M. Spencer Green, Associated Press
A therapist adjusts acupuncture needles near a patient's spine to relieve lower back pain at the Pacific College of Oriental Medicine in Chicago.

Acupuncture used in children — a common practice — is generally safe as long as practitioners are well-trained, according to a study published in the December issue of Pediatrics, the journal of the American Academy of Pediatrics.

Canadian researchers from the University of Alberta, Edmonton, Canada reviewed data from multiple countries over 60 years to see about the connection between needle acupuncture and different types and severities of adverse events in kids.

They found that, of the 279 adverse events identified, 253 were mild, one was moderate and 25 were serious. Of the latter, the study authors concluded that substandard practice more likely contributed to very bad outcomes than any inherent risk from acupuncture itself. Pediatric acupuncture, the researchers said, is safe.

The National Center for Complementary and Alternative Medicine in the National Institutes of Health notes that acupuncture is thousands of years old and has been practiced all over the world, from the United States to China, Japan, Korea and beyond. Research efforts centering on acupuncture have increased and there are "relatively few complications reported," although there is potential for serious side effects if it's "not delivered properly by a qualified practitioner."

The word acupuncture, it said, "describes a family of procedures involving the stimulation of anatomical points on the body using a variety of techniques." The most studied scientifically "involves penetrating the skin with thin, solid, metallic needles that are manipulated by the hands or by electrical stimulation."

The researchers from Alberta scoured 18 databases and the studies they examined included 37 that between them involved more than 1,400 children. Of those, 168 had mild adverse reactions such as crying or pain. The 25 serious events included 12 thumb deformities and five infections that occurred in a single Chinese clinic between 1983 and 1989 and isolated incidents of heart problems, lung problems, bleeding, nerve impairment, intestinal obstructions, hospitalization and a reversible coma. The sole fatality was a 9-year-old boy who it appeared died as a result of a number of technical errors, including needle punctures in the diaphragm, pericardium and right ventricular wall, among others, according to Medscape. He was being treated for tuberculosis, severely enlarged heart and malnutrition, the article said.

To be included in the review, the studies had to be original, peer-reviewed work, have subjects 17 and younger and include adverse events assessments.

The Canadian researchers suggest that more study and standardized reporting would help future assessments of risk in pediatric patients.

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Experts recommend that parents ask for referrals from acupuncture professional associations such as The National Certification Commission for Acupuncture and Oriental Medicine, since someone they certify is more likely to be well trained. The commission notes that "Children of all ages are treated and respond well to acupuncture and Chinese herbal treatment. In addition, young children or those apprehensive of the use of acupuncture needles may be treated without needles using Asian bodywork and/or electrical probes. In addition, herbal formulas are usually prescribed to enhance the acupuncture treatments and to provide further care between treatments as well."

Parents should know a little about what to expect. Jeannie Kang, president of the American Association of Acupuncture and Oriental Medicine, told U.S. News and World Reports-produced HealthDay's Serena Gordon that most acupuncture specialists don't use needles in children younger than 11, instead opting for a tool that "looks like a spiky rolling pin" to put pressure on acupoints.

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