When I first qualified I had very limited experience of babies in general, and absolutely none in treating them with homeopathy. During my sitting-in hours I had seen a couple of babies being treated, but hadn’t really gleaned much about the best way to take a case.
I recall my first baby case. Mum brought in a 4 month old baby who was frequently getting red ears. I looked at the baby and he looked at me and I wondered where on earth to start! I remember thinking “someone should write a book about treating babies and children”. Every year I repeat this to the students who come to me for tutorial sessions, in the hope that one of them will undertake it as a final year project, but so far none of them has. So, I am writing it myself to help other homeopaths, particularly those like me, who have had limited experience with babies.
Since my initial encounter with that 4 month old boy, I like to think that my baby case-taking skills have improved. In recent years I ran a drop-in baby clinic with a cranial osteopath colleague and we had great fun. Parents would bring in babies up to 12 months old, and whilst he did his cranial treatment I would take a brief case and choose a remedy. The most common condition we saw was colic, but poor sleep problems and feeding and teething difficulties were also quite usual on. We stopped the clinic after a couple of years when it became difficult to predict how many would come in, and I think because we lost motivation for it. During those couple of years it enabled me to learn a great deal about treating babies and the best way to take a case.
Another turning point in my confidence in treating young children came after a lecture day with Geoff Johnson, who is a homeopathic vet. He was actually speaking about Sankaran’s sensation method, but as part of the lecture he showed us video clips of some of the animals which had been brought to him for treatment. Just from watching the animal’s behaviour we were encouraged to recommend a remedy. I realised that treating babies and young children is very similar – observing their behaviour in the consultation room is very important.
In this article I have focused on the type of questions I ask the parent(s) and what I am looking for when observing the patient. One thing I have found is that it is pays to be quite specific in terms of questions – the open-ended type often are not beneficial, particularly if the parent has no experience in homeopathy and if it is their first baby.
For many parents, this may be their first experience of homeopathic treatment, so it is important that they know what to expect. I usually give an idea of how long the first session will last (up to an hour in my clinic, but may be less with young babies, depending on how talkative the parents are).
I explain to the parent that it is useful to get an idea of the baby’s health from conception, through pregnancy, birth and early months to the present day. This ensures they are not surprised when I ask whether they conceived easily.
As with any case I start with asking the parent (usually the mother brings the child) about the presenting complaint, which isn’t always what you would expect from looking at the child. Generally I make a note of the complaint and come back to it later.
It is important to get as much information about the complaint as possible and often questions have to be quite specific :
- When did it start?
- Describe the exact symptoms.
- What the baby/child does when the symptoms occur (position of the body, applying pressure, needing food/drink, crying etc)
- If crying, what sort of cry is it – really scared and in great distress, or whimpering for attention
- How often it occurs
- If there are time modalities
- Any change in bowels or urination when the problem is present
- Any change in behaviour generally
It is really useful if the baby’s symptoms occur in the clinic. One mother was anxious about her baby’s crying, but when he did cry it was very mild, not the full-lunged yelling she had indicated.
Conception and pregnancy
Many mothers will comment on their physical health in pregnancy but may not realise the importance of their emotional health, so a few gentle questions about stresses during pregnancy, whether they were working, any other children in the family can be a useful gauge. It can also be useful to know if mum had experienced any miscarriages prior to this pregnancy or difficulties conceiving – it gives an idea of how much emotion may be invested in the pregnancy by the parents. I have seen some cases where a previous baby died at or shortly after birth, which inevitably makes the next pregnancy emotionally highly charged.
If the conception was unexpected asking about the father’s reaction can also be useful. I have known women whose partner (furious at the pregnancy) did not mention the forthcoming arrival throughout the whole nine months, and I am sure this has a significant impact on the mother as well as the unborn child. I know that my own father was livid when my mother announced her pregnancy with me and I feel sure that her suppressed anger coloured my behaviour and relationship with my parents as a child, not to mention her repeated bouts of cystitis during pregnancy; if only she had known about Staphysagria!
Some women will talk for hours about their birth experience, whereas others can give you all the details in two sentences. In itself this is revealing – a long birth story usually indicates that it was fairly traumatic for the mother, although in itself it may not have been a particularly difficult birth. A short birth story usually means that it was satisfactory for the mother, unless she says something like “It was awful, don’t ask”. Further gentle probing may be required in this case, but this may be better left until subsequent consultations when you have got to know the family better.
Parental expectations are important here; many women have a particular birth plan and if it is thwarted for some reason can feel massively disappointed and guilty. This seems to be more usual with first babies and I have often seen that women who experience this disappointment will later suffer from post-natal depression. The baby’s health will, to a large extent depend on the emotional state of the mother, so finding out all you can about the birth and mother’s state of mind is crucial.
I routinely ask how soon the baby and mother made contact after birth, particularly if it was a C-Section birth. It is also important to know if mum and baby were separated after the birth, for example if the mother needed to have stitches in surgery.
Obviously, premature births or babies who were unwell when born require more information, particularly with regard to feeding methods and the amount of contact the baby had with his/her parents.
The length of stay in hospital and early days at home are important. Did the parents have support from friends and family during this time or did they feel isolated and scared?
I am non judgemental about breast-feeding – some women or babies are unable to breast-feed for physiological reason, whilst other women find it hugely stressful and feel that they are better able to bond once they use formula milk and a bottle.
If you are treating a young non-breast fed baby, it is useful to know how he/she is held during feeding. Ideally the position should be as close to that of breast-feeding as possible, so that mum and baby have some closeness during the feeding process.
It is usual for me to ask about the relationship between mum, dad and baby in these early days. Few mothers will want to admit that they haven’t bonded, but you can often detect the lack of closeness. One woman brought her second daughter to me for help with the baby’s sleeping. She repeatedly referred to “my daughter”, meaning her older child, and there was an evident lack of affection for the baby. I found Lac Humanum to be a very useful remedy in this case.
We are all unique and babies develop at different rates. First time parents can become anxious about their baby’s (lack of) development early on, and parents with older children will often compare them to each other. This can become confusing during case-taking, so try to keep a clear record of your patient’s development, not that of his/her brothers or sisters. Gently bring the story back to that of the child whom you are treating, and try to avoid too much focus on the stories of the other children in the family.
It is important to note down how active the child is when you see it, so that you can measure its progress at the next appointment. Sitting, rolling, talking, standing and walking are all things that should be noted, together with number of teeth in evidence.
I often ask parents to bring the baby’s red book, which shows growth over the early months as well as being a record of any vaccinations given to the child.
The majority of children I see have been vaccinated. It still seems to be the MMR injection which causes the most debate, whereas I see just as many, if not more problems arising after the initial vaccines. This may be because children are so young (8 – 10 weeks) when they have their first vaccinations. Even premature babies will be routinely inoculated at around 8 weeks, regardless of their ‘true’ age.
Here is the current UK schedule of vaccinations (2011). Note that babies in high risk areas, or with family history of TB in the past 6 months, may be given the BCG (tuberculosis) vaccine at 3 days old.
- Diphtheria, tetanus, pertussis (whooping cough), polio and Haemophilus influenzae type b (Hib, a bacterial infection that can cause severe pneumonia or meningitis in young children) given as a 5-in-1 single jab known as DTaP/IPV/Hib
- Pneumococcal infection
- 5-in-1, second dose (DTaP/IPV/Hib)
- Meningitis C
- 5-in-1, third dose (DTaP/IPV/Hib)
- Pneumococcal infection, second dose
- Meningitis C, second dose
Between 12 and 13 months:
- Meningitis C, third dose
- Hib, fourth dose (Hib/MenC given as a single jab)
- MMR (measles, mumps and rubella), given as a single jab
- Pneumococcal infection, third dose
3 years and 4 months, or soon after:
- MMR second jab
- Diphtheria, tetanus, pertussis and polio (DtaP/IPV), given as a 4-in-1 pre-school booster
MMR used to be given separately from the Hib/Men C/Pneumoccal booster which was given at 12 months with MMR at 13 months, but these are now given at the same appointment.
Where there is a family history of eczema, this often seems to start at around two to three months, after the first set of vaccinations have been administered. Giving the vaccines in potency can be effective, but may need to be repeated over several days – often a single dose is not enough. Constitutional treatment will be required too.
It is important to enquire closely whether the child had a reaction to any of the vaccinations. It is common practice at GP surgeries to advise giving Calpol before and after the vaccination is administered, which suppresses any fever that the child may show. If parents are determined to vaccinate I suggest that they don’t use Calpol. It seems to me that a fever after a vaccination can indicate good vitality – the child’s body is trying to get rid of the toxins with which it has been injected. Belladonna and/or Aconite can be useful stand-by remedies in this case.
Sleep is critical for both the parent’s and child’s sanity and good humour. The type of questions I ask are:
- What time the child goes to bed
- Whether they fall asleep quickly, without company or need someone there until they drop off
- Whether they wake in the night
- What happens if they wake – are they crying, or just awake, or do they seem afraid. This is really important to judge whether the child has perhaps been frightened by a dream, or if he/she is hungry or just wants to play.
- What time they wake in the morning and what mood they are in on waking
- Bowel and bladder activity in the night
- Need for feeds during the night
- Sleeping position
- Daytime sleeps – where they prefer to sleep and for how long
I like to envisage the child’s sleeping arrangement – are they in a bed/cot in their own room or with parents. If older children wake in the night it can be useful to know whether they come into their parent’s room or shout from their own bed (children benefitting from Calc Carb and Phos may be too scared to get out of bed).
Some children will start crying as soon as they are put down in their cot. If they also have a fear of loud noises (vacuum cleaner, hairdryer etc), and dislike going downstairs or in lifts, Borax is a remedy for consideration.
Bowels and digestion
This is one of my favourite subjects which seems to be shared by most babies in the clinic who obligingly move their bowels during the consultation. It does give me an opportunity to see an awful lot of baby poo!
Frequency, colour and texture are all important things to find out, but also the ease with which the child can move its bowels is vital. Some babies will grunt or go red when having a stool which indicates some difficultly.
Once children are out of nappies it is more difficult to find out the frequency of bowel movements as most don’t keep track of how often they go.
Colic is such a common complaint that it deserves its own book, so it’s fortunate that my colleague, Christian Bates is in the process of writing one!
Whilst we’re waiting for that you may want to take a look at his free download of useful information available at www.theperrymount.com/downloads/downloads_files/Colic_help.pdf
Also in the Downloads menu is a mother’s diet diary, as well as information on useful post natal supplements.
If the baby is breastfed, changes to the mother’s diet can make a huge difference to a colicky baby. If it is on formula, a change of formula will often help, together with homeopathic treatment in both cases.
Find out if the baby is windy and if so, whether it prefers to burp or passes wind as flatulence. A feel and listen to its abdomen may reveal whether it appears to be suffering from trapped wind or a gurgly tummy, and whether the abdomen is distended.
Once babies have been weaned, it is incredibly useful to get an idea about their appetite. In particular, you are concerned with how hungry they are, and which meals seem to be the most popular. (Sulphur-type children may not want much breakfast but will be starving by 11am, for example).
The foods they seem to prefer can also be revealing, as can their level of thirst. Even from an early age there are likely to be meals that children prefer.
Note that children who are given quite a lot of milk may not be very hungry, because they are filling up on milk.
Red ears will usually indicate a mild allergy to something that was eaten a couple of hours earlier. Keeping a food diary may be the way to find out the offending food.
Many children show a reaction to raw tomato, with redness around the mouth. Cooked tomato is often alright. Eggs are another common allergy and babies who have shown a reaction to eggs should be given the MMR vaccine at hospital (although it is likely that the earlier vaccines may also be grown on eggs, which was probably the child’s first exposure to it). It may be worth avoiding giving a child raw tomato or eggs until they are at least 18 months old.
Asking about the child’s character from the parent is useful to establish something about them, but you can also glean a huge amount just from watching how a child reacts when they first come into your room. Their level of interaction with you and the things in the room can be big indicators towards certain remedies. Watch how they play with the available toys, how they are with their parent(s), whether they make eye contact with you or hide behind mum.
I generally shut my remedy cases when I have young children in, because I prefer not to have remedy bottles emptied all over the floor, but if I forget it is interesting to see how different children react to the remedy bottles. Most are fascinated by them and will stand looking at them for a while.
Observing the child’s physical state is important as well. Bitten nails or ground down teeth (from grinding) may indicate parasites. A huge number of children breathe through their mouth, even when they don’t have a cold, and it is worth asking if they snore – many do and are prime candidates for tonsillectomies and grommets.
Remember that parents often don’t notice things like mouth-breathing in their children because it is the norm. I have never knowingly upset a parent by commenting on it, but diplomacy in the phrasing of questions may be required. Most parents are quite gratified to have their child given so much attention.
Look at their posture and physique, in relation to their age. Some children look very young with slow hair growth until they are three or so, whilst others can look much older even as babies. Do they take off their shoes and socks or perhaps all their clothes, as one child insisted on doing in my clinic recently? Her behaviour resulted in a prescription of Medorrhinum, which helped her immensely.
It is worth considering why children may behave as they do. One mother described her daughter as ‘grinding’. She liked to sit on her mother’s foot and rub back and forth. It occurred to me that she probably had thrush and was using the grinding motion as a way of scratching through her nappy. Further questioning revealed that she was usually red in the genital area. The grinding stopped and redness disappeared after an appropriate remedy.
Slightly older children will react in different ways to being the centre of attention. Most children from two years upwards will know that they are being spoken about, and although they may appear to be preoccupied with their current toy, they may correct their parent if incorrect information is given. Others will positively hate being talked about and may try and distract their parent from you to get her to play with them. This in itself is a good indicator of remedies.
It the presenting complaint is behavioural, it is appropriate to speak to one or both parents without the child present to get an idea of what is going on at home.
Find out about favourite toys and activities and the way in which the child plays. Do they happily sit with a puzzle for an hour, or do they need constant entertainment and interaction with frequent changes of toy? Slightly older children can be the most amazing artists. I have some crayons and colouring books and it can be interesting to see what children produce. Some are very particular about colouring within the lines whilst others prefer a more freeform approach.
I have a toy in my room which involves pressing buttons to match the head and tail of various animals. When they are matched a different button can be pressed and the animal will pop up. It is amazing how children differ in their ability to be able to work it out. Some older children take ages to fathom it whilst some toddlers can figure it in less than a minute.
I like to get on the floor and play with children with whichever toy they choose. Seeing how they interact with me, the toy and the space around them is a good remedy indicator, as well as their attention span with any given toy.
Interaction with other children
Whilst it can be extremely revealing to see how your patient interacts with his/her siblings, I generally discourage parents from bringing more than one child to appointments, unless they are very well-behaved. This is more to do with my clinic set-up and a wish not to disturb other practitioners, and I find that two or more children are usually several times noisier than one.
It is useful to find out from the parent how the patient behaves with other children and also with adults, both familiar and strangers. Their reaction to you may not be typical, so it is worth asking the question.
Other useful information
When asked if their child is afraid of anything, parents may not immediately have an answer. Specifics may be:
- the dark
- loud noises (vacuum cleaner, slamming doors etc)
- being left alone in a room
- dogs, cats or other animals
- insects, such as flies, spiders, wasps etc
- water, swimming or getting a wet face
It is worth asking if there are any rooms in the house which the child seems not to like. Children are usually very sensitive to energy and if there are some slightly odd corners in the house, a child will often detect them.
Getting an idea of parents’ and grandparents’ health is useful in the choice of remedy. If the child is demanding and it is difficult to speak to the parent without interruptions, you may wish to ask them to write this down or email it to you.
The more you treat small children the better at it you will become. You may want to consider setting up a low cost baby clinic, which will be of great benefit to families who may not be able to afford homeopathy under normal circumstances.
Don’t worry if you feel you haven’t got all the information you need – there is always next time. Children can be very absorbing for their parents, and some are so distracted that it can be difficult to get a full story. That is all part of the picture – mothers and babies are intricately connected, so what you see in the mother is a large part of the baby too. Just observe the child, how it interacts with those around it, and prescribe based on what you see – remember the animal videos.
Now that we have stopped the drop-in baby clinic, I do see fewer babies and I have to say I miss it, so perhaps I’ll have to reintroduce it soon.
Good luck and may all your baby and toddler patients thrive!
Also read Homeopathy for Infants and Children