AboutKidsHealth is a health education website for children, youth and their caregivers.



Helmets: How to get your child to wear oneHelmets: How to get your child to wear oneHelmets: How to get your child to wear oneHEnglishPreventionChild (0-12 years);Teen (13-18 years)HeadNAHealthy living and preventionCaregivers Adult (19+)NAhttps://assets.aboutkidshealth.ca/akhassets/Helmet_safety_front_EQUIP_ILL_EN.jpg2022-07-13T04:00:00Z6.9000000000000073.6000000000000953.000000000000Health (A-Z) - ProcedureHealth A-Z<p>A step-by-step guide for parents on how to fit a safety helmet and encourage a child to wear one.</p><p>Making sure that your child always wears a helmet when they are cycling or playing particular sports is the best way to prevent head injuries. To do this, it is important to know how to fit a helmet correctly and teach your child why it is important to use a helmet for protection.</p><h2>Key points</h2> <ul> <li>A child's helmet should be centered on their head, over the forehead. It should not slip forward or back or from side to side.</li> <li>Always buy a helmet that is the right size for your child at the time you buy it. The front and back straps should meet just under the ear in a 'V' shape.</li> <li>Make sure the helmet is snug but not too tight. The strap under the chin should not be loose, but it should allow your child to open their mouth.</li> <li>Encourage your child to wear a helmet by wearing a helmet yourself and talking about why it is so important to protect their brain.</li> </ul><h2>How to get your child to wear a helmet</h2> <p>Your child's attitude can be a barrier to wearing a helmet, but it does not offer any protection against injury. Many children insist they do not need to wear a safely-fitted helmet. Some older children might worry about messing up their hair or might say that they do not need to wear a helmet because none of their friends do. However, there is a lot you can do to help your child commit to wearing a helmet.</p> <h3>Set a good example</h3> <p>As a parent, you are a role model to your children. Your actions could be your child’s best <a href="/Article?contentid=1984&language=English">protection against head injury</a>. Research shows that when parents wear a helmet, their children are more likely to want to wear one. Demonstrate the importance of wearing a helmet by wearing one every time you ride your bike. Most professional athletes use helmets when taking part in sports.</p> <h3>Start early and be consistent</h3> <p>Get your child used to wearing a helmet as soon as they start riding a tricycle or bicycle. If you allow your child to ride occasionally without a helmet, they will not believe that helmet use is really important. Helmets should be worn on all rides, no matter how short. Tell your child that they will not be able to use their bicycle unless they wear a helmet.</p> <h3>Talk to your child about why you want them to protect their head</h3> <p>Unlike your elbows or your ribs, your <a href="https://pie.med.utoronto.ca/htbw/module.html?module=brain-child">brain</a> is you. It stores everything you think, feel and experience. Children often do not fear death, but they may understand the dangers of their sport better if you discuss the loss of mental abilities that can come with repeated concussions. These can include learning difficulties, social problems and attention disorders. Even a single serious brain injury can have lifelong effects on a person's thoughts and emotions.</p> <h3>Demonstrate the importance of a helmet</h3> <p>As part of science class, many kids take part in the well-known "egg drop" experiment. Kids build a protective structure that allows a raw egg to survive a fall of almost two metres.</p> <p>If your child is working on a similar project, discuss how egg protection is very similar to head protection. You can also mention this to your child's teacher; it is a real opportunity to combine physics with health promotion.</p> <p>A small watermelon works well for the experiment too. Try dropping one from a height of two metres. Then drop another watermelon that is protected with a helmet. Your child will easily see benefits of helmets right away.</p><h2>How to fit a helmet correctly</h2><p>Helmets that do not fit or that are not fastened correctly are no help to the <a href="https://pie.med.utoronto.ca/htbw/module.html?module=brain-child" title="The Brain">brain</a>. Use the tips below to make sure that your child is wearing a helmet properly.</p><p>A helmet must not slip forward or back. The frontal lobes, a part of the front of the brain that is important for memory and decision-making, and occipital lobes, a crucial vision centre at the back of the brain, need protection. This can only be achieved when the helmet is centred on your child's head.</p> <figure class="asset-c-100"><img src="https://assets.aboutkidshealth.ca/akhassets/Helmet_safety_side_EQUIP_ILL_EN.jpg" alt="Correct helmet position and incorrect helmet position" /><figcaption class="asset-image-caption">Make sure that the helmet is level at the front and back, it should not be tilted back on an angle. Adjust the straps so the helmet fits securely.</figcaption> </figure> <p>The helmet must fit snugly, but not tightly and not sit too high on the head. It should cover the forehead and must not slip from side to side. The straps from the front and back of the helmet should form a 'V' around the ears and meet just under the ear. When fastened, the helmet straps should allow the mouth to open to drink or shout, but the strap under the chin must not be loose.</p> <figure class="asset-c-100"><img src="https://assets.aboutkidshealth.ca/akhassets/Helmet_safety_front_EQUIP_ILL_EN.jpg" alt="Checking helmet fit" /><figcaption class="asset-image-caption">Check to make sure the helmet is secure and fits snugly.</figcaption> </figure> <p>Do not buy a large helmet and let your child grow into it. Make sure that the helmet fits perfectly at the time you buy it. You can adjust the fit for comfort using the small foam pads included with the helmet.</p><p>Take a look at this video for more tips.</p><div class="asset-video"> <iframe src="https://www.youtube.com/embed/Zie-UrMfMKk?rel=0"></iframe> </div><p>Your child should not wear anything under the helmet, such as a hat. Helmets are designed to provide the most effective protection from head injuries when they are worn directly next to the head. If you are concerned about keeping your child warm during the winter, you can buy helmets with outer warmth protection that help keep children's heads warm during activities.</p>helmetsafetyhelmetsafetyHow to get your child to wear a helmetMain
Water safety and drowning preventionWater safety and drowning preventionWater safety and drowning preventionWEnglishPreventionChild (0-12 years);Teen (13-18 years)NANAHealthy living and preventionCaregivers Adult (19+)NA2020-11-09T05:00:00Z7.0000000000000072.30000000000001552.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Learn how to keep children safe in or around water.</p><p>Timing is critical when it comes to saving your baby or your child from a near-drowning (submersion) episode. If enough oxygen is not being delivered to the brain, severe damage can occur within a few minutes. If your child's heart has stopped beating for more than eight to 10 minutes, their chances of surviving are greatly reduced.<br></p><div class="asset-video"> <iframe src="https://www.youtube.com/embed/CI1BvnNEQNY" frameborder="0"></iframe><br> <p>For more videos from SickKids experts in collaboration with Youngster, visit <a href="https://www.youtube.com/channel/UCoKMd2cYwegtZX19uHdNLQA">Youngster on YouTube</a>.</p></div><h2>Where can drowning happen?</h2><p>Drowning can happen in as little as 20 seconds, even in shallow water that is only inches deep. Most drowning or near-drowning cases happen in backyard pools, bathtubs and inflatable pools. Natural bodies of water, toilets and drainage sites are other places where drowning can occur. Always supervise children near any water and keep young children within arm's reach.</p><h2>Key points</h2><ul><li>Drowning can occur in as little as 20 seconds.</li><li>Most accidents happen when swimming, boating or bathing in the bathtub.</li><li>Always supervise children near any water and keep young children within arm's reach.</li><li>Do not put your life at risk trying to save your child. If you must enter the water to perform a rescue, bring a flotation device with you.</li><li>If your child is unconscious and not breathing, have someone call 911 and get an AED right away.</li><li>After a drowning episode, see a doctor if your child develops fever or difficulty breathing.</li></ul><h2>How can you tell if your baby or your child is drowning?<br></h2><p>Be sure to monitor your child at all times when they are in, or near, water. Watch for signs of drowning because a child in distress will be <strong>unable</strong> to yell for help.</p><h3>Signs of drowning</h3><ul><li>head tilted back with mouth open</li><li>floating face down</li><li>gasping for air</li></ul><h2>Rescue</h2><h3>Avoid putting yourself at risk trying to save your child</h3><p>You should not put your life in danger trying to rescue your baby or your child. If your only option is to enter the water, bring a flotation device with you. This can be a life-jacket or even a pool noodle. </p><h3>CPR</h3><p>CPR stands for cardiopulmonary resuscitation. CPR is an emergency procedure that involves a combination of chest compressions and rescue breaths (mouth-to-mouth resuscitation). <a href="/Article?contentid=1044&language=English">CPR given to a baby</a> younger than 12 months of age is different from <a href="/Article?contentid=1041&language=English">CPR given to an older child</a>.</p><p>Once you are safely out of the water and if your child is not responsive, not breathing or only gasping, call for help and begin CPR right away.</p><h2>Assess your child’s state</h2><h3>Checking for alertness and injuries </h3><p>Check to see if <strong>your baby</strong> is responsive by rubbing their back, flicking their feet and calling their name.</p><p>Check to see if <strong>your child</strong> is responsive by tapping them on the shoulder and asking loudly, "Are you OK?"</p><ul><li>If you get an answer or a physical response, quickly check to see if they have any injuries. If they need medical attention, have someone call 911 right away.</li><li>If you get no answer or physical response, shout for help, ask someone to call 911 and have them get an AED (automated external defibrillator) right away, if available, while you begin CPR. If you are alone, call 911 from a cell phone that you can put on speaker and begin CPR.</li></ul><h3>Check for breathing</h3><p>Check for normal breathing (no gasping) by watching your child's chest for any movement. If you are alone, make sure your child is breathing normally before you leave to call 911. Carry your baby with you to make the call.</p><h2>Swimming safety</h2><h3>Backyard swimming pools</h3><p>If you have a backyard swimming pool, check to make sure that it follows local by-laws. Make sure a fence surrounds the pool on all sides. The pool should be completely fenced-in if a child could otherwise exit the house through sliding doors and directly enter the pool unsupervised.</p><p>A pool fence should to be 1.2 metres (4 feet) high and have a self-latching gate. The latch should be out of your child's reach so they cannot open it on their own. Keep toys and furniture away from the pool fence to prevent children from climbing over it to get into the pool.</p><p>If any door in the house leads directly to the pool, it should close by itself and have a lock that a child cannot reach and open. The pool should always have a safety cover over it when it is not in use.</p><h3>Other pool safety tips</h3><ul><li>Always have an adult watching children in the pool. This adult should know basic life-saving skills and cardiopulmonary resuscitation (CPR) for a baby and a child.</li><li>Keep life-saving equipment, such as a safety ring with a rope, near the pool.</li><li>Enrol children in swimming and water safety lessons by the time they are age four. Water safety programs for adults and younger children are also a good idea.</li><li>Even if your child has taken swimming lessons, have an adult watch them closely in and around water.</li><li>Children can drown in seconds; do not turn away to answer the phone or focus on something else. Do not assume that a child in trouble will be able to make noise to alert you.</li><li>Always check the pool first if a child is missing.</li></ul><h3>Lakes and rivers</h3><p>Because lakes and rivers are not fenced in, it is even more important to watch children closely when at the cottage or the beach. Remember these safety tips.</p><ul><li>Give your children your full attention. Make sure they know to always tell an adult before they go swimming. Young children should always be supervised when playing in or around water.</li><li>Children under the age of three or children who cannot swim should wear a life jacket or personal flotation device (PFD) in or around water. Young children should always be within arm's reach.</li><li>Put children on a buddy system so that if one is in trouble the other can call for help.</li><li>Make sure children swim close to shore. They should be able to see you at all times.</li><li>Teach young children how to swim or play within arm's reach.</li><li>Swim at supervised waterfronts and beaches.</li><li>Choose a safe place to swim. Check for hazards on the beach and in the water, including water pollution levels.</li><li>Watch for boats and jet skis while swimming.</li></ul><h2>Boating safety</h2><p>By law, boaters must have life jackets or PFDs for each person aboard the boat. Life jackets offer a higher level of protection, but PFDs may be less bulky and more comfortable.</p><p>No matter which option you choose, it must be the right size, fit properly and be in good condition. If you want your child to wear a life jacket or PFD, set a good example and do the same.</p><p>Pay special attention to your children's PFD. Each one should be chosen according to your child's size and weight, have a collar to keep their head up in the water, a handle on the collar to lift them and a safety strap so the PFD does not slide up over the head.</p><h3>Other boating safety tips</h3><ul><li>Do not rock the boat. Move slowly when you enter the boat because it could tip over, or tip you out, if you are not careful.</li><li>Remind children to keep their arms, legs and head inside the boat at all times.</li><li>At least one adult should be able to see the child at all times to make sure the child does not fall into the water. Even if the water is shallow, it might be in a rocky area.</li><li>If sleeping on the boat, make sure young children cannot open a door or window and get outside unsupervised.</li></ul><h2>Bath time</h2><p>Drowning can even happen in a bathtub. This is because very young children do not have the motor skills to lift their heads above water or get themselves out of the water if they are in danger. Small children can even drown in water that is just a few centimetres deep.</p><p>Once an infant is in the tub, pay full attention to them. Do not turn your back or rely on another child to watch them.</p><p>Lock the door to the bathroom to prevent a child from entering and getting into dangerous situations there. For example, they may attempt to run a bath on their own in the same way they have seen a parent do it.</p><p>Many parents use bathing aids such as bath seats or rings to free up their hands to wash their baby. These plastic seats use suction cups to attach to the bottom of the tub and are designed to secure an infant until they can sit up unassisted. Although a bath seat can be convenient, it is not a safety device. Never leave an infant unattended while they are placed in one.</p><p>Whether or not you use a bath seat, children in the tub should be within arm's reach at all times and should not be left alone even for a second.</p><h2>When to call a doctor</h2><p>Get medical attention right away if you see any of these signs in your baby or your child:</p><ul><li>persistent coughing</li><li>difficulty breathing</li><li>blue colour on skin and lips</li><li>loss of consciousness (fainting)</li><li>fever</li><li>being moody or very sleepy</li></ul>watersafetywatersafetyhttps://assets.aboutkidshealth.ca/AKHAssets/water_safety_and_drowning_prevention.jpg Did you know drowning can occur in as little as 20 seconds? Learn how to keep children safe in or around water. Main
Poison ivyPoison ivyPoison ivyPEnglishDermatologyChild (0-12 years);Teen (13-18 years)SkinSkinConditions and diseasesCaregivers Adult (19+)Rash2022-07-13T04:00:00Z6.1000000000000075.6000000000000801.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Learn how to recognize a poison ivy plant, prevent rashes and how to treat the rash if your child is exposed.</p><p>Poison ivy is a plant that grows at sea level and can be found in every province in Canada, except Newfoundland. It can cause a rash when it makes contact with the skin (contact dermatitis). The rash occurs when the skin reacts to substances in the oily sap (called urushiol) in the plant's roots, stems and leaves.<br></p><h2>What does the poison ivy plant look like?<br></h2><p>Poison ivy usually grows up large tree trunks as a shrub or as a vine.</p><ul><li>Each leaf has three leaflets that can be either shiny, smooth and hairless, or rough, hairy and velvety.</li><li>The leaves are reddish in the spring, green in the summer and yellow, orange or red in the fall.</li><li>The plant may have yellow-green flowers, or green or off-white berries.</li></ul> <figure class="asset-c-80"> <span class="asset-image-title">Poison ivy</span><img src="https://assets.aboutkidshealth.ca/akhassets/Poison_ivy_seasons_EQUIP_ILL_EN.png" alt="Poison ivy with green leaves in summer, green and red leaves in spring, and a mix of green, yellow and red leaves in fall" /></figure><h2>Key points</h2><ul><li>Poison ivy is a plant that can cause a rash when it makes contact with the skin.<br></li><li>Each leaf has three leaflets that can be shiny, smooth and hairless, or rough, hairy and velvety.</li><li>The rash is caused by oily sap in the plant's roots, stems and leaves.<br></li><li>To prevent poison ivy rash, stay away from the plant and wear protective clothing. A helpful rule for avoiding poison ivy is "leaves of three, leave them be".</li><li>Wash exposed skin and clothing thoroughly. This may help to prevent a reaction.</li><li>The rash should go away after a few weeks. Mild rashes can be treated with antihistamines. Very severe rashes might require steroids.</li><li>See your doctor if your child develops a <a href="/article?contentid=30&language=English">fever</a> or if the area around the rash becomes redder or swollen or has a milky discharge.</li></ul><h2>Signs and symptoms of a poison ivy rash</h2><p>The symptoms of a poison ivy rash may include:</p><ul><li>redness</li><li>extreme itching</li><li> <a href="/Article?contentid=789&language=English">hives</a></li><li>swelling</li><li>small or large blisters, often forming a line or streak</li><li>crusting skin</li></ul><p>The typical rash can last from one to three weeks.<br></p><p>The rash usually occurs on skin surfaces that are exposed directly to poison ivy. People can also be exposed to poison ivy's oily sap through indirect contact, including:</p><ul><li>scratching or rubbing, which moves the sap to other skin areas</li><li>contact with clothing, a pet, tools, sports equipment or other things that may have come into contact with the plant.</li></ul><p>If poison ivy is burned, the sap can cling to smoke particles and become airborne. This can cause reactions involving the skin, the eyes or the <a href="https://pie.med.utoronto.ca/htbw/module.html?module=lung-child">lungs</a>.</p><h2>How to treat a poison ivy rash</h2><h3>Mild rash</h3><ul><li>Place cool cloths on your child's skin.</li><li>Have your child take cool showers or lukewarm baths.</li><li>Give your child an antihistamine.</li></ul><p>Try not to let your child scratch. This can cause infection and scarring and may spread the sap to other parts of the body. If the rash is very severe, your child may need to take steroid medication by mouth.</p><p>Reactions may vary from person to person. Some people may not react to poison ivy at all, while others may have a very severe reaction.</p><h3>Signs of a serious reaction to poison ivy<br></h3><p>Your child has a serious reaction if:</p><ul><li>nothing helps to ease the itch</li><li>the skin around the rash seems to be infected</li><li>they develop a <a href="/article?contentid=30&language=English">fever</a></li><li>the rash appears on their eyelids, lips, face or genitals</li><li>their face swells</li></ul><h2>How to prevent a poison ivy rash</h2> <p>The best way to prevent a rash is to avoid contact with the plant by learning to recognize it. A helpful rule for avoiding poison ivy is "leaves of three, leave them be".</p> <h3>What to do if your child cannot avoid an area where poison ivy may be present</h3> <ul> <li>Apply a product to their skin that helps prevent the skin from absorbing the plant's sap. These products are available over the counter and usually contain bentoquatam.</li> <li>Have your child wear clothing such as pants, long sleeves, boots and gloves when they are around poison ivy. Depending on your child's age, help them or remind them to remove exposed clothing carefully.</li> </ul> <p>Poison ivy sap can remain active for a long time. For this reason, use hot, soapy water to wash your child's clothing, shoes and anything else that may have made contact with the plant.</p> <p>If your child touches poison ivy, it is possible to prevent a rash by:</p> <ul> <li>washing their skin well with warm water and soap</li> <li>washing everything that may have sap on it.</li> </ul><h2>When to see a doctor</h2><p>See a doctor if your child:</p><ul><li>develops a <a href="/Article?contentid=801&language=English">skin infection</a> (increasing redness, swelling, pain or a milky discharge from the irritated areas)</li><li>is not responding to any of the treatments for a mild rash.</li></ul><p>Take your child to your nearest hospital emergency department right away if they are having trouble breathing or swallowing.</p><img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/poison_ivy.jpg" style="BORDER:0px solid;" />poisonivypoisonivyhttps://assets.aboutkidshealth.ca/AKHAssets/poison_ivy.jpg Do you know what poison ivy looks like? Learn how to recognize a poison ivy plant and how to treat the rash if your child is exposed. Main
Sex, gender and sexual orientation: An overviewSex, gender and sexual orientation: An overviewSex, gender and sexual orientation: An overviewSEnglishAdolescentTeen (13-18 years)NANASupport, services and resourcesAdult (19+) CaregiversNAhttps://assets.aboutkidshealth.ca/AKHAssets/Gender_Stick_Person.jpg2021-07-30T04:00:00Z10.200000000000046.30000000000001258.00000000000Flat ContentHealth A-Z<p>It is common for people to confuse sex, gender and sexual orientation, but they are all different things. Read more to better understand the complete story of who your child is on the inside and how they want to present to the world.</p><h2>What is gender?</h2><p>Traditionally, gender has been defined as being either one of the two sexes: male or female. But gender is actually a much broader concept. There is a lot more to gender than the sex your child was assigned at birth, and it does not tell the complete story of who they are.</p><h2>Key points</h2><ul><li>There are four main concepts of identity to understand, and each one is distinct: sex, gender identity, gender expression and sexual orientation.</li><li>Sex is determined by biological features including chromosomes, hormones, internal reproductive organs and external sexual anatomy.</li><li>Gender identity is how you feel about your gender on the inside as a woman, a man, both, in between or something else.<br></li><li>Gender expression is how you demonstrate your gender to the world, and it may match traditional gender norms or may differ from those norms.</li><li>Sexual orientation is who you are attracted to, sexually and romantically (emotionally).</li></ul><h2>Identity</h2><p>It is common for people to confuse sex, gender and even sexual orientation, but they are all different things. Each category exists independently and has its own spectrums. It can be helpful to visualize these concepts through the illustration below.</p> <figure class="asset-c-80"> <img src="https://assets.aboutkidshealth.ca/AKHAssets/Gender_Stick_Person.jpg" alt="A grey stick person with gender identity at the head, sex at the groin, sexual orientation at the heart and gender expression all encompassing." /></figure> <h2>What is sex?</h2><p>Sex is determined by biological features including chromosomes (e.g., XX, XY), hormones (e.g., estrogen, progesterone, testosterone), internal reproductive organs (e.g., uterus, vagina, prostate) and external sexual anatomy (e.g., vulva, penis, testicles). People are usually assigned male or female at birth and this marker goes on legal documents such as a birth certificate.</p><h3>What does it mean to be intersex?</h3><p>Intersex is a term that describes someone who is born with or develops reproductive or sexual anatomy that doesn’t seem to fit the typical definitions of female or male. One example of an intersex person might be someone who has androgen insensitivity syndrome (AIS). When a person has AIS, their body is resistant to certain sex hormones and can develop differently than what would be expected for the chromosomes that person was born with.</p><p>Some people who are intersex will choose to self-identify as intersex and some will adopt a gender identity that best reflects how they feel on the inside.</p><h2>What is gender identity?</h2><p>Gender identity is how you feel about your gender on the inside. It is the psychological sense of feeling like a woman, a man, both, in between or something else. Your child's gender identity is something that they come to understand for themself. The most common gender identity is cisgender – someone who feels their gender identity matches their assigned sex at birth – but there are many other recognized gender identities. These include, but are not limited to, the following:</p><ul><li>Agender – someone who identifies as having no gender</li><li>Bigender – someone who identifies as having two full genders</li><li>Gender creative – children who identify and express their gender in ways that are different than what society/cultures expect</li><li>Gender fluid – someone who sees their gender as changeable</li><li>Genderqueer – someone who does not conform to society’s expectations for their gender roles or gender expression</li><li>Non-binary –someone whose gender identity is neither male nor female</li><li>Pangender – someone who identifies with multiple and/or all genders</li><li>Trans or transgender – someone whose gender identity differs from their assigned sex at birth</li><li>Two-spirit – a term used by some Indigenous communities to describe the sexual and gender diversity in Indigenous cultures</li></ul><p>Most children by the age of three are aware of their own gender, although it is okay to question their gender identity as they grow older. The formation of identity can be influenced by biological sex, hormones and the environment. Identity can also shift and evolve over time.</p><h2>What is gender expression?</h2><p>Gender expression is how you present to the world. It is the way you demonstrate who you are, and it can match traditional gender norms but does not have to. Gender expression can be motivated by gender identity, sexuality, mood and many other things (e.g., needing to wear a uniform for work or a costume for a performance).</p><p>Your child can demonstrate their gender through their name, pronoun choice, clothing, voice, hairstyle and the ways that they act and interact with others (intentionally or unintentionally). Gender expression is most commonly classified as either masculine, feminine or androgynous, which has elements of both masculinity and femininity. The ways gender is communicated is flexible and may change depending on the day or setting:</p><ul><li>Your child may wear an androgynous uniform at work and wear bright feminine colours at home.</li><li>They might keep their hair neat and short during the day and wear fun wigs at night.</li><li>They may have a deep masculine voice when they are sad and moody, but use a higher-pitched feminine tone when they are feeling giddy and excited.</li></ul><h3>What are gender norms?</h3><p>Gender expression is something that is interpreted by others around you based on the traditional gender norms of your society and culture. Gender norms are the expectations that your society traditionally has for women and men (e.g., men wear pants; women wear dresses). These can include expectations about how each gender should:</p><ul><li>be classified, identified and treated under the law</li><li>speak and be spoken to</li><li>perform their respective gender roles</li><li>dress or wear their hair</li><li>play with toys and engage in sports activities</li><li>form relationships and families</li><li>be educated and which industries they should work within</li></ul><p>There are many different norms for gender expression, and they vary by culture, generation, region, and between communities and peer groups. Because gender expression and norms are constantly changing, it is important to remember that there is no one “right” way to demonstrate gender. Your child's gender expression is their choice.</p><h2>What is sexual orientation?</h2><p>Sexual orientation is who you are attracted to, sexually and/or romantically. Sexual attraction is the desire to have sexual contact with someone, while romantic attraction is the desire for emotional relationships and intimacy. The label of your child's sexual identity will usually describe the relationship between their gender identity and the gender identities of the people they are attracted to. The most common sexual orientation is straight – someone who is primarily attracted to the opposite gender – but there are many other recognized sexual orientations. These include, but are not limited to, the following:</p><ul><li>Gay – a male who is attracted to males</li><li>Lesbian – a female who is attracted to females</li><li>Bisexual – a male or female who is attracted to both males and females (not always equally or at the same time)</li><li>Pansexual – someone who is attracted to people of any gender</li><li>Asexual – someone who is not sexually attracted to any gender</li><ul><li>Some asexual people experience romantic attraction, and others do not</li></ul><li>Queer – a general term for someone who is not straight</li></ul><p>If your child's sexual orientation is not straight, they may identify as belonging to the “queer community” or the LGBTQ2S+ community. LGBTQ2S+ stands for lesbian, gay, bisexual, transgender, queer/questioning and two-spirit; and the plus indicates that nobody is left out.</p><h2>Resources<br></h2><p></p><h3>AboutKidsHealth Teens</h3><p> <strong> <a href="https://teens.aboutkidshealth.ca/adolescenthealth">Adolescent Health Learning Hub</a> - </strong><a href="https://teens.aboutkidshealth.ca/Article?contentid=3953&language=English&hub=gender#adolescenthealth">Sex, gender and sexual orientation</a>. Share this article with your child so they can learn more about sex, gender and sexual orientation.</p><p>Killermann, S (2015, March 27). Breaking through the Binary. Retrieved from <a href="https://www.genderbread.org/wp-content/uploads/2017/02/Breaking-through-the-Binary-by-Sam-Killermann.pdf">https://www.genderbread.org/wp-content/uploads/2017/02/Breaking-through-the-Binary-by-Sam-Killermann.pdf</a>.</p><p>Exploring Gender Diversity. <em>Trans Care BC</em>. Retrieved from <a href="http://www.phsa.ca/transcarebc/Documents/HealthProf/Exploring_Gender_Diversity.pdf">http://www.phsa.ca/transcarebc/Documents/HealthProf/Exploring_Gender_Diversity.pdf</a>.</p><p>Gender. <em>Trans Care BC</em>. Retrieved from <a href="http://www.phsa.ca/transcarebc/trans-basics/gender">http://www.phsa.ca/transcarebc/trans-basics/gender</a>.</p><p>Sex&U. <em>The Society of Obstetricians and Gynaecologists of Canada</em>. Retrieved from <a href="https://www.sexandu.ca/">https://www.sexandu.ca/</a>.</p><p>Sexual Orientation. <em>HealthLinkBC</em>. Retrieved from <a href="https://www.healthlinkbc.ca/health-topics/abj9152">https://www.healthlinkbc.ca/health-topics/abj9152</a>.</p><p>What is intersex? <em>interACT: Advocates for Intersex Youth</em>. Retrieved from <a href="https://interactadvocates.org/">https://interactadvocates.org/</a>.</p>Sex, gender, and sexual orientation Learn about the main concepts of identity including sex, gender and sexual orientation, and what each of these represents. Main
Sickle cell disease: OverviewSickle cell disease: OverviewSickle cell disease: OverviewSEnglishHaematologyChild (0-12 years);Teen (13-18 years)BodyCardiovascular systemConditions and diseasesCaregivers Adult (19+)NAhttps://assets.aboutkidshealth.ca/akhassets/Sickle_cell_vaso_occlusion_MED_ILL_EN.png2023-04-18T04:00:00Z8.5000000000000060.1000000000000978.000000000000Health (A-Z) - ConditionsHealth A-Z<p>An easy-to-understand overview of sickle cell disease for parents.</p><h2>What is sickle cell disease (SCD)?</h2><p>Sickle cell disease (SCD) is an inherited blood disorder. It is not contagious. Most children with SCD are of African ancestry, but children of Middle Eastern, Mediterranean and South Asian ancestry are also affected.<br></p> <figure class="asset-c-80"> <span class="asset-image-title">Sickle cell shape</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Sickle_cell_comparison_MED_ILL_EN.png" alt="A red blood cell with normal hemoglobin molecules and a sickled red blood cell with abnormal hemoglobin molecules" /> <figcaption class="asset-image-caption">Red blood cells carry a protein called hemoglobin, which brings oxygen to all the parts of the body. People with sickle cell disease carry sickle-shaped hemoglobin cells that tend to get stuck in the smaller blood vessels.</figcaption> </figure><h2>Key points</h2><ul><li>Sickle cell disease (SCD) is an inherited blood disorder.</li><li>The two main characteristics of SCD are long-term anemia and recurrent episodes of vaso-occlusion.</li><li>Anemia is a result of increased breakdown of red blood cells. Children may appear pale and have yellow eyes from time to time.</li><li>Vaso-occlusive episodes are blockages of the blood vessels by deformed red blood cells.</li><li>Infection, fatigue and dehydration are possible triggers for a pain crisis.</li><li>Do not use ice packs to treat pain.</li></ul><h2>Signs and symptoms of sickle cell disease</h2><p>The two main characteristics of SCD are a long-standing <a href="/Article?contentid=841&language=English">anemia</a> and recurrent episodes of vaso-occlusion:</p><ul><li> <strong>Anemia</strong> is caused by a lack of either hemoglobin or red blood cells in the body. When this happens not enough oxygen gets delivered to the body and can cause paleness, tiredness or fatigue, and weakness. For example, your child may become tired sooner than their peers when doing an activity. Sickle-shaped cells do not live as long as normal red blood cells. They die faster resulting in an increased breakdown of red blood cells. The liver sometimes cannot keep up with filtering all the broken-down cells and the bilirubin from the broken-down cells can build up in the system making the whites of the eyes appear yellow from time to time.</li><li> <strong>Vaso-occlusive episodes</strong> are blockages of the blood vessels anywhere in the body caused by deformed red blood cells. Sickle-shaped red blood cells cannot flow through the body as well as normal red blood cells leading to blockages and a lack of oxygen in the affected area of the body. Symptoms depend on where the blood vessels are blocked. If a blood vessel going to the brain is blocked, then there will be symptoms of a stroke, such as weakness on one side of the body. If the blood vessel going to a leg bone is blocked, then there will be pain in the leg.</li></ul> <figure class="asset-c-80"> <span class="asset-image-title">Vaso-occlusion in sickle cell disease</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Sickle_cell_vaso_occlusion_MED_ILL_EN.png" alt="Normal blood flow with healthy red blood cells compared to blocked blood flow from sickled red blood cells" /> <figcaption class="asset-image-caption">Healthy red blood cells are soft, round and flexible. Sickled red blood cells are sticky and hard and can block blood flow.</figcaption> </figure> <h3>Pain crises</h3><p>The most common symptom of a vaso-occlusive episode is bone pain. Any bone can be affected, including the arms, legs, back and skull. These episodes, commonly called pain crises, are unpredictable. Some children feel unwell before the actual onset of pain and can let an adult know.</p><p>Possible triggers for a pain crisis include:</p><ul><li>infection</li><li>stress/fatigue</li><li>dehydration</li><li>exposure to cold and very hot temperatures</li></ul><p>Some pain crises happen without a known reason.</p><h3>Preventing pain crises</h3><p>You can help prevent a pain episode by:</p><ul><li>Giving your child lots of fluids to drink so they are not thirsty.</li><li>Dressing your child in a few layers of warm clothing in the winter when they are leaving home.</li><li>Sending an extra sweatshirt and socks to school with your child in case they become wet during recess or at any other time.</li><li>Recognizing fever as a sign of infection and having your child seen immediately by a doctor.</li><li>Making sure your child avoids vigorous exercise without the ability to take breaks and drink fluids, especially during hot days.</li></ul><p>Even with these measures, though, children may still have a pain crisis.</p><h2>Treatment</h2><p>See Sickle cell disease: Treatment to understand what to do if your child with sickle cell disease is unwell. Find information about:</p><ul><li>Temperature</li><li>Pain assessment</li><li>Pain management</li><ul><li>Medications</li><li>Physical strategies</li><li>Psychological strategies</li></ul></ul><p>With SCD, the spleen function is not as good at destroying the cell coating of some bacteria. If your child is under the age of five, they should be on preventative antibiotics. Also, they should be receiving additional vaccinations to prevent infections caused by the pneumococcal and meningococcal bacteria.</p><p>Fever in a child with SCD is considered an emergency and requires prompt treatment with antibiotics. Fever is a sign of infection.</p><p>A thermometer must be available at home for assessing the temperature of your child if they are feeling unwell. A temperature higher than 38°C under the arm and higher than 38.5°C by mouth requires that they be seen promptly at an emergency department.</p><p>Medicines such as acetaminophen and ibuprofen will reduce fever but will not affect the infection that is causing the fever. Using them can lead to a false sense of security or to the fever not being taken seriously. Do not give your child these medicines to treat a fever.</p><h2>Fluid requirements for children with sickle cell disease</h2><p>Children with SCD excrete higher volumes of urine compared with their peers because their kidneys cannot concentrate urine.</p><p>Correspondingly, when a child produces more urine than usual, they must also increase their fluid intake. This is particularly important in SCD, as dehydration can trigger pain crises. When a child with SCD is dehydrated, blood cells also become dehydrated and change shape, causing blood vessel blockage and acute pain. Make sure your child has easy access to water at all times.</p> <h2>Special situations where parents should call 9-1-1</h2> <p>If any of the following occurs, call 9-1-1 right away:</p> <ul> <li>difficulty breathing</li> <li>loss of consciousness</li> <li>severe headache</li> <li>difficulty speaking or slurring of speech</li> <li>weakness of limbs</li> <li>seizure activity</li> <li>fever greater than 39°C</li> <li>unexplained lethargy/sleepiness</li> <li>persistent vomiting</li> <li>recognition of an enlarged spleen</li> </ul> Sickle cell disease is an inherited blood disorder. Learn about the signs and symptoms, potential treatments and when to call 911. Main



Diarrhea in childrenDiarrhea in childrenDiarrhea in childrenDEnglishGastrointestinalChild (0-12 years);Teen (13-18 years)Large Intestine/ColonLarge intestine;RectumConditions and diseasesAdult (19+)Diarrhea2019-10-30T04:00:00Z8.1000000000000059.10000000000001120.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Diarrhea causes frequent, loose bowel movements. Read about the causes of diarrhea in babies and children, how to take care of them, and how to prevent dehydration.</p> <h2>What is diarrhea?</h2><p>Diarrhea is when your child has watery stool that is more frequent than their usual number of stools. There are many different causes of diarrhea. In children, it is most often caused by a virus that infects the lining of the intestines, called <a href="https://www.aboutkidshealth.ca/Article?contentid=907&language=English">gastroenteritis</a>. Other causes include bacterial infections, parasitic infections, food poisoning or medications such as antibiotics. Diarrhea caused by antibiotics is known as <a href="/Article?contentid=820&language=English">antibiotic-associated diarrhea</a>. Diarrhea is also caused by medical conditions that affect how food is absorbed from the intestines.<br></p><p>During the first few months of life, it is normal for many breastfed babies to have bowel movements with very loose stool. This is unlikely diarrhea.</p><h2>Key points</h2> <ul> <li>Diarrhea is frequent bowel movements and loose or watery stool. </li> <li>Diarrhea can cause dehydration.</li> <li>Signs of dehydration include dry mouth, sunken eyes, not peeing often and low energy. </li> <li>When your child has diarrhea, continue with their regular diet. Give plenty of fluids.</li> <li>If your child is a baby check with the doctor about giving certain fluids. </li> <li>Talk to your doctor before giving your child an oral rehydration solution to prevent dehydration. </li> <li>Talk to your doctor if your child is not able to drink fluids, has blood in their stool, or has pain that does not go away.</li> <li>Talk to your doctor if your child seems to be getting sicker. </li> </ul><h2>Signs and symptoms of severe diarrhea</h2><p>Signs of diarrhea include:</p><ul><li>sudden increase in the number of bowel movements</li><li>stool that contains mucus or blood</li><li>stool with a very bad smell</li></ul><p>Severe diarrhea can be harmful because it causes dehydration. <a href="/Article?contentid=776&language=English">Dehydration</a> is a loss of fluid in the body. Infants can lose too much fluid very quickly. </p><p>Signs of dehydration include:</p><ul><li>dry mouth </li><li>fewer tears when crying </li><li>sunken eyes </li><li>not urinating (peeing) as often as usual or less than three times per day<br></li><li>dark urine </li><li>sunken fontanelle (the "soft spot" on the top of the baby's head) in babies less than a year old </li><li>low energy </li></ul><h3>Diarrhea can last up to one week</h3><p>Diarrhea can last from one to seven days. During this time, give your child plenty of fluids to prevent dehydration. Your child should continue eating to keep healthy. Talk to your doctor if diarrhea continues for more than two to three weeks.<br></p><h2>Infectious diarrhea spreads easily</h2><p>Diarrhea caused by viruses and other infections is very contagious. Wash yours and your child's hands well with soap and water after every trip to the bathroom or diaper change. Children are considered contagious for as long as they have diarrhea.<br></p><h2>How to take care of your child with diarrhea at home<br></h2><p>In general, the best treatment for diarrhea is to prevent dehydration by giving your child plenty of fluids.</p><h3>Diarrhea in babies less than 6 months old<br></h3><p>Breastfed babies should continue to breastfeed while they have diarrhea. If you need to stop breastfeeding for any reason, make sure to pump your breasts until you can start breastfeeding again.</p><p>Formula-fed babies should continue to take their usual formula while they have diarrhea. Do not dilute the formula. </p><p>If you think your baby has diarrhea and is not <a href="https://www.aboutkidshealth.ca/vomiting">vomiting</a>, continue breastfeeding or offer their usual formula, but offer the feedings more frequently.<br></p><p>Do not give other types of liquids, such as juice, rice water, sports drinks, tea or homemade drinks to your baby.</p><p>If the diarrhea is very severe or you notice signs of dehydration, you may give your child an oral rehydration solution (ORS), such as Pedialyte or Enfalyte. Give the ORS after or between feedings. The ORS should NOT replace breast milk. </p><p>If your baby is not drinking as much as usual, use a dropper to give either expressed breast milk, formula or ORS. Give your baby 1 teaspoon (5 mL) of fluid every three minutes. Increase the amount as tolerated.<br></p><h3>Diarrhea in babies who eat solid foods</h3><p>If your baby eats solid foods and has diarrhea, continue with their regular diet.</p><h3>Diarrhea in toddlers and children<br></h3><p>If the diarrhea is mild, limit your child's intake of juice, ginger ale and other soft drinks. These drinks contain sugars that can make the diarrhea worse. Drinks with caffeine, such as colas, also make diarrhea worse.</p><p>If the diarrhea is frequent and very watery, give your child plenty of fluids. If your child is showing signs of dehydration, you can give them diluted apple juice (half apple juice and half water) or their preferred liquid. You may also give your child ORS (such as Pedialyte, Enfalyte or Pediatric Electrolyte).<br></p><p>Sometimes your child can develop a temporary lactose intolerance and diarrhea may worsen after drinking milk. Your child can try drinking lactose-free milk for one to two weeks until their gut heals.<br></p><p>Your child should keep eating solid foods while they have diarrhea. Good nutrition will help their recovery.<br></p><h3>Treating diaper rash</h3><p>Diarrhea can be very irritating to the skin of the diaper area. Apply creams or ointments to your child's skin to reduce <a href="https://www.aboutkidshealth.ca/Article?contentid=26&language=English">diaper rash</a>. Use zinc-containing ointments. Clean your child's skin immediately after each bowel movement. Then, apply a very thick layer of protective ointment.<br></p><h2>Do not give medicine for diarrhea unless your doctor says to do so</h2><p>There are no proven safe and effective prescription or over-the-counter medications for diarrhea caused by viruses. Some medication can cause excessive sleepiness, worsen cramping or cause other problems. Others may be unsafe for children.</p><p></p>Antibiotics can make diarrhea worse. They can interfere with healthy bacteria that live in the gut. <p></p><p>Do not give your child a medicine for diarrhea without talking to your doctor.<br></p><div class="asset-video"><p> </p> <iframe src="https://www.youtube.com/embed/ESvlOfNkjaA">frameborder=&amp;amp;amp;amp;amp;amp;quot;0&amp;amp;amp;amp;amp;amp;quot;</iframe>  <br> <p></p></div><h2>When to see a doctor</h2> <p><strong>Make an appointment with your child's regular doctor if:</strong></p> <ul> <li>your child is showing mild signs of dehydration but can drink some fluids </li> <li>your child has been vomiting more than 48 hours </li> <li>your child is less than three months of age </li> <li>your child has fever and is older than three months old<br></li> <li>your child has mucus in the diarrhea </li> <li>your child has severe diarrhea (more than eight times per day) for more than two days </li> <li>your child has mild diarrhea for more than two weeks</li> </ul> <p><strong>Go to the nearest Emergency Department or call 911 if:</strong></p> <ul> <li>your child is showing signs of dehydration and is not able to drink fluids </li> <li>your child has vomit or diarrhea that is green or bloody </li> <li>your child has severe abdominal (belly) pain that is getting worse and is not relieved by passing stool </li> <li>your child appears to be very sick </li> <li>your child has a fever and/or diarrhea that does not go away, and is less than three months of age</li> </ul>diarrheadiarrheahttps://assets.aboutkidshealth.ca/AKHAssets/antibiotic-associated_diarrhea.jpg Diarrhea causes frequent, loose bowel movements. Read about the causes of diarrhea in babies and children and how to prevent dehydration.Main
Sleep tips: How to help your child get a good night's sleepSleep tips: How to help your child get a good night's sleepSleep tips: How to help your child get a good night's sleepSEnglishPreventionChild (0-12 years)NANAHealthy living and preventionCaregivers Adult (19+)NA2020-04-13T04:00:00Z7.4000000000000069.90000000000001305.00000000000Flat ContentHealth A-Z<p>​Learn some tips to help your child get enough sleep.</p><p>Sleep brings your child a wide range of <a href="/Article?contentid=645&language=English">physical and mental benefits</a>. From birth onwards, your child’s wellbeing depends on their getting enough sleep for their age and activity levels. Following the tips below will help your child fall asleep and stay asleep through the night.<br></p><div class="asset-video"> <iframe src="https://www.youtube.com/embed/videoseries?list=PLjJtOP3StIuUzDEHQ26azPp3X36nXGstg" frameborder="0"></iframe> <br> <p>For more videos from SickKids experts in collaboration with Youngster, visit <a href="https://www.youtube.com/channel/UCoKMd2cYwegtZX19uHdNLQA">Youngster on YouTube</a>.</p></div><h2>Key points</h2> <ul> <li>​Help your child get enough sleep by following a regular schedule, encouraging your child to exercise and follow a balanced diet and limiting caffeine from the afternoon onwards.</li> <li>A relaxing routine and a comfortable sleep environment - free of electronics - can also help a child fall asleep more easily and sleep through the night.</li> <li>Make the morning routine easier by preparing breakfast and laying out clothes the night before.</li> <li>See a doctor if your child seems inattentive or sleepy during the day or experiences loud snoring or pauses in their breathing at night.</li> </ul><h2>Keep to a schedule</h2><p>Your child's body likes a regular schedule. Keep a regular sleep routine that allows your child to wake up and go to bed at about the same time every day. During times of stress or uncertainty, it is especially important to keep to a regular schedule of sleep and wake times. Older children may see the lack of formal school or routine as a reason to allow later bedtimes and as a result, later wake up times, but try to encourage them to keep to a regular sleep and wake schedule. </p><p>Try to make sure your child falls asleep and wakes up at the same time at least six days a week. Bedtimes and wake times should not vary by more than one hour from one day to the next, including on weekends.</p><p>Try to avoid letting your child sleep in late on weekends. Sleeping in can make it harder for your child to keep a regular schedule during the week. If your child is well rested, you can change the schedule once in a while for special events and they can recover from the occasional late night much faster.</p><h2>Help your child develop healthy habits</h2><p>Help your child develop and maintain good daily lifestyle habits. These will help make your child comfortable and ready for sleep.</p><ul><li>Encourage your child to get regular exercise.</li><li>Avoid or limit caffeine (from pop, energy drinks, coffee, tea or chocolate) from the afternoon onwards.</li><li>Offer regular, balanced meals based on the four food groups in <a href="/Article?contentid=1436&language=English">Canada's Food Guide</a>.</li></ul><h2>Avoid naps for children aged six and older</h2><p>A healthy child over six years of age should not need a nap during the day. Daytime naps for older children can affect the time the child will fall asleep at night. This results in a later bedtime and may lead to poorer quality nighttime sleep.</p><p>If your child is under six years of age, allow them to have a nap if they need one. If your child is six years old or older, try to limit daytime napping. Napping during the day, or early evening, will make it harder for your child to fall asleep at bedtime.</p><h2>Create a relaxing routine</h2><p>Create a relaxing bedtime routine that your child can follow each night. To start, be clear about when it is bedtime each night. For example, tell your child that 8:00pm is ‘pyjama time’ and 8:30pm is lights out, and stick with those times. If your child has difficulty falling asleep, you could allow extra time by starting their bedtime a little earlier.</p><p>Encourage your child to take a bath or shower before bed to help them feel sleepier and more relaxed. Going to bed with a calm state of mind can reduce the risk and frequency of common <a href="/Article?contentid=306&language=English">sleeping problems</a> such as nightmares, sleep walking and <a href="/Article?contentid=305&language=English">night terrors</a>.</p><p>Include 20 to 30 minutes of quiet time in your child’s bedtime routine. Good wind-down activities include reading, looking through a magazine, listening to music or writing in a journal. Dimming the lights half an hour before your child’s bedtime will help your child feel sleepy.</p><p>Avoid and discourage stimulating activities such as playing videogames, using the computer, using a cell phone. <a href="/Article?contentid=644&language=English">Turn off all electronics</a> at least one hour before bedtime.</p><h2>Create a comfortable sleep environment</h2><p>Make sure your child’s pyjamas are comfortable and appropriate for the season and that their bedroom is cool and quiet. It is also important for them to sleep on a mattress and pillow that offer good support to their spine.</p><p>Keep the bed for sleeping only. In other words, discourage your child from doing their homework or using a computer in bed. These activities can cause your child to link bedtime with stress or active thinking when they are trying to sleep.</p><p>Avoid having a television, computer, tablet or cell phone in the bedroom. Watching television or using a computer, tablet or a phone at night can stimulate the brain rather than relax it. In addition, your child may get into the habit of turning on the television or checking their phone if they cannot stay asleep during the night. If you are watching television after your child falls asleep, make sure the volume is low enough that they cannot hear it.</p><p>Put a glass of water by the bed so your child does not need to get out of bed if they are thirsty during the night. Make sure the water is in easy reach for your child.</p><p>Consider engaging your child’s different senses to help them fall asleep. For instance, children who have trouble falling asleep may enjoy the relaxing smell of lavender. You could use lavender scented laundry detergent or place a few drops of lavender oil on your child’s pillow.</p><h2>Tips for a happier morning</h2><p>Offer your child some options for breakfast and prepare it with your child the night before, if possible. For example, you could cut up fresh fruit and cook oatmeal the night before so you or your child can quickly combine them the next morning.</p><p>Help your child choose an outfit the night before. If your child is old enough to get dressed alone, place the outfit somewhere they can easily reach it in the morning.</p><p>If your child is in school, help them pack their backpack before bed. Making sure everything is packed and ready to go the night before makes for a much less stressful morning. At night, you have more time to look for something that may be missing or to sign an important school note.</p><p>Let your child know what time you will wake them up in the morning. Calmly wake your child in the morning by giving them a hug, gently rubbing their arm or quietly saying their name.</p><h2>When to see a doctor about your child’s sleep</h2><h3>Toddler/preschooler</h3><p>See your child’s doctor if your child:</p><ul><li>has persistent and loud snoring or pauses or <a href="/Article?contentid=1918&language=English">problems breathing</a> while sleeping</li><li>seems irritable, hyperactive, inattentive or sleepy during the day</li><li>has excessive <a href="/Article?contentid=271&language=English">anxiety</a> about being separated from you during the day and night</li><li>has just developed a problem with sleep</li><li>finds it hard to change from two naps to one nap a day</li><li>sleepwalks</li><li>has <a href="/Article?contentid=305&language=English">night terrors</a> or frequent nightmares.</li></ul><h3>School-aged child</h3><p>See your child’s doctor if:</p><ul><li>your child's teacher tells you they seem tired even though you think they get enough sleep</li><li>your child develops new night terrors or sleepwalking habits that they did not have before the age six or seven</li><li>your child needs regular naps</li><li>your child experiences loud snoring, pauses in their breathing or extreme restlessness at night.</li></ul><h2>Further information</h2><p>For more tips on maintaining your child's mental health, please see the following pages:</p><p><a href="https://meant2prevent.ca/">Meant2Prevent</a></p> <p> <a href="/Article?contentid=639&language=English">Nutrition: How a balanced diet and healthy eating habits can support your child's mental health</a></p><p> <a href="/Article?contentid=642&language=English">Physical activity: Guidelines for children and teens​</a><br></p><p> <a href="/Article?contentid=641&language=English">Physical activity: Benefits of exercise for health and wellbeing​</a></p><p> <a href="/Article?contentid=645&language=English">Sleep: Benefits and recommended amounts​</a></p><p> <a href="/Article?contentid=647&language=English">Sleep tips: How to help your teen get a good night's sleep</a></p><p> <a href="/Article?contentid=643&language=English">Screen time: Overview</a></p><p> <a href="/Article?contentid=644&language=English">Screen time: How to help your child set healthy limits</a></p><h2>Resources</h2><p>Canadian Paediatric Society (2012). <em> <a target="_blank" href="http://www.caringforkids.cps.ca/handouts/healthy_sleep_for_your_baby_and_child">Healthy sleep for your baby and child​</a></em>.​</p><p>National Sleep Foundation (2016). <em> <a target="_blank" href="https://sleepfoundation.org/sleep-topics/children-and-sleep">Children and sleep</a></em>.</p><img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/sleep_benefits_recommended_amounts.jpg" style="BORDER:0px solid;" />https://assets.aboutkidshealth.ca/AKHAssets/sleep_benefits_recommended_amounts.jpgSleep tips for children Sleep brings your child a wide range of physical and mental benefits. Learn some tips to help your child get enough sleep. Main
Speech and language development in children aged 0–3 yearsSpeech and language development in children aged 0–3 yearsSpeech and language development in children aged 0–3 yearsSEnglishDevelopmentalBaby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years)NANAHealthy living and preventionCaregivers Adult (19+)NA2023-04-24T04:00:00Z8.7000000000000061.70000000000001305.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Find out how a child’s speech and language skills usually develop by age three and what you can do to support speech and language development. </p><h2>What is speech and language?</h2><p>Many parents and caregivers wonder about their child’s speech and language development. ‘Speech’ refers to how we make and combine sounds to say words. ‘Language’ refers to the words we use and how we use them to communicate. Language is often divided into two categories:</p><ol><li>Receptive language: how we understand what is said to us</li><li>Expressive language: how we share our own thoughts, needs and ideas (this can be verbal or non-verbal)</li></ol><h2>What does early speech and language development look like?</h2><p>Early speech and language development can look different for every child. However, there are general milestones that can be used to track your child’s speech and language development. These milestones look at a child’s speech, receptive language, expressive language and overall communication. </p><h2>Milestones from 0–3 years </h2><p>(Adapted from Toronto Preschool Speech & Language Milestones)</p><h3>By 6 months</h3><ul><li>Startles in response to loud noises</li><li>Turns to look where a sound is coming from</li><li>Makes different sounds for different states (e.g., happy, hungry, tired) </li><li>Watches your face while you talk to them </li><li>Smiles or laughs when you smile or laugh</li><li>Imitates some sounds </li><li>Coos or babbles with simple sounds (“pa”, “ba”, “ma”)</li></ul><h3>By 9 months</h3><ul><li>Responds to their name </li><li>Uses some functional gestures (e.g., reaching to be picked up) </li><li>Enjoys social games (e.g., peek-a-boo, tickle games) </li><li>Enjoys being around people </li><li>Understands “no” (although they may not always follow) </li><li>Babbles and repeats sounds (e.g., “bababa”, “mamama”, “dadada”) </li></ul><h3>By 12 months</h3><ul><li>Can follow simple one-step directions (e.g., “sit down”) (they may not always follow!) </li><li>Follows a point </li><li>Gets your attention using sounds, gestures, pointing </li><li>Uses intentional gestures (e.g., waving hi/bye, shaking head for “no”) </li><li>Combines different sounds together (e.g., “abada baduh abee”) </li><li>Uses 3–5 words consistently </li></ul><h3>By 18 months</h3><ul><li>Understands simple prepositions (e.g., in, out, on, off) </li><li>Can point to at least two body parts when asked </li><li>Uses 20 words consistently </li><li>Responds with gestures or words to simple questions (e.g., “where is teddy?”) </li><li>Makes at least four different consonant sounds (p, b, m, n, d, g, w, h)<br></li><li>Points to pictures with one finger </li></ul><h3>By 2 years</h3><ul><li>Follows two-step directions (e.g., “go find your shoes and put them on”) </li><li>Uses 100–150 words </li><li>Combines 2–4 words (e.g., “red car”, “ball go down”) </li><li>Is understood about 50% of the time </li><li>Begins to engage with other children (e.g., sharing toys, imitating actions/words) </li><li>Engages in early pretend play (e.g., giving teddy a drink, pretending bowl is a hat) </li></ul><h3>By 2.5 years</h3><ul><li>Understands size concepts (e.g., big/little) and quantities (e.g., a lot/a little, more) </li><li>Uses over 350 words </li><li>Uses a variety of action words (e.g., run, spill, fall, eat, sleep, go) </li><li>Participates in some turn-taking activities with other children </li><li>Puts sounds at the beginning of most words </li><li>Uses words with two or more syllables or beats (e.g., “pu-ppy”, “ba-na-na”) </li><li>Remembers and understands familiar stories </li></ul><h3>By 3 years</h3><ul><li>Understands who, what, where and why questions </li><li>Uses sentences of five to eight words </li><li>Talks about past events (e.g., what they did at day care, trip to the zoo) </li><li>Tells simple stories </li><li>Is understood most of the time by people outside of family </li><li>Enjoys playing with peers and has preferred playmates </li><li>Engages in multi-step pretend play (e.g., pretending to cook a meal) </li></ul><h2>Key points</h2><ul><li>Speech refers to how we make and combine sounds to say words.​</li><li>Language refers to how we use words to communicate.</li><li>Receptive language is understanding what is said to us. Expressive language is how we share our own thoughts, needs and ideas verbally and non-verbally.</li><li>General milestones can be used to track a child’s development of speech, receptive language, expressive language and overall communication.</li><li>Supports are available to your child both in and out of hospital.<br></li></ul><h2>What are some strategies I can use to support my child’s speech and language development?</h2><h3>Face to face</h3><p>Getting face to face with your child allows them to watch your mouth while you speak to see how you form sounds and lets you see each other’s facial expressions for better interactions. Get on your child’s level by lying down with them on the floor during tummy time, sitting them facing you on your lap or pulling up a chair facing them when they are in their highchair.</p><h3>Imitate gestures, sounds and words</h3><p>Imitating your baby can help them learn how to imitate you. This is how your baby learns to make different sounds and words. Watch your baby and copy their actions, sounds, and words—they may start to catch on and copy back-and-forth with you!</p><h3>Show</h3><p>Using visuals can help support your child’s understanding of language. Try using pictures, gestures and facial expressions to help support your spoken language. This will help your child follow and learn new words.</p><h3>Model short words and phrases</h3><p>Keeping language short and simple can help children understand you and learn to imitate you. If your baby is not using any words yet, try using one word to label actions, people and objects (e.g., “up!”, “mama”, “ball”). If your baby uses one word, try modeling simple two-word combinations (e.g., if they say “ball”, try “big ball”; if they say “milk”, say “more milk”). Try to stay one word ahead of their current level.</p><h3>Word choice</h3><p>The words you use matter! Children are more likely to try words that help them get what they want (think common requests such as “more”, “milk”, “up”) or words that are fun (think animal sounds like “moo” or “baa”, or words like “boom”, or “uh oh!”). Children may also have an easier time with one-syllable words and words with simple sounds such as /m/ and /b/.</p><h2>What should I do if I have concerns about my child’s speech or language development?</h2><p>If you are concerned about your child’s speech or language development, get in touch with your local Preschool Speech & Language Program (PSL) to access a speech-language pathology assessment. Visit <a href="https://www.ontario.ca/page/preschool-speech-and-language-program">https://www.ontario.ca/page/preschool-speech-and-language-program</a> to find your local PSL and for information on how to self-refer. You do <strong>not</strong> need a doctor’s referral to access your local PSL—families can refer themselves online. If you have extended health coverage, you may also check with your insurance provider to see if private speech and language therapy is covered. </p><h2>At SickKids</h2><p>If your child is a SickKids inpatient (i.e., they are admitted overnight at SickKids) and you have concerns about their speech or language development, ask your health-care team about an inpatient speech-language pathology referral. An inpatient speech-language pathologist (SLP) may be able to consult with you to provide strategies—or in some cases, offer assessment and ongoing support for your child—and help with any community referrals upon discharge. </p><p>Your child may be able to access inpatient speech-language pathology support if:</p><ul><li>They are 0–3 years old and admitted for >3 weeks. </li><li>They have baseline speech or language delays and are not connected to community supports. </li><li>They are any age and have had a change to their speech or language associated with their illness or hospital stay. </li><li>They need support in accessing communication (e.g., if they have a tracheostomy, if they are intubated, or if they need devices to help them communicate). </li></ul><p>If your child meets any of the above criteria, or if you have further questions about speech and language support in hospital, ask your health-care team for an inpatient speech-language consult. </p><h2>Helpful links</h2><p><a href="https://www.surreyplace.ca/resources/communication-checklist/">Communication checklists in 21 different languages</a> — Surrey Place</p><p><a href="https://www.toronto.ca/community-people/children-parenting/pregnancy-and-parenting/parenting/speech-language-vision-hearing/speech-and-language/help-your-child-now/">Speech & language: Help your child now</a> — City of Toronto</p><p><a href="https://www.zerotothree.org/resources/for-families/">Family resources to promote children’s growth and development</a> — Zero to Three</p><p><a href="https://www.hanen.org/Helpful-Info/Parent-Tips.aspx%20">Hanen Tips for Parents</a> — The Hanan Centre  </p><p><a href="https://www.asha.org/public/speech/development/activities-to-encourage-speech-and-language-development/">Activities to encourage speech and language development</a> —American Speech-Language-Hearing Association</p><img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/speech_language_milestones.jpg" style="BORDER:0px solid;" />https://assets.aboutkidshealth.ca/AKHAssets/speech_language_milestones.jpgSpeech and language development Main
ResilienceResilienceResilienceREnglishNAPreschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)NANAHealthy living and preventionCaregivers Adult (19+)NA2022-08-26T04:00:00Z11.000000000000047.5000000000000648.000000000000Flat ContentHealth A-Z<p>Resilience is a learned skill. Resilient children are able to cope with stress, particularly after a traumatic life event or stressor.</p><h2>​What is resilience?</h2><p>Resilience is often referred to as one’s ability to “bounce back” from adversity when faced with a difficult life event or stressor. But resilience is about more than bouncing back. It is also the ability to incorporate adaptive strategies to successfully adapt to and navigate the stressor. Whenever we face adversity, we are changed or impacted by it and things will be different.</p> <h2>Key points</h2><ul><li>Resilience is the ability to cope with and adapt to, stress brought on by a difficult life event or situation.</li> <li>Some children develop resilience through natural process, while others require assistance.</li><li>Parents and caregivers play a key role in the development and nurturing of resilience in children.</li></ul><h2>Resilience in children</h2><p>Developmental psychologists agree that some children develop resilience through natural process, while others need extra support to access that capacity for resilience. However, this doesn’t mean that those who require a little help will be less resilient over time compared to their counterparts. Parents and caregivers need to remember that cultivating resilience is dependent on many factors and can take some time. It is also important to remember that a child’s expression of sadness and/or emotional distress, particularly following a traumatic event, is normal.</p><h2>Helping your child become more resilient</h2><p>A common characteristic shared among resilient individuals is the ability to seek support from family, friends, caregivers and even community-based programs when they are distressed. For children, it’s a parent or caregiver, who is often relied on to provide comfort and support during times of need. Therefore, parents and caregivers often play a key role in developing resilience in their children.</p><h3>Encourage your child to learn more about themselves</h3><p>Facing a difficult situation head-on can be an exercise in self-discovery, especially for young children. Encourage your child to talk openly about their experience, particularly what it is they learned about their ability to cope with stress. Parents and caregivers can model this by expressing their emotions and sharing difficult experiences. Doing this can encourage your child to express their own emotions and experiences. This will help your child get the support they need from others, as well as help them to process difficult situations and life events in a healthy way.</p><h3>Teach your child about self-care</h3><p>Lead by example when teaching your child about the benefits of taking care of one’s self. This includes eating properly, exercising, taking time to rest and doing something nice for one’s self. Avoid over-scheduling your child with activities, chores or tasks. Instead, try to facilitate a balanced schedule of work, fun and rest.</p><h3>Teach your child about the inevitability of change</h3><p>Change can be a daunting reality for children and adults alike. Teaching your child from an early age about life’s uncertainties will enable them to roll with the punches a little easier. Change, too, is a great opportunity to sit down with your child and set some new, attainable goals.</p><h3>Label and validate feelings</h3> <p>Labelling and validating your child’s experience can be soothing, comforting and settling for them. When your child is calmer, you can then engage in problem-solving and develop strategies to cope. Parents and caregivers can take the “validation shortcut” by replacing ‘but’ with ‘because’ when talking to their children about how they are feeling. For example, instead of saying, ‘you’re feeling sad, but you’re strong and you’ll get over it,’ you can say, ‘you’re feeling sad because I know this was important to you.’</p><h3>Balance uncertainties with certainty</h3><p>Focus on what is under your control, whether it is establishing new routines, making a small choice or relying on the consistent things and/or people in your life. For example, you can say, ‘I don’t know when this will end, but I know we can get through it together.’</p><h2>Resources</h2><p><strong>Kids Help Phone – <a href="https://kidshelpphone.ca/">kidshelpphone.ca</a></strong></p> <p>Kids Help Phone is a 24/7 e-mental health service offering free, confidential support to young people.</p><p> <a href="https://kidshelpphone.ca/get-info/fostering-hope-how-to-build-resilience-in-youth/">Fostering hope: How to build resilience in youth</a></p><img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/resilience.jpg" style="BORDER:0px solid;" />https://assets.aboutkidshealth.ca/AKHAssets/resilience.jpgMain

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