erysipelas, cholecystitis, tonsillitis, and febrile convulsions in children.

Needless to say, isatis is useful in cold & flu prevention & treatment, but also has a much wider range of uses for more serious infectious diseases.

Conditions currently treated by ban lan gen or da qing ye in Asia and in the west include:
  • common cold
  • sore throat
  • sinus infections
  • mumps
  • encephalitis
  • hepatitis A, B, C
  • lung abscesses
  • cancer
  • AIDS/HIV
  • psoriasis (by external or internal application)

Research published in China's Second Military Medical College in 2000 by a Dr. Li Sheng showed that ban lan gen had direct therapeutic and preventative effects on the Influenza A virus. Other clinical trials conducted in China have shown ban lan gen's effectiveness in strengthening immune response and in countering:
  • bacillus (isatis was more effective than penicillin)
  • pyloric heliobacterium
  • hepatitis B
  • viral myocarditis
  • cytomegalovirus
  • herpes
  • pink eye
  • chronic pharyngitis
Patients who are weak and suffer from poor digestion due to cold would not want to use isatis in large quantities or over a prolonged period because it is so cold and draining. It should be used in concert with other herbs. Your acupuncturist or TCM herbalist can create a formula that is just right for your unique condition.

References:
Bensky & Gamble. Chinese Herbal Medicine: Materia Medica. Revised Edition. Seattle: Eastland Press, 1986.

2006 lecture by Dr. Robert Johns, OMD, L.Ac., Berkeley.

www.healthconcerns.com


Saturday, February 18, 2012

Yu Ping Feng San -- an Herbal Formula to Strengthen Immunity

This elegant formula contains three herbs which work synergistically to increase the body's resistance to colds, flus and allergies.

It's an old formula. First documented by a famous Chinese physician in the Yuan Dynasty (1271-1368), it was likely used well before that time.

Yu Ping Feng San translates from Chinese as "jade screen wind formula."

The term "jade" poetically suggests:
1. the preciousness of the formula, and
2. its reinforcing quality.

Jade was traditionally used to reinforce coffins in order to preserve the contents. As jade might reinforce a protective windscreen, this formula strengthens our bodies' exterior to keep out pathogenic influences, like cold or flu viruses. (Keep in mind that traditional Chinese medicine treats colds primarily by regulating/venting the body's skin surface. We regulate the body's inherent physiology prior to or in addition to eliminating infectious pathogens. For more details, please see my article "Colds & Flus: Traditional Chinese Perspective Summarized." )

Three herbs are combined for a synergistic effect:

1. Astragalus (huang qi) tonifies the Lung and Spleen, improves physiological function at a deep level, while regulating the surface of the body.

2. Atractylodes alba (bai zhu) also tonifies Lung and Spleen and improves physiological function to improve immunity.

3. Siler (fang feng) is pungent and opens the body's pores, promoting a gentle sweat, to vent any cold or flu pathogens that may have entered, without compromising the body's surface too much.

Don't take this formula when you have a cold, because the tonifying herbs will make your cold symptoms worse. Rather, use this formula when you are well during the winter months to keep your immunity up. Keep in mind that it acts gradually, and is most effective if taken in small amounts over the course of one or more months. Consult your Chinese herbalist. He or she might incorporate this formula along with other herbs to more specifically address your unique condition.

This article cites a relevant clinical trial:

Yu Ping Feng San for Allergic Rhinitis

Astragalus: The Immune System Herb

Astragalus, called "huang qi"[pronounced hwang-chee] in Chinese, is a wonderful herb for strengthening the Lung and the immune system.

In the traditional Chinese herbal pharmacopoiea, it falls under the category of digestive tonic. (Remember that digestion and respiration are closely intertwined according to traditional Chinese physiology. For more details, please see my article on the physiology of the Lung in Chinese medicine.)

Western herbalists have categorized this herb as a powerful adaptogen (a restorative tonic increasing the body's resistance to trauma, stress, anxiety and fatigue). In Chinese medicine, we say thathuang qi builds the body's qi and blood, i.e. improves the physiological function of the body, particularly in terms of digestive and respiratory health.

Huang qi strengthens the Lung and treats frequent colds, asthma, allergies and other problems related to ineffecient or suboptimal Lung function.

In an elegantly complex way,huang qi regulates underactivity or overactivity of the immune system, making it useful in preventing colds, flus and allergies. It regulates the skin pores, so that the body's exterior is less vulnerable to outside pathogens, while simultaneouly releasing pathogens through an appropriate amount of sweating. (In Chinese medicine, the first way of treating a new cold virus is to open the pores to produce a mild sweat.)

Other powers of huang qi:
  • It has a raising quality, and is used to treat prolapse and excessive uterine bleeding.
  • It is used in cases of severe trauma or in postpartum to counteract severe blood loss and quickly rebuild energy.
  • It has a mild diuretic effect and reduces edema.
  • It can help chronic sores and ulcers heal and regenerate healthy flesh.

Some cautionary notes:
Do NOT use huang qi when you already have a cold. Its tonic nature will strengthen that power of the cold, making you feel worse. Rather, you should treat colds with pathogen-releasing, circulating and antimicrobial herbal formulas. I'll discuss some of these in my next newsletter issue. Consult your herbalist for the right combination of herbs for your condition.

Because this herb is strongly tonifying and elevating, we use it cautiously in conditions like hypertension, headaches, stroke risk, etc.

In TCM, single herbs are rarely used alone in treating patients. Rather they are incorporated into formulas where they balance and work synergistically with other herbs. Your Chinese herbalist might likely incorporate huang qi in your herbal formula this autumn.

Here are some additional references to the immune-enhancing affect of huang qi:

Astragalus alone is effective in preventing depletion of white blood cells during chemotherapy. A clinical study involving 115 patients receiving various forms of chemotherapy found that 83 percent had higher white blood cell counts when given astragalus. Common cold - Chinese studies have shown that using astragalus during cold season reduces the number of colds caught and shortens the duration of those that are caught. If you tend to get colds and flu often, astragalus can help you build up a natural resistance.
-Prescription for Herbal Healing: An Easy-to-Use A-Z Reference to Hundreds of Common Disorders and Their Herbal Remedies by Phyllis A. Balch, CNC

In a study of 28 people, astragalus given orally over a 2-month period significantly increased the production and secretion of interferon compared with controls. Remarkably, the levels of interferon remained high for 2 months after astragalus treatment ended. These results have been duplicated in laboratory studies. Astragalus also increases levels of natural killer (NK) cells, which roam the body via blood and lymph fluid, destroying a wide variety of invaders, including cancer cells and virus-infected body cells.
-The Encyclopedia of Popular Herbs by Robert S. McCaleb, Evelyn Leigh, and Krista Morien

Wednesday, February 15, 2012

Immune-Boosting Supplements for Cold & Flu Season

The best ways for staying healthy during the cold & flu season are eating regular, nutritious meals; getting enough high-quality sleep; avoiding stress; spending time outdoors; and exercising moderately. It may also be helpful to take a few dietary supplements on a daily basis to boost immunity.

Here is a list of immune-boosting supplements for kids and adults to consider taking on a daily basis. They are easily available in health food stores and come from a western, naturopathic medical perspective as opposed to a Chinese medicine perspective.


1. Vitamin D tops the list. Vitamin D3 is essential to immune-function and has been shown to help prevent flu as well as to significantly reduce the severity and duration of symptoms. A healthy supplement dose is 5,000IU for adults, 2,000-2,500IU for children and 1,000IU for babies. Doseage can be increased therapeutically to treat cold and flu infections.

Fermented cod liver oil is an excellent source of bioavailable vitamin D.

Here's a summary of one recent Vitamin D study that show Vitamin D3 supplementation can cut your chances of catching the flu nearly in half:

The study, entitled "Randomized Trial of Vitamin D Supplementation to Prevent Seasonal Influenza A in Schoolchildren," published in a 2010 issue of the American Journal of Clinical Nutrition, compared two groups of schoolchildren during the 2008-2009 cold & flu season. The children in the test group, who were given daily vitamin D3 supplementation (1200 IU/day) contracted contracted the Influenza A virus at a rate of 58% of the rate at which the non-supplemented control group contracted the virus. Children with a previous history of asthma who received vitamin D3 supplementation in the study developed asthma as a secondary symptom to influenza A infection at a far lesser rate than the children in the non-supplemented group who contracted influenza A.

A lot has been written lately about the importance of vitamin D3. Here is a nice summary article by a colleague, Los Angeles pediatric acupuncturust Emily Bartlett, L.Ac.

2. Omega 3 Fatty Acids establish healthy cell membranes that prevent inflammation and resist toxins and attack by viral and bacterial pathogens.

Best sources are high quality fish oil or cod liver oil.

Here are some useful articles on fish oil:
Cod Liver Oil Basics and Recommendations by Sally Fallon and Mary Enig, Ph.D. of the Weston A. Price Foundation (includes recommended brands & suppliers)
Benefits of Fermented Cod Liver Oil by Emily Bartlett, L.Ac.

3. Vitamin C fights and prevents infection. Vitamin C produced from acerola is better absorbed by humans than synthetic ascorbic acid.


For adults or children who get frequent colds or are around sick kids a lot, consider:

1. Colostrum helps the body to resist infection.

2. Zinc is anti-viral. It stimulates immune function, prevents infections, and acts as a cofactor in many enzyme reactions, including the creation of antioxidants. There is some convincing evidence that zinc can shorten the duration of colds and reduce the severity of symptoms. Prolonged use of zinc can cause a copper deficiency, so use a supplement that combines both in a ratio 10 zinc: 1 copper.

3. Medicinal mushrooms
I took this from Dr. Mercola's website:

There is another exciting emerging supplement that can be a very helpful adjunct to supporting your immune system, and that's mushrooms.

Over 300 different species of mushrooms are now believed to have human health-promoting potential. Evidence continues to emerge, confirming how mushrooms' proteins, trace minerals, polysaccharides, amino acids and fiber support overall health by:

  • Promoting normal cellular growth
  • Protecting against environmental stressors
  • Supporting your body's normal detoxification process
  • Supporting healthy gut flora
  • Promoting optimal digestion

While most people think only of eating the fleshy fruiting body of the mushroom, meaning the part you see growing above ground, most of the magic in the mushroom is actually located in their complex root structure that grows underground, called the mycelium, which can be up to 95 percent of a mushroom's total biomass.

Beta glucans and proteoglycans are the primary biologically active compounds in the mushroom fruit body and mycelia that support your immune system.

Beta glucans are chains of polysaccharides, and proteoglycans are special proteins, often found in connective tissue. The beta glucans found in mushrooms are large and complex long-chain molecules. What sets certain beta glucans apart are their unique side-branching patterns. Just like a key and lock, the beta glucan compounds in mushrooms "fit" perfectly with cellular receptor sites that support your immune system.

A supplement containing a blend of medicinal mushrooms is best.


If your child is not eating a varied and nutrient-rich diet, consider supplementing:

1. Vitamin A isessential for growth and repair of tissue, strong bones and teeth, good eyesight and a thriving immune system.

2. Vitamin E reduces inflammation throughout the body and strengthens the immune system. Vitamin E with mixed tocopherols is best for kids.

If you're coming down with a cold, consider taking any of these herbs/supplements:
  • echinacea, goldenseal, elderberry extract
  • vitamin C acerola
  • zinc
  • propolis
  • oregano oil
  • olive leaf extract

Monday, February 13, 2012

Pediatric Fevers: "The Good Fight"

It's hard for parents to watch our children suffer through cold and flu symptoms like congestion, runny nose, sneezing, coughing, achiness and malaise. But a fever in our babies or small children can be downright scary.

As part of my series on colds and flu, I wanted to include an article on pediatric fevers to help alleviate parents' and caregivers' fears and to provide a resource for caring for fevering children and babies.

As you scroll down you'll find:
  • How Can Fever Be Good?
  • Facts About Fever
  • Guidelines for Caring for a Fevering Baby/Child
  • Danger Signs/When to Call Your Doctor
  • Cautions about Over-the-Counter Fever-Reducing Medications
  • Holistic Home-Treatment Methods for Fever

Most of this information is drawn from Randall Neustaedter, OMD's book, The Holistic Baby Guide. Neustaedter is pediatric acupuncturist, herbalist and homeopath working in the South Bay Area. I recommend this book to new parents as an accessible, reader-friendly guide to dealing with a range of common pediatric health conditions holistically.


HOW CAN FEVERS BE GOOD?
Whether by conditioning or by instinct, we tend to feel worried and afraid when our baby or child has a fever. In most cases, pediatric fever is a good and important thing. If we know the facts about fever (see below), it is easier to care for a fevering bay with more calm and reassurance.

Fevers fight infections. When animals are deprived of their ability to fight infections with fever, they die. A fever speeds up metabolism and heart rate, increasing blood circulation. It increases white blood cell production to fight bacteria and viruses, and it increases production of interferon, a natural antiviral chemical in the body. Babies get fevers to exercise their immune systems so they can build their own immunity to the pathogenic microbes they encounter.

For all these reasons, fevers represent a healing process and a healthy body defense. Generally, it is better not to suppress them, but to let them do the important work they "are meant" to do.

GUIDELINES FOR CARING FOR A FEVERING CHILD OR BABY:

1. Know the facts about fever
  • A fever is a temperature above 100.5 degrees F. Anything below that is just a normal variation in temperature.
  • Any baby under three months of age should be seen by a doctor. Infants do not have the ability to fight off infections on their own, and even simple infection can quickly develop into a serious, invasive illness. The cause of an infection may not be visible through symptoms, and doctors may want to do lab tests to screen for invasive illness in a fevering newborn.
  • Children fever higher than adults. They are naturally hot and reactive, responding quickly and vigorously to pathogens. Some children are more prone to fever than others--and that's natural and ok.
  • Most pediatric fevers are not dangerous. Brain damage does not occur until body temperature rises to 108 degrees F. The body has good mechanisms for keeping the temperature under 106 degrees F. So, even when your child's temperature is rising, you can be assured that your child's body has mechanisms to stop it before it gets dangerous.
  • A child can fever safely to 105 degrees F without need to call your doctor or health care provider. At 105 degrees, it is recommended to check in with your health care provider. This does not necessarily mean that you will take measures to reduce the fever, but it is important at this point to seek medical consultation.
  • Fevers can sometimes lead to seizures--and that's ok. Febrile seizures are actually fairly common. Although they are frightening to parents, they are usually harmless to parents. If your baby begins twitching or jerking with a fever, stay calm, turn your baby on his/her side, and do not retrain him/her. If the seizure lasts more than five minutes, or if the baby becomes unconscious, call 911. There is no reason to seek emergency care, however, if your baby has a short seizure with a fever and remains conscious. After the seizure is over, call your doctor to see if an exam is needed to discover any other causes, such as meningitis. Giving fever-reducing drugs does not prevent febrile seizures.
2. Know the Cause of the Fever
A fever with localized symptoms such as runny nose, ear pain, or diarrhea is less worrisome than a fever without apparent causes. This is because babies or children with no obvious focus of infection (or no obvious cold or flu symptoms) may be harboring a more serious internal infection.

That being said, many illnesses in babies begin with a fever as the first sign, signaling that the body is mounting an immune response. Other symptoms may appear in the next day or two.

If the cause of the fever is obvious, it is safe to monitor the baby at home without checking in with a health care provider. If the cause is not obvious, it is a good idea to check in with with your trusted health care provider.

3. How Your Child Looks & Acts is More Important than the Number on the Thermometer
With any illness, the most important indicator of the need for medical care is your child's level of energy, not the level of the fever. A baby who appears weak and lethargic and who has little energy to cry and nurse may have a worrisome condition. A screaming baby may have pain with an illness, but the level of energy indicates a robust reaction. Babies who are weak may not be fighting off an illness adequately.

DANGER SIGNS --
You should consult with a trusted professional health care practitioner if:
  • Your baby/child's fever persists for more than one day and there is no apparent cause. Persistent fever can be an indication of an infection that warrants professional evaluation and treatment.
  • Your child's fever is accompanied by vomiting, listlessness, extreme lethary (i.e. they are difficult to wake up). Meningitis is often accompanied by these signs and symptoms.
  • Your child's fever persists for more than two days.
  • Your child gets a fever after having a cold or cough for several days. This may be a sign that his/her immune system is not managing the infection well on its own. A deeper infection could take hold in these circumstances.
  • Your baby seems very sleep, unresponsive to stimulation, unable to generate lusty crying.
  • Your baby is under three months of age and develops a fever.

CAUTIONS REGARDING OVER-THE-COUNTER DRUGS FOR FEVER:

It is best not to reach for Tylenol (acetaminophen) and Advil (ibuprofin) at the first sign of fever in your child as these drugs do carry some potential risk.

Tylenol has been shown to be potentially toxic to the human liver, and this risk would be amplified in babies and small children who have small, underdeveloped livers. There is also some research that shows that suppressing fever with acetaminophen increases the length of viral illness. Additionally, suppressing fevers with acetaminophen in the first year of life may increase the risk of allergies, eczema and asthma in later childhood.

Advil (ibuprofin) also has some attendant risks; but this drug is the safer choice for those times when your baby simply needs some relief from pain. A dose of ibuprofin can provide a much needed good night's sleep in a truly distressed baby.

Aspirin should never be given to children with fevers. Aspirin given during a viral illness can cause Reye's syndrome, severe liver dysfunction and brain swelling.


HOLISTIC HOME-TREATMENT METHODS FOR FEVER:
Following the theme that fevers are a natural, healthy and almost always safe response to infection and illness, there are several safe, gentle home remedies you can use when caring for your fevering child. The goal of home treatment is to encourage healing and stimulate a strong immune response. Reducing fever is not necessarily the goal, as the fever will do what is necessary to fight the underlying illness.

1. Fluids:
Keep your child/baby hydrated. If your child still nurses, have them nurse as much as they are willing. For bigger kids, keep offering water or diluted juice. You might want to supplement their fluid intake with electrolytes to help the body stay hydrated. The company that makes Emergen-C packets also sells a product called Electromix, specifically for rehydration after exertion, which comes in single packets and is free of sugar and artificial additives.

2. Homeopathic remedies:
There are several homeopathic remedies which effectively treat pediatric fevers. The first and easiest remedy to try is Belladonna. Classical indications for Belladonna are fever with sudden onset, radiating heat, flushing and redness of the skin. Homeopathic remedies do not suppress the fever. Rather they help the body process through the illness more quickly and effectively. They can be extremely effective in reducing the severity of illness.

I think it's a good idea for new parents to invest in a home-treatment homepathic remedy kit. These kits come with about 30 commonly-used remedy, along with an easy-to-use instruction manual.

3. Western Herbs:
Echinacea and black elderberry are two immune-supporting herbs known to shorten the duration of viral illness and help to prevent more serious illness. They are available in health food stores in the form of tinctures or syrups and are usually well-tolerated by babies.

4. Chinese Herbs:
An acupuncturist specializing in pediatrics can provide you with kid-friendly Chinese herbal tinctures to keep on hand during cold and flu season. Chinese herbs in appropriate combinations serve to boost the body's immune system and to stimulate the body's own healing mechanisms in the case of cold or flu infection. Appropriately-selected Chinese herbs can help reduce fever while also helping the body kick out pathogens causing the fever.

Yin Chao Junior (by Health Concerns) and Windbreaker (by Kan Herb Company, Gentle Warriors product line) are two pediatric Chinese herb tinctures that useful in relieving heat and pathogens when taken at the first sign of illness.


5. Lukewarm Sponge Bath:
A lukewarm sponge bath can temporarily bring the fever down enough to relieve your child's discomfort. (But sponging does not reduce fevers because the body's thermostat is unaffected by external manipulation of temperature.)

Simply seat your child or baby in a few inches of lukewarm water and/or sponge them off with a lukewarm wet cloth.

DO NOT USE COLD WATER. This will only make your child shiver which has the effect of elevating body temperature. Not to mention, cold deters the immune system. You don't want that.

6. Pediatric Massage:

Here is one massage technique for gently easing fever and comforting your little one:

On the inner surface of the forearm, rub in a straight line from the elbow crease toward the wrist. Rub in one direction only, rapidly, 100-300 times.

This technique is appropriate when the child is fevering and agitated. It will help release heat and pathogens from the body and calm the fever.

Apply an evaporative medium like rubbing alcohol or water (or even a dab of cooled-off peppermint or ginger tea) when you do this technique to help the body vent heat. DO NOT USE MASSAGE OIL in the case of fever or illness because oil traps heat and pathogens in the body.

See my related articles for more information on pediatric massage:

Pediatric Massage Techniques for Cold & Flu Season

Do-It-Yourself Pediatric Massage: An Introduction for Parents & Caregivers


7. Acupuncture & Herbs
An acupuncturist who specializes in pediatrics knows multiple protocols for gently reducing fever and supporting a child's immune system to fight infection more efficiently using modalities including acupuncture, needle-less acupuncture such as shonishin, pediatric massage, and herbal treatment.

8. Round-the-Clock Support
Parent need and deserve support when caring for sick and fevering children, especially when making choices about whether to use or forego fever-reducing medications.

Find a pediatrician you like and trust. Have the phone numbers of your pediatrician and 24-hour medical advice resources in a readily accessible place. Find a holisitic pediatric health care provider who is available to answer kid-related health care questions on a round-the-clock basis. I am available to take calls from parents on a 24-hour basis and there are others like me.

I hope this information helps you to be more at ease when dealing with your child's next illness.

Food Therapy for Colds & Flus

RICE PORRIDGE (a.k.a. congee, or zhou in Mandarin Chinese, or jook in Cantonese) is a popular -- and DELICIOUS -- breakfast food in China.

It is also a great food to eat when you have a cold or flu.

When you're sick, your body's energy is compromised. It's working hard to fight off an infection.

The key to eating when you're sick is to support your body's innate mechanism for healing. Eat warm, cooked, easy-to-digest foods so your digestive system does not have to do extra work. Rice porridge (jook) is the perfect food to eat when you're sick because it's warm, easy to digest and gently tonifies your body's Qi and nourishes body fluids without producing phlegm. When prepared with mildly pungent herbs, jook produces a slight sweat, helping the body to rid itself of invading cold or flu pathogens.

When you're just coming down with a new cold or flu, I recommend the following home-treatment protocol:

1. Take a dose of herbal medicine (see my article on Chinese patent herbal cold remedies).

2. Eat a cupful of hot rice porridge (see recipes below).

3. Go to bed. Cover yourself with a warm blanket. Rest. Allow yourself to sweat slightly.


WHAT ABOUT CHICKEN SOUP?

Chicken soup (and other animal protein, for that matter) is very tonifying. It is excellent for rebuilding strength and stamina in cases of long-term, chronic illness and debility or in the recovery stages of a cold or flu.

In the early stages of a cold/flu, however, I would recommend eating plain rice porridge--without meat. Why? Because meat is tonifying and because it requires energy to digest. In the early stage of cold or flu, we want to be cautious not to add fuel to the cold and flu pathogens, and not to overtax the body's innate energy with difficult-to-digest foods.

Within in 2-3 days of fighting a cold, or as the cold begins to clear, your body will need to rebuild it energy. At this time, it's a great idea to begin incorporating bone broth, meat, eggs and other protein sources into your jooks. You can even poach meats or eggs in the jook in the late stages of cooking if your porridge is thin & liquid enough. This is a common practice in China.


WHAT NOT TO EAT WHEN YOU'RE SICK WITH A COLD OR FLU:

  • cold foods (ice cream, yogurt, sodas, etc.)

  • difficult to digest foods (again, cold foods, meats, greasy foods, anything with complex flavor or texture, even wheat or other complex grains that are harder to digest)

  • sour foods (The sour flavor is an astringent and acts to hold things in the body, including cold or flu pathogens.)

  • sweet foods (The sweet flavor is a tonic and will increase the vigor of invading pathogens. Sweet foods also increase phlegm, damp and heat in the body providing a habitat conducive to the proliferation of virus, as well as bacteria, fungal overgrowth, etc.)


So, contrary to the popular American notion, orange juice is NOT a good choice when you have a cold. It's sour, sweet and phlegm-producing. It may contain a nominal amount of Vitamin C, but it will also entrap and strengthen viruses and other pathogens in your body.


Here are FOUR Rice Porridge Recipes Useful in Home-Treatment of Colds, Flus and Other Acute Bugs:


BASIC JOOK RECIPE:

1 cup of white rice

8-15 cups water (more water for thinner consistency)

Bring water & rice to boil in a pot. Then reduce to low heat and simmer, covered, for 1 ½-2 hours. Stir occasionally. The result will be a dilute rice soup. Mix it with a wire whisk to enhance the smooth, creamy quality. Season with a small amount of salt or soy sauce & pepper.

(For quicker preparation, use leftover cooked rice. In a pot, add 6 cups of water to 1 cup of cooked rice. Bring to a boil, reduce heat, simmer for 1/2 hour.)


FRESH GINGER & SCALLION JOOK -- for new onset of cold or flu:

Prepare basic jook. Then add the following fresh herbs in the last five minutes of cooking:

freshly grated ginger

finely chopped scallions (especially the little white root hairs)

Don't overcook the herbs. Their fresh, pungent quality will help your body push out cold/flu pathogens through sweat. They also ease nasal congestion and stomach/abdominal pain.

If you don't have scallions & ginger on hand, you can achieve a similar effect simply by adding 1-2cups of peppermint or chamomile tea to the your porridge toward the end of cooking. Peppermint & chamomile are cooling, but their spicy quality will help release pathogens from the body.


FERMENTED SOYBEAN & SCALLION JOOK -- early-stage cold/flu with mild fever, nasal congestion, irritability, insomnia, or digestive upset:
This is another famous recipe for treating early-stage cold or flu. Fermented soybeans (dan dou chi is the Chinese herbal name) help the body expel cold and flu pathogens. They also soothe dryness, irritability, restlessness and insomnia that sometimes result from fever. Together, fermented soybeans & fresh scallions treat colds & flu with fever, stuffy nose and upset stomach.

Note: Fermented soybeans inhibit lactation and should not be used by nursing moms.

2-3 scallions coarsely chopped

2 Tbsp. fermented soybeans (available in Chinese herb shop, or ask your acupuncturist)

2-3 cups of water

Simmer herbs in water 1/2 hour. Then, remove herb parts and stir the remaining liquid into your congee toward the end of cooking.


HONEYSUCKLE JOOK -- for cold or flu with secondary infections: bronchitis, pneumonia, dyssentary, acute sore throat, eye inflammation:

This famous jook recipe clears heat and toxins, attacks germs and disperses inflammation. It is useful for conditions secondary to cold and flu viruses like pneumonia or bronchitis. It also treats acute bacterial dysentery. Honeysuckle flowers (Flos Lonicerae or jin yin hua) clear infections characterized by heat and inflammation, including acute swollen sore throat, absesses and acute eye inflammation.

1/2 cup of dried honeysuckle flowers (available in Chinese herb shop, or ask your acupuncturist)

2-3 cups of water

Simmer herbs in water 1/2 hour. Then, remove herb parts and stir the remaining liquid into your congee toward the end of cooking.


UME & GINGER JOOK -- for recovery from "stomach flu:"

This recipe is not exactly for cold or flu therapy. It is helpful in recovery from those 24-hour "stomach flu" episodes. It stops dysentery and diarrhea, epigastric and intestinal cramping, and colitis, while helping the body rebuild its fluids and alleviate dry mouth. Umeboshi are preserved pickled plums, popular in Japanese cooking. They can be found in health food stores. In Chinese medicine, umeboshi plums (known as wu mei) are famous for their ability to expel worm and parasite infestations, as well as to rebuild the body post-illness.

1 cup rice

8 cups water

4-5 umeboshi plums (available at health food stores)

5 slices fresh ginger

Bring to boil in a pot. Then reduce to low heat and simmer, covered, for 1 ½-2 hours, stirring frequently. In cases of severe "stomach flu" with vomiting, diarrhea or dysentery, eat this food exclusively until urine runs clear and symptoms abate.


HISTORICAL BACKGROUND: Rice Porridge and Cold/Flu Treatment in Early Chinese Medical Literature

The Discussion of Cold-Induced Diseases (or Shang Han Lun), written by the physician Zhang Zhong Jing around 220CE, is one of the oldest clinical medicine textbooks in the world. In this work, we find one of the early systematic discussions of externally-contracted infectious disease in Chinese medicine.

In the Shang Han Lun, Dr. Zhang gives instructions for administering a simple herbal formula for an early stage cold or flu (which in his framework is tai yang syndrome or invasion of wind-cold into the outermost surface of the body, causing chills, slight fever, mild sweating and nasal congestion.) Dr. Zhang's formula for this syndrome is cinnamon twigs, peony root, licorice root, fresh ginger and jujube dates.

The second part of Dr. Zhang's instructions, however, relate speficially to food intake. Dr. Zhang writes, shortly after taking the first dose of herbal decoction, the patient should take a small amount of “hot thin [rice] gruel to reinforce the strength of the medicinals.” Next, the patient should warm his/her body by covering with a blanket to induce a mild sweat, in order to eliminate the disease.

Finally, this set of instructions ends with a list of the foods which the patient should NOT eat while treating an early stage cold or flu. He writes, “Foods contraindicated include raw and cold foods, sticky and slimy foods, meats and noodles, the five acrids, liquor, mild products, and foods with a peculiar or spoiled flavor or odor.

These are very old instructions. But they are still applicable to home treatment of early-stage colds & flus or, for that matter, with a little modification, any acute or chronic illness. (For more historical perspective on Chinese medical theory of colds & flus, see my previous article.)


WHY RICE PORRIDGE?

An important theme in Chinese medicine is that efficient digestion is the root of good health, and that warmth is required for good digestion. According to Chinese medicine theory, the digestive process begins with the Stomach turning ingested food into a warm mash or soup. The warmth for this process is provided by the Yang Qi of the Spleen. Until food is turned into a warm mash, no further digestion can take place. As the process of digestion continues, food is turned by the body into the precious substances of Qi and Blood which drive all physiological function.

The take-home messages here are that digestion requires energy from the body's organs and warmth. So, the simpler a food is and the closer it is to a 100-degree-Fahrenheit soup, the more easily digestible it is, and the more easily it is transformed into Qi and Blood to build the body and fuel its activities, including recovery from illness.

On the other hand, cold and uncooked foods place a tremendous burden on the body and particularly on the Spleen. Since the health of the Spleen Qi is critical to the health of the Lungs and the immune system, one can see that eating raw, cold foods would be a bad choice when you're fighting a cold or flu.

Jook or congee actually refers to porridge made from a single grain or combination of grains, beans, vegetables, animal proteins or herbs. But, most of the time, jook is made from rice. Rice, itself has a variety of medicinal benefits. In particular, it tonifies the Spleen, Stomach and Intestines, supporting the digestive process. The liquid quality of rice porridge helps moisten the fluids of the stomach and intestines which tend to become depleted in old age and due to chronic illness. Rice porridge is beneficial to anyone with weak digestion, including small children and elderly people.

To read more about the benefits of rice porridge, check out Bob Flaws' book The Book of Jook. Along with some interesting theory, it contains of jook recipes for all sorts of medical conditions. Many of these are rooted in hundreds of years of history and come from the writings and clinics of famous Chinese doctors. The book is a pretty easy read, and quite accessible as a cookbook!


GET SUPPORT FROM YOUR ACUPUNCTURIST!

Food is the basis of good health. I love talking about food and cooking, and am happy to consult with patients about food, nutrition and cooking techniques to support your path toward greater wellness. I'm also happy to provide herbs and advice for medicinal cooking with Chinese herbs.


References:

Coursework with Briahn Kelly-Brennan, City College of San Francisco, 2002.

Dr. Robert Zeiger, OMD, L.Ac., Pharm D., Berkeley, CA.

Flaws, Bob. The Book of Jook. Boulder: Blue Poppy Press, Inc., 1995.

Bensky & Gamble. Chinese Herbal Medicine: Materia Medica, Revised Ed. Seattle: Eastland Press, Inc., 1986.

Mitchell, Ye & Wiseman. Shang Han Lun: On Cold Damage, Translation & Commentaries. Brookline, Mass: Paradigm Publications, 1999.