Pediatric treatment is a well-established area in Chinese medicine, known for its safety and effectiveness. With centuries of clinical experience, Chinese medicine offers unique advantages in supporting children’s health. Over the past decade in my Toronto practice, I have treated a wide range of pediatric patients using Chinese herbal medicine and acupuncture, with consistently positive outcomes. Respiratory infections and digestive conditions are among the most common pediatric concerns. In this article, I present the case of two brothers whom I treated with Chinese herbal medicine for immune-related and digestive system issues, respectively. Through these two cases, I aim to illustrate how Chinese medicine can support children in improving immune function and digestive health. I intentionally avoid the popular term “BOOST the immune system,” as the immune system is highly complex, and in some cases, attempting to overstimulate it can actually lead to imbalance, autoimmunity, or adverse effects. These case studies offer insight into how Chinese medicine works to regulate and harmonize, rather than simply stimulate, immune and digestive functions.
Chai Hu (柴胡), a Chinese herb for immune and mental health
Holistic Children’s Care with Natural Medicine at Kampo Health Toronto
In my decades of TCM practice, I have helped with many pediatric conditions, from allergy, eczema, and asthma to digestive issues, hormonal, mental, and psychiatric conditions. Chinese medicine, by nature, is a safe and holistic system with thousands of years of experience and a variety of treatments. The cases in this post are treated by Chinese herbal medicine. In addition, TCM also offers other therapies such as moxa therapy, meridian therapy, acupressure, and acupuncture. You may be surprised that many children are perfectly fine with those fine needles. No matter where you’re coming from, if you’re looking for natural and effective medicine to support your children’s health, Kampo Health is a trusted place to find safe and reliable solutions.
Overview: The Principle of Traditional Chinese Medicine in Pediatric Treatments
In Chinese medicine, a child’s body is viewed as being in an active stage of growth and development, with an immune system that is both robust and highly responsive. As a result, when treatment is applied correctly and in appropriate, gentle doses, children often respond quickly and effectively to Traditional Chinese Medicine (TCM) interventions. At the same time, TCM practitioners follow the same foundational principles used in adult care—identifying underlying imbalances through a detailed intake process, which includes thorough questioning, observation, and physical examination. Treatment is applied with great care and consideration. Common TCM approaches for pediatric care include herbal medicine, acupuncture or acupressure, as well as individualized guidance on diet and parenting practices.
The Importance of Digestive Function for a Functioning Immune System
I wrote a post on digestive health in TCM, and you can read more about it if you are interested in more details.
Interestingly, in Chinese medicine, the words for digestive energy (胃气) and protective/immune energy (卫气) are both pronounced “Wei Qi.” While this may be a coincidence, it also suggests that ancient practitioners may have understood an important link between the digestive and immune systems. Modern research continues to highlight what Chinese medicine has long understood: a healthy gut is essential for a strong immune system. Over 70% of immune cells reside in the digestive tract, and any imbalance, such as poor absorption, inflammation, or microbial disruption, can directly weaken immune defenses. Digestion is also essential for the absorption of nutrients that are critical for building immune cells, producing antibodies, and supporting tissue repair. This connection helps explain why many children with recurring colds or allergies also experience digestive symptoms like bloating, loose stools, or a picky appetite. In TCM, restoring digestive balance is often the first step in naturally supporting immune function.
Shi Gao (石膏), a mineral Chinese medicine used for HEAT conditions (infection and/or inflammation)
TCM Pediatric Cases: Infectious Disease and Iron Deficiency Anemia
Case #1: Recurring Flu, Common Cold, and Ear Infections
Two young brothers, aged three and two, were brought into the clinic due to ongoing health concerns. The older child, age three, had frequent colds and flu-like illnesses, often accompanied by ear infections. He had recently started kindergarten, had a strong physical build and a bold temperament. At the time of consultation, he was also waking up at night and knocking on his parents’ door, leaving the family feeling exhausted.
His symptoms during illness typically included nasal congestion, ear pain, and reduced appetite. A key detail noted during intake was that his skin became moist when sick, indicating sweating. In Traditional Chinese Medicine (TCM), whether or not a child sweats during an illness is an important diagnostic factor in selecting appropriate herbal formulas for respiratory infections.
TCM herbal formula for flu and lung infection – Ma Xing Gan Shi Tang (麻杏甘石汤)
An initial herbal prescription I formulated aimed to release the exterior and clear heat. This is one of the best classic herbal formulas Chinese medicine has used for 2000 years to treat flu, cold, and lung-related illnesses:
Ma Huang, Xing Ren, Gan Cao, Shi Gao
Following this treatment, the night waking resolved. The formula was then modified with the addition of the following herbs to further support immune regulation and digestive function:
Chai Hu, Ban Xia, Sheng Jiang, Huang Qin, Da Zao
During the two-month period after he started the herbal treatment, he experienced no new illnesses, no flu, no ear pain, and was energetic and well. “Knock on wood!” his mother said happily. However, he began having trouble falling asleep and started waking earlier than usual. This was in April, a spring month, which in TCM corresponds to the Liver system. TCM theory teaches that Liver qi is more active in spring, and when it becomes excessive, it can disrupt sleep and digestion, especially in children. A common pediatric pattern called “Liver overacting on Spleen” was considered.
(Please note: In Traditional Chinese Medicine, the Liver system refers to more than just the physical liver organ. It also encompasses many functions related to the autonomic nervous system. Therefore, when a TCM practitioner refers to “Liver” issues, they are not necessarily talking about a problem with the anatomical liver.)
So I made some further adjustments to the formula:
Lian Qiao, Zhi Zi, Hou Po, Da Huang, Shao Yao, Zhi Ke added (Ma Huang, Shi Gao, and Xing Ren were removed)
During that same visit, the mother inquired about treatment for her two-year-old son, which is the next case.
Case #2: Iron Deficiency Anemia in the Younger Sibling
The two-year-old sibling had recently been diagnosed with iron deficiency anemia. He appeared pale, and rather than beginning with iron supplementation, the family sought TCM treatment to address the root cause. In Chinese medicine, when no obvious causes such as blood loss or chronic disease are present, iron deficiency is typically linked to digestive weakness and poor nutrient absorption. The younger brother had no major health issues besides low iron, which supported the TCM diagnosis of Spleen Qi deficiency.
Another Classical Herbal Formula for Children’s Digestive Health – Xiao Jian Zhong Tang (小建中汤)
A gentle formula was prescribed to strengthen digestion and enhance nutrient assimilation:
This is a combination of two formulas: Xiao Jian Zhong Tang and Xiao Chai Hu Tang
Gui Zhi, Shao Yao, Yi Tang (maltose), Chai Hu, Huang Qin, Ban Xia, Sheng Jiang, Gan Cao, Da Zao
After just two weeks, the child’s facial color began to improve, with a healthy red tone returning, indicating better circulation and improved iron absorption.
If you compare this formula with his brother’s, some herbs are the same. Why is that?
Treating Digestive and Immune Health Together with Chinese Medicine
At first glance, these two boys may seem to have entirely different conditions—one presenting with recurrent colds and ear infections, the other with iron deficiency anemia. So why did I use some of the same herbs, such as Shao Yao, Chai Hu, and Huang Qin, in both of their treatments?
The answer lies in the deep connection between the digestive system and the immune system. In Chinese medicine, this relationship has long been recognized, with many classical formulas intended to simultaneously support digestion and immune regulation. Even in modern Western medicine, this concept is gaining traction.
“Anemia, particularly iron deficiency anemia, can contribute to a weakened immune system, increasing susceptibility to infections. Iron is crucial for immune cell development and function, and its deficiency can impair various aspects of the immune response.”
Below are the slightly more expanded explanations:
How Anemia Affects the Immune System
Reduced immune cell production and function: Anemia, especially due to iron deficiency, can decrease the number and effectiveness of immune cells such as lymphocytes, which are crucial for defending against infections.
Weakened pathogen response: When iron is deficient, immune cells may struggle to recognize and respond properly to invading pathogens like bacteria, viruses, and fungi.
Disrupted innate immune defenses: Iron deficiency can compromise the innate immune system by reducing cytokine production and impairing the function of natural killer (NK) cells, which play a key role in eliminating infected or abnormal cells.
Greater risk of infections: With a weakened immune defense, individuals with anemia are more vulnerable to frequent infections, including respiratory, urinary, and skin-related illnesses.
Thousands of years before these insights were confirmed by modern research, Chinese medicine had already recognized the vital role of the digestive system in supporting immunity. This principle guided the formulation I prescribed for the younger boy. At just two years old and preparing to enter kindergarten, he is about to face daily exposure to various germs. My goal with the herbal treatment was not only to enhance his nutrient absorption but also to strengthen his immune system in preparation for the challenges ahead.
Shao Yao(芍药), a common Chinese herb used for digestive and circulation issues
How Chinese Herbs Work: A Closer Look
In Traditional Chinese Medicine (TCM), the body is seen as a unified whole. When an infection occurs, it doesn’t just affect one area; the entire system is impacted. Treatment, therefore, aims not only to eliminate symptoms but also to rebalance and support the affected systems throughout the body.
Case of the Older Brother: Infection, Cough, Ear Pain, and Restlessness
The older child presented with symptoms related to upper respiratory infection, including cough, ear infection, and signs of mental agitation. The first formula I used was Ma Xing Shi Gan Tang (麻杏石甘汤), a classical prescription recorded over 2,000 years ago in the Shang Han Za Bing Lun. This formula is one of the most widely used in TCM for treating respiratory infections and even pneumonia.
Its mechanism is complex, but broadly, it includes:
- Shi Gao – Clears heat and inflammation
- Ma Huang – Regulates the neuroendocrine system and opens the lungs
- Gan Cao – Harmonizes the formula and has anti-inflammatory effects (not a steroid)
- Xing Ren – Reduces phlegm production and suppresses cough
Although there were no severe digestive symptoms like vomiting or diarrhea, the child consistently experienced reduced appetite during illness. In TCM, this indicates weakened digestive function, which must be addressed to support overall recovery and immune resilience.
To support this, I modified the formula by adding:- Sheng Jiang (fresh ginger), Ban Xia, Da Zao, and Chai Hu: Herbs that regulate the digestive system and help the body process and eliminate pathogens more effectively
Case of the Younger Brother: Iron Deficiency and Poor Absorption
The younger child’s formula focused on enhancing nutrient absorption, particularly to address iron deficiency linked to digestive weakness. Key herbs included:- Gui Zhi, Shao Yao, Sheng Jiang, Gan Cao, and Yi Tang (maltose)
Yi Tang is especially interesting in today’s sugar-averse culture. In classical Chinese medicine, Yi Tang (Barley Malt) is considered nourishing and is essential for improving absorption in children with poor digestive function. In this formula, Shao Yao was used at twice the normal dose to guide Yi Tang directly into the Middle Jiao (中焦)—the region associated with the small intestine and digestion.
This formula is known as Xiao Jian Zhong Tang (小建中汤), which translates to “Minor Construct the Middle Decoction.” As the name suggests, the primary goal is to strengthen and support the digestive system, which TCM refers to as the “Middle.”
Some of the herbs used in this case, such as Shao Yao and Gan Cao, overlapped with those in his older brother’s treatment. As explained earlier, this is because supporting digestion and regulating the immune system are interconnected principles in TCM—and both children benefited from this holistic approach.
Principles of Pediatric Treatment in Chinese Medicine
Chinese medicine has a long history of treating pediatric conditions with great success. Over thousands of years of clinical practice, a few core principles have consistently guided treatment for children:
1. Always Support the Digestive System: Addressing Children’s GUT Health Naturally
In TCM, digestion is considered the foundation of health, especially in children, whose bodies are still developing. Life depends on the quality of the air and food we take in, and any malfunction in the digestive system can affect a child’s overall health, both in the short term and long term.
One of the key goals in pediatric care is to ensure a good appetite, efficient nutrient absorption, and regular bowel movements. For example, I am currently treating a four-year-old girl with eczema who also experiences chronic constipation. Her herbal formula includes ingredients to promote regular bowel movements and help eliminate internal heat and toxins. Since beginning treatment, her bowel movements have become daily (instead of once every three days), and her skin condition has also improved. Her mother, who prefers to avoid conventional medications and supplements, has been very pleased with the results of Chinese herbal therapy.
2. Safety Comes First: Is Chinese Medicine Safe for Children?
Safety is a top priority in treating all patients, and even more so in children. TCM practitioners ensure safety through careful herb selection, accurate dosing, and frequent follow-ups. A child’s body is more delicate and changes more rapidly than that of an adult, so treatment must be closely monitored and adjusted as symptoms evolve.
This principle is especially critical during the early and acute stages of infections, where symptoms can shift quickly. For chronic or constitutional imbalances, follow-up appointments may be spaced further apart, but they still play an important role in tracking progress and adapting the treatment plan as needed.
3. Strengthen the Immune System by Supporting Core Systems: A Functioning Immune System Is the Key to Children’s Growth
In TCM, a strong immune system depends on the proper function of the digestive and respiratory systems. These two systems are the most commonly affected in pediatric medicine, and many other childhood conditions stem from imbalances in these areas. Before treating the immune system directly, TCM focuses on building a strong foundation by improving digestion and respiration. This approach doesn’t just address symptoms, it supports the child’s overall vitality and long-term health. The two clinical cases presented earlier in this article demonstrate how Chinese medicine works holistically, addressing the interrelationship between organ systems to restore balance and promote healing.
Life is precious and fragile,when the body is ill, a safe, supportive and effective treatment is our priority. As a Traditional Chinese Medicine practitioner, I apply these built-in TCM principle in every treatments for my patients. At Kampo Health Chinese medicine clinic, Toronto, I provide in-person and virtual sessions for anyone who is looking for a holistic approach to help them restore their health and wellbeing. Contact us or Book online!