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Asthma: Care after an emergency room visitAsthma: Care after an emergency room visitAsthma: Care after an emergency room visitAEnglishRespiratoryChild (0-12 years);Teen (13-18 years)LungsRespiratory systemConditions and diseases;Drug treatmentCaregivers Adult (19+)Cough;Wheezinghttps://assets.aboutkidshealth.ca/akhassets/Asthma_ShakePuffer_EN.jpg2018-07-19T04:00:00ZKelly Andersonclodagh.mccarthy@sickkids.ca | Clodagh McCarthy | 693A30232E777C7369636B6B6964735C636C6F64616768206D63636172746879 i:0#.w|sickkids\clodagh mccarthyHealth (A-Z) - ConditionsHealth A-Z<p>​Asthma is a condition that affects the lungs and causes breathing difficulties. Learn how to recognize, manage and treat asthma at home. <br></p><h2>What is asthma?</h2><p>Asthma is a condition that affects your child’s lungs. When asthma is not well controlled, the airways narrow, swell and produce mucus. This makes it difficult to breathe.<br></p> <figure class="asset-c-80"> <span class="asset-image-title">Narrowing of airways in asthma</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Asthma_narrow_airways_MED_ILL_EN.jpg" alt="" /> <figcaption class="asset-image-caption">During an asthma attack, the muscles around the airways get tight. The airways become narrow, swell and produce mucus, making it hard to breathe.</figcaption> </figure> <h2>Key points</h2><ul><li>When asthma is not well controlled, the airways narrow, swell and produce mucus, causing breathing difficulties.</li><li>Early signs of breathing difficulties include coughing and wheezing. Late signs include fast breathing, pale skin and flared nostrils.</li><li>The most effective way to control your child's asthma is to minimize any triggers such as cigarette smoke, dust mites and mould.<br></li><li>The medicines you will use to treat your child's asthma are decided by an "asthma action plan" that you develop with your child's doctor.<br></li></ul><h2>What are the signs and symptoms of asthma?</h2><h3>Early warning signs</h3><p>Early warning signs of breathing difficulties include:</p><ul><li>coughing</li><li>wheezing (noisy breathing)</li><li>being less active than normal</li><li>not keeping up with friends when playing</li><li>difficulty with feeding (for infants).</li></ul> <figure><span class="asset-image-title">Late warning signs of breathing </span><span class="asset-image-title"></span><span class="asset-image-title">trouble</span><img src="https://assets.aboutkidshealth.ca/akhassets/AsthmaSymptoms_EN.jpg" alt="" /><figcaption class="asset-image-caption">Additional</figcaption><figcaption class="asset-image-caption"></figcaption><figcaption class="asset-image-caption"> late warning signs of breathing trouble include fast breathing, pale skin, blue or grey skin around the mouth and difficulty speaking in full sentences. If you see any of these signs, see a doctor immediately. </figcaption> </figure> <h3>Late warning signs</h3> <p>Late warning signs that your child is having trouble breathing include:</p><ul><li>fast breathing</li><li>pale skin</li><li>blue or grey skin colour around the mouth</li><li>difficulty speaking in full sentences</li><li>skin pulling in between or under ribs and in the neck (due to breathing effort)</li><li>nostrils flaring when breathing.<br></li></ul><p>If you see any of these late warning signs, <strong>see a doctor immediately</strong>.<br></p><h2>How is asthma treated?</h2><p>Asthma can be treated with a range of medicines. Your child’s asthma medicines are part of an “asthma action plan” that you will develop with your child’s doctor.</p><h3>Rescue medicine</h3><ul><li>This medicine comes in a blue puffer.</li><li>It relaxes the muscles around the airways to provide immediate relief when your child finds it hard to breathe.</li><li>One example is salbutamol, also known by the brand name Ventolin.</li></ul><h3>Controller medicine </h3><ul><li>This medicine often comes in an orange or a brown puffer.</li><li>It reduces swelling and mucus in the lungs.</li><li>It does not provide immediate relief. Instead, your child should take it regularly, even when they are feeling well.</li><li>One example is fluticasone, also known by the brand name Flovent.</li></ul><h3>Oral steroids (liquid or tablet medicine taken by mouth)</h3><ul><li>These are powerful medicines that reduce swelling in the lungs.</li><li>Your child should take them only for a short time until their asthma is back under control.</li><li>Examples of oral steroids include dexamethasone and prednisolone.</li></ul> <h2>How do I use a puffer to give asthma medicine to my child?</h2><p>Always use a spacer with a puffer to help the medicine enter your child’s lungs.</p><ol class="akh-steps"><li> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/Asthma_ShakePuffer_EN.jpg" alt="" /> </figure> <p>Remove the cap and shake the puffer five times.</p></li><li> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/Asthma_PufferSpacer_EN.jpg" alt="" /> </figure> <p>Put the puffer upright into the rubber hole of the spacer. </p></li><li><p>Have your child sit up or stand in a comfortable position and put the mask firmly on their face. Be sure to cover their mouth and nose.</p><div class="akh-series"><ul><li> <figure><img src="https://assets.aboutkidshealth.ca/AKHAssets/Asthma_OlderChildPositioning_EN.jpg" alt="" /></figure> <p>Older children can sit or stand in a comfortable position while you give them their puffer.</p></li><li><p>Younger children should be held on a parent’s lap. You can then use the “one-person approach” or “two-person approach” to give medicine to a younger child.</p><div class="asset-2-up"> <figure><span class="asset-image-title">One-person </span> <span class="asset-image-title"></span><span class="asset-image-title">approach</span><img src="https://assets.aboutkidshealth.ca/akhassets/Asthma_OnePersonApproach_EN.jpg" alt="" /><figcaption class="asset-image-caption">Sit</figcaption><figcaption class="asset-image-caption"></figcaption><figcaption class="asset-image-caption"> in a chair and place your child on your lap. Hug the child tightly with one arm and, with your other hand, press the top of the puffer firmly to release a puff of </figcaption></figure> <figure> <figcaption class="asset-image-caption"></figcaption></figure><figure><figcaption class="asset-image-caption">medicine.</figcaption></figure><figure><span class="asset-image-title">Two</span></figure><figure><span class="asset-image-title"></span></figure><figure><span class="asset-image-title">-person </span> <span class="asset-image-title"></span><span class="asset-image-title">approach</span><img src="https://assets.aboutkidshealth.ca/akhassets/Asthma_TwoPersonApproach_EN.jpg" alt="" /><figcaption class="asset-image-caption">Cross</figcaption><figcaption class="asset-image-caption"></figcaption><figcaption class="asset-image-caption"> your leg over your child’s legs, hold their arms with your own arm and hold their forehead against your chest. Another adult will hold your child’s chin, place the mask firmly over your child’s nose and mouth and press the top of the puffer firmly to release a puff of medicine. </figcaption></figure></div></li></ul></div></li><li> <figure> <img src="https://assets.aboutkidshealth.ca/AKHAssets/HowToUse_MDI_with_Spacer_5_EQUIP_ILL_EN.jpg" alt="" /> </figure> <p>Press the top of the puffer firmly. This will release one puff of medicine. Hold the mask over your child’s nose and mouth for 15 seconds.</p></li><li><p>Encourage your child to take deep breaths.</p></li></ol><p>If your child needs more than one puff of the medicine, remove the puffer from the spacer and repeat steps 1 to 5.</p><h2>What to do when you finish giving asthma medicine with the puffer</h2><div class="akh-series"><div class="row"><div class="col-md-12"> <figure><img src="https://assets.aboutkidshealth.ca/akhassets/HowToUse_MDI_with_Spacer_6_EQUIP_ILL_EN.jpg" alt="" /> </figure> <p>Take the mask off your child’s face and encourage them to drink or rinse their mouth with water.</p></div></div></div><h2>My child does not like using their puffer. What can I do?</h2><p>Giving puffers may upset a young child. This is natural.</p><p>Try to make it fun for your child by singing, counting, watching a video or showing how to use the puffer on yourself or a teddy bear. Your child will become more comfortable with puffers over time.</p><p>If you would prefer not to wake your child overnight or during a nap, it is fine to give a puffer when they are sleeping.</p><h2>How often do I need to replace my child’s spacer?</h2><p>The spacer you receive from the hospital should be used only for a short time. You will then need to buy a spacer from your pharmacy. Most spacers last about a year before you need to replace them.</p><h2>How do I clean my child’s spacer?</h2><p>Once a week, wash the spacer with soap and warm water by hand and let it air dry. Or you can put the spacer in the top shelf of your dishwasher on a low heat setting.</p><p>It is very important to wash the spacer regularly to clear any build-up of saliva and medicines.<br></p> <br> <br><h2>How can I control my child’s asthma?</h2><p>The most effective way to control your child's asthma is to minimize any triggers that can make it worse. </p><p>The most common triggers are viral infections such as colds and the flu. Other triggers include:</p><ul><li>cigarette smoke</li><li>air pollution</li><li>dust mites</li><li>cold air</li><li>pet dander</li><li>pollen<br></li><li>mould.<br><br></li></ul> <p>For more information, contact Ontario Lung Association's Lung Health Information Line on <strong>1-888-344-LUNG</strong> (5864) from 8.30 to 4.30, Monday to Friday.<br></p>
Mental healthMental healthMental healthMEnglishPsychiatryChild (0-12 years);Teen (13-18 years)NANANACaregivers Adult (19+)NALanding PageLearning Hub<p>Learn how to support your child’s wellbeing with activity, sleep and nutrition and how to recognize and manage various mental health conditions.<br></p><p>This hub includes resources for parents on how to support your child's mental health and general wellbeing through physical activity, sleep and nutrition. It also provides information on the signs, symptoms and treatments of different mental health conditions, including anxiety, bipolar disorder, depression, behavioural disorders, anorexia nervosa and attention deficit hyperactivity disorder.<br></p><div class="panel panel-primary"><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span> <h2 class="panel-title">Wellbeing<br></h2></div><div class="panel-body list-group" style="display:none;"><p>The everyday pressures of growing up can put a strain on any child's mental wellbeing. Find out how physical activity, a healthy sleep routine, screen time limits and balanced nutrition can boost your child's mental health and support them through difficult times.</p></div><ol class="list-group" style="display:none;"><li><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span> <h3>Physical Activity</h3></div><ol class="list-group" style="display:none;"><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=642&language=English">Physical activity: Guidelines for children and teens</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=641&language=English">Physical activity: Benefits of exercise for health and wellbeing</a></li></ol></li><li><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span> <h3>Sleep</h3></div><ol class="list-group" style="display:none;"><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=645&language=English">Sleep: Benefits and recommended amounts</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=646&language=English">How to help your child get a good night's sleep</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=647&language=English">How to help your teen get a good night's sleep</a></li></ol></li><li><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span> <h3>Screen time</h3></div><ol class="list-group" style="display:none;"><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=643&language=English">Screen time: Overview</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=644&language=English">How to help your child set healthy screen time limits</a></li></ol></li><li><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span> <h3>Nutrition</h3></div><ol class="list-group" style="display:none;"><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=639&language=English">Nutrition: How a balanced diet and healthy eating habits can help your child's mental health</a></li></ol></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span> <h2 class="panel-title">Anxiety disorders<br></h2></div><div class="panel-body list-group" style="display:none;"><p>Every child feels anxiety at some point as a natural part of growing up. An anxiety disorder, however, is when anxious feelings interfere with a child's everyday routine. Learn more about the signs, symptoms and range of anxiety disorders and how they ​are treated.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=18&language=English">Anxiety: Overview</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=271&language=English">Signs and symptoms</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=270&language=English">Types of anxiety disorders</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=701&language=English">Treatment with medications</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=702&language=English">Psychotherapy and lifestyle changes</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span> <h2 class="panel-title">Obsessive compulsive disorder<br></h2></div><div class="panel-body list-group" style="display:none;"><p>Obsessive compulsive disorder (OCD) occurs when a person suffers from troubling and intrusive thoughts and/or follows repetitive or strict routines to feel less worried. Learn about the causes, signs and impact of this disorder and how you can help your child.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=285&language=English">Obsessive compulsive disorder: Overview</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=288&language=English">Signs and symptoms</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=286&language=English">How OCD affects your child's life</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=709&language=English">Psychotherapy and medications</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=287&language=English">How to help your child at home</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span> <h2 class="panel-title">Depression<br></h2></div><div class="panel-body list-group" style="display:none;"><p>Depression is an illness that causes someone to feel deep sadness or a lack of interest in activities that they once enjoyed. Discover how this condition affects a child's mood, sleep, concentration and energy levels, and how it can be treated.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=19&language=English">Depression: Overview</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=284&language=English">Signs and symptoms</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=707&language=English">Treatment with medications</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=708&language=English">Psychotherapy and lifestyle changes</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span> <h2 class="panel-title">Bipolar disorder</h2></div><div class="panel-body list-group" style="display:none;"><p>When a person has bipolar disorder, they alternate between low and elevated moods for days, weeks or months at a time. Learn about the bipolar disorder spectrum, the symptoms of manic and depressive episodes and how medications, therapy and lifestyle changes can help.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=279&language=English">Bipolar disorder: Overview</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=280&language=English">Signs and symptoms</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=704&language=English">Treatment with medications</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=705&language=English">Psychotherapy and lifestyle changes</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span> <h2 class="panel-title">Suicide and self-harm</h2></div><div class="panel-body list-group" style="display:none;"><p>A child who experiences thoughts of suicide or self-harm is often suffering from overwhelming emotional pain. Find out how to help your child cope with difficult emotions, how to support and protect your child and where to find professional help.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=291&language=English">Suicide in children and teens: Overview</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=289&language=English">Self-harm in children and teens: Overview</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=290&language=English">Signs and symptoms of suicide risk</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=293&language=English">How to help your child with difficult emotions</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=292&language=English">How to protect your child from harm</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span> <h2 class="panel-title">Eating disorders<br></h2></div><div class="panel-body list-group" style="display:none;"><p>An eating disorder not only risks your child's health but can also disrupt family life. Find out about the symptoms and treatment of anorexia, bulimia, avoidant/restrictive food intake disorder and binge eating disorder and how you can help your child recover.</p></div><ol class="list-group" style="display:none;"><li><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span> <h3>Anorexia nervosa</h3></div><ol class="list-group" style="display:none;"><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=268&language=English">Anorexia nervosa: Overview</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=269&language=English">Signs and symptoms</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=267&language=English">Medical complications</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=700&language=English">Treatment options</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=266&language=English">How to help your child at home</a></li></ol></li><li><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span> <h3>Bulimia nervosa</h3></div><ol class="list-group" style="display:none;"><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=282&language=English">Bulimia nervosa: Overview</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=283&language=English">Signs and symptoms</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=281&language=English">Medical complications</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=706&language=English">Treatment options</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=294&language=English">How to help your child at home</a></li></ol></li><li><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span> <h3>Avoidant/restrictive food intake disorder (ARFID)</h3></div><ol class="list-group" style="display:none;"><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=274&language=English">Avoidant/restrictive food intake disorder: Overview</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=275&language=English">Signs and symptoms</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=273&language=English">Medical complications</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=703&language=English">Treatment options</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=272&language=English">How to help your child at home</a></li></ol></li><li><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span> <h3>Binge eating disorder (BED)</h3></div><ol class="list-group" style="display:none;"><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=277&language=English">Binge eating disorder: Overview</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=278&language=English">Signs and symptoms</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=640&language=English">Obesity: Medical complications</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=276&language=English">How to help your child at home</a></li></ol></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span> <h2 class="panel-title">Attention deficit hyperactivity disorder (ADHD)</h2></div><div class="panel-body list-group" style="display:none;"><p>Attention deficit hyperactivity disorder (ADHD) involves difficulties with controlling attention and regulating behaviour. Discover the main symptoms of ADHD in children and teens, how the disorder is diagnosed and how to help your child at home and at school.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=1922&language=English">Attention deficit hyperactivity disorder: Overview</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=1923&language=English">Signs and symptoms</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=1997&language=English">How to help your child at home</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=1999&language=English">Communicating with your child's school</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=1998&language=English">Treatment with medications</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span> <h2 class="panel-title">Behavioural disorders</h2></div><div class="panel-body list-group" style="display:none;"><p>Behavioural disorders include oppositional defiant disorder and conduct disorder. Learn how these disorders differ from typical misbehaviour, how therapy and medications can help and how you can manage problematic behaviour at home.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=1924&language=English">Behavioural disorders: Overview</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=1925&language=English">Signs and symptoms</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=2000&language=English">Treatment with psychotherapy and medications</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=2001&language=English">How to help your child at home</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span> <h2 class="panel-title">Post-traumatic stress disorder (PTSD)</h2></div><div class="panel-body list-group" style="display:none;"><p>Post-traumatic stress disorder (PTSD) is triggered by experiencing or witnessing a terrifying event. Learn about the main symptoms of PTSD, how the condition is diagnosed and how psychotherapy and medications can help your child.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=1927&language=English">Post-traumatic stress disorder: Overview</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=1928&language=English">Signs and symptoms</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=2005&language=English">Treatment with psychotherapy and medications</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span> <h2 class="panel-title">Brain disorders and mental health</h2></div><div class="panel-body list-group" style="display:none;"><p>A brain disorder includes a condition, illness or injury that affects the brain and how it develops before or after birth. Find out how a brain disorder can affect your child's learning, mood and social skills, how its impact on mental health is assessed and how to help your child cope.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=1926&language=English">Brain disorders and mental health: Overview</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=2002&language=English">Assessing your child for neuropsychological difficulties</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=2003&language=English">How to help your child cope</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=2004&language=English">Common treatments</a></li></ol></div>https://assets.aboutkidshealth.ca/AKHAssets/Mental_health_landing-page.jpgmentalhealthhealthyliving
Influenza (flu): Seasonal flu and pandemic fluInfluenza (flu): Seasonal flu and pandemic fluInfluenza (flu): Seasonal flu and pandemic fluIEnglishInfectious DiseasesChild (0-12 years);Teen (13-18 years)BodyImmune systemConditions and diseasesCaregivers Adult (19+)Cough;Fever;Headache;Sore throat2014-02-27T05:00:00ZUpton Allen, MBBS, MSc, FRCPC, FAAP;Shawna Silver, MD, FRCPC, FAAP, PEng7.0000000000000061.0000000000000750.000000000000Flat ContentHealth A-Z<p>The main goal of the influenza virus is to make copies of itself. Learn how the influenza virus mutates and how pandemics can begin.<br></p><h2>Life of the influenza virus</h2> <p>The <a href="/Article?contentid=912&language=English">influenza</a> (flu) virus's main job in life is to make copies of itself. However, the virus is not very good at it. As the virus makes copies of itself, it makes mistakes called mutations.</p> <p>Most of these mistakes hurt the virus and it dies or becomes unable to make copies of itself. Other mutations help the virus survive and make it easier for it to make copies of itself. A mutation may make it easier for the virus to spread from one person to another.</p><h2>Key points</h2> <ul> <li>The flu virus makes copies of itself quickly and makes mistakes called mutations in its genetic material. These mutations may sometimes be helpful to the virus.</li> <li>When two different types of flu virus exchange genetic material a new type of flu virus can be created.</li> <li>If a new virus spreads fast and widely because people do not have immunity against it yet, it may become a pandemic flu.</li> </ul><h2>Small mutations</h2><p>The flu virus makes copies of itself small but helpful mutations occur. After thousands of years, this process has resulted in many types and subtypes of flu. They live in a wide range of hosts, from pigs and birds to civet cats and humans. As hosts are infected and re-infected, they make antibodies to fight the virus which helps the host develop some immunity to the virus.</p><p>Because most of the virus's mutations are small, the host usually has some immunity to the slightly altered virus. This is because the antibodies that the host already has still have some ability to fight the slightly altered virus. The result is although people still get sick, their illness is milder and fewer people get very sick.</p><h2>Larger mutations</h2><p>Copying mistakes are not always small. Sometimes, large mutations occur. Large mutations may occur when two types of influenza that would normally be seen in different organisms infect the same host. For example, a small mutation may allow a pig to be infected with a flu virus normally only seen in birds. At the same time, the pig may also be infected with a flu virus that infects humans. When the viruses are making copies of themselves, genetic material from one virus can combine with the genetic material from the other. This can produce very large and sudden changes in the virus. It can create a new subtype of the virus.</p><p>If this mutation also helps the virus, hosts may have no natural immunity to it. This can cause more people to become infected. There may be more severe illness.</p> <figure class="asset-c-100"><span class="asset-image-title">Evolution of a pandemic strain of </span><span class="asset-image-title">influenza</span><img src="https://assets.aboutkidshealth.ca/akhassets/H1N1_flu_antigentic_shift_EDIT_ILL_EN.jpg" alt="" /><figcaption class="asset-image-caption">This</figcaption><figcaption class="asset-image-caption"> is a simplified explanation of the process that likely created the H1N1 virus strain (swine flu). Since the new virus is substantially different from the seasonal flu virus, humans have had little time to develop any immunity, making it potentially dangerous.</figcaption> </figure> <h2>What is pandemic flu?</h2><p>When a copying mistake is large and helps the virus, it makes the mutated virus different from the old virus. Because the virus is new very few people are immune to it. It is easier for this new virus to spread around the world and become a pandemic strain.</p><p>Pandemic flu can be mild or severe. It may infect many people or only a few. It may circulate for many months or die out. Predicting what will happen during a pandemic is very difficult. Pandemic strains of influenza have circulated at least three times in the last 100 years.</p><p>Most people have heard of the Spanish flu of 1918. It killed tens of millions of people. But two other pandemic influenzas have circulated since then: Asian flu in 1957 killed between one and four million people. Hong Kong flu in 1968 killed approximately one million people.</p><p>The 2009 H1N1 pandemic flu infected millions of people. However, relatively few became severely ill. Over time, the virus will continue to mutate. It is difficult to predict what will happen with H1N1 in the future.</p><p>Statement on Seasonal Influenza Vaccine for 2013-2014. (2013, November 14). <em>Public Health Agency of Canada</em>. Retrieved December 20, 2013. <a target="_blank" href="http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/13vol39/acs-dcc-4/">http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/13vol39/acs-dcc-4/</a></p><p>Influenza (Seasonal) Fact sheet No211. (2009, April). <em>World Health Organization</em>. Retrieved December 20, 2013. <a target="_blank" href="http://www.who.int/mediacentre/factsheets/fs211/en/">http://www.who.int/mediacentre/factsheets/fs211/en/</a></p><p>Seasonal Influenza (Flu) (2013, April 8). <em>Health Canada</em>. Retrieved December 20, 2013. <a target="_blank" href="http://www.hc-sc.gc.ca/hc-ps/dc-ma/influenza-eng.php#flu">http://www.hc-sc.gc.ca/hc-ps/dc-ma/influenza-eng.php#flu</a></p><p>Key Facts about Influenza (Flu) & Flu Vaccine. (2013, September 26). <em>Centers for Disease Control and Prevention.</em> Retrieved December 20, 2013. <a target="_blank" href="http://www.cdc.gov/flu/keyfacts.htm">http://www.cdc.gov/flu/keyfacts.htm</a></p><p>Protect yourself, your family and your community. (2013, October 31). <em>Ministry of Health and Long-Term Care.</em> Retrieved December 20, 2013. <a target="_blank" href="http://www.health.gov.on.ca/en/public/programs/publichealth/flu/">http://www.health.gov.on.ca/en/public/programs/publichealth/flu/</a></p><p>Osterholm, M.T. (2005). Preparing for the Next Pandemic.<em> New England Journal of Medicine</em>, <i>352</i>(18):1839-1842.</p><img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/influenza_seasonal_pandemic.jpg" style="BORDER:0px solid;" />https://assets.aboutkidshealth.ca/AKHAssets/influenza_seasonal_pandemic.jpg
Juvenile enthesitis-related arthritis (ERA)Juvenile enthesitis-related arthritis (ERA)Juvenile enthesitis-related arthritis (ERA)JEnglishRheumatologyChild (0-12 years);Teen (13-18 years)Back;Knee;Ankle;Foot;HipImmune system;Ligaments;TendonsConditions and diseasesCaregivers Adult (19+)NAhttps://assets.aboutkidshealth.ca/akhassets/Entheses_affected_by_ERA_MED_ILL_EN.jpg2016-08-12T04:00:00ZShirley Tse, MD, FRCPC;Michelle Anderson, BScN;Jo-Anne M​arcuz, BSc, MSc PT9.0000000000000052.0000000000000894.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Juvenile enthesitis-related arthritis includes swelling and pain where tendons and ligaments attach to bone. It affects more boys than girls.<br></p><h2>What is juvenile idiopathic arthritis (JIA)?</h2> <p>Juvenile idiopathic arthritis (JIA) is arthritis that affects children who are less than 16 years old. It is also called childhood arthritis.</p> <p>Arthritis means "joint swelling" or "joint inflammation." Arthritis leads to pain, swelling, stiffness and loss of motion in the joints. "Idiopathic" means that we do not know the cause.</p> <h2>What is enthesitis-related arthritis (ERA)?</h2> <p>There are many different types of arthritis. Enthesitis-related arthritis (ERA) is one type. Patients with ERA not only have joint swelling or inflammation (arthritis), but also have enthesitis. Enthesitis is swelling or inflammation of the entheses, the connective tissue where tendons or ligaments attach to bone.</p> <p>Between 10% and 15% of all children with JIA have ERA. It is usually seen in late childhood or adolescence (eight to 15 years of age). It affects boys more often than girls.</p> <p>The severity of ERA can vary. For some children, it can be mild and last only a short time. For others, it can be more severe and last a long time. Some children may develop inflammation in their back when they are adults.</p> <p>ERA can also be called spondyloarthritis or ankylosing spondylitis.</p> <p>These diseases are managed by rheumatologists, doctors who specialize in diseases of the joints and inflammation.</p> <h2>Enthesitis-related arthritis is an autoimmune disease</h2> <p>Inflammation (irritation and swelling) is a normal process in the body. It is how our immune system protects our bodies from bacteria and viruses that cause infection.</p> <p>In ERA, like other types of childhood arthritis, there is no infection. Instead, the immune system is confused and attacks the cells and tissues in the body’s connective tissues including the joints, tendons and entheses. This leads to redness, swelling, pain, warmth, stiffness or loss of movement in the connective tissue. For this reason, ERA is called an autoimmune disease. So far, we do not know what causes it. There is nothing that you did or did not do to cause your child’s ERA.</p> <h2>Key points</h2> <ul> <li>ERA is a type of juvenile idiopathic arthritis (JIA).</li> <li>ERA is a disease that causes pain, swelling and stiffness in the joints of the hips, knees, ankles, feet and lower back.</li> <li>ERA is an autoimmune disease. We do not know why some people get ERA.</li> <li>People with ERA may also have inflammation in the eyes, skin or intestines.</li> <li>There are several steps to diagnose ERA and your child will need various tests.</li> <li>There are a variety of treatments to help with the pain and inflammation.</li> </ul> <h2>Signs and symptoms of enthesitis-related arthritis</h2><p>The arthritis in ERA is mainly in the lower limbs (hip, knee, ankle and foot). Arthritis in the back (spondylitis) and the base of the spine at the sacroiliac joint (sacroiliitis) is not as common at first, but can occur later. Children with spondylitis or sacroiliitis often complain of lower back or buttock pain that is worse with rest and better with activity. Arthritis can also occur in the upper limbs, especially the shoulders.</p> <figure class="asset-c-80"> <span class="asset-image-title">Joints affected by enthesitis arthritis (ERA)</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Joints_affected_by_ERA_MED_ILL_EN.jpg" alt="" /> <figcaption class="“asset-image-caption”">Arthritis in the lower joints can be part of ERA. Some children have just the arthritis, some have just the enthesitis, some have a combination of both.</figcaption> </figure> <p>The most common areas affected by enthesitis are the knees, heels and bottom of the feet. As a result, children with enthesitis report heel, foot or knee pain, with or without swelling. To help with enthesitis pain in the foot and heel, your child’s health-care team may recommend supportive footwear and padded heel inserts for your child's shoes.</p><p>Symptoms of ERA can come and go. Sometimes your child may have a flare of their disease when there is more pain and swelling of joints and/or entheses.</p> <figure class="asset-c-80"> <span class="asset-image-title">Entheses affected by enthesitis arthritis (ERA)</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Entheses_affected_by_ERA_MED_ILL_EN.jpg" alt="" /> <figcaption class="“asset-image-caption”">Entheses are where tendons and ligaments insert into bone. Enthesitis is inflammation of entheses.</figcaption> </figure> <h3>Possible other symptoms of ERA</h3><p>For some patients with ERA, inflammation can occur in other areas of the body as well. Not all children with ERA will have these symptoms, but doctors will always be checking for:</p><ul><li>Eye inflammation occurs in up to 30% of children who have ERA. It usually occurs in one eye and can reoccur. Inflammation occurs in the iris, where it is called acute anterior uveitis. The eye is usually red, painful and sensitive to light. Eye inflammation is an emergency. Your child will need to see an eye doctor (ophthalmologist) right away. Your child will need to have routine eye exams with a "slit lamp" to look for early signs of eye inflammation. Please speak to your child’s doctor about how often your child will need to have an eye exam.</li><li>Skin inflammation can also occur in children with ERA. Inflammation in the skin is called psoriasis. This is a persistent skin rash that looks like red patches covered with white scales. It can be found on the scalp, underarms, elbows and around the belly button.</li><li>Bowel inflammation can also occur in children with ERA. Inflammation in the bowel (intestines) is called inflammatory bowel disease (IBD). There are two types of IBD: Crohn's disease, and ulcerative colitis.</li></ul><h2>Diagnosis of enthesitis-related arthritis</h2> <p>There are several steps to diagnosing ERA. The doctor will ask you about your child's symptoms and medical history and will also do a physical exam to look for joint inflammation. They may suspect ERA when a child has joint pain and swelling, especially in the lower limbs; pain in the lower back or buttocks; or signs of enthesitis for more than six weeks. The doctor will usually order blood tests, X-rays and sometimes additional tests, like magnetic resonance imaging (MRI), to help diagnose the disease.</p> <p>One blood test that can be helpful when trying to diagnosis ERA is the HLA-B27 genetic marker. It can tell us who is at higher risk of developing ERA. Most children with ERA are "positive" for the HLA-B27 marker, but it is important to note that:</p> <ul> <li>Not every person who carries this marker will have ERA.</li> <li>A child can have ERA and still be "negative" for HLA-B27.</li> </ul> <h2>Treatment of enthesitis-related arthritis</h2> <p>ERA is treated with various types of medicine:</p> <ul> <li>Some medicine can improve symptoms of inflammation, helping to reduce pain and stiffness and improve movement in the joints.</li> <li>Some people with ERA need stronger medicine that suppresses the immune system and helps to control inflammation and prevent joint damage.</li> </ul> <p>Your child will be followed by a rheumatology team including doctors, nurses, physical therapists, social workers, dieticians and child life specialists. This team has a lot of experience treating children with ERA.</p> <p>For more information, please see <a href="/Article?contentid=1003&language=English">Juvenile enthesitis-related arthritis: Treatment</a>, <a href="/Article?contentid=14&language=English">Living with ERA</a>, <a href="/Article?contentid=1004&language=English">Exercises for enthesitis and arthritis</a> and <a href="/Article?contentid=15&language=English">Enthesitis-related arthritis: A guide for teenagers</a>.</p>https://assets.aboutkidshealth.ca/AKHAssets/Juvenile_enthesitis-related_arthritis.jpg



Human papillomavirus (HPV) vaccineHuman papillomavirus (HPV) vaccineHuman papillomavirus (HPV) vaccine: What you need to knowHEnglishPharmacyPre-teen (9-12 years);Teen (13-18 years)PelvisReproductive systemDrugs and SupplementsCaregivers Adult (19+)NAhttps://assets.aboutkidshealth.ca/AKHAssets/ICO_DrugA-Z.png2013-04-29T04:00:00ZElly Berger, BA, MD, FRCPC, FAAP, MHPE00765.000000000000Drugs (A-Z)Drug A-Z<p>Separate fact from fiction with up-to-date and accurate information on the human papillomavirus (HPV) vaccine.</p><p>The <a href="/Article?contentid=25&language=English">human papillomavirus (HPV)</a> is an infection that spreads through sexual intercourse and sexual contact. The HPV vaccine protects against the most common strains of the virus. <br></p><h2>How can the HPV vaccine help protect against HPV? </h2><p>Gardasil protects against four types of HPV: </p> <ul><li>HPV-16 and HPV-18, which cause about 70 percent of all cancers of the cervix</li><li>HPV-6 and HPV-11, which cause about 90 percent of all genital warts </li></ul><p>Gardasil can be prescribed to females between the ages of nine and 45. The vaccine is licensed for use in males age nine to 26. It offers protection against certain cancers of the penis, anus, head and neck. It also protects the partners of males who have had the vaccine. Unfortunately, the cost of the vaccine for boys is not yet funded by most public health programs. </p><p>Cervarix protects against HPV-16 and HPV-18. It is given to females between the ages of 10 and 25. </p><p>Both vaccines require three doses to be given over the course of six months (Cervarix is given at zero, one and six months; Gardasil is given at zero, two and six months). In Canada, one of the vaccines is given to females in school in Grade 4-8, depending on the province (see table below). </p><h2>Important facts about the HPV vaccine</h2><p>There are many common misconceptions about the HPV virus and vaccine. The correct information is provided below so that you have all the facts when discussing sexual health and the HPV vaccine with your child.</p><h3>The HPV vaccine is <em>not</em> a substitute for regular checkups </h3><p>The vaccine protects against some types of HPV that can potentially lead to cancers. Regular checkups with the doctor are still important. About 30% of cervical cancers will not be prevented by the vaccine because it does not cover all HPV strains. Women should continue to be screened for cervical cancer with pap smears, even after getting all three shots of either HPV vaccine. </p><h3>The vaccine <em>cannot </em>treat HPV infections or HPV-related disease </h3><p>HPV vaccine helps prevent HPV-related infections or disease but will not treat an infection. It is most effective in women who are not yet sexually active because they are less likely to have contracted an HPV infection. </p><h3>There is currently <em>no medical cure</em> for the HPV virus </h3><p>Once someone is infected it can take weeks to months before genital warts become apparent. Warts inside the vaginal or anal areas may not be obvious. Some home therapies and other treatments in the doctor's office can be used to treat warts, but none can completely eliminate the virus. Even if the warts disappear, the virus can remain and warts recur. When warts are treated it can take 8 months or longer for them to disappear. </p><h3>HPV vaccines <em>do not </em>protect against other sexually transmitted infections </h3><p>The HPV vaccine protects against genital warts, which is one type of sexually transmitted infection (STI). It cannot protect against all types of STIs, such as HIV, chlamydia, or gonorrhea. It is important to practice safe sex. Parents should advise teens on how to reduce their risk of contracting STIs.<br></p><h3>The HPV vaccine <em>will not</em> make your child more promiscuous </h3><p>There is no evidence that giving the vaccination will increase sexual activity. </p><p>The HPV vaccination is an opportunity for parents to discuss sex and health with their children. <a href="/Article?contentid=718&language=English">Parents should be talking about sex with their children </a>regularly. </p><p>Studies show that sex education does not increase sexual activity. In fact, sex education may decrease early sexual activity, especially if the message encourages delaying sex and having protected sex. </p><h2>Can sexually active females benefit from the vaccine? </h2> <p>The vaccines are most beneficial when given to girls before becoming sexually active. For this reason, doctors usually prescribe HPV vaccines to girls between the ages nine and 13. However, few sexually active women are infected with all types of HPV. For this reason, the vaccine can still help prevent infection and can be given to girls older than 14 years of age. A person with HPV usually has it for life. However, the vaccine can still help prevent recurrences. </p><h2>Is the vaccine protection long-lasting? </h2> <p>Studies show that people exhibit strong immunity against HPV. Scientists do not know exactly how long the vaccine protects again HPV because long-term studies have not been done, but protection is for at least five years. </p><h2>Are the HPV vaccines safe? </h2><p>Studies show both HPV vaccines are safe. For both vaccines, the most common side effect is soreness at the site of injection. This is temporary. </p><p>The only reason not to get the vaccine would be if you have had an allergic reaction to a previous dose of the vaccine or if you are pregnant. </p><p>The vaccines contain particles from part of the virus. They cannot infect you with HPV. The vaccines also do not contain any antibiotics or preservatives, such as mercury or thimerosal. Cervarix contains a new additive called (ASO4). According to Health Canada, ASO4 is safe. </p><p>For more information, visit <a href="http://healthycanadians.gc.ca/health-sante/sexual-sexuelle/hpv-vph-eng.php">Health Canada</a>. </p>
Obstructive sleep apneaObstructive sleep apneaObstructive sleep apneaOEnglishRespiratoryChild (0-12 years);Teen (13-18 years)NANasopharynxConditions and diseasesCaregivers Adult (19+)NAhttps://assets.aboutkidshealth.ca/akhassets/Tonsils_adenoid_MED_ILL_EN.jpg2017-08-02T04:00:00ZSuhail Al-Saleh, MBBS, MSc, FRCPC​9.0000000000000058.0000000000000774.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Sleep apnea is a condition that affects a child's breathing while they are sleeping. Learn about the causes, symptoms and diagnosis.</p> <br><h2>What is obstructive sleep apnea?</h2> <p>Paediatric obstructive sleep apnea (OSA), or sleep apnea, happens when a child's airway becomes partially or completely blocked while they are sleeping. The blockage of the airway can cause snoring, gasping, pauses in breathing and changes in the body's oxygen levels.</p> <p>Sleep apnea affects one to five children in 100. If your child snores, for example, it may not always be due to sleep apnea.</p><h2>Key points</h2> <ul> <li>Obstructive sleep apnea (OSA) occurs when a child’s airway becomes blocked while they are sleeping.</li> <li>Common causes of sleep apnea in children are larger than normal tonsils or enlarged adenoids. Other causes include excess body weight and weakness in the muscles involved in breathing.</li> <li>Nighttime symptoms of sleep apnea include snoring, breathing through the mouth and restless sleeping. Daytime symptoms include drowsiness, poor concentration and lack of energy.</li> <li>Sleep apnea is diagnosed through a sleep study. Treatment can include surgery, a weight loss program or positive airway pressure.</li> </ul><h2>Nighttime symptoms of obstructive sleep apnea</h2> <p>If your child has obstructive sleep apnea, you will recognize a number of signs while you watch them sleep. These may include:</p> <ul> <li>snoring – this may be continuous or with pauses or may only occur in certain body positions (for example while your child lies flat on the back) or during certain periods of sleep</li> <li>breathing only through the mouth </li> <li>restless sleep</li> <li>long pauses in breathing</li> <li>frequently waking up at night</li> <li><a href="/Article?contentid=799&language=English">sweating</a></li></ul> <p>When your child is experiencing restless sleep, they may be turning from side to side, jerking their legs or sitting up in an attempt to breathe better while still asleep.</p> <h2>Daytime symptoms of obstructive sleep apnea</h2> <p>Because your child is waking up many times during the night, they are not rested in the morning. As a result, they may have the following symptoms during the day:</p> <ul> <li>sleepiness, especially at school or during quiet activities</li> <li>learning difficulties</li> <li>poor concentration for homework</li> <li>lack of energy for sports and hobbies</li> <li>irritability, hyperactivity, impulsivity or aggression.</li> </ul><h2>What causes obstructive sleep apnea?</h2><p>Common causes of obstructive sleep apnea in children are larger than normal <a href="/Article?contentid=748&language=English">tonsils</a> or <a href="/Article?contentid=831&language=English">enlarged adenoids</a> at the back of the nasal passages (the airways behind the nose). Obstructive sleep apnea due to enlarged tonsils or adenoids commonly occurs in children aged two to eight years.</p><p>Other possible causes of obstructive sleep apnea include:</p><ul><li>a child being overweight or <a href="/Article?contentid=640&language=English">obese</a></li><li>weakness in the muscles involved in breathing, such as the diaphragm and muscles in the neck and around the ribs, such as in a neuromuscular disease (a disease that affects the nerves and muscles)</li><li>the shape and size of a child's skull and jaw</li><li>other health conditions that affect your child's airways or ability to breathe.</li></ul> <figure> <span class="asset-image-title">Tonsils and </span> <span class="asset-image-title"></span><span class="asset-image-title"></span><span class="asset-image-title"></span><span class="asset-image-title">adenoids</span><img src="https://assets.aboutkidshealth.ca/akhassets/Tonsils_adenoid_MED_ILL_EN.jpg" alt="" /><figcaption class="asset-image-caption">Common</figcaption><figcaption class="asset-image-caption"></figcaption><figcaption class="asset-image-caption"></figcaption><figcaption class="asset-image-caption"></figcaption><figcaption class="asset-image-caption"> causes of sleep apnea include enlarged adenoids or tonsils.</figcaption> </figure><h2>How is sleep apnea diagnosed in children?</h2> <p>Your health-care provider will usually refer your child to a sleep medicine specialist in the hospital. The sleep medicine specialist will meet with you to see if your child's symptoms need a closer look. If so, your child will come back to the hospital for a <a href="/Article?contentid=1287&language=English">sleep study</a>.</p> <p>This study is an overnight sleep "test" during which your child will have wires attached to their skin with paste and child-friendly tape. The wires do not hurt and are connected to a machine. As your child sleeps, the machine will record their oxygen level, breathing pattern, heart beat and sleep pattern. A sleep technologist will also observe your child during the study.</p> <p>Once the sleep study is over, a sleep respiratory therapist will study the recordings on the machine to identify the type of sleep problem your child has and how serious it is.</p><h2>How is obstructive sleep apnea treated?</h2> <p>Obstructive sleep apnea can be treated with:</p> <ul> <li><a href="/Article?contentid=1019&language=English">surgery to remove your child's tonsils and/or adenoids</a></li> <li>a weight loss program if your child is overweight or obese </li> <li>medicines to reduce swelling in the nasal passage or airway </li> <li>continuous <a href="/Article?contentid=977&language=English">positive airway pressure</a> therapy (commonly known as CPAP) </li> <li>reduced exposure to <a href="/Article?contentid=1963&language=English">second-hand tobacco smoke</a> and other indoor and outdoor forms of pollution</li> </ul> <p>If your child has other medical conditions that may affect or be affected by obstructive sleep apnea, the sleep medicine team may refer them to other specialists and clinics to make sure they get the best treatment.</p><h2>Why is it important to diagnose and treat obstructive sleep apnea?</h2><p>It is important to diagnose obsctructive sleep apnea early. If it is not treated, it can be linked to other health issues, such as:</p><ul><li>cardiovascular complications, including high <a href="/Article?contentid=1257&language=English">blood pressure</a></li><li>not growing well or gaining weight</li><li>learning difficulties at school</li><li>behavioural problems such as <a href="/Article?contentid=1922&language=English">hyperactivity</a> or inattention.</li></ul><h2>At SickKids</h2><p>The sleep medicine team at SickKids includes:</p><ul><li>a respirologist - a doctor specially trained to diagnose and manage sleep disorders in children</li><li>a nurse practitioner</li><li>a respiratory therapist</li><li>a sleep technologist</li><li> <a href="/Article?contentid=1153&language=English">a child life specialist</a></li></ul><p>Other members of the health care team, such as a <a href="/Article?contentid=1168&language=English">social worker</a> or a psychiatrist, may provide specialized care when needed.</p>
Regular eye exams for JIARegular eye exams for JIARegular eye exams for JIAREnglishRheumatology;OphthalmologyChild (0-12 years);Teen (13-18 years)EyesSkeletal systemTestsAdult (19+)NA2017-01-31T05:00:00ZJennifer Stinson RN-EC, PhD, CPNPLori Tucker, MDAdam Huber, MSc, MD, FRCPC7.0000000000000070.0000000000000464.000000000000Flat ContentHealth A-Z<p>If your child has JIA, regular eye exams are very important for detecting early signs of eye inflammation. Learn what happens during an eye exam.</p><p>Regular eye exams for JIA are important as many children and teens with JIA are at risk for uveitis, which can lead to other eye conditions such as cataracts or glaucoma.</p><h2>Key points</h2> <ul><li>Eye exams are important as eye inflammation (uveitis) usually occurs without any eye symptoms until it is too late.</li> <li>Eye inflammation can lead to cataracts and glaucoma.</li> <li>Various, painless tests will be conducted during the eye exam.</li></ul><h2>Why are eye exams important?</h2><p> <a href="/Article?contentid=1057&language=English">Eye inflammation</a> is called iritis or uveitis. It is another key feature of JIA. There is a high risk (approximately 20%) of eye inflammation among young people with oligoarticular JIA. The risk is highest among young girls who test positive on a blood test called an antinuclear antibody (ANA). However, eye inflammation can still occur in other types of JIA and in those who test negative for ANA.</p><p>Most importantly, eye inflammation usually occurs without any eye symptoms until it is too late. Eye inflammation can lead to other eye conditions such as cataracts or glaucoma. A cataract is when the lens of the eye becomes cloudy. Glaucoma is high pressure in the eye, and it also has no early symptoms.</p><p>This is why having regular eye exams with an eye doctor is important if for children and teens who have JIA.</p><h2>How are eye exams done?</h2><p>First, someone will test your child's vision.</p><p>Next, the eye doctor might put numbing drops in the eyes followed by some other drops. These drops will temporarily dilate the pupils of the eyes, which means the pupils will be larger. It will take 20 to 40 minutes for the drops to take effect, at which time your child's vision will be quite blurry and sensitive to light. These drops will give the eye doctor a clear view of the inside of the eye.</p><p>Another part of the eye exam is called a slit lamp exam. The eye doctor will use a machine called a slit lamp to look at the front parts of the eye. The slit-lamp is a type of microscope. It gives off a blue light. It allows the eye doctor to see any inflammation cells floating in the eye.</p><p>The slit lamp can also help the doctor find other complications such as cataracts or glaucoma. If your child is being tested for glaucoma, they will receive another set of eye drops that allows the eye doctor to test the pressure in the eye.</p><p>Other methods to check eye pressure include a machine that squeezes a puff of air into the eye or using a small hand-held device that looks like a pen, which gently touches the eye. These are painless tests due to the numbing drops they will have already received.</p><p>The entire eye exam is completely painless. Once the exam is over, your child can go home, but they will still have large pupils and blurry vision from the drops. They may also be sensitive to bright light due to the enlargement of the pupils. The blurry vision will last six or more hours. The effect on your child's pupil will last about 24 hours. Bring sunglasses for you child to wear on the way home.</p><p>The recommended frequency of eye checkups will be based on the type of JIA your child has, how long they have had JIA and the presence or absence of autoantibodies.</p>https://assets.aboutkidshealth.ca/AKHAssets/regular_eye_exams_for_JIA.jpg
Belly BonanzaBelly BonanzaBelly BonanzaBEnglishhttps://assets.aboutkidshealth.ca/AKHAssets/J4K_belly_Bonanza_promo.pngKids ContentKids<p>Follow the adventures of Blueberry and Green Pea to help your child learn how food travels through their digestive system.</p> <figure class="swf-asset-c-80"> <div class="akh-video">src="https://www.youtube.com/embed/BU-tzxqU0CA"</div></figure><br>belly-bonanza
Halloween safetyHalloween safetyHalloween safetyHEnglishPreventionChild (0-12 years);Teen (13-18 years)NANAHealthy living and preventionCaregivers Adult (19+)NA2013-10-08T04:00:00ZElly Berger, BA, MD, FRCPC, MHPE7.0000000000000071.0000000000000957.000000000000Flat ContentHealth A-Z<p>Halloween is a time for dressing up, eating candy, carving pumpkins and decorating homes. Learn how to make it safe as well as fun.<br></p><p>Halloween is a time when children get dressed up in costumes and roam their neighbourhoods in search of candy. It is a time for carving pumpkins and decorating your home with spider webs, bats and maybe a few tombstones. This can be a lot of fun, but can also create some safety issues.</p><h2>Key points</h2><ul><li>Make sure children can be seen. Use bright colours, reflective tape in costumes. Have children carry some sort of light such as a flashlight or glow stick.</li><li>Make sure children can see. Make sure hats, wigs and scarfs are secure and do not cover or slip over their eyes. Use not-toxic face paint or makeup instead of masks.</li><li>Make sure costumes fit properly and are not a tripping hazard.</li><li>Make sure children know how to cross the street safely.</li><li>Make sure children know not to eat any treats before you can inspect them.</li></ul><h2>Costumes</h2><p>Costumes should let your child see and be seen. They should also fit properly and not be able to cause harm to your child or anyone else.</p><ul><li>Make sure drivers can see your child. Ideally, use costumes with bright fabrics. Keep ninjas and assassins visible with reflective tape. </li><li>Give each child a flashlight or battery operated lantern to carry. Robots and wielders of magic wands can incorporate lights right into their costumes. Glow sticks are fun and can also make children more visible, but make sure they do not break, as the liquid inside them can irritate your child's skin and eyes.</li><li>Make sure your child can see. Masks can cut down on your child's range of vision. Instead use hypoallergenic, non-toxic face paint or makeup for your Lone Ranger or superhero. If your child's costume involves a hat, wig or scarf, fasten it securely so it will not slip over your child's eyes.</li><li>To prevent tripping, make sure shoes fit properly (sorry, clowns and scuba divers) and make sure the length of your child’s costume does not go below their ankles (sorry, wizards and witches).</li><li>Devils and dragons should not have real flames. Make sure your child's costume cannot catch fire easily. If you are buying a costume, look for a label with the words "flame resistant." Avoid costumes with loose sleeves, baggy pants and billowing skirts.</li><li>For obvious reasons, your musketeer's or pirate's sword, cutlass or dagger should not be sharp. Look for or make "weapons" in soft, flexible materials.</li></ul><h2>Trick-or-treating</h2><p>Supervise younger children when trick-or-treating. Make sure all children know the <a href="/Article?contentid=1955&language=English">rules for crossing the street safely</a>: </p><ul><li>Before crossing the street, stop and look left, right and straight ahead – then do it again.</li><li>Cross the street only at crosswalks or intersections. Do not cross between parked cars or other obstacles, such as giant pumpkins or tombstones. If you must cross at a spot with poor visibility, be extra careful about looking left, right and straight ahead before crossing. </li><li>Walk, do not run, from house to house, and stay on the sidewalk or at the side of the road facing traffic.</li><li>Rather than crossing and recrossing the street, go up one side of the street and down the other. Keep in mind that Halloween is exciting, and children may forget the rules they follow every day when walking to school.</li></ul><h3>Other trick-or-treating safety tips:</h3><ul><li>Young children should be supervised by an adult when trick-or-treating.</li><li>If not with an adult, older children should trick-or-treat in a group.</li><li>Children should stay in well-lit areas and should only visit homes that have their outside lights turned on. Children should not go inside homes. </li><li>Tell your children to bring their treats home before eating them so you can inspect them. Discard any treats without wrappers, or treats whose wrappers are damaged. </li></ul><h2>Halloween tips for children with food restrictions</h2><p>With some planning, even if your child has <a href="/Article?contentid=804&language=English">food allergies</a>, <a href="/Article?contentid=1718&language=English">diabetes</a> or other food restrictions, they should still be able to enjoy Halloween! Here are some tips: </p><ul><li>Try not to make treats the main focus of Halloween. Instead, focus on the fun of making a great costume, decorating the house and carving a pumpkin. You could throw a party, watch scary movies or go to a community activity such as a haunted house. </li><li>Talk to your child before they go out trick-or-treating and agree on some ground rules. For example, your child with food allergies could agree not to eat any candy until you look at it and say it is OK. </li><li>If your child has food allergies, carry their epinephrine auto-injector and some safe treats with you while trick-or-treating. Read the labels on treats before letting your child eat them. You may prefer to buy allergy-safe treats in advance and exchange the treats your child collected for treats you know are safe. </li><li>If your child has diabetes, they can still have some treats. Remember to build the carbohydrates into their meal plan and <a href="/Article?contentid=1724&language=English">check blood glucose</a> as usual. Talk to your diabetes nurse or dietitian for more ideas. You can also use low-fat candy such as lollipops or hard candy (but not chocolate) to treat low blood glucose all year round. </li><li>Exchange treats for small toys, stickers, temporary tattoos and other items your child will enjoy.</li></ul><h2>Jack-o'-lanterns and other home decorating</h2><ul><li>Obviously, you do not want your young child carving a pumpkin on their own. Share the job instead! Have young children draw the face on the pumpkin and scoop out the seeds, while older children or adults do the actual carving.</li><li>Make your home safe for trick-or-treaters: turn on your outside light and remove tripping hazards. </li><li>Be careful with candles. Keep them out of children's reach and away from anything that could catch fire. You can use small flashlights to light jack-o'-lanterns safely.</li></ul><h2>Driving</h2><p>Halloween means many children are out and about on the streets. If you do not need to be out, stay home and run errands another time. If you have to drive, try to avoid residential streets during prime trick-or-treating time (5:00 to 9:30 p.m.).</p><ul><li>Drive slowly in residential areas and check your speed often. </li><li>Watch for pedestrians on sidewalks, crossing streets and coming from between parked cars. Children will be excited and they move fast.</li><li>Take extra care when entering and exiting driveways and alleys.</li></ul><p>Have a safe and spooky Halloween!<br></p>https://assets.aboutkidshealth.ca/AKHAssets/halloween_safety.jpg

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