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Celiac diseaseCeliac diseaseCeliac diseaseCEnglishGastrointestinalBaby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)Small IntestineSmall intestineConditions and diseasesCaregivers Adult (19+)NAhttps://assets.aboutkidshealth.ca/akhassets/IMD_celiac_disease_EN.jpg2017-02-06T05:00:00ZPeggy Marcon, MD, FRCPC;Inez Martincevic, MSc, RD;Catharine Walsh, MD, MEd, PhD, FAAP, FRCPC9.0000000000000055.00000000000001469.00000000000Health (A-Z) - ConditionsHealth A-Z<p>An overview of the causes, signs, treatment, and gluten-free diet tips for children diagnosed with this medical condition. </p><h2>What is celiac disease?</h2><p>In people with celiac disease, any contact with gluten (a family of food proteins) triggers a reaction from the body’s defense (immune) system. This immune response to gluten—no matter where in the body the contact happened—mainly results in damage to the gut (small intestine) lining. This is why celiac disease is called an autoimmune disease.</p><p>A healthy small intestine is lined with tiny finger-like projections (called villi) that stick up from the surface. Villi increase the area available to absorb nutrients from food. When children with celiac disease are exposed to gluten, the resulting immune reaction damages villi, which become flat. As a result:</p><ul><li>It becomes difficult to absorb nutrients. This is called malabsorption.</li><li>Lack of nutrients due to malabsorption may affect growth and development.</li><li>It also may cause digestive system (gastrointestinal) symptoms, such as <a href="/Article?contentid=7&language=English"> diarrhea</a> and stomach pain.</li></ul> <figure> <span class="asset-image-title">Celiac disease: Villi damage</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_celiac_disease_EN.jpg" alt="" /> <figcaption class="asset-image-caption">With celiac disease the finger-like projections (villi) found in the small intestine become damaged and flattened. This makes absorbing nutrients difficult.</figcaption> </figure> <h3>What is gluten?</h3><p>Gluten is the name of a family of proteins found in grains. Gliadin and glutenin are the two main gluten proteins.</p><p>Gluten is found in:</p><ul><li>all forms of wheat (including durum, semolina, spelt, kamut, einkorn and farro)<br></li><li>rye</li><li>barley</li><li>triticale (rye and barley mix).</li></ul><h2>Key points</h2> <ul> <li>Celiac disease is an autoimmune condition in which any contact with gluten (a family of food proteins) triggers a reaction from the body’s defense (immune) system.</li> <li>Gluten is found in rye, barley, triticale and all forms of wheat.</li> <li>In celiac disease, the lining of the small intestine is damaged by the immune system reaction. This means that it will be harder for your child’s body to get nutrients from foods.</li> <li>Common symptoms of celiac disease include diarrhea, constipation, tiredness, headaches and poor growth. Some people experience no symptoms at all.</li> <li>The only treatment for celiac disease is following a strict gluten-free diet for life. Never get your child to start a gluten-free diet before your doctor confirms the diagnosis.</li> </ul><h2>Signs and symptoms of celiac disease</h2><p>Some people with celiac disease may have no symptoms at all.</p><p>However, many people with celiac disease experience some symptoms. When a person with celiac disease is exposed to gluten, they may have trouble with their digestive system, malabsorption-related issues and other symptoms. Below are some common symptoms of celiac disease. Some people may only have one of these symptoms, while others may experience multiple symptoms.<br></p> <a href="https://assets.aboutkidshealth.ca/akhassets/CeliacSymptoms_poster.pdf"> <figure class="asset-small"> <img alt="Download celiac symptoms poster PDF" src="https://assets.aboutkidshealth.ca/akhassets/celiac_symptoms_PDFdownload.jpg" /> </figure> </a> <h3>Digestive system symptoms</h3><p>When a person with celiac disease is exposed to gluten, they may experience one or more of the following digestive system symptoms:</p><ul><li> <a href="/Article?contentid=822&language=English">excessive gas</a></li><li>diarrhea</li><li> <a href="/Article?contentid=6&language=English">constipation</a></li><li> <a href="/Article?contentid=823&language=English">irritable bowel</a> symptoms</li><li>stomach cramps and/or tummy pain</li><li>nausea</li><li> <a href="/Article?contentid=746&language=English">vomiting</a></li><li>bloating of the abdomen (tummy)</li><li>abdominal distension (expansion)</li><li>decrease in appetite</li><li>indigestion</li></ul><h3>Malabsorption-related symptoms</h3><p>They may also experience one or more symptoms that are not related to the digestive system but are due to nutrient malabsorption. These may include:</p><ul><li> <a href="/Article?contentid=841&language=English">anemia</a> (low blood haemoglobin from iron malabsorption)</li><li>fatigue</li><li>poor growth (being shorter than expected)</li><li>weight loss or poor weight gain</li><li>delayed puberty</li><li> <a href="/Article?contentid=1453&language=English">vitamin or mineral </a>deficiencies (e.g. <a href="/Article?contentid=1448&language=English">calcium</a>, <a href="/Article?contentid=1446&language=English">B12</a>, vitamins A, <a href="/Article?contentid=1447&language=English">D</a>, E and K)</li></ul><h3>Brain</h3><p>A person with celiac disease may experience one or more symptoms affecting their mental health including:</p><ul><li> <a href="/Article?contentid=29&language=English">headaches</a> or migraines</li><li>difficulty concentrating</li><li> <a href="/Article?contentid=19&language=English">depression</a></li><li> <a href="/Article?contentid=18&language=English">anxiety</a></li><li>mood swings and irritability</li></ul><h3>Skin</h3><p>People with celiac disease may also experience skin conditions including:</p><ul><li>skin rash (dermatitis herpetiformis)</li><li>brittle nails</li></ul><h3>Mouth</h3><p>Symptoms of celiac disease that affect the mouth include:</p><ul><li>mouth sores</li><li>tooth enamel defects</li></ul><h3>Reproductive</h3><p>Both males and females with celiac disease may experience issues related to reproduction including:</p><ul><li>infertility (difficulty conceiving children, in both men and women)</li><li>miscarriage</li><li>menstrual irregularities</li></ul><h3>Body</h3><p>Other celiac disease symptoms that could affect parts of the body include:</p><ul><li>osteopenia (mild) or <a href="/Article?contentid=948&language=English">osteoporosis </a> (more serious bone density problem)</li><li>joint pain</li><li>fatigue</li><li>liver and biliary tract disorders</li></ul><h2>Causes of celiac disease</h2> <p>Celiac disease affects about 350,000 Canadians (roughly 1 in 100). It occurs in people all over the world and at any age. People develop celiac disease because of a combination of a genetic susceptibility and environmental factors. If the two conditions are met, some people will develop the condition.</p> <p>People with a relative with celiac disease or who have certain genetic conditions (such as <a href="/Article?contentid=9&language=English">Down syndrome</a> or <a href="/Article?contentid=869&language=English">Turner syndrome</a>) are at higher risk of developing celiac disease.</p> <p>People who already have one autoimmune condition, such as <a href="/Article?contentid=1719&language=English">type 1 diabetes</a>, are at higher risk for developing other autoimmune conditions, such as celiac disease.</p><h2>How celiac disease is diagnosed</h2><h3>Blood tests</h3><p>Doctors can order blood tests to screen for celiac disease. These blood tests look for immune proteins (called auto-antibodies) that the body has made in response to gluten in people with celiac disease.</p><p>The possible blood tests include:</p><ul><li>Anti-tissue transglutaminase (TTG) antibodies</li><li>Anti-deamidated gliaden peptide (DGP) antibodies</li><li>Anti-endomysial antibodies (EMA)</li></ul><p>Your doctor does not need to order all of these blood tests to screen for celiac disease. </p><p>Depending on the results, your doctor or health-care provider will talk to you about further testing to confirm celiac disease. </p><h3>Upper endoscopy</h3><p>An <a href="/Article?contentid=2472&language=English">upper endoscopy</a> may help confirm the diagnosis. An upper endoscopy is a procedure that allows doctors to see the upper part of your child’s digestive system (from the mouth to the top part of the small intestine). Never start your child on a gluten-free diet before you know for sure whether an upper endoscopy is needed to confirm the diagnosis of celiac disease.</p> <figure> <span class="asset-image-title">Upper endoscopy</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_endoscope_EN.jpg" alt="" /> <figcaption class="asset-image-caption">During an upper endoscopy, a thin flexible tube with a camera on the end is inserted into the mouth and down the esophagus to look at the esophagus, stomach, and duodenum (top part of the small intestine).</figcaption> </figure> <h3>Biopsy of the small intestine</h3><p>During an upper endoscopy, small pieces of tissue (biopsies) of the small intestine are taken; they will be examined under a microscope. If your child has celiac disease, the biopsy will show changes to villi in the sample from the small intestine.</p><p>Never start your child on a gluten-free diet without first getting a confirmed diagnosis of celiac disease. If a biopsy is done after your child starts a gluten-free diet, your child’s villi may look normal because they will have had a chance to heal since the immune response will have stopped. The biopsy may give a false negative result, which means that the result is negative even though your child has celiac disease.</p><p>Talk to your child’s doctor for more information about screening for celiac disease.</p><h2>Treatment of celiac disease</h2><p>Celiac disease is a life-long condition. There is no cure or medication for celiac disease. The only treatment is a strict gluten-free diet for life. The diet will help with the symptoms and will keep your child healthy.</p><p>Even if your child has no symptoms, once diagnosed your child must follow a strict gluten-free diet for life for treatment of the disease. </p><p>Your child must also limit skin contact with <a href="/Article?contentid=956&language=English">gluten-containing products</a>. Gluten-containing products can include food or non-food items (for example, hand cream). Contact with gluten can trigger skin reactions in some people with celiac disease. It is also possible for people with celiac disease to transfer gluten from their skin to their mouth and gut when they are in contact with gluten, which is not safe.</p><h3>Starting treatment: The gluten-free diet</h3><p>Once gluten is removed from your child’s diet, the small intestine will start to heal. Your child should start to feel better and symptoms should improve after about six months of being strictly gluten-free. </p><h3>Maintaining treatment: Sticking to a gluten-free diet</h3><p>Do not stop the gluten-free diet if your child’s symptoms improve. Your child is feeling better because the gluten-free diet is working. If you stop the gluten-free diet, the symptoms are going to come back and the villi will flatten. Even if your child has no symptoms, stopping the gluten-free diet will damage the villi and any previous symptom is going to return.</p><p>If your child’s symptoms of celiac disease do not improve after six months, contact your doctor.</p><p>These <a href="/Article?contentid=957&language=English">tips and resources</a> can help you and your child stick to a strict gluten-free diet.</p><h3>What happens without a gluten-free diet?</h3><p>Gluten is toxic to people with celiac disease because it triggers an immune reaction even if your child shows no symptoms.</p><p>If your child continues to be exposed to gluten, celiac disease may lead to future health problems including:</p><ul><li>low bone density (osteopenia or osteoporosis)</li><li>some small bowel cancers</li><li>other autoimmune diseases (for example thyroid problems)</li><li> <a href="/Article?contentid=1453&language=English">vitamins and mineral</a> deficiencies because of malabsorption</li><li> <a href="/Article?contentid=2499&language=English">premature delivery</a> if pregnant</li></ul><p>If your child follows a strict gluten-free diet, their chances of getting these conditions become the same as the general healthy population.</p><h2>Monitoring your child’s symptoms</h2> <p>After the diagnosis, no other upper endoscopy is usually needed. Your child will have more blood tests that check anti-TTG antibody levels. As your child continues a strict gluten-free diet, their antibody levels should lower. High antibody levels tell the doctor that your child was probably exposed to gluten. </p> <p>Your child’s doctor will also make sure that your child is growing well. If your child had symptoms at the time of diagnosis, they should improve while on a strict gluten-free diet.</p><h2>When to see a doctor</h2> <p>See your child’s doctor if:</p> <ul> <li>your child’s symptoms remain after more than six months of following a strict gluten-free diet</li> <li>your child’s symptoms worsen</li> </ul> <p>Your child’s doctor may refer you to a dietitian. A dietitian can give you more advice about celiac disease, how to plan a gluten-free diet, and how to get a balance of nutrients while following a gluten-free diet.</p>
Cystic fibrosis: Physical activity and exerciseCystic fibrosis: Physical activity and exerciseCystic fibrosis: Physical activity and exerciseCEnglishGeneticsChild (0-12 years);Teen (13-18 years)Lungs;PancreasPancreas;LungsNon-drug treatmentCaregivers Adult (19+)NA2014-04-10T04:00:00ZJane Schneiderman, PhD, CSEP-CEP;Blythe Owen, MScPT;Donna Wilkes, MSc;Jennifer Agnew, BS(PT), BHK7.0000000000000062.0000000000000822.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Physical activity and exercise are important parts of what you can do to manage cystic fibrosis (CF). Learn about activities you can do to improve lung function.</p><h2>What is cystic fibrosis?</h2><p> <a href="/article?contentid=882&language=English">Cystic fibrosis</a> (CF) is a genetic disease. It affects mainly the lungs and digestive tract.</p><p>CF causes a build-up of thick mucus in the lungs, which leads to breathing troubles. Mucus in the lungs also benefits bacteria that are responsible for infections. A child with CF may have cycles of infection.</p><p>Thick mucus also blocks the ducts of the pancreas. This blocks digestive enzymes from reaching the intestines to digest food. This can increase the risk of malnutrition and delayed development in patients with CF.</p><h2>Why exercise is important in CF treatment<br></h2> <p>Exercise benefits us all, but people with CF benefit even more from being physically active because exercise can:</p> <ul> <li>slow the rate of decline in lung function, which means children with CF may keep good lung function longer. </li> <li>help clear mucus from the lungs, allowing for easier breathing. </li> <li>create more reserve for the whole body to rely on, during periods of lung infection. This means that someone who is fit may be able to resume their activity faster following a bout of illness.</li> </ul> <p>If you have CF, being physically active will not just make you feel better, it will improve your quality of life.</p><h2>Key points</h2> <ul> <li>Being more active can slow down the decline in lung health, strengthen your heart and muscles, and make you feel better about yourself. </li> <li>You can enjoy a wide range of physical activity. Try to find activities you enjoy. </li> <li>Your cystic fibrosis care team can help.</li> </ul><h2>How to get the most out of exercise</h2> <p>There are many types of exercise and each has different benefits. Knowing which exercises will best treat your CF is very helpful. The following are different types of exercise:</p> <ul> <li>Endurance: Activities done for extended periods. These make everyday tasks easier.</li> <li>Chest mobility: Activities done to loosen up the chest cavity. These make it easier to breathe.</li> <li>Core strengthening: Activities using muscles of the abdominal (belly) wall. These improve posture and breathing.</li> <li>Leg strengthening: Activities using leg muscles. These make everyday tasks easier to perform.</li> <li>Breathing exercises: Activities done to stretch the lungs. These make breathing feel easier.</li> </ul> <h3>Exercises for babies and toddlers</h3> <p>Endurance:</p> <ul> <li>Crawling or climbing up stairs</li> <li>Toys pushed by child</li> <li>Water play or infant swim classes</li> <li>Encourage walking and standing during play</li> </ul> <p>Chest mobility:</p> <ul> <li>Crawl under or over various surfaces</li> <li>Reach overhead with both hands to grab objects</li> <li>Do activities lying on stomach</li> <li>Throw balls</li> </ul> <p>Core strengthening:</p> <ul> <li>Roll</li> <li>Sit independently</li> <li>Push or pull toys</li> </ul> <p>Leg strengthening</p> <ul> <li>Climb up and down on couch, bed or playground</li> <li>Bounce or jump during play </li> <li>Play in squat position </li> </ul> <p>Breathing exercises: </p> <ul> <li>Sing songs using high and low pitches </li> <li>Hold a sound for as long as you can </li> <li>Blow bubbles </li> <li>Pretend to blow out candles </li> </ul> <h3>Exercises for preschoolers and school-aged children</h3> <p>Endurance:</p> <ul> <li>Games such as tag, hide and seek and red light/green light </li> <li>Bike, scooter and skateboard </li> <li>Enroll in sport, dance or outdoor programs </li> </ul> <p>Chest mobility:</p> <ul> <li>Practice ball skills: throwing, catching and dribbling </li> <li>Hit a ball with a bat </li> <li>Rolling on a Swiss ball </li> </ul> <p>Core strengthening: </p> <ul> <li>Push or pull games such as tug-of-war </li> <li>Climb at playground </li> <li>Crab walk </li> </ul> <p>Leg strengthening: </p> <ul> <li>Jumping games such as hopscotch, long jump, jump rope and trampoline </li> <li>Walk up and down hills </li> <li>Jumping jacks </li> </ul> <p>Breathing exercises: </p> <ul> <li>Blow up balloons </li> <li>Contests for holding breath and holding a note </li> <li>Play a wind instrument</li> </ul> <h3>Exercises for pre-teens, teens and adults</h3> <p>Endurance: </p> <ul> <li>Go for walks or runs </li> <li>Get involved in organized sports or clubs </li> <li>Swim lessons or recreational swimming </li> <li>Cardio classes at health clubs </li> </ul> <p>Chest mobility: </p> <ul> <li>Yoga </li> <li>Shooting a basketball </li> <li>Swinging a baseball bat, golf club or tennis racquet </li> </ul> <p>Core strengthening: </p> <ul> <li>Sit-ups, crunches and plank pose </li> <li>Pilates </li> <li>Sitting on a Swiss ball</li> </ul> <p>Leg strengthening: </p> <ul> <li>Plyometrics: standing jumps, long jumps, side jumps, etc. </li> <li>Run up hills or stairs </li> <li>Squats </li> <li>Obstacle courses </li> </ul> <p>Breathing exercises: </p> <ul> <li>Play a wind instrument </li> <li>Take singing lessons</li> </ul> <h3>Sneaky fitness</h3> <p>"Sneaky fitness" is a great way to exercise without taking time out of your day. Examples include taking the stairs instead of the elevator or escalator, changing television stations without using the remote, and standing or stretching during commercial breaks.</p><h2>Physical activity, exercise and your CF team</h2> <p>There are many people on your CF care team with whom you can talk about physical activity and exercise.</p> <ul> <li>Physiotherapists teach different ways to keep your airways clear of secretions. They also work with you to make fun physical activity and exercise part of your everyday life. </li> <li>Exercise physiotherapists use tests to understand how your body works when it exercises. From these tests, they can suggest areas where you can get stronger. You will see them in the exercise testing lab once a year when you are tall enough to ride a stationary bike. </li> <li>Dietitians teach you how eating and taking extra enzymes give you the energy you need to be active and strong.</li> </ul><h2>More information</h2> <p>For more information, visit the following:<br></p> <ul> <li>CF Canada: <a target="_blank" href="http://www.cysticfibrosis.ca/">www.cysticfibrosis.ca</a></li> <li>CF Foundation: <a target="_blank" href="https://www.cff.org/">www.cff.org</a></li> <li>Canadian Society for Exercise Physiology:<a target="_blank" href="http://www.csep.ca/english/view.asp?x=1"> www.csep.ca</a> – see Physical Activity option</li> </ul>cfexercise cfexercisehttps://assets.aboutkidshealth.ca/AKHAssets/cystic_fibrosis_physical_activity_and_exercise.jpg
AllergiesAllergiesAllergiesAEnglishAllergyChild (0-12 years);Teen (13-18 years)BodyImmune systemConditions and diseasesCaregivers Adult (19+)Cough;Eye discomfort and redness;Runny nose;Rash;Wheezing2014-12-18T05:00:00ZVy Kim, MD, FRCPC;Anna Kasprzak, RN​7.0000000000000065.00000000000001244.00000000000Health (A-Z) - ConditionsHealth A-Z<p>This page explains what allergies are, types of allergens, the signs and symptoms of allergies, and also the causes. It also gives examples of common allergies and what to do if your child has an allergic reaction. </p><h2>What is an allergy?</h2> <p>The immune system protects us by attacking harmful substances such as viruses and bacteria. An allergy is the immune system’s response to a substance called an allergen.</p> <p>The allergen is not harmful for most people. However, when a child has an allergy, the immune system treats the allergen as an invader and over-reacts to it. This results in symptoms from mild discomfort to severe distress.</p> <p>Allergic disorders, including food allergies, are common in childhood. Many children with allergies also have asthma.<br></p><h2>Types of allergens</h2><h3>Common airborne allergens</h3><p>Dust mites are common airborne allergens. These tiny bugs live in warm, damp, dusty places in your home and survive by eating dead skin cells. Their waste is a major cause of allergies and asthma.</p><p>Other common airborne allergens include:</p><ul><li>pollen from flowers and other plants</li><li>mould</li><li>pet dander (dead skin cells from pets)</li><li>cockroaches</li></ul> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/Common_airborne_allergens_EQUIP_ILL_EN.jpg" alt="" /> </figure> <h3>Common food allergens</h3><p>The most common food allergens include:</p><ul><li> <a href="/Article?contentid=809&language=English">peanuts</a></li><li> <a href="/Article?contentid=812&language=English">tree nuts</a> such as hazelnuts, walnuts, almonds, and cashews</li><li> <a href="/Article?contentid=806&language=English">eggs</a></li><li> <a href="/Article?contentid=808&language=English">cow's milk</a></li><li> <a href="/Article?contentid=813&language=English">wheat</a></li><li> <a href="/Article?contentid=805&language=English">soy</a></li><li> <a href="/Article?contentid=807&language=English">fish</a></li><li> <a href="/Article?contentid=810&language=English">seafood</a></li></ul><p>Even small amounts of these foods can trigger anaphylaxis in some allergic children. <a href="/Article?contentid=781&language=English">Anaphylaxis</a> is the most severe type of allergic reaction.</p><p>Food allergens can also be hidden in common party dishes such as cookies, cakes, candies or other foods. Always ask the cook or the host if dishes contain foods your child is allergic to. </p><p>Far more people have a food intolerance than a food allergy. Unlike a food allergy, a food intolerance does not involve an immune reaction. Rather, it produces unpleasant symptoms as food is digested. These symptoms appear over a few hours rather than as soon as the food is swallowed or inhaled.</p> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/Common_food_allergens_EQUIP_ILL_EN.jpg" alt="" /> </figure> <h3>Other common allergens</h3><ul><li> <a href="/Article?contentid=800&language=English">Insect bites</a></li><li>Medicines</li></ul><h2>Key points</h2> <ul> <li>An allergy is the immune system’s response to a substance that is not harmful to most people. </li> <li>If you suspect that your child has an allergy, an allergist can do tests to find out exactly what is causing the allergy and the severity of your child's reaction. </li> <li>To reduce your child's exposure to airborne allergens, have a pet-free home and remove carpeting. </li> <li>To manage a food allergy, make sure your child avoids all foods they are allergic to and learns how to read food labels and ask about the ingredients in served food.</li> <li>If your child has a severe allergy, tell their teachers and other caregivers.</li> </ul><h2>Signs and symptoms of allergies</h2><p>Allergic reactions will vary from child to child and from allergen to allergen. Where you live can also affect the type and severity of the allergy.</p><p>Common allergy symptoms may include:</p><ul><li>breathing problems</li><li>burning, tearing or itchy eyes</li><li> <a href="/Article?contentid=782&language=English">conjunctivitis</a> (red, swollen eyes)</li><li> <a href="/Article?contentid=774&language=English">coughing</a></li><li> <a href="/Article?contentid=789&language=English">hives</a> (raised, red, itchy bumps)</li><li>runny nose</li><li>skin rashes</li><li>wheezing</li><li>swelling around the face or throat</li><li>shock</li></ul><h3>Symptoms for airborne allergens</h3><p>Airborne allergens usually cause sneezing, itchy nose or throat, nasal congestion, red and itchy eyes and coughing. Some children also have wheezing and shortness of breath. </p><h3>Symptoms for food allergens and insect bites</h3><p>Your child's response to a food allergy or insect bite will depend on how sensitive they are to that food or bug. Symptoms can include:</p><ul><li>itchy mouth and throat when food is swallowed</li><li>hives</li><li> <a href="/Article?contentid=746&language=English">vomiting</a></li><li> <a href="/Article?contentid=7&language=English">diarrhea</a></li><li>runny, itchy nose</li><li>difficulty breathing</li><li>swelling around the face or throat</li> <li>going into shock</li></ul><h2>What causes an allergic reaction? </h2> <p>Allergens may come in contact with the skin or be breathed in, eaten or injected.</p> <p>When the body detects an allergen, it sends a signal to the immune system to produce antibodies called immunoglobulin E (IgE). Those antibodies cause certain cells in the body to release chemicals called histamines. Histamines travel through the bloodstream to fight the invading substance or allergen.</p> <p>Your child's allergic reaction depends on which part of their body has been exposed to the allergen. Most commonly, allergic reactions affect the eyes, inside of the nose, throat, lungs or skin.</p><h2>What your child's doctor can do for allergies</h2> <p>If you suspect your child has an allergy, consult an allergist. This is a doctor who specializes in diagnosing and treating allergies.</p> <p>To identify your child's allergy, the allergist will usually:</p> <ul> <li>examine your child</li> <li>ask for your child's allergy history</li> <li>ask for a description of your child's allergic symptoms</li> </ul> <p>Your child might then have skin tests, blood tests, a chest X-ray, a lung function test or an exercise tolerance test. The doctor will explain these tests to you.</p> <p>When the tests are done, the allergist will use the results to make a diagnosis. You and your child will meet the allergist at a later date to discuss them.</p> <h3>How to prepare for an allergy test </h3> <p>Your child may need to stop using certain medications for a period of time before an allergy test. These medications may include antihistamines and other pills for motion sickness. Always ask your doctor if your child'should stop taking medications before the visit.</p><h2>Taking care of your child with an allergy at home</h2> <p>If your child has a severe allergy, your doctor might give you a prescription for an epinephrine auto-injector (Epi-Pen or Allerject). Your doctor can show you how and when to use the auto-injector. You or your child may need to carry one at all times.</p> <p>As much as possible, try to prevent allergic reactions by reducing your child's contact with the allergen(s). The steps you take depend on the substance to which your child is allergic. Discuss this with your child's doctor.</p><h2>How to prevent allergic reactions</h2> <h3>Airborne allergens</h3> <ul> <li>Have a pet-free home. Or if you have a pet, keep it out of the child's room and bathe it regularly.</li> <li>Remove carpets and rugs from the home, especially from your child's bedroom. Hard floor surfaces do not collect dust as much as carpets do.</li> <li>Reduce the relative humidity in the home.</li> <li>Wash bedding in hot water. This will help reduce dust mites.</li> <li>Control contact with outdoor pollen by closing windows in peak seasons. Use an air conditioning system with a small-particle filter.</li> <li>Get rid of items in the home that collect dust. These include heavy drapes or old, unclean furniture.</li> <li>Clean your home often.</li> <li>Seal pillows and mattresses if your child is allergic to dust mites.</li> <li>Keep bathrooms and other mould-prone areas clean and dry.</li> </ul> <h3>Food allergens</h3> <p>Your child must avoid all foods they are allergic to. Some children may outgrow their allergies, but others may have to avoid the allergen for life. </p> <p>Avoiding a food allergen can be difficult. As a result, many children unintentionally eat food they are allergic to.</p> <p>If your child has a food allergy, teach them to be aware of the foods to avoid and all the possible names of those foods. You and your child'should learn to read labels on food packaging and ask questions about served food. Your child'should also know why it is important to look for an allergen in ingredients.</p> <p>It is also important to tell all caregivers about your child's allergy and any foods or drinks your child must avoid. </p><h2>When to get medical help for an allergic reaction</h2> <p>Call 911 or take your child to the nearest emergency department if they have:</p> <ul> <li>breathing difficulties</li> <li>swelling, particularly of the face, throat, lips or tongue</li> <li>a rapid drop in blood pressure</li> <li>dizziness</li> <li>loss of consciousness</li> <li>hives</li> <li>tightness of the throat</li> <li>hoarse voice</li> <li>light-headedness</li> </ul> <p>Your child'should also go to the nearest emergency department even if they have received epinephrine (EpiPen or Allerject), as the symptoms can start again hours after the epinephrine is given.</p><img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/allergies.jpg" style="BORDER:0px solid;" />allergiesallergieshttps://assets.aboutkidshealth.ca/AKHAssets/allergies.jpg
Exercise and juvenile idiopathic arthritisExercise and juvenile idiopathic arthritisExercise and juvenile idiopathic arthritisEEnglishRheumatologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemNon-drug treatmentAdult (19+)NA2017-01-31T05:00:00ZJennifer Stinson RN-EC, PhD, CPNPLori Tucker, MDKristi Whitney, BSc PT, MScChristine O’Brien, OT Reg (Ont), MScAdam Huber, MSc, MD, FRCPCLynn Spiegel, MD, FRCPC6.0000000000000066.00000000000001204.00000000000Flat ContentHealth A-Z<p>This page describes the use of various types of exercise to help treat arthritis symptoms. These include range of motion exercises, stretching, strengthening, and cardiovascular exercise.</p><p>Regular daily exercise can help improve a child's sense of well-being, which may increase their energy level and help their sleep better. This is because during exercise, the body produces chemicals called endorphins. Endorphins help to reduce pain, joint stiffness, and anxiety. Children should select activities that are fun and that they can do with their friends and family.</p><h2>Key points</h2> <ul><li>The body produces endorphins during exercise, which help to reduce pain, joint stiffness and anxiety.</li> <li>Different types of exercise include range of motion, stretching, strengthing and cardiovascular fitness.</li> <li>Speak to a doctor or physiotherapist to find the right type of exercise for your child so they can avoid injury.</li></ul><h2>Types of exercises</h2><p>There are several different types of exercises that a child can do to help keep their joints healthy. These can help to reduce some of the symptoms they are having. </p><h3> <a href="#motion">Range of motion exercises </a></h3><h3> <a href="#stretching">Stretching </a></h3><h3> <a href="#strengthening">Strengthening exercises</a></h3><h3> <a href="#cardio">Cardiovascular fitness </a></h3><p>The child's physiotherapist or doctor can advise about which exercises are right for them. Doing the wrong kind of exercise can actually cause more pain or problems!</p><p>There should be no restrictions on the types of sports and leisure activities a child can do. The one exception would be if they have severe joint damage or neck problems. The doctor can advise if they have any activity restrictions.</p><h2 id="motion">Range of motion exercises</h2><p>Range of motion is the amount the joints can be moved in certain directions. When a joint has active arthritis, a child may tend to hold it in a ‘position of comfort.’ This position is usually bent. This can quickly lead to a loss of joint motion and a flexion contracture. A flexion contracture is when the joint has persistent limitation in joint movements with the joint stuck in a bent position.</p><p>Range of motion exercises help to reduce stiffness and improve joint motion. These are gentle exercises that can be performed safely. They can be done even when joints are painful and swollen. Range of motion exercises are important since most daily activities do not move the joints through their full range of motion.</p><p>These exercises are most effective if they are done daily. However, most people find this hard to do. Have your child choose the range of motion exercises that work on their stiffest joints and do them as regularly as possible. They may find it easier to do these exercises while taking a shower. Or they can try doing them by taking a quick break from homework or computer time.</p><p>A child does not need to do range of motion exercises for ALL of their joints ALL of the time. A physiotherapist can help with this.</p><h2 id="stretching">Stretching</h2><p>Stretching can reduce stiffness and help keep joints and muscles flexible. This can make everyday activities much easier. Stretching gradually expands range of motion by improving muscle flexibility. Stretching can also help a child to move more comfortably.</p><p>In order to help improve muscle flexibility, these exercises need to be done regularly.</p><p>Make sure your child warms up before they start stretching. Have them move around for five to 10 minutes first. They might like to do these stretches after having a hot shower or bath. Stretches should be done slowly and held for at least 20 seconds. No bouncing! Ideally, they should stretch at least three to five times per week to see improvements in flexibility. Talk to your child's physiotherapist about some stretches they can do.</p><p>Why not try out yoga or pilates? They are activities that focus on muscle flexibility and stretching exercises. This may be a way to incorporate stretching in a more fun way. Maybe some of your child's friends would like to do this too!</p><h2 id="strengthening">Strengthening exercises</h2><p>Strengthening exercises can help to maintain or improve muscle strength. Strong muscles help to support joints, which is especially important for people with JIA. There are different types of strengthening exercises. Your child's physiotherapist or doctor can help you determine which type is right for your child.</p><p>Isometric: In these exercises, the muscles tighten without moving the joint. This is safe. Because the joint does not move during these exercises, they are more comfortable to do when the joint is painful and swollen.</p><p>Isotonic: In these exercises, you use your muscles while moving the joint(s) through some range of motion. Isotonic exercises can be done with or without resistance added. Resistance can be added with the use of body weight. External weights such as ankle or wrist weights, or elastic exercise bands can also be added. A general rule of thumb is, if you can complete two sets of 10 repetitions of an exercise easily, you can add some resistance. Start with a low weight (1 lb to 5 lbs) or low-resistance band. Have your child build up slowly, as they are able.</p><p>It is important to be in the correct position when doing these exercises. A little bit of muscle soreness the next day is okay. However, these exercises should NOT make joints more sore or swollen.</p><p>Talk to your child's physiotherapist or another exercise expert before starting a strengthening regime. Generally speaking, people with JIA will use the principles of low weight and higher repetitions. A good starting point may be 10 repetitions of an exercise, a brief rest, and then a repeat set of 10. Do this three to five times per week. This is the type of routine that we know will help improve muscle strength and endurance. However, anything that your child is able to do is better than nothing!</p><p>You and your child may be feeling overwhelmed by all of the exercises that you have been given. Talk to the physiotherapist about how to make this more realistic. You may want to rotate the exercises so your child is not doing all exercises every day. Or focus on one or two of the most important exercises for a period of time and then focus on others later. Look at what your child's goals are and what exercises can help them to meet these goals.</p><h2 id="cardio">Cardiovascular fitness</h2><p>Cardiovascular fitness is the ability of the lungs to provide oxygen to the blood and heart, and to transport that oxygen to the cells in the body. It is also the ability of the body to do an activity like swimming or walking for an extended period of time.</p><p>Cardiovascular fitness is extremely important for everyone, including young people with JIA. It can help maintain a healthy weight, help control pain, and improve sleep and mood.</p><p>In order to improve cardiovascular fitness, an exercise must be intense enough to raise the heart rate and maintain it for a period of time. Any continuous activity will help. Swimming, water aerobics, brisk walking, in-line skating, dancing and cycling may be easier to do for children who have JIA.</p><p>If you are interested in learning more about heart rate, target heart rate and how to monitor the intensity of exercise, check out this link:</p><p> <a href="https://www.healthyfamiliesbc.ca/home/articles/canadas-physical-activity-guidelines">https://www.healthyfamiliesbc.ca/home/articles/canadas-physical-activity-guidelines</a></p><p>For suggestions on how to become more physically active, visit Health Canada website:</p><p> <a href="http://www.hc-sc.gc.ca/hl-vs/physactiv/index-eng.php">http://www.hc-sc.gc.ca/hl-vs/physactiv/index-eng.php</a></p><h2>Tips for becoming physically active </h2><ul><li>Start slow, build up gradually, and have fun!</li><li>Recruit a friend or family member to exercise with. This will help to keep motivated.</li><li>Set goals and work toward them. </li><li>For additional advice or support, speak to the physiotherapist or other health care provider.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/exercise_and_juvenile_ideopathic_arthritis.jpg
Eye examination for your childEye examination for your childEye examination for your childEEnglishOphthalmologyChild (0-12 years);Teen (13-18 years)EyesNervous systemNon-drug treatmentCaregivers Adult (19+)NAhttps://assets.aboutkidshealth.ca/akhassets/PMD_eye-checkuph-lens_EN.jpg2014-05-22T04:00:00ZAgnes Wong, MD, PhD, FRCSC;Maryam Rezvani, OD;Helen Siomos, RO9.0000000000000060.00000000000001737.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn about eye examinations, the optometrist’s role and the equipment used, so you can prepare your child, and yourself, for the vision test.</p><h2>What is an eye examination?</h2><p>An eye examination consists of a series of tests performed by a licensed eye care professional (for example an ophthalmologist or optometrist) to check your child’s eye health.</p><h2>The vision care team</h2> <p>According to the Canadian Ophthalmological Society your vision care team includes ophthalmologists, optometrists and opticians.</p> <h3>Ophthalmologists</h3> <p>Ophthalmologists are highly-trained eye doctors and surgeons, the medical leaders in the eye care team. They are licensed medical specialists in eye and vision care, surgery and medical interventions, and in diagnosing, treating and preventing serious eye disease. Ophthalmologists perform comprehensive eye exams, conduct surgery, prescribe and give medication and determine the ideal prescription for corrective lenses.</p> <p>Ophthalmologists are physicians who, when they graduate from medical school, do several years of post-graduate training in diagnosing and treating diseases of the eye.</p> <h3>Optometrists</h3> <p>Optometrists are primary health-care providers who specialize in examining, diagnosing, treating, managing and preventing disease and disorders of the visual system and the eye and associated structures. They also diagnose ocular manifestations of systemic conditions.</p> <p>A four-year doctor of optometry degree program follows a university degree.</p> <h3>Opticians</h3> <p>Registered opticians are specially trained to design, fit and dispense eyeglasses, contact lenses, low vision aids and prosthetic ocular devices. They interpret written prescriptions from ophthalmologists (medical doctors) and optometrists (non-medical eye care professionals) to determine the specifications of ophthalmic appliances necessary to correct a person’s eyesight.</p><h2>Key points</h2> <ul> <li>An eye examination is performed by a licensed eye care professional, either an ophthalmologist or optometrist, who checks your child’s eye health and vision.</li> <li>If you suspect your child has a vision problem, ask a licensed eye care professional’s opinion.</li> <li>When choosing glasses for your child, make sure they like their glasses and they are going to wear them.</li> </ul><h2>Eye examinations</h2><p>Ophthalmologists and optometrists are both professionals that are licensed to perform eye examinations. The Canadian Paediatric Society recommends vision screening by your child’s primary health-care provider at all infant and well-child visits. If there are any risk factors (for example prematurity, certain genetic syndromes) or vision complaints, they should be seen by a licensed eye care professional. Keep in mind that the sooner a condition is discovered, the sooner treatment can be started.</p> <figure><img alt="An optometrist’s office" src="https://assets.aboutkidshealth.ca/akhassets/PMD_eye-checkuph-office_EN.jpg" /> </figure> <h3>Signs that your child needs to see a licensed eye care professional</h3><p>There are a number of signs that parents should look for that may indicate their child is having a visual problem. Here are a few examples.</p> <figure><img alt="An optometrist holds up a lens" src="https://assets.aboutkidshealth.ca/akhassets/PMD_eye-checkuph-lens_EN.jpg" /> </figure> <ul><li>If, when you look at your child, you notice that one eye is not aligned.</li><li>Your child has trouble focusing or squints a lot.</li><li>Your child holds books too close or loses their place when reading.</li><li>Your child turns or tilts their head when they want to look at something.</li><li>Your child covers an eye when stepping into sunlight.</li><li>One of your child's eyes is whiter and brighter than the other eye in a picture taken head on.</li><li>Your child moves to the front of the classroom to see the blackboard better.</li></ul><p>Your child may not complain about not seeing correctly because they are unaware there is a problem. Only you, as a parent, can make sure that any visual problem your child may have is caught early on.</p><h2>Eye examinations for children aged two and over</h2><p>A licensed eye care professional often uses toys to get a child’s attention or may involve the parents. It also helps if one of the parents has an eye examination while the child watches. To lessen your child’s anxiety, explain what is going to happen in a simple way they can understand.</p> <figure><img alt="An optometrist uses a toy to get a child’s attention" src="https://assets.aboutkidshealth.ca/akhassets/PMD_eye-checkuph-toys_EN.jpg" /> </figure> <h3>What tests are performed during an eye examination?</h3><p>A licensed eye care professional will first review your child’s history and will ask about any health issues or conditions that may affect your child’s eye health. The will then ask parents questions such as:</p><ul><li>Have you noticed any visual problems, such as squinting, tilting/turning their head or holding books too close?</li><li>Was your baby premature? Did anything happen during the birth of your baby? Was it a difficult delivery? Was the baby hurt during the delivery?</li><li>What is your child's development like?</li><li>Is there any history of eye turn or <a href="/Article?contentid=835&language=English">lazy eye</a> in the family?</li></ul><p>Remember to bring to your appointment any documents that can help you answer these types of questions. Your child will then have a series of tests to check their vision. None of them are uncomfortable, painful, invasive or risky. They include (but are not limited to) the following tests.</p><div class="akh-series"><div class="row"><div class="col-md-12"> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/PMD_eye-checkuph-vis-acuity_EN.jpg" alt="An optometrists chart for a young child" /> </figure> <h3>Visual acuity</h3><p> <a href="/Article?contentid=1941&language=English">Visual acuity</a> is how clearly and sharply your child can see objects that are far away and close up. Your child will cover one eye and read the letters or pictures projected on a wall or on a chart. They will then cover the other eye and do the same. This tests vision at a distance.</p></div></div><div class="row"><div class="col-md-12"> <figure><img alt="An optometrist’s chart for measuring near sight" src="https://assets.aboutkidshealth.ca/akhassets/PMD_eye-checkuph-reading_EN.jpg" /> </figure> <p>To test your child’s near vision, your child will be asked to read lines of text or pictures that become smaller and smaller on a hand-held chart.</p></div></div><div class="row"><div class="col-md-12"> <figure><img alt="An optometrist checks a patients binocular vision" src="https://assets.aboutkidshealth.ca/akhassets/PMD_eye-checkuph-binocular_EN.jpg" /> </figure> <h3>Binocular vision</h3><p>Binocular vision is seeing with both eyes. The licensed eye care professional makes sure that, up close and at a distance, the eyes are aligned and there is no eye turn.</p></div></div><div class="row"><div class="col-md-12"> <figure><img alt="Light-testing pupil movement" src="https://assets.aboutkidshealth.ca/akhassets/PMD_eye-checkuph-light_EN.jpg" /> </figure> <h3>Pupil response</h3><p>Pupil response is tested with a moving light in front of the eyes. The pupils (the black circle in the centre of the iris) should get smaller when they are exposed to light and get larger when the light is removed.</p></div></div><div class="row"><div class="col-md-12"> <figure><img alt="Testing for colour-blindness" src="https://assets.aboutkidshealth.ca/akhassets/PMD_eye-checkuph-colour_EN.jpg" /> </figure> <h3>Colour blindness</h3><p>Colour blindness is the inability to distinguish between colours in normal light conditions. Colour blindness can be as extreme as seeing only in black and white (very uncommon) or it could just mean being unable to distinguish different shades of colours (for example different reds). To test colour vision, your child will look at a chart with drawings, letters or numbers represented only with colours.</p></div></div><div class="row"><div class="col-md-12"> <figure><img alt="An optometrist measures eye turn" src="https://assets.aboutkidshealth.ca/akhassets/PMD_eye-checkuph-eyeturn_EN.jpg" /></figure> <h3>Eye turn and extraocular motility</h3><p>Eye turn (or <a href="/Article?contentid=836&language=English">strabismus</a>) is when the eyes are not aligned. The eyes can be turning in ("crossed") or turning out ("wall eye") or one can be higher than the other. A prism bar measures the angle of an eye turn.</p><p>Extraocular motility is your child's ability to move their eyes in different directions.</p></div></div><h3>Eye convergence</h3><p>Eye convergence (or eye crossing) is the inward movement of both eyes toward each other. The licensed eye care professional holds a stick in front of your child and asks them to follow it with their eyes. By moving the stick closer to your child’s face, your child’s eyes move inward toward each other to maintain focus on the stick. This is an important skill that is required for reading. When reading, the eyes converge for a long periods of time. Reading for 20 minutes is going to be uncomfortable for your child if their eyes do not move towards each other properly. As a result, your child may avoid reading.</p><div class="akh-series"><div class="row"><div class="col-md-12"> <figure><img alt="An optometrist assessing prescription lenses" src="https://assets.aboutkidshealth.ca/akhassets/PMD_eye-checkuph-retinoscopy_EN.jpg" /> </figure> <h3>Retinoscopy</h3><p>Retinoscopy is a light test to see if your child needs corrective glasses (or prescription lenses). With an adult, the licensed eye care professional tests different lenses and asks the patient whether they can see well. It is difficult for a child, as they cannot understand what “seeing better or worse” means.</p></div></div><div class="row"><div class="col-md-12"> <figure><img alt="The optometrist places eye drops to dilate the pupils" src="https://assets.aboutkidshealth.ca/akhassets/PMD_eye-checkuph-drops_EN.jpg" /> </figure> <h3>Focusing ability</h3><p>To test focusing ability, the licensed eye care professional may put two drops of a drug in each eye to dilate the pupil. This prevents accommodation, the ability to see an object clearly at different distances. The eye drops mean that your child cannot see up close clearly. Putting the drops in does not hurt and their effect will wear off in a few hours. It may take six to eight hours to recover the focusing ability. Pupils can stay dilated for up to 24 hours.</p></div></div> <div class="row"><div class="col-md-12"> <figure><img alt="Dilated fundus examination" src="https://assets.aboutkidshealth.ca/akhassets/PMD_eye-checkuph-dfe_EN.jpg" /> </figure> <h3>Dilated fundus</h3><p>Dilated fundus examination checks the retinaat the rear of the eye and makes sure it is healthy. Your child places their chin on the device and rests their forehead against it. The device is moved around your child’s head to allow the licensed eye care professional to see the entire retina.</p></div></div><div class="row"><div class="col-md-12"> <figure><img alt="An optometrist looks into a patient’s eye" src="https://assets.aboutkidshealth.ca/akhassets/PMD_eye-checkuph-ret-test_EN.jpg" /> </figure> <p>If your child is uncomfortable around such an intimidating device, the licensed eye care professional may use a smaller device instead.</p></div></div><div class="row"><div class="col-md-12"> <figure><img alt="An optometrist wearing special glasses for an examination" src="https://assets.aboutkidshealth.ca/akhassets/PMD_eye-checkuph-op-glasses_EN.jpg" /> </figure> <h3>General eye health</h3><p>The licensed eye care professional looks at the cornea, lens and blood vessels to make sure that each part of your child’s eye is healthy. They use different objects such as a portable lens and even wears special glasses to perform this check.</p></div></div></div></div><h2>Eye examinations for children aged under two </h2> <p>Different tests are used to check an infant’s visual acuity. These tests are used to assess your child’s eye and vision development.</p> <p> “Preferential looking” tests for vision problems in children aged under two. For example, a licensed eye care professional may use a board with a small hole in the middle to look at the child without the child seeing them and being distracted. The board has two halves: one is a grey square, the other has black and white stripes. The licensed eye care professional will want to check if the child looks at the stripes, as this is what babies will normally choose to do. </p> <p>The infants's visual acuity is tested as the stripes become smaller and closer together and look more like the grey side. </p> <p>If a problem is suspected, further tests will be carried out, and your child might be given prescription lenses or referred to a paediatric ophthalmologist. A paediatric ophthalmologist is a doctor specialized in eye conditions in children.</p> <p>Remember that, when children are born, they do not have <a href="/Article?contentid=1941&language=English">perfect vision (20/20)</a>. It takes some time to get there.</p> <p>When booking an appointment, make sure to tell the licensed eye care professional your child’s age so they can prepare the appropriate tests and material.</p><h2>How to choose glasses for your child<br></h2><p>Ask your optician to help you find glasses that will fit your child properly. Involve your child in the process if they are old enough to understand. Remember, they are your child’s glasses not yours. If your child does not like the glasses, they are not going to wear them. Instead your child may hide or break the glasses or do whatever they can to not wear them.</p> <figure> <img alt="Choosing a pair of glasses" src="https://assets.aboutkidshealth.ca/akhassets/PMD_eye-checkuph-glasses_EN.jpg" /> </figure><h2>Help your child prepare for their eye examination</h2><p>To help you be ready for your child's visit to the licensed eye care professional, you and your child can watch this video together.</p> <div class="asset-video"> <iframe src="https://www.youtube.com/embed/-VassqhXmQw?rel=0" frameborder="0"></iframe> </div> <br><h2>References</h2> <p>Canadian Ophthalmological Society. <em><a href="http://www.cos-sco.ca/vision-health-information/your-ophthalmologist/">Your Ophthalmologist & The Vision Care Team</a>. </em>Retrieved May 23, 2014. <br></p> Canadian Paediatric Society. <a href="http://www.cps.ca/documents/position/children-vision-screening" target="_blank"><em>Vision screening in infants, children and youth</em></a> (2014, February 1)<br> <p>Retrieved May 23, 2014. <br></p>https://assets.aboutkidshealth.ca/akhassets/PMD_eye-checkup-girl_EN.jpg
Hepatitis BHepatitis BHepatitis BHEnglishGastrointestinalChild (0-12 years);Teen (13-18 years)LiverImmune systemConditions and diseasesCaregivers Adult (19+)NAhttps://assets.aboutkidshealth.ca/akhassets/IMD_liver_EN.jpg2014-06-02T04:00:00ZConstance O'Connor, NP;Simon Ling, MD9.0000000000000058.00000000000002176.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Overview of signs, symptoms, transmission and treatment of hepatitis B.</p><h2>What is hepatitis?</h2> <figure><span class="asset-image-title"></span><span class="asset-image-title">Liver</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_liver_EN.jpg" alt="" /><figcaption class="asset-image-caption">The</figcaption><figcaption class="asset-image-caption"> liver is an organ that is part of our digestive system. It helps us get rid of toxins, digest food, and store energy from food.</figcaption> </figure> <p>Hepatitis B is a <a href="/Article?contentid=1468&language=English">liver</a> disease caused by a virus.</p><p>The liver is an organ in our abdomen (belly). It helps our bodies remove toxins and waste. It also helps us digest food and store the energy we get from food.</p><p>The word "hepatitis" means that there is inflammation of the liver. Inflammation of the liver can affect the liver's ability to work properly. Hepatitis can be caused by infections (virus, bacteria or parasites), drugs or toxins (including alcohol). There are several types of viruses that can cause hepatitis. One of these viruses is the hepatitis B virus. The hepatitis B virus is sometimes referred to as HBV.</p><h2>Key Points</h2> <ul> <li>Hepatitis B is an infection due to a virus called hepatitis B virus. You can protect yourself and your family from hepatitis B by getting the proper vaccination.</li> <li>Children can get hepatitis B if they come in contact with the blood or bodily fluids of someone who has hepatitis B. This can happen around the time of birth, by having unprotected sexual contact, contact with contaminated needles or, very rarely, by sharing items which may be contaminated with blood (such as toothbrushes, nail clippers and razors).</li> <li>Hepatitis B cannot be spread to other people by hugging, kissing, sneezing, coughing or breastfeeding. However, if you are breastfeeding and have cracked or bleeding nipples, talk to your health-care team.</li> <li>When the infection stays in the body for a long time, this is called chronic hepatitis B. Many children with chronic hepatitis B will not have any symptoms unless they have developed liver damage.</li> <li>If your child has chronic hepatitis, they should be seen by a health-care provider regularly to monitor their general health and the health of their liver. As your child gets older, your healthcare provider can help to provide teaching for your child about hepatitis B.</li> </ul><h2>Signs and symptoms of hepatitis B</h2> <h3>Acute hepatitis</h3> <p>Many people who become infected with hepatitis B, especially children, do not have any symptoms at the time of infection and never feel sick. Others get a brief illness with fatigue, decreased appetite and their eyes may turn yellow (jaundice).</p> <h3>Chronic hepatitis</h3> <p>A hepatitis B infection that lasts for more than six months is called chronic hepatitis. Infants and young children infected with hepatitis B have a high likelihood of developing chronic hepatitis. Most teenagers and adults are able to clear the virus on their own and develop life-long protection against it. Almost all children with chronic hepatitis B have no symptoms and grow normally.</p><h2>How do people get hepatitis B</h2> <p>People may get the hepatitis B virus if they come in contact with the blood or other bodily fluid of someone who has hepatitis B. The virus then infects the liver. </p> <p>Here are some ways that children can be infected with the hepatitis B virus:</p> <ul> <li>Most children with hepatitis B were born to mothers who are also infected with the virus. The hepatitis B virus is passed to the baby either during pregnancy or delivery. It is possible to lower the risk of infection for the baby by using medicines and vaccination. This is why all pregnant women should be tested for hepatitis B during pregnancy. It is safe for a woman with hepatitis B to breastfeed her child because the virus does not pass through breast milk. However, if a mom has cracked and bleeding nipples, she should discuss breastfeeding with her health-care provider.</li> <li>Very rarely, children can get hepatitis B if they share personal items that may have the blood of someone with hepatitis B on them (such as toothbrushes, nail clippers or razors). The virus on these items may get into the children's bodies through tiny cuts and openings on the skin.</li> <li>Children can get hepatitis B if they use needles that are contaminated with the hepatitis B virus. This happens when they use the same needles that were already used by someone with hepatitis B. This includes body piercing, tattooing, acupuncture, accidental needle stick injuries or intravenous drug use. </li> <li>The chance that a child can get hepatitis B from blood transfusion or organ transplantation in Canada is extremely small. All blood products and donated organs are tested for hepatitis B infection before they are given to patients. In some other parts of the world, this is a more common problem.</li> <li>Anyone can get hepatitis B by having unprotected sexual contact with someone who has hepatitis B. </li> </ul> <p>It is important to know that children with hepatitis B can live normally. Many people live their whole lives with hepatitis B without significant damage to their liver because of the virus.</p><h2>How easily can hepatitis B be spread to other people?</h2> <p>The risk of getting hepatitis B infection is very low in regular day-to-day activity. If someone in your home has hepatitis B then all other people living there should be immunized against it. </p> <p>If your child has hepatitis B, they should not share personal items that may have traces of blood on them (toothbrush, nail clippers or razors). Your child'should be taught not to let other people touch their blood if they have an accident and they should not touch the blood of others.</p> <p>Because the amount of virus in saliva is low, the risk to pass the virus is minimal. It is unnecessary to have two sets of eating utensils or dishes at home. Your child and the rest of the family can safely use the same sets.</p> <p>There is no risk of passing the virus to others by:</p> <ul> <li>breastfeeding, unless you have cracked and bleeding nipples. In this case, discuss the problem with your health-care provider. They may advice you to use breast shields or to stop breastfeeding.</li> <li>sneezing and coughing around other people</li> <li>hugging and kissing</li> </ul> <p>To protect your child's health and others, it is important to teach your child about good general health routines such as washing their hands, and not touching blood and bodily fluids. It is best to inform your child of their hepatitis B status when they are mature enough to understand the information. Talk to your child before they start to have romantic relationships or be tempted to experiment with alcohol or drugs. Teenagers should be taught about the importance of practicing safe sex, including the use of condoms, to reduce the risk of passing on hepatitis B to others.</p><h2>Tests for diagnosis and monitoring of hepatitis B</h2><h3>Hepatitis B serology</h3><p>Serology is the study of the blood and its content, in particular immune system components. The first test your child will have looks for markers in the blood indicating that they have hepatitis B. The test looks for surface components of the outer "coat" of the hepatitis B virus. These components are called antigens. If this test is positive, this means your child has hepatitis B infection. If it continues to be positive for longer than six months, this means your child has chronic hepatitis B.</p><p>Your child may also have a test that looks for the specific reaction of the immune system to the hepatitis B virus. The immune system makes antibodies that recognize the hepatitis B surface antigens. This test measures the protective antibodies that your child developed against the hepatitis B virus. A positive result may mean that your child is immune to the hepatitis B virus, either because they have recovered from a past infection or received the vaccination.</p><h3>Viral load</h3><p>A second test may be used to see what amount of hepatitis B virus is present in your child's blood. This is called the "hepatitis B viral load".</p><h3>Liver enzymes</h3><p>Blood tests called ALT and AST (liver enzymes) tell how active the disease is and other blood tests indicate if the liver is working properly.</p><h3>Monitoring hepatitis B</h3><p>Many children have a high viral load because their immune system does not recognize and control the hepatitis B virus. As long as the liver enzymes are normal and your child has regular checkups, a high viral load is common and does not mean your child will be unwell.</p><p>High levels of liver enzymes in your child's blood usually mean that your child's immune system has recognized the virus and is trying to fight it. The immune system may eventually be able to reduce the amount of hepatitis B virus in the blood. This is good because it means the risk of damage to the liver from scarring because of hepatitis B is reduced.</p><p>This inflammation of the liver may go away on its own over a short period of time without causing a reduction in the amount of the virus in the blood. In children where the liver enzymes are high for a long time (six to 12 months) your doctor may recommend treatment to help stop the inflammation in the liver before scarring can develop.</p><p>Many people live their whole lives without significant damage to their liver due to hepatitis B. However as people age, the risk of scarring in the liver increases. Mild scarring in the liver does not usually affect the way the liver works. Severe scarring (cirrhosis) may make it difficult for the liver to work properly. Cirrhosis only rarely happens in children with hepatitis B. Chronic hepatitis B infection also increases the risk for liver cancer, especially if it has caused bad liver scarring. Liver cancer is very rare in children with hepatitis B.</p><p>It is important that your child have regular medical follow-up throughout life. This allows problems in your child's liver to be identified and treated early, which may prevent or delay development of liver scarring or cirrhosis and liver cancer.</p><h2>Treatment for hepatitis B </h2> <p>There is currently no cure for hepatitis B. For chronic hepatitis B there are medications which may reduce the amount of inflammation and/or damage the virus may cause to the liver. If your child's hepatitis B is chronic and progressing or if there are other health problems, your doctor may recommend medication to treat the hepatitis B infection.</p> <p>For acute hepatitis B infection, there are no medications. Treatment will help relieve symptoms.</p> <h3>Immunization</h3> <p>As for any illness, the best treatment is prevention. There are very effective vaccines to prevent hepatitis B. In Canada, this vaccine is part of the <a href="/Article?contentid=1986&language=English">routine immunization schedule</a>. This means that all children are protected against hepatitis B if they get all their required shots from the doctor or at school. Children and teenagers are immunized at various ages depending on the province in which they live.</p> <p>When a pregnant woman has hepatitis B, sometimes she needs to take medication to lower her viral load before delivering her baby. When the baby is born, they receive the first dose of the hepatitis B vaccine and another medicine to protect them from the virus. This medicine is called the hepatitis B immune globulin or HBIG. The baby will need at least two additional doses of the hepatitis B vaccine at one month and six months of age.</p> <h3>How to care for your child at home</h3> <p>Many people live their whole lives with hepatitis B but do not experience significant damage to their liver. However, the risk of scarring in the liver increases with age. That is why if your child has chronic hepatitis B, your health-care provider will see your child regularly.</p><h2>Who to tell about your child's hepatitis B status?</h2> <p>It is up to you who you tell about your child's hepatitis B infection.</p> <p>You should tell people who look after your child's general health, like dentists, doctors and nurses.</p> <p>Sometimes people who work with children, including teachers, sports coaches and other volunteers do not really know about hepatitis B. In some communities there may be a stigma associated with hepatitis B infection. Therefore, you may wish to discuss strategies with your child's health-care team before you tell others about your child's hepatitis B infection.</p> <h2>What can I do to help keep my child's liver healthy?</h2> <p>There are many things that help your child's liver stay healthy:</p> <ul> <li>A <a href="/Article?contentid=1435&language=English">healthy diet</a> with plenty of fresh vegetables and fruit helps provide antioxidants that protect the liver from the bad effects of inflammation.</li> <li>Regular physical activity when combined with a healthy diet keeps weight under control. Being overweight will often cause extra difficulty for the liver.</li> <li>Be careful with herbal, natural or other alternative or complimentary treatments. Check with your health-care provider before giving any herbal medications as some of these may be harmful to the liver.</li> <li>Be careful about other medications. Some medications are processed by the liver. If your child needs medication for other health conditions, it is important to follow the instructions carefully. Ask for advice from your health-care provider or pharmacist.</li> <li>Get immunized against other infectious diseases. There are no benefits from getting immunized against hepatitis B if your child already has it. Your child should have all of the recommended immunizations available and should be immunized against hepatitis A. However, the rest of the family and care-givers should be immunized against hepatitis B.</li> <li>Explain to your child and/or teen why they should avoid alcohol and other types of drugs which may cause damage to the liver.</li> </ul>
Nutrition before and during pregnancyNutrition before and during pregnancyNutrition before and during pregnancyNEnglishPregnancyAdult (19+)NANANon-drug treatmentAdult (19+)NA2016-12-22T05:00:00ZStacey Segal, BScA, MSc, RD;Daina Kalnins, MSc, RD​​10.000000000000052.00000000000002022.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Find out how to get the right nutrients to support you and your baby before and during pregnancy.</p><p>Eating a balanced diet, before becoming pregnant and during pregnancy, can help you make sure that you receive the right nutrients to support a healthy pregnancy. Healthy eating can also help to reduce your risk of developing conditions that can affect pregnancy, such as high blood pressure, diabetes and obesity.</p><p>The time when you begin planning a pregnancy is a great opportunity to think about how you can maximize your health through wise food choices and regular exercise. It is also a good time to start a multivitamin supplement. Speak to your health-care provider about choosing the right prenatal multivitamin supplement for you.</p><p>It is important to eat nutritious food <strong>before</strong> you become pregnant because good nutrition supports your baby during the first trimester (three months) as their lungs, heart, brain and other important organs start to develop.</p><p>Learning about good nutrition will benefit you and your baby through your pregnancy and have long-term benefits for your child as they grow.</p><h2>Key points</h2> <ul> <li>Good nutrition is important for gaining the recommended amount of pregnancy weight, supporting fetal development and reducing the risk of complications during pregnancy and birth.</li> <li>Eat a variety of foods from the four food groups, adding more servings from each of these food groups if pregnant with multiples.</li> <li>Important nutrients in pregnancy include folic acid, calcium, iron, protein, iodine, vitamin C, vitamin B12 and vitamin D.</li> <li>Make sure you are taking in enough folic acid from folate-rich foods and a prenatal multivitamin with folic acid from before (or as soon as you suspect) you are pregnant until four to six weeks after giving birth or as long as breastfeeding continues.</li> <li>If eating fish, choose varieties with low levels of methyl mercury, such as sole, haddock, salmon and trout.</li> </ul><h2>General healthy eating recommendations for women of childbearing age</h2> <p>Consuming a healthy diet involves choosing a variety of items from the four food groups listed in <a href="/Article?contentid=1436&language=English">Canada’s Food Guide</a>.</p> <ul> <li><a href="/Article?contentid=1437&language=English">Vegetables and fruit</a>: Choose seven to eight servings a day, making sure to include dark green and orange vegetables and orange fruit.</li> <li> <a href="/Article?contentid=1438&language=English">Grain products</a>: Choose six to seven servings a day, including whole grain and enriched products.</li> <li> <a href="/Article?contentid=1439&language=English">Milk products and alternatives</a>: Choose four servings a day and include lower-fat products.</li> <li><a href="/Article?contentid=1440&language=English">Meat and alternatives</a>: Choose two to three servings a day of lean meat, poultry or fish or alternatives such as peas, tofu, beans and lentils.</li> </ul> <p>To make sure that both you and your baby get enough nutrition, Health Canada recommends adding an <strong>extra two to three servings of food a day</strong> during your second and third trimester, and while breastfeeding.</p> <p>If you are pregnant with twins or other multiples, you will need even more calories and nutrients to help them develop their bones, brain and organs. Health Canada recommends adding an extra two to three servings for <strong>each</strong> baby during the second and third trimester.</p> <h3>Fluids</h3> <p>You may find that you are very thirsty during pregnancy. This is partly because of the increase in blood volume. Drinking plenty of fluids will help you quench your thirst and help with constipation and swelling.</p><h2>Key nutrients for pregnancy</h2> <h3>Calcium</h3> <p>Your developing baby will need <a href="/Article?contentid=1448&language=English">calcium</a> to grow strong bones and teeth, a healthy heart, nerves and muscles.</p> <p>To help you get enough calcium from your diet, choose at least four servings a day from the milk and alternatives food group. Use milk in puddings, soups, pancakes and casseroles. If you are lactose intolerant, try lactose-reduced milk. You can also get calcium from edamame, tofu, almonds, dark leafy vegetables and tahini. Some women may benefit from calcium supplements in addition to a prenatal multivitamin.</p> <h3>Iron</h3> <p>Both you and your baby will need <a href="/Article?contentid=1450&language=English">iron</a> during pregnancy. Iron requirements increase throughout pregnancy and peak in the third trimester. If you do not take in enough iron, you could become <a href="/Article?contentid=1450&language=English">anaemic</a>, which could cause complications during pregnancy and childbirth.</p> <p>To increase iron in your diet, choose the recommended servings of meat and meat alternatives as well as whole and enriched grains.</p> <p><strong>Note:</strong> The body can better absorb iron from animal sources, such as beef, than from non-animal sources, such as vegetables or beans. To help your body absorb iron from non-animal sources, eat foods rich in vitamin C at the same time. For example, eat an orange with a lentil dish.</p> <p><strong>Health Canada recommends that pregnant women should take a prenatal multivitamin that has 16-20 mg of iron</strong>. Some women may need an additional low-dose iron supplement.</p> <h3>Folic acid</h3> <p><a href="/Article?contentid=1449&language=English">Folic acid</a>, also known as folate, is a B vitamin that protects against neural tube defects (defects that affect the brain and spinal cord), such as spina bifida.</p> <p><a href="/Article?contentid=371&language=English">Neural tube defects</a> develop in the first month of pregnancy. For this reason, it is very important to take enough folic acid both <strong>before conceiving and throughout pregnancy</strong>.</p> <ul> <li>Start taking folic acid two to three months before becoming pregnant.</li> <li>Continue it until at least four to six weeks after giving birth, or as long as you are breastfeeding.</li> </ul> <p>If you did not take folic acid before becoming pregnant, start taking it as soon as you suspect you are pregnant.</p> <p>For the <strong>general population</strong>, the Society of Obstetricians and Gynaecologists of Canada (SOGC) recommends:</p> <ul> <li>a diet high in folate-rich foods</li> <li>a daily multivitamin supplement that contains 0.4 mg to 1 mg folic acid and 2.6ug vitamin B12</li> </ul> <p>You can find folate naturally in broccoli, spinach, peas, Brussels sprouts, corn, lentils and other legumes, oranges and as an ingredient in fortified white wheat flour and enriched grain products such as pasta.</p> <p>Some people have a <strong>higher-than-average risk</strong> of having a baby with a neural tube defect. If your doctor tells you that are at higher risk, the SOGC recommends:</p> <ul> <li>a diet high in folate-rich foods</li> <li>a daily multivitamin supplement that contains 1 mg or 4 mg folic acid, depending on whether you are at moderate or high risk, and 2.6 ug vitamin B12. Take this multivitamin supplement from three months before becoming pregnant until the end of your first trimester. After that, take a multivitamin supplement containing 0.4 mg to 1 mg folic acid.</li> </ul> <p>Health Canada and the SOGC advise women to avoid taking more than one multivitamin supplement a day in an attempt to consume a higher dose of supplemental folic acid. In large doses, some substances in multivitamins could be harmful. This is especially true of vitamin A in retinol form (including retinyl palmitate and retinyl acetate).</p> <p>Speak to your health-care provider about finding the right prenatal multivitamin supplement for you.</p><h2>Other important nutrients in pregnancy</h2><ul><li> Protein: Dietary <a href="/Article?contentid=1444&language=English">protein</a> is required to help the unborn baby grow and to develop the placenta, uterus and breast tissue. Protein is found in meat, fish, eggs, milk products and plant sources such as tofu, beans and nuts.</li><li>Iodine: Iodine is required to help an unborn baby’s brain and nervous system develop. Iodized salt is the most common source of iodine.</li><li>Vitamin C: Vitamin C supports the immune system, has a role in growth and repair of tissues and also helps the body absorb iron from plant based foods. Try to eat foods rich in vitamin C, such as citrus fruit, red peppers or tomatoes, at the same time as foods rich in animal sources of iron, such as meat.</li><li>Vitamin B12: <a href="/Article?contentid=1446&language=English">Vitamin B12</a> helps to make healthy red blood cells and keep nerves working properly. The food groups that are sources of vitamin B12 are milk and alternatives and meat and alternatives. If you do not eat meat, you may need to include vitamin B12-fortified foods in your diet.</li><li> Vitamin D: <a href="/Article?contentid=1447&language=English">Vitamin D</a> works with calcium to help maintain healthy bones. Pregnant women should take 600 IU a day. You can usually find this in a prenatal multivitamin supplement.</li></ul><h2>Fish and omega-3 fatty acids</h2><p>Fish is an excellent source of protein, vitamin D, iron, selenium, zinc and omega-3 fatty acids. Omega-3 fatty acids are essential fats (fats that we can only get from our diet) that play an important role in the unborn baby’s growth and development.</p><p>Health Canada suggests that all women of childbearing age, in particular those who are pregnant or breastfeeding, pay special attention to the types of fish they eat. This is because some fish contain methyl mercury, a metal that builds up in the bloodstream over time and can damage an unborn baby’s nervous system. Though the body removes methyl mercury naturally, it can take a year for it to drop to safe levels.</p><p>Health Canada recommends eating at least 150 grams (5 oz.) of cooked fish (with low mercury) each week during pregnancy. The table below lists the fish to choose and fish to avoid before and during pregnancy.</p><table class="akh-table"><thead><tr><th>Fish with low levels of methyl mercury (eat 5 oz. a week)</th><th>Fish with higher levels of methyl mercury (eat <em>less than</em> 5 oz. a month)*</th></tr></thead><tbody><tr><td>Salmon</td><td>Tuna (fresh or frozen)</td></tr><tr><td>Trout</td><td>Shark</td></tr><tr><td>Herring</td><td>Swordfish</td></tr><tr><td>Haddock</td><td>Marlin</td></tr><tr><td>Canned light tuna</td><td>Orange roughy</td></tr><tr><td>Pollock (Boston bluefish)</td><td>Escolar</td></tr><tr><td>Sole</td><td></td></tr><tr><td>Flounder</td><td></td></tr><tr><td>Anchovy</td><td></td></tr><tr><td>Char</td><td></td></tr><tr><td>Hake</td><td></td></tr><tr><td>Mullet</td><td></td></tr><tr><td>Smelt</td><td></td></tr><tr><td>Atlantic mackerel</td><td></td></tr><tr><td>Lake white fish</td><td></td></tr></tbody></table><p>*These fish are all predatory (they hunt other fish), so they tend to accumulate methyl mercury from their diet as well as the surrounding water.</p><h2>Caffeine</h2><p>Health Canada recommends limiting caffeine to 200 to 300 mg a day. Consuming this amount of caffeine a day will not negatively affect a woman’s fertility or pregnancy or a baby’s development. However, it is important to stay within this limit because there are very few – and often conflicting – findings about the effects of consuming more than 300 mg of caffeine a day.</p><p>This table lists the typical caffeine content of common drinks.</p><table class="akh-table"><thead><tr><th>Drink</th><th>Caffeine level</th></tr></thead><tbody><tr><td>8 oz. cup of brewed coffee</td><td>150 mg</td></tr><tr><td>8 oz. cup of regular tea</td><td>35 mg</td></tr><tr><td>12 oz. can of cola</td><td>30-100 mg</td></tr></tbody></table><h2>Artificial sweeteners</h2><p>Moderate use of some artificial sweeteners is safe during pregnancy. Certain other sweeteners are not considered safe.</p><table class="akh-table"><thead><tr><th>Approved sweeteners during pregnancy</th><th>Unsafe sweeteners during pregnancy</th></tr></thead><tbody><tr><td> Aspartame (NutraSweet, Equal)</td><td> Cyclamates (Sweet'N Low, Sugar Twin)</td></tr><tr><td> Acesulfame potassium (Ace K)</td><td></td></tr><tr><td> Sucralose (Splenda)</td><td></td></tr><tr><td> Saccharin</td><td></td></tr><tr><td>Stevia</td><td></td></tr><tr><td> Sugar alcohols</td><td></td></tr></tbody></table><h2>Alcohol during pregnancy</h2><p>The Society of Obstetricians and Gynecologists of Canada (SOGC) recommends that you completely avoid alcohol during pregnancy. There is not enough evidence to confirm how much harm even small amounts may cause your baby.</p><h2>Managing your weight during pregnancy</h2><p>During pregnancy, it is important to gain a steady amount of weight by eating a balanced diet. Pregnancy is not a time to restrict food unless instructed by your doctor or dietitian.</p><p>The amount of weight you should gain is based on your body mass index (BMI)* before you became pregnant.</p><p>Health Canada and the Institute of Medicine recommend the following rates of weight gain during pregnancy.</p><table class="akh-table"><thead><tr><th>Pre-pregnancy BMI</th><th>Second and third trimester weight gain</th><th>Recommended total weight gain</th></tr></thead><tbody><tr><td>Underweight (BMI less than 18.5)</td><td>1 lb (about half a kilogram) a week</td><td>28 to 40 lbs (about 12 to 18 kilograms)</td></tr><tr><td>Normal weight (BMI 18.5 to 24.9)</td><td>1 lb (about half a kilogram) a week</td><td>25 to 35 lbs (about 11 to 16 kilograms)</td></tr><tr><td>Overweight (BMI 25.0 to 29.9)</td><td>0.6 lbs (about 300 g) a week</td><td>15 to 25 lbs (about 7 to 11 kilograms)</td></tr><tr><td>Obese (BMI greater than 30)</td><td>0.5 lbs (about 250 g) a week</td><td>11 to 20 lbs (about 5 to 9 kilograms)</td></tr></tbody></table><p>*Your BMI is the ratio between your weight and your height. To calculate your BMI, divide your weight in kilograms (kg) by your height in metres squared. For example, a woman who is 5 feet 6 inches (1.676 meters) at 135 lbs (61.4 kg) has a BMI of 21.8 → 61.4/(1.676 x 1.676 ) = 21.8.</p><p>Pregnant women who eat a nutritious, balanced diet and gain at least their recommended amount of weight can reduce the risk of premature birth and a low birth weight baby. In contrast, excessive weight gain is linked to high birth weight, longer labour, birth trauma and <a href="/Article?contentid=406&language=English">caesarean section</a>.</p><p><a href="/Article?contentid=313&language=English">Exercise</a> can also support a healthy pregnancy. According to the SOGC, all women should do regular aerobic and strength exercises as part of a healthy lifestyle during pregnancy, unless there is a medical reason to avoid it.</p>https://assets.aboutkidshealth.ca/AKHAssets/nutrition_before_and_during_pregnancy.jpg
Obsessive compulsive disorder: OverviewObsessive compulsive disorder: OverviewObsessive compulsive disorder: OverviewOEnglishPsychiatrySchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)NANAConditions and diseasesCaregivers Adult (19+)NA2016-07-19T04:00:00ZSandra L. Mendlowitz, PhD, C Psych​​000Health (A-Z) - ConditionsHealth A-Z<p>Find out the main features and causes of OCD and what you can do to help your child.</p>​ ​<h2>What is obsessive compulsive disorder (OCD)?</h2><p>OCD occurs when a person suffers from troubling and intrusive thoughts or images in their head and/or follows repetitive or strict patterns of behaviour (rituals) to feel less worried.</p><p>Most people with OCD, except very young children, recognize that the thoughts and/or images they experience are not true. However, they still believe them and feel compelled, or forced, to perform certain rituals to make them less troubling. This link between thoughts and behaviour means that it is more common for someone with OCD to experience obsessions and compulsions together than to experience either an obsession or a compulsion on its own.</p><p>Often, people with OCD engage in compulsive behaviour out of fear that something terrible will happen if they do not follow certain patterns. Completing the behaviour helps them feel "just right", if only for a short time. Teens and adults can express their worries about what will happen if they do not perform their ritual, but children – especially very young children – cannot do so.</p><h2>Where does a child usually display their OCD symptoms?</h2> <p>Children and teens are more likely to display <a href="/Article?contentid=288&language=English">symptoms of OCD</a>, at least in the early stages, in the safety of their own home. However, in the more severe stages of the disorder, <a href="/Article?contentid=286&language=English">OCD can often affect other parts of their lives</a>, including their schooling.</p><h2>Key points</h2> <ul> <li>OCD is a disorder that causes a person to experience intrusive thoughts and/or repetitive behaviour.</li> <li>The main causes of OCD include genetics and chemical imbalances.</li> <li>A child may have OCD on its own or with other mental health conditions such as an anxiety disorder, depression, ADHD or an eating disorder.</li> <li>Speak to your child's doctor or paediatrician if you suspect that your child has OCD.</li> </ul><h2>What causes OCD?</h2> <p>The exact cause of OCD is unknown, but research is looking at many different factors.</p> <ul> <li>Genetics (characteristics that run in families) are known to play an important role in OCD. People who have relatives with OCD or anxiety have a greater chance of developing OCD in childhood.</li> <li>Abnormal levels of neurotransmitters (brain chemicals that carry information) are also known to play a part. In particular, low or imbalanced serotonin can contribute to OCD.</li> <li>OCD can also occur after a streptococcal infection. However, this type of OCD results from an autoimmune reaction where the body confuses its own tissues for the strep infection. Symptoms occur suddenly (many parents describe as almost overnight). As a result, it is <em>very</em> different from what occurs in what is normally considered to be childhood OCD.</li> </ul> <h2>How common is OCD?</h2> <p>OCD affects between 1 and 4 percent of children and teens, making it the fourth most common youth mental health problem today. Some studies have shown that as many as 8 percent of children and teens may have a mild form of OCD. This means that, while they may have some symptoms, they do not interfere significantly with their everyday routine.</p><h2>What to do if you suspect your child has OCD</h2> <p>If you suspect your child has OCD, speak to your child's doctor. They can refer your child to a specialist for diagnosis and treatment.</p> <p>If your child has already been diagnosed with anxiety, seek help for OCD from someone who is experienced in using <a href="/Article?contentid=709&language=English">CBT <em>and</em> treating OCD</a>. It is not enough to see a therapist experienced in anxiety treatment on its own, as different skills are needed to treat OCD.</p><h2>Does OCD occur with other mental health conditions?</h2><p>It is not unusual for a child or teen with OCD to have another mental health condition, such as:</p><ul><li>one or more <a href="/Article?contentid=270&language=English">anxiety disorders</a></li><li><a href="/Article?contentid=19&language=English">depression</a></li><li>tic disorder</li><li><a href="/Article?contentid=1922&language=English">attention deficit hyperactivity d​isorder (ADHD)</a></li><li>eating disorders such as <a href="/Article?contentid=268&language=English">anorexia</a>, <a href="/Article?contentid=282&language=English">bulimia</a> or <a href="/Article?contentid=274&language=English">avoidant/restrictive food intake disorder</a></li><li>hoarding disorder</li><li>trichotillomania (hair pulling)</li><li>excoriation disorder (skin picking)</li></ul><p>Some of these mental health conditions can be treated alongside OCD, but others may need other treatments. For example, tic disorders respond to a therapy called Comprehensive Behavioural Intervention for Tics (CBIT). During CBIT therapy, a person learns to recognize the urge that arises before the tic and then learns a competing response to essentially block the tic. Another type of anxiety disorder, such as social anxiety or generalized anxiety, usually responds well to <a href="/Article?contentid=702&language=English">cognitive behavioural therapy (CBT)</a>. This involves understanding the relationship between thoughts, feelings and behaviours and learning coping strategies to manage distressing thoughts.</p><h2>Further information</h2><p>For more information about OCD, please see the following pages:</p><p><a href="/Article?contentid=288&language=English">OCD: Signs and symptoms</a></p><p><a href="/Article?contentid=286&language=English">OCD: How it affects your child's life</a></p><p><a href="/Article?contentid=709&language=English">OCD: Treatment with psychotherapy and medications</a></p><p><a href="/Article?contentid=287&language=English">OCD: How to help your child</a></p><h2>Resources</h2><p>The following books and websites have some useful advice about OCD for parents and teens.</p><h3>Books</h3><p>Chansky, T. (2001). <em>Freeing Your Child from Obsessive-Compulsive Disorder: a Powerful, Practical Program for Parents of Children and Adolescents</em>. Harmony.</p><p>Derisley, J., et al (2008). <em>Breaking Free from OCD: a CBT Guide for Young People and Their Families</em>. London: Jessica Kingsley Publishers. </p><p>Dotson, A. (2014). <em>Being Me with OCD: How I Learned to Obsess Less and Enjoy My Life</em>. Free Spirit Publishing. </p><p>Jassi, A. (2013). <em>Can I Tell You about OCD? A Guide for Friends, Family, and Professionals</em>. London: Jessica Kingsley Publishers.</p><h3>Websites</h3><p>International OCD Foundation (2016). <a href="https://kids.iocdf.org/" target="_blank"><em>OCD in Kids</em></a> </p><p>TeenMentalHealth.org (2016). <em><a href="http://teenmentalhealth.org/learn/mental-disorders/obsessive-compulsive-disorder-ocd/" target="_blank">Obsessive Compulsive Disorder</a></em></p><p>AnxietyBC (2016). <em><a href="https://www.anxietybc.com/parenting/obsessive-compulsive-disorder" target="_blank">Obsessive Compulsive Disorder</a></em></p><img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/obsessive_compulsive_disorder_overview.jpg" style="BORDER:0px solid;" />https://assets.aboutkidshealth.ca/AKHAssets/obsessive_compulsive_disorder_overview.jpg
Mental healthMental healthMental healthMEnglishPsychiatryChild (0-12 years);Teen (13-18 years)NANANACaregivers Adult (19+)NALanding PageLearning Hub<p>This hub offers resources on supporting your child's mental health through physical activity, sleep and nutrition. It also offers information on recognizing, treating and coping with a range of 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

 

 

Lyme diseaseLyme diseaseLyme diseaseLEnglishInfectious DiseasesChild (0-12 years);Teen (13-18 years)BodyImmune systemConditions and diseasesCaregivers Adult (19+)Fatigue;Fever;Headache;Joint or muscle pain;Swollen glands2011-09-20T04:00:00ZJonathan Gubbay, MBBS, MSc, FRCPC8.0000000000000063.00000000000001331.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Learn how to prevent, recognize and treat Lyme disease.</p><h2>What is Lyme disease?</h2><p>Lyme disease is a bacterial infection transmitted by the blacklegged tick, also known as the deer tick. The infection is caused by the bacterium <em>Borrelia burgdorferi</em>, which is spread through tick bites.</p><p>When treated early with the appropriate medications, children can recover completely from deer tick bites. However, if it is undiagnosed or untreated, Lyme disease can lead to serious recurring or long-term health problems.</p><p>Lyme disease is often called "the great imitator" because it can look like different diseases or neurological disorders. Lyme disease is often misdiagnosed as a number of other conditions and illnesses, for example multiple sclerosis, Parkinson's disease, <a href="/Article?contentid=1493&language=English">autism</a> or schizophrenia.</p>​ <h2>Key points</h2><ul><li>Lyme disease is a bacterial infection transmitted by the deer tick.</li><li>The first sign of infection is usually a circular red rash at the location of the tick bite, which then spreads in a "bulls eye" pattern. Not everyone with Lyme disease has this rash.</li><li>If your child is diagnosed with Lyme disease, the doctor will prescribe antibiotics.</li><li>To help prevent tick bites and Lyme disease, keep skin covered, apply insect repellent to your child's skin and check for ticks on clothing and skin after playing or hiking in tick-infested areas.</li> </ul><h2>Signs and symptoms of Lyme disease</h2><p>Symptoms of Lyme disease may occur in three stages. Not all children infected by Lyme disease go through these stages.</p><h3>Stage 1 Lyme disease</h3><p>For most people, the first sign of infection may be a circular rash at the site of the tick bite. The rash can appear from a day to a month after a tick bite. The most common sites for a rash are the thigh, groin and armpit.</p> <figure><img alt="Lyme disease rash on a leg" src="https://assets.aboutkidshealth.ca/AKHAssets/lyme_disease_rash.jpg" /> </figure> <p>When the rash starts, it is usually flat, but it can sometimes be slightly raised. Patients often describe the skin as burning or occasionally painful or itchy. Over time, the redness becomes wider, measuring anything from 1 cm to 30 cm (1/2 to 12 inches) across. It may look like a bull's eye, with a red ring surrounding a clear area and a red centre.<br></p><p>The rash usually fades after three to four weeks, but it can persist for over a year. It is often accompanied by the following symptoms:</p><ul><li>fatigue</li><li>chills</li><li> <a href="/Article?contentid=30&language=English">fever</a></li><li> <a href="/Article?contentid=29&language=English">headache</a></li><li>muscle and joint pain</li><li> <a href="/Article?contentid=777&language=English">swollen lymph nodes</a>.</li></ul><h3>Stage 2 Lyme disease</h3><p>Left untreated, Lyme disease can spread in the body over the following days and weeks and progress to a second stage. The symptoms of stage 2 Lyme disease may include:</p><ul><li>nervous system disorders</li><li>multiple skin rashes</li><li>arthritis and arthritic symptoms</li><li>heart palpitations (occasional skipped and/or faster heartbeats)</li><li>extreme fatigue and general weakness.</li></ul><h3>Stage 3 Lyme disease</h3><p>If Lyme disease is still left untreated, it can progress to the third stage over the following months or years. The symptoms of stage 3 Lyme disease can last for months or years and may include:</p><ul><li>chronic arthritis</li><li>neurological problems like <a href="/Article?contentid=761&language=English">meningitis</a> or <a href="/Article?contentid=850&language=English">Bell's palsy</a></li><li>numbness or weakness in the arms and legs</li><li>impaired muscle movement</li><li>memory loss</li><li>difficulty concentrating</li><li>changes in mood or sleep habits.</li></ul><p>Children who are treated with antibiotics in the first or second stage of Lyme disease almost never develop third-stage disease.</p><h2>Risk factors for Lyme disease</h2> <p>If your child plays in a tick-infested forest or in grassy fields, they will be at a greater risk for Lyme disease. Since ticks attach easily to bare skin, having exposed skin is also a risk factor.</p> <p>If a tick attaches to your child's skin, it is important to remove the tick as soon as possible. Removing ticks with a tweezers within 24 to 36 hours usually prevents infection.</p><h2>How ticks spread Lyme disease</h2> <p>The bacteria that cause Lyme disease are usually carried in squirrels, mice, birds and other small animals. Blacklegged ticks (deer ticks) spread Lyme disease to humans by feeding on infected animals and then feeding on people. The tick must be attached to the skin for at least two days to transmit the Lyme bacteria.</p> <h3>How to identify a deer tick</h3> <p>Deer ticks are usually red or dark brown and can be 3 mm to 5 mm (1/8 to 1/4 inch) long. After feeding on an animal or human, the tick can swell to the size of a grape.</p> <h3>How ticks are transported</h3> <p>Ticks travel from southern regions on the wings of migrating birds. Household pets, like cats and dogs, may also transport ticks on their fur into your home. Ticks can also be found in forest bushes and overgrown areas between the woods and open spaces.</p> <p>Ticks attach to a person by their mouth when that person's bare skin brushes up against long grasses or bushes or comes in contact with surfaces (such as animal fur) where ticks are already present.</p> <h3>Where deer ticks are most common</h3> <p>Deer ticks are found in Europe, Asia and many parts of North America. In Canada, the western blacklegged tick can be found in British Columbia's lower mainland, on Vancouver Island and in British Columbia's Fraser Valley. The blacklegged tick has been found in southern and eastern Ontario, southeastern Manitoba and parts of Nova Scotia. Because the tick is carried on migrating birds, it can also be found in other locations.</p><h2>How a doctor can help your child with Lyme disease</h2> <p>Lyme disease is not always easy to diagnose because its symptoms can resemble those of other diseases. In addition, not everyone who gets a tick bite develops a rash.</p> <p>Your child's doctor will evaluate your child's symptoms and may order a blood test if they suspect Lyme disease. Blood test results can be negative or positive. A negative result means that no antibodies to the bacteria causing Lyme disease have been found in the blood.</p> <p>If your child gets a negative result to a blood test that is done when symptoms first appear, it does not always mean that they are free of Lyme disease. Blood tests become more reliable as the condition progresses. If the first blood tests are negative, repeat blood tests are recommended several weeks later to test for any antibodies.</p><h2>Treatment of Lyme disease</h2> <p>It is important to treat Lyme disease very quickly so that your child's condition does not get worse. If your child is diagnosed with Lyme disease, the doctor will likely prescribe antibiotics.</p> <p>Most children will recover after two to four weeks of antibiotic treatment. If your child's Lyme disease has had a chance to progress, they may need to take antibiotics for longer. If your child has other symptoms, like neurological disorders, they may require other medications. </p><h2>Complications of Lyme disease</h2> <p>Lyme disease in pregnant women has been associated with stillbirths.</p><h2>Preventing Lyme disease</h2> <p>If your child plans to play in tick-infested grasses or fields, there are some ways that you can reduce their exposure to ticks.</p> <ul> <li>Apply insect repellent on exposed skin.</li> <li>Wear long pants, closed-toe shoes (no sandals) and socks to protect bare skin from ticks.</li> <li>Wear light-coloured clothing so ticks are easier to spot.</li> <li>Avoid areas where there are many insects.</li> <li>Wear clothing treated with insecticide. </li> <li>Check for ticks on clothing and skin after playing or hiking in tick-infested areas.</li> </ul> <p>If you find a tick on your child's skin, carefully remove it with tweezers. Do not squash or crush the tick while it is attached to the skin, as this can increase the chance of spreading infection. You can save the tick in a plastic bag to show to a doctor later.</p> <h3>Be careful with DEET insect repellent</h3> <p>DEET-based insect repellents work very well against ticks, but a high concentration of DEET can be harmful to your child. Make sure that your child's insect repellent is specially formulated for children and contains 10% DEET or less. Natural insect repellents, such as citronella, also work but may need to be re-applied more frequently.</p><h2>​Further information</h2> <p>Centers for Disease Control and Prevention (US) <a title="Lyme Disease: CDC" href="http://www.cdc.gov/lyme/" target="_blank">Lyme Disease</a></p> <p>Public Health Agency of Canada. <a href="http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/14vol40/dr-rm40-05/assets/pdf/14vol40_05-eng.pdf" target="_blank"><em>Canada Communicable Disease Report CCDR:​ Lyme Disease​</em></a>. Volume 40-5, March 6, 2014. Ottawa, ON: Government of Canada.</p><img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/lyme_disease.jpg" style="BORDER:0px solid;" />https://assets.aboutkidshealth.ca/AKHAssets/lyme_disease.jpg
Speech problemsSpeech problemsSpeech problemsSEnglishDevelopmentalBaby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years)MouthMouthConditions and diseasesCaregivers Adult (19+)NA2013-07-02T04:00:00ZJanine Flanagan, HBArtsSc., MD, FRCPC000Health (A-Z) - ConditionsHealth A-Z<p>An easy-to-understand overview of the causes, signs, and treatment of difficulties in your child's ability to talk.<br></p><h2>What are speech and language difficulties?</h2> <p>Speech and language difficulties are made up of two sets of delays or difficulties. Speech difficulties include challenges in pronunciation or articulation like stuttering or lisping. Language difficulties include challenges in speaking using words and/or gestures (expressive language). It can also include challenges in understanding language commands and questions (receptive language).</p><h2>Key points </h2> <ul> <li>Development of speech and language milestones varies tremendously from child to child.</li> <li>Children who are not meeting milestones or are at risk for speech and language delay should have a hearing test, be seen by their doctor and then assessed by a speech language pathologist.</li> <li>Children with speech and language difficulties should be evaluated as early as possible. Watching and waiting is not recommended.</li> <li>Articulation difficulties and stuttering may be normal until about 5 years of age.</li> <li>Speech and language therapy is very helpful for children and the earlier the intervention is started the better the outcome.</li> </ul><h2>Signs and symptoms of speech and language difficulties </h2><p>There is a wide range of speech and language milestones which can vary from child to child, but there is an expected age range of onset. In general, speech and language milestones include: </p><h3>8 to 13 months </h3><ul><li>starts using gestures like pointing, shaking head to indicate "no", waving good-bye</li><li>uses sounds as if they were words (babbling and repetitive babble like "mamama")</li><li>imitates adults' sounds</li></ul><h3>12 to 18 months </h3><ul><li>uses approximately 10 to 20 words or word approximations<br></li><li>expands use of gestures (nodding, eye contact, hand gestures)</li><li>begins to develop a receptive vocabulary of understood words (points to objects when named by an adult)</li><li>responds to name</li><li>understands a number of single words and short phrases</li></ul><h3>18 to 24 months </h3><ul><li>using too many single words to count (200+)</li><li>begins to combine two words ("mommy up", "daddy go")</li><li>understands simple questions</li><li>follows one-step commands</li><li>begins to use negatives: "no juice"</li><li>speech is 50% intelligible to strangers at 2 years</li></ul><h3>2 to 3 years </h3><ul><li>uses three-word sentences ("I want juice")</li><li>grammar will become more precise (adds 'ing', 's' for plurals, using 'a' and 'the' to fill and lengthen sentences, uses prepositions such as "in" and "on")</li><li>learns to use pronouns, negatives, and conjunctions in the middle of sentences: "he," "can't," "and"</li><li>understands many concepts: in/out; big/little; go/stop; top/bottom; animals; toys</li><li>follows two-step directions: "get your coat and close the door"</li><li>follows simple stories in books</li><li>begins to ask "why?"</li><li>can produce the following sounds: h, p, m, d and k</li><li>speech is 75% intelligible to strangers at 3 years</li></ul><h3>3 to 5 years </h3><ul><li>vocabulary increases to 1,000 words at 3 years and 5,000 words by 5 years</li><li>uses full sentences</li><li>retells stories</li><li>turn taking and conversational skills develop</li><li>speech is 100% intelligible at 4 years</li><li>complexity develops (links ideas in sentences using "and," "because," "what," "when," "but," "that," "if," "so")</li><li>adjusts order of words in sentences ("What is he doing?" as opposed to "What he is doing?")</li><li>uses pronouns correctly (I, she, he, her, him, me, mine, they)</li><li>uses more advanced forms of negatives ("didn't")</li><li>uses plurals, but may make some errors ("two gooses") and overgeneralizes some rules ("I runned")</li></ul><p>Between 3 to 5 years, pronunciation improves and blended letter use grows. Children are able to produce the following specific sounds: </p><ul><li>at 4 years: w, b, t, f, g, ng, n</li><li>at 5 years: l, sh, ch, s, j</li><li>at 6 years: z, r</li><li>some pronunciation of specific sounds and articulation difficulties (like stuttering) may be normal until about 5 years old</li></ul><h2>Causes </h2><h3>Genetics </h3><p>A family history of speech and language difficulties is common. A family will often report that someone was a 'late talker'. Learning difficulties or developmental delays may also be more prevalent and increase the risk of a child having speech and language difficulties.</p><h3>Hearing loss </h3><p>The presence of any amount of hearing loss can affect your child's communication. If your child has had some <a href="/Article?contentid=8&language=English">ear infections</a>, this may put your child at risk for hearing loss. <a href="/Article?contentid=761&language=English">Meningitis</a>, severe <a href="/Article?contentid=775&language=English">jaundice</a> as a newborn or prematurity can also cause hearing loss. If you think your child is not hearing well for any reason, ask your doctor about performing a hearing test.</p><h3>Another condition </h3><p>Speech and language difficulties can be a sign of another condition like <a href="/article?contentid=1493&language=English">autism spectrum disorder</a>. Physical disorders like cerebral palsy can also affect your child's ability to speak. Many other medical conditions such as snoring or allergies, and more complex conditions which cause developmental delays may also cause speech and/or language problems.</p><h2>When to see a doctor </h2> <p>Monitor your child's speech and language development. If you have questions, speak to your child's doctor on the next visit. If you are concerned, see your doctor as soon as possible.</p> <h2>What your child's doctor can do</h2> <p>Your doctor will take a medical and developmental history and do a physical examination to assess the cause of the speech and language difficulties. Treatment and intervention will depend on the cause of the speech and language difficulties, and on how severe the problem is. Your doctor will order a hearing test to rule out hearing loss and may recommend that your child see a speech-language pathologist (SLP) or another type of specialist (developmental paediatrician; ear, nose and throat specialist).</p> <h2>Treatment</h2> <p>If possible, the underlying cause should be treated (hearing loss) with a referral to an ear, nose and throat specialist. If the speech and language difficulty is part of another condition (autism spectrum disorder), then this should be evaluated and a referral to a developmental paediatrician may be needed. All children with significant speech and language problems should be seen by an SLP.</p> <p>Parents can self-refer their child to their provinces Preschool Speech and Language Services program. This is a free service funded by the government and offered to children from birth until school age.</p> <p>An SLP will help your child develop their speech and language skills. An SLP may work one-on-one with your child or work in a small group setting with other children needing support. The SLP will teach parents techniques to use at home to encourage your child to speak.</p><img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/speech_problems.jpg" style="BORDER:0px solid;" />https://assets.aboutkidshealth.ca/AKHAssets/speech_problems.jpg
TeethingTeethingTeethingTEnglishDentalBaby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years)TeethMouthConditions and diseasesCaregivers Adult (19+)NA2014-01-07T05:00:00ZMichael J. Casas, DDS, MSc, FRCD(C)000Health (A-Z) - ConditionsHealth A-Z<p>​Learn the signs and symptoms to look for when your baby is teething and how you can help to soothe your baby's gums.<br></p><h2>What is teething?</h2> <p>Teething is when your baby's first set of teeth ("baby teeth" or primary teeth) start to appear. Caring for your baby's teeth begins as soon as the first tooth peeks through your child's gums. Healthy teeth are an integral part of your baby's overall health. They will help your baby chew and eat properly, learn how to speak and they hold place for the future permanent teeth.​</p> <p>Teething can be a tough period both for babies, who feel the pain, and parents, who witness it. Your baby may cry and drool more than usual, may be agitated and cranky. They may sleep poorly while teething. However, most babies seem to get through teething without any symptoms. If your baby experience symptoms, there are steps you can take that will help both you and your child can get through this stage in good health and spirits.</p><div class="akh-series"><div class="row"><div class="col-md-12"> <figure> <p class="asset-image-title">Primary teeth</p> <img src="https://assets.aboutkidshealth.ca/akhassets/Teeth_primary_MED_ILL_EN.jpg" alt="" /> <figcaption class="“asset-image-caption”">The first set of teeth that babies develop is called primary teeth. The teeth erupt in a specific order as numbered above. They last until permanent (adult) teeth come in.</figcaption> </figure> <h2>What you can expect</h2><p>The first tooth usually appears at about six months. Every child develops at a different pace, so do not worry if your child's teeth appear as early as three months or as late as 12 months.</p><p>The two bottom front teeth (lower central incisors) are usually the first teeth to appear. These are followed by the two top front teeth (upper central incisors). Most children will have all 20 primary teeth by three years of age. Between the ages of five and 13, your child will lose the primary teeth to make room for the permanent teeth.</p></div></div></div><h2>Key points</h2> <ul> <li>Healthy teeth are an important part of your baby's health.</li> <li>Treat your baby's pain with acetaminophen or ibuprofen. Never give ASA (acetylsalicylic acid) without first checking with your baby's doctor.</li> <li>You can help soothe your baby's gums with a chilled (but not frozen) washcloth or teething ring made of rubber.</li> <li>Sugary drinks such as juice and soda contribute to tooth decay. Limit your baby's intake of these drinks and never allow them to sleep with a bottle.</li> </ul><h2>Signs and symptoms</h2> <p>You may not be able to see your baby's incoming teeth, but your infant will probably feel them and show signs of teething. Signs and symptoms of teething may include:</p> <ul> <li>swollen or red gums</li> <li>a desire to chew on solid objects</li> <li>drooling, which may begin about two months before the first tooth appears</li> <li>crankiness, irritability or bad temper</li> </ul> <p>Teething does not cause <a href="/article?contentid=30&language=English">fever</a> or <a href="/article?contentid=7&language=English">diarrhea</a>. If you notice your baby showing these symptoms, contact your doctor right away. In addition, do not assume that crankiness, irritability or bad temper are due to teething.</p><h2>Causes</h2> <p>Teeth pushing through the gums cause discomfort. Since your baby cannot express their soreness and tenderness in words, they may be more irritable and cranky as the teeth emerge.</p><h2>Tips on how you can help soothe your baby's gums</h2><p>When your baby seems uncomfortable, consider helping her with some of these simple tips:</p><h3>Rub your baby's gums</h3><p>Using a clean finger or a damp washcloth, massage your baby's gums. The cold sensation and pressure will help ease the discomfort.</p><h3>Offer your baby a teething ring</h3><p>A teething ring made of firm rubber will allow your baby to put pressure on their gums. Liquid-filled rings are not recommended, as they could break or hurt your baby under the chewing pressure.</p><p>Your child may also like chewing on a pacifier or a bottle, which also puts pressure on the gums. Make sure to fill the bottle with water, not milk or juice, as prolonged contact with the sugar in those liquids can lead to tooth decay called early childhood carries. </p> <h3>Keep it chilled, not frozen</h3><p>A cold washcloth or chilled teething ring will likely relieve your baby. If your baby is <a href="/Article?contentid=497&language=English">eating solid foods</a>, they will also enjoy chilled foods like applesauce or yogurt. However, frozen teething rings are not recommended, as the extreme cold could hurt rather than soothe your baby.</p><h3>Wipe the drool</h3><p>Constant drooling is a part of the teething process. It keeps your baby's mouth hydrated and lets the teeth break through without gum damage. However, too much drool can irritate your baby's skin. Keep your baby's chin dry by wiping the drool with a clean cloth.</p><h3>Monitor the pain</h3><p>If your baby is especially irritated or cranky, you may offer <a href="/Article?contentid=62&language=English">acetaminophen</a> or <a href="/Article?contentid=153&language=English">ibuprofen</a> to ease the pain. Do not give your child <a href="/Article?contentid=77&language=English">ASA</a> (acetylsalicylic acid).</p><h3>Avoid over-the-counter teething creams</h3><p>Unless your doctor recommends a certain type of lotion, avoid teething medications that can be rubbed directly on the baby's gums. Your baby may swallow the medication that could numb their throat. This could interfere with the normal gag reflex. The lotion will more likely be washed away by your baby's saliva and have no effect at all.</p><h2>Mouth care and cleaning</h2><h3>Start cleaning with the first tooth</h3><p>Start taking care of your baby's teeth as soon as they come out. Clean the teeth at least once a day as soon as <a href="https://www.youtube.com/watch?v=NgnNHtbIwlY">the first tooth appears</a>. Bedtime is usually a good time to start the routine. Use a soft bristle toothbrush designed for babies. For more information, see our page on <a href="/article?contentid=1994&language=English">dental care</a>.​</p><h3>Avoid juices and sugary drinks</h3><p>Limit the amount of sugary beverages your baby drinks. Do not allow your baby to go to bed with a bottle filled with anything else but plain water​. Natural sugars in juice, formula or breast milk will cause serious tooth decay, especially if these liquids pool in your baby's mouth while they are sleeping. Early childhood carries are also associated with iron deficiency <a href="/article?contentid=841&language=English">anemia</a>.</p><h3>Brush twice a day when ready</h3><p>When your child is three or four years of age, you can teach them to brush their teeth for at least two minutes twice a day. Use a green pea-sized amount of toothpaste, and encourage your child to spit out the toothpaste rather than swallow it. Use fluoride containing toothpaste when your child is old enough to spit.</p><h2>When to see a doctor</h2> <p>Contact your baby's doctor if you notice a persistent fever. Teething does not cause fever. </p> <p>Your child should have their first visit to a dentist at 12 months of age or when they get their first tooth.</p>teethingteethinghttps://assets.aboutkidshealth.ca/AKHAssets/teething.jpg
Moles (acquired nevi)Moles (acquired nevi)Moles (acquired nevi)MEnglishDermatologyChild (0-12 years);Teen (13-18 years)SkinSkinConditions and diseasesCaregivers Adult (19+)NAhttps://assets.aboutkidshealth.ca/akhassets/PMD_nevus_EN.jpg2015-05-06T04:00:00ZBlanca DelPozzo-Magana, MD;Irene Lara-Corrales​, MSc, MD8.0000000000000066.00000000000001112.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Moles are common skin growths that vary in size, colour and appearance. Find out how to tell the difference between benign and potentially harmful moles.</p><h2>What is a mole?</h2><p>A mole, or nevus, is a very common skin growth that occurs when skin colour cells, known as melanocytes, build up under the surface of the skin. Moles vary in size, colour and appearance and can also change over time. They are usually round, but they may also have an oval or jagged shape. Their colour ranges from pinkish red or light brown to dark brown or black.</p> <figure> <span class="asset-image-title">Healthy and benign moles</span> <img src="https://assets.aboutkidshealth.ca/akhassets/PMD_nevus_EN.jpg" alt="" /> </figure> <p>Moles can be flat, bumpy or verrucous (like a wart). They usually occur in body parts that are frequently exposed to the sun, but they can be found anywhere, even inside the mouth, eyes and genitals.</p><p>Moles fall into two main groups:</p><ul><li>congenital melanocytic nevi – moles that your child has at birth or are noticed shortly after birth</li><li>acquired nevi – moles that develop later in life</li></ul><h2>Key points</h2> <ul> <li>Moles occur when there is a build-up of melanocytes under the skin. This can happen as a result of sun exposure, high levels of growth hormones or chemotherapy.</li> <li>Most moles are benign. They are symmetrical and have a regular border and even pigment throughout.</li> <li>The ABCDE acronym can help you, your child or a dermatologist identify any potentially harmful moles.</li> <li>To reduce the risk of harmful moles (melanoma), avoid too much sun exposure, use sunscreen and check your child’s skin at least once every six months.</li> </ul><h2>How do moles affect the body?</h2> <p>Moles are usually benign (harmless), but they can sometimes change and become skin cancer (melanoma). This can be very serious and sometimes lead to death if not treated in time.</p> <h2>Benign moles</h2> <p>A benign mole has the following three features.</p> <ul> <li>It is symmetrical – you can draw an imaginary line and divide it into two identical pieces.</li> <li>It has a regular border – there is a clear difference between the colour of the mole and skin around it.</li> <li>It has a uniform pigment – every area of the mole is the same colour.</li> </ul> <p>In general, benign moles:</p> <ul> <li>grow as your child grows, becoming bigger as the skin stretches</li> <li>get darker or lighter with time</li> <li>may sometimes have coarse hair growing from them</li> <li>will normally change a little throughout life, for example become raised over several years</li> </ul> <h2>Potentially harmful moles</h2> <p>A mole that is potentially harmful might:</p> <ul> <li>change shape</li> <li>rapidly grow (out of proportion with the child’s growth)</li> <li>develop an uneven colour</li> <li>form a scab or bleed without any injury</li> </ul> <p>A dermatologist (skin specialist) should examine your child’s skin if it looks different than it used to, if an area opens up, bleeds and has a hard time healing or if a new mole suddenly appears.</p><h2>What causes moles to appear?</h2><p>Several factors can cause moles to appear:</p><ul><li>sun exposure (more time in the sun increases the number of moles on your skin)</li><li>higher levels of cortisone, corticotropin and other hormones that help the body grow</li><li>chemotherapy (medication that treats cancer)</li><li> <a href="/article?contentid=1170&language=English">immunosuppression</a> (a weakened immune system that prevents the body from fighting infections).</li></ul><h2>Can children develop melanoma?</h2><p>Yes they can, although melanoma in children is very rare. Only one child in one million children below age 15 develops melanoma.</p><p>The risk factors for developing melanoma during childhood include:</p><ul><li>having dysplastic nevi (irregular looking moles)<br></li><li>having a close family member, such as a parent or grandparent, with a history of melanoma</li><li>having a large number (more than 100) of melanocytic nevi, or moles</li><li>being immunosuppressed or having inherited immunodeficiency (weakened immune system)</li><li>having a sun-sensitive phenotype (very fair skin, light coloured eyes and red or light hair)</li><li>being exposed to ultraviolet radiation from the sun</li><li>having a history of malignancy (any form of cancer)</li><li>having a genetic disorder that makes the skin more sensitive to sun damage (for example xeroderma pigmentosum)</li></ul><h2>How is a potentially harmful mole diagnosed?</h2><p>Dermatologists and other health-care professionals use the letters "ABCDE" as a guide when checking the skin for potentially harmful changes in existing or new moles. You can also use this guide when checking your child’s skin at home. </p><ul><li> <strong>A </strong>stands for asymmetry (having two sides or halves that are not the same)</li><li> <strong>B</strong> stands for border irregularity (the borders of the mole are not well defined)</li><li> <strong>C </strong>stands for colour variation (different colour tones in the same mole, for example light and dark brown)</li><li> <strong>D </strong>stands for diameter larger than 6 mm</li><li> <strong>E </strong>stands for evolving (including any dramatic change in shape, colour or appearance in existing moles)</li></ul><p>If a mole has any of these characteristics, it should be examined more closely. A dermatoscopic examination (examining the skin using a special magnifying glass) or a <a href="/article?contentid=2464&language=English">skin biopsy</a> (examining a small sample of the mole’s cells under a microscope) can tell your dermatologist or doctor if the mole is benign or malignant.</p> <figure> <span class="asset-image-title">ABCDEs of potentially harmful moles</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_mole_ABCDE_EN.jpg" alt="" /> </figure><h2>How can I or my child inspect my child’s skin at home?</h2><ol><li>Do the inspection in a well-lit area.</li><li>If you are inspecting your child’s skin, gather a hair dryer, two chairs or stools, a camera or smartphone, a ruler and a pen and paper. If your child is inspecting their own skin, they will need these tools and two mirrors, one that is hand-held mirror and one hanging on a wall or a door.</li><li>Inspect the different parts of the body in the same order each time. For example, always work from the head down or the feet up.</li><li>If working down from the head, for example, start by parting your child’s hair with a hair dryer or your hands to check their scalp. This is easier to do when the hair is wet.</li><li>Check your child’s shoulders, chest and genital area.</li><li>Check the back of their shoulders, their upper and lower back and their buttocks.</li><li>Check their upper arms, elbows, forearms, wrists, hands, palms and fingers, including the space between their fingers.</li><li>Check their inner and outer legs, front and back, including their knees and ankles.</li><li>Check their feet and toes, including the soles and the space between the toes.</li><li>Take a photo of any moles with a ruler beside them so you can record the size and keep track of any changes over time.<br></li></ol><br><h2>What can I do to reduce the risk of melanoma?</h2><ul><li> <a href="/article?contentid=308&language=English">Avoid too much sun exposure</a> (use a hat and special SPF clothing at the beach or in sunny places).</li><li>Do not let your child or teenager use tanning beds.</li><li>Use sunscreen (SPF 30 or higher, covering both UVA and UVB rays) every day, even during winter months, and reapply it periodically during the day.</li><li>Check the skin using the ABCDE acronym at least once every six months.</li><li>Talk to your child’s doctor if you notice any change that concerns you.</li></ul><div class="asset-video"> <iframe src="https://www.youtube.com/embed/7n9wjuEEwio?rel=0" frameborder="0"></iframe>  </div> <div class="asset-video"> <iframe src="https://www.youtube.com/embed/_ek6RydayLY?rel=0" frameborder="0"></iframe>  <br></div>

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