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After heart surgery: Caring for your childAfter heart surgery: Caring for your childAfter heart surgery: Caring for your childAEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartHeartNon-drug treatmentCaregivers Adult (19+)NA2019-11-15T05:00:00ZJudith Wilson, RN, BScN, MN;Jennifer Russell, MD, FRCPC;Carrie Morgan, RN, BScN, MN;Jennifer Kilburn, BScN, MN8.5000000000000065.40000000000002325.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Following heart surgery, children require extra care and attention. Read about care after heart surgery including diet, pain management and school.</p><p>When it is time for your child to go home after heart surgery, you will be given an after visit summary. The after visit summary tells you about your child's hospital stay and when your child needs to come back to the hospital for follow-up appointments.</p><h2>Key points</h2><ul><li>When your child goes home from the hospital you will be given a date and time for their first follow-up appointment.</li><li>Your child will have an incision and other small wounds from their surgery. Check these daily for signs of infection.</li><li>Your child will need to be careful about the type of physical activity they do for at least 12 weeks after the surgery.<br></li></ul><h2>Taking care of your child's wounds</h2><p>After heart surgery, your child will have an incision (surgical cut) in the middle or the side of the chest, as well as other smaller wounds where tubes and wires may have been. Check each of these wounds every day for signs of infection, including:</p><ul><li> <a href="/Article?contentid=30&language=English">fever</a></li><li>redness </li><li>swelling </li><li>liquid draining from the wound </li><li> <a href="/pain">pain</a></li></ul><p>If you see any of these signs, or if you have any concerns within the first 4 weeks after surgery, contact the post-operative nurse practitioner (for SickKids patients, please see contact information in the At SickKids section).</p><h3>Your child's chest tube site</h3><p>Two days after your child's chest tube(s) is/are taken out, the bandages over the chest tube site(s) should be taken off. The black stitch will be removed before your child is discharged or at your child’s post-operative clinic appointment.</p><h3>Surgical incision care</h3><p>For the first 4 weeks after surgery, your child’s incisions will require special care at home to help promote healthy healing and prevent infection. This care will be required until your child’s incisions are healed and the scabs have fallen off.</p><p>Protect the incision and new skin:</p><ul><li>Do not submerge the incision in water (i.e. bathtub, swimming pool) for a minimum of 4 weeks and not until the scabs have fallen off.</li><li>Keep the incision covered with clean clothing at all times and use a bib when feeding babies.</li><li>Do not scrub the incision or pick at scabs to avoid disrupting the healing process.</li><li>The incision might be covered with Steri-Strips when your child is discharged. The Steri-Strips should be removed at your child's post-operative clinic appointment.</li></ul><p>How to clean your child's incision:</p><p>Clean the area around the incision every day for a minimum of 4 weeks and until the scabs have fallen off.</p><ol><li>With a soft, clean cloth, use liquid soap and clean water to wash the area around the incision, including the edges of the Steri-Strips.</li><li>Using a new clean cloth, wipe off the soap with clean water.</li><li>Gently pat dry with a new clean cloth.</li></ol><p>Make sure your child takes shallow baths or showers daily. If the incision gets dirty (i.e. vomit, milk), clean only the dirty portion of the incision, and then clean the area around the incision with liquid soap and water.</p><h3>Sun protection</h3><p>Until all the scabs have fallen off and the area looks healed, cover the wounds with clothing that does not let the light through. Apply sunscreen on all of your child’s exposed skin. After the scabs have fallen off and the wounds are healed, always put sunscreen on the new scars, as that skin is more sensitive.</p><h2>Managing your child’s pain</h2><p>Your child may have pain for several weeks after surgery. As time passes, the pain will become less severe. When your child leaves the hospital, they will usually have a prescription for pain medicine. As your child heals, they will need to take this medicine less frequently.</p><p>If your child’s pain gets worse, see your paediatrician or family doctor. Ask your child’s nurse how to assess your child’s pain before discharge.</p><h2>Limit your child’s physical activity for several weeks</h2><p>Children need regular physical activity as part of a healthy lifestyle. However, your child will need to be careful for several weeks after their operation, to avoid disturbing the wounds.</p><div class="pdf-page-break"><h3>Activity restrictions for babies</h3><table class="akh-table"><thead><tr><th>Time period</th><th>Activity restrictions</th></tr></thead><tbody><tr><td>For the first <strong>2</strong> weeks after surgery</td><td><p>Avoid activities that might disturb the wound.</p><p>Avoid lying on the tummy. After 2 weeks, lying on the tummy is encouraged for normal development.</p></td></tr><tr><td>For the first <strong>6</strong> weeks after surgery</td><td><p>Protect the chest muscles and bone during all activity.</p><p>Avoid lifting under the arms. Instead, lift your baby under head/neck and bottom.</p></td></tr></tbody></table></div><div class="pdf-page-break"><h3>Activity restrictions for toddlers, children and teens</h3><table class="akh-table"><thead><tr><th>Time period</th><th>Activity recommendations</th></tr></thead><tbody><tr><td>For the first <strong>2</strong> weeks after surgery</td><td><p>Avoid activities that might disturb the wound.</p><p>Avoid lying on tummy.</p></td></tr><tr><td>For the first <strong>6</strong> weeks after surgery</td><td><p>Protect the chest muscles and bone during all activity.</p><p>Avoid lifting toddlers and children under the arms. Instead, lift them under head/neck and bottom.</p><p>Avoid pushing or pulling heavy objects.</p><p>Avoid doing push-ups, sit-ups or pulling themselves up on furniture.</p><p>Avoid backward arm circle movements.</p></td></tr><tr><td>For the first <strong>12</strong> weeks after surgery</td><td><p>Protect the chest bone during all activity.</p><p>Avoid activities that could cause a blow to the chest. These include rough play, ball throwing, football, hockey, karate or other contact sports.</p></td></tr></tbody></table></div><div class="pdf-page-break"><h2>Your child’s behaviour</h2><p>After surgery, you may notice a change in your child’s behaviour. The following changes are normal after a hospital stay:</p><ul><li>disturbed sleep patterns </li><li>wetting the bed </li><li>being more fussy or clingy </li></ul></div><h2>Medicines</h2><p>If your child needs medicine at home, you will be given a prescription before you leave the hospital. It is recommended to have the prescription filled at the hospital outpatient pharmacy before you go home. Your local pharmacy may not have some of the specific medicines your child needs. The nurse or pharmacist will let you know what the medicine is for and how to give it.</p><h3>When and how to give medicines</h3><ul><li>Give the medicine at the same time every day. If your child is taking several medicines, you can ask your nurse or pharmacist to give you a chart to help you remember when to give the medicines.</li><li>You should always try to give medicine before feeding your child. Babies are more likely to take their medicine when they are hungry, and they are less likely to throw up if they get their medicine before their stomachs are full.</li><li>Try not to add medicine to food or drinks. When medicine is mixed with food or drink, it can be hard to know if the full dose has been taken. If you must add medicine to food or drink, put the medicine in a very small amount of food or drink so that the child will finish it all.</li><li>Clean the oral syringes, spoons or medicine cups with hot water and soap after each use.</li><li>Do not mix different syringes with different medicines. Each medicine must have its own syringe.</li></ul><h3>Read all the information about your child’s medicine</h3><ul><li>Read the written information about your child’s medicine before you leave the hospital. The pharmacist, nurse or doctor can answer any questions you may have.</li><li>Always read the labels on the medicine that you get from the pharmacy. Make sure that you know when to give it and how much to give.</li><li>Some of the medicine that your child takes may need to be refrigerated. Be sure to check the labels and store them correctly. </li></ul><h3>If you miss a dose or your child throws up</h3><ul><li>If your child throws up <strong>all</strong> of the medicine right away, give your child another dose.</li><li>If your child throws up 15 to 20 minutes after you have given the medicine, do NOT give your child another dose. If you are not sure what to do, call your doctor or pharmacist.</li><li>If you miss a dose, do not double up on the next dose. If you are less than two hours late, go ahead and give the medicine. If you are more than two hours late, give the next regular dose at the regularly scheduled time. If you are not sure what to do, call your doctor or pharmacist. </li></ul><h3>Other things to remember</h3><ul><li>Check with your doctor or pharmacist before you give any over-the-counter medicines. </li><li>Bring all of your child’s medicines with you to each visit to the hospital and/or take pictures of the medicine bottles on your phone.</li></ul><p> <strong>Keep all medicines locked away and out of the reach of children at all times.</strong> </p><h2>Routine health care</h2><p>Your child should see their paediatrician or family doctor within 1 or 2 weeks after your child leaves the hospital. They will follow your child’s ongoing general health needs. If you have any general concerns about your child’s health, speak to their paediatrician or family doctor.</p><h3>Immunizations</h3><p>If you have questions about your child’s <a href="/Article?contentid=1986&language=English">immunizations</a>, talk to your child’s paediatrician or family doctor. There are special considerations for some children who have had heart surgery, for example the immunization schedule may be delayed if your child received blood products. If these considerations apply to your child, this will be noted on the after visit summary that you receive when your child is discharged.</p><h3>Dental care, surgery, and other procedures</h3><p>Talk to your child’s cardiologist before your child has any dental treatment, surgery or other procedures. Ask your child’s cardiologist if your child needs to take special precautions before these procedures. Before your child has any procedures, make sure your child’s health-care providers know that your child has had heart surgery.</p><h2>Going back to school or day care</h2><p>Your child can go back to school 2 weeks after surgery, or when they feel physically well enough to go. Babies and toddlers can go back to daycare after 2 weeks.</p><p>If other children at the day care or school are sick or have an infection, your child should not go back until 4 weeks after the surgery. Good hand washing and avoiding contact with others who are sick can stop the spread of infection.</p><h2>Travel</h2><p>If you and your child live out of town, you may need to stay close to the hospital until you have had your post-operative clinic visit. Once the cardiologist is happy with your child’s condition, you can go home.</p><p>If your child has ongoing health concerns, this may limit your travel or vacation plans. If you are not sure what your child can do, contact your child’s cardiologist.</p><h3>Car seat</h3><p>When travelling in a car, you must make sure that your children are safely seated in a car seat or secured with a seat belt at all times. There is no need for modifications to the car seat or straps if your child has had heart surgery.</p><div class="pdf-page-break"><h2>Learning first aid</h2><p>Basic Life Support or BLS courses are recommended for all parents. These skills could let you save your child’s life or someone else’s. If you are interested in taking one of these courses offered by the hospital please visit <a href="http://www.cvent.com/d/g4qls1">http://www.cvent.com/d/g4qls1</a>.</p></div><h2>Feeding your child</h2><p>If your baby or child has special nutrition or feeding needs, or requires tube feeding, you will receive additional information from a dietitian and/or an occupational therapist before discharge.</p><h2>When to seek medical attention</h2><p>For SickKids patients, please see the "At SickKids" section for who to contact if you have concerns about your child’s heart condition. </p><h3>What to do in case of an emergency</h3><p>Contact 911 or take your child to the nearest emergency department if your child is:</p><ul><li>having trouble breathing</li><li>experiencing seizures</li><li>not waking up</li></ul><h3>Non-urgent health concerns</h3><p>If you have any questions or concerns about your child’s health that are not related to your child’s heart problem, please contact your child’s paediatrician or family doctor. </p><h2>Follow-up appointments at the cardiology clinic</h2><p>When your child leaves the hospital, you will be given a time to meet with your child's cardiologist. In the future, you can schedule follow-up appointments with the cardiologist during your child's clinic visits.</p><p>One week after your child leaves the hospital, you may have a follow-up appointment in the post-operative clinic. During this visit, your child may:</p><ul><li>have their wound checked by the nurse practitioner</li><li>have a <a href="/Article?contentid=1600&language=English">chest X-ray</a>, <a href="/Article?contentid=1274&language=English">echocardiogram</a> (heart ultrasound), or <a href="/Article?contentid=36&language=English">blood work</a></li><li>see the dietitian or occupational therapist</li></ul><p>During the follow-up appointment, you and your child will both be able to ask questions and talk about any concerns.</p><p>Please arrive on time for your appointments, and come prepared. Appointments can sometimes be delayed, or you may need to wait for tests to be done. <a href="/Article?contentid=1162&language=English">Bring books, toys, snacks</a>, diapers and anything else you and your child need to be comfortable while you wait. Before an appointment, write down questions you may have and bring them to the clinic. If you cannot come to an appointment, call the cardiology clinic as early as possible to reschedule.</p><h2>At SickKids</h2><p>For SickKids patients, if you have any questions or concerns related to your child’s heart condition within <strong>1 week</strong> after your child is discharged from the hospital contact the 4D Cardiac Inpatient Unit at (416)- 813- 6901.</p><p>If you have concerns that your child's wounds may be infected <strong>within the first 4 weeks</strong> after surgery, call (416)-813-6901 ext. 2 and ask to speak to the Post-Operative Nurse Practitioner during regular business hours.</p><p>If you have any non-urgent questions or concerns after <strong>1 week</strong> of discharge from the hospital and you have been seen in post-operative clinic, contact your clinic nurse directly or call 4A Cardiac Clinic at (416)- 813-5848 during regular business hours. You may also leave a message after hours.</p><img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/after_heart_surgery_caring_for_your_child.jpg" style="BORDER:0px solid;" />https://assets.aboutkidshealth.ca/AKHAssets/after_heart_surgery_caring_for_your_child.jpgCaring for a child after heart surgery Children need extra care and attention after heart surgery. Read about care after heart surgery including diet, pain management and school.Main
E-cigarettes and vapingE-cigarettes and vapingE-cigarettes and vapingEEnglishRespiratoryTeen (13-18 years)Lungs;BrainRespiratory systemHealthy living and preventionAdult (19+) CaregiversNA2019-11-04T05:00:00ZTheo Moraes, MD, PhD, FRCPC; Trisha Tulloch, MD, MSc, FRCPC, FAAP10.900000000000048.20000000000001075.00000000000Flat ContentHealth A-Z<p>Learn about e-cigarettes, how they work and who is using them. Also find information about the health risks associated with vaping.</p><h2>About e-cigarettes</h2><p>E-cigarettes belong to a group of devices commonly known as electronic nicotine delivery systems (ENDS). While there are many types of ENDS, they have a few things in common including a:</p><ul><li>battery</li><li>heating coil or atomizer</li><li>mouthpiece</li><li>reservoir or tank</li><li>sensor or button to activate the heating coil</li></ul><p>E-cigarettes can be disposable, or have a reloadable cartridge or a refillable reservoir for the vaping solution. In some e-cigarettes the wattage and voltage can also be modified.</p><p>E-cigarettes are known by many different names, such as:</p> <figure> <img alt="Small vaping device that looks like a flash drive" src="https://assets.aboutkidshealth.ca/AKHAssets/vaping.jpg" /></figure> <ul><li>cig-a-like</li><li>vape/dab pen</li><li>box-mod</li><li>pod device (JUUL, Blu, Phix, Suorin, STIG)</li><li>Chronic/Dank Vapes</li></ul><p>E-cigarettes are available in many different shapes and sizes. Some are small and look like a flash drive or pen, while others are much larger.</p><h2>Key points</h2><ul><li>The use of e-cigarettes, or vaping, is very common among teens and young adults and has been increasing over the past several years.</li><li>Vaping solutions can contain nicotine and other chemicals such as tetrahydrocannabinol (THC) and cannabidiol (CBD) oil.</li><li>Nicotine is highly addictive and can quickly become a long-term addiction, especially for teens and young adults whose brains are still developing.</li><li>The chemicals in vaping solutions can lead to short-term health problems and increase the risk of long-term health problems.</li><li>If you are trying to quit using tobacco cigarettes, talk to your health-care professional to come up with a plan that makes sense for you.</li></ul> <h2>How e-cigarettes work</h2><p>The action of using an e-cigarette is called vaping. When a user inhales from the mouthpiece of the e-cigarette, the heating coil is activated. The energy from the battery allows the heating coil to heat the vaping liquid and the vapor is then generated, which is inhaled, mimicking the use of a tobacco cigarette. The vapor that is generated is actually an aerosol that contains fine particles.</p><h2>Vaping solutions</h2><p>Vaping solutions are sometimes known as e-juice or e-liquid, and can contain a number of different chemicals.</p><ul><li>Propylene glycol: One of the main liquids (along with glycerin) used to carry the other chemicals</li><li>Glycerin: One of the main liquids (along with propylene glycol) used to carry the other chemicals</li><li>Nicotine: The main addictive chemical found in tobacco cigarettes and vaping solutions</li><li>Flavorings: Various chemicals, including diacetyl, used to create different tastes and smells</li><li>Tetrahydrocannabinol (THC) and cannabidiol (CBD) oil: Two chemicals that are sometimes added to vaping solutions</li></ul><p>Moreover, various heavy metals (nickel, tin and lead) can also be found in vaping solutions.</p><h2>Who is using e-cigarettes?</h2><p>The most recent studies from 2018 show that 37% of teens (aged 16-19) in Canada have tried e-cigarettes. This is an increase of 8% compared to 2017. Most of these teens do not use tobacco cigarettes. About 3.6% of 16 to 19 year olds in Canada when surveyed in 2018 had used e-cigarettes on more than 15 days in the past 30 days.</p><p>In addition, less than 1% of North American adults (45 year of age and older) use e-cigarettes on a daily basis whereas about 8% of 18 to 24 year olds use e-cigarettes daily. Currently, e-cigarettes are used disproportionally by young people.</p><h2>Health risks and vaping</h2><p>There are both short- and long-term health risks associated with vaping. One rare short-term risk is that devices have caught fire or exploded causing physical injury. Seizures have also been described. More seriously, severe, life threatening lung injury has been associated with e-cigarette use. Some people have died from this lung injury. While it is not known why the lungs of these people were injured in this way, there is evidence that it is related to one or more of the chemicals found in vaping solutions.</p><p>A long-term risk associated with vaping is that nicotine use by teens can have a negative impact on their brain development. It can harm the parts of their brain that control attention, learning, mood and impulse control.</p><p>Another important risk is nicotine addiction. The developing brains of teens and young adults are highly susceptible to the addictive properties of nicotine. In a single pod, e-cigarettes can deliver more nicotine to a person than a pack of cigarettes. Moreover, while high doses of nicotine can lead to nausea and headache, there is no irritating smoke and no need to light a new cigarette, so a person can receive large amounts of nicotine in a day.</p><p>Nicotine is not harmless. Nicotine is toxic to the lungs and long-term use may increase the risk of chronic lung disease.</p><p>While vaping has not been around long enough to be sure of the long-term effects health effects, research studies in cells and animal models suggest that the other chemicals in vaping solutions may also lead to health problems with long-term use.</p><h2>E-cigarettes as a type of nicotine replacement therapy</h2><p>E-cigarettes that contain nicotine have sometimes been used as a type of nicotine replacement therapy to help adults, who are not pregnant, to quit using tobacco cigarettes or to reduce the use tobacco cigarettes. There is some data that suggests that e-cigarettes can help tobacco cigarette users to quit. However, there is also data that the use of e-cigarettes does not lead to more people quitting using tobacco cigarettes.</p><p>There are other types of nicotine replacement and other ways to quit using tobacco cigarettes that do not involve nicotine replacement therapy. If you are considering vaping in order to help you to quit using tobacco cigarettes, talk to a health-care professional and explore the different options that may work for you.</p><h2>Summary</h2><p>With the information that is currently available about e-cigarettes, the recommendation is, if you do not smoke then do not vape. If you do smoke and want to vape, know your options, and the risks and benefits so you can make an informed choice.</p><h2>Resources</h2><p>The Substance Abuse Program at the Hospital for Sick Children is for teens up to 18 years of age to help them with alcohol and other substance abuse related issues: <a href="http://www.sickkids.ca/adolescentmedicine/programs/substance-abuse-program/substance-abuse-program.html">http://www.sickkids.ca/adolescentmedicine/programs/substance-abuse-program/substance-abuse-program.html</a></p><p>The Nicotine Dependence Clinic located at CAMH is for anyone who wants to quit or reduce their tobacco use: <a href="https://www.camh.ca/en/your-care/programs-and-services/nicotine-dependence-clinic">https://www.camh.ca/en/your-care/programs-and-services/nicotine-dependence-clinic</a></p><p>The Youth Addiction and Concurrent Disorders Service at CAMH is for teens and young adults (ages 14-24) who have substance use challenges and/or concerns, with or without concurrent mental health concerns: <a href="https://www.camh.ca/en/your-care/programs-and-services/youth-addiction--concurrent-disorders-service">https://www.camh.ca/en/your-care/programs-and-services/youth-addiction--concurrent-disorders-service</a></p><p>Find resources from the Canadian Cancer Society to help you to quit using tobacco cigarettes: <a href="https://www.smokershelpline.ca/">https://www.smokershelpline.ca/</a></p> <h2>References</h2><p>Dai, H. & Leventhal, A.M. (2019, September 16). Prevalence of e-Cigarette Use Among Adults in the United States, 2014-2018. <em>The Journal of the American Medical Association</em>. Retrieved from <a href="https://doi.org/10.1001/jama.2019.15331">https://doi.org/10.1001/jama.2019.15331</a></p><p>Government of Canada. (2019, July 25). Talking with your teen about vaping: a tip sheet for parents. Retrieved from <a href="https://www.canada.ca/en/services/health/publications/healthy-living/talking-teen-vaping-tip-sheet-parents.html">https://www.canada.ca/en/services/health/publications/healthy-living/talking-teen-vaping-tip-sheet-parents.html</a></p><p>Government of Canada. (2019, August 6). About vaping. Retrieved from <a href="https://www.canada.ca/en/health-canada/services/smoking-tobacco/vaping.html">https://www.canada.ca/en/health-canada/services/smoking-tobacco/vaping.html</a></p><p>Hammond, D., Reid, J.L., Rynard, V.L., Fong, G.T., Cummings, K.M., McNeill, A.,…White, C.M. (2019). Prevalence of vaping and smoking among adolescents in Canada, England, and the United States: repeat national cross sectional surveys. <em>The British Medical Journal, 365</em>. <a href="https://doi.org/10.1136/bmj.l2219">https://doi.org/10.1136/bmj.l2219</a></p><p>Stanwick, R. (2018, February 28). E-cigarettes: Are we renormalizing public smoking? Reversing five decades of tobacco control and revitalizing nicotine dependency in children and youth in Canada. <em>Canadian Paediatric Society</em>. Retrieved from <a href="https://www.cps.ca/en/documents/position/e-cigarettes">https://www.cps.ca/en/documents/position/e-cigarettes</a></p><p>US Department of Health and Human Services. (2016). E-cigarette Use Among Youth and Young Adults: A Report of the Surgeon General. Retrieved from <a href="https://www.cdc.gov/tobacco/data_statistics/sgr/e-cigarettes/pdfs/2016_sgr_entire_report_508.pdf">https://www.cdc.gov/tobacco/data_statistics/sgr/e-cigarettes/pdfs/2016_sgr_entire_report_508.pdf</a></p><p>Walley, S.C., Wilson, K.M., Winickoff, J.P., & Groner, J. (2019). A Public Health Crisis: Electronic Cigarettes, Vape, and JUUL. <em>Pediatrics, 145</em>. Retrieved from <a href="https://pediatrics.aappublications.org/content/143/6/e20182741">https://pediatrics.aappublications.org/content/143/6/e20182741</a></p>https://assets.aboutkidshealth.ca/AKHAssets/vaping_devices.jpgMain
Avoidant/restrictive food intake disorder: OverviewAvoidant/restrictive food intake disorder: OverviewAvoidant/restrictive food intake disorder: OverviewAEnglishPsychiatryToddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)NANAConditions and diseasesCaregivers Adult (19+)NA2016-02-02T05:00:00ZSe​ena Grewal, MD, MSc, FRCP(C);Melissa Lieberman, PhD​​9.3000000000000054.8000000000000494.000000000000Health (A-Z) - ConditionsHealth A-Z<p>​Learn about the possible causes of ARFID and how it differs from picky eating.</p><h2>What is avoidant/restrictive food intake disorder?</h2><p>Avoidant/restrictive food intake disorder, or ARFID for short, is an eating disorder that occurs when a child or teen does not eat enough to meet their energy or nutritional needs. This could be for a range of reasons, including concerns about food texture or not feeling well when eating.</p><p>Children and teens with this disorder eat very little food or avoid certain foods. This can result in significant weight loss or a failure to gain weight.</p><h2>Key points</h2><ul><li>​A child who has ARFID eats very little food or avoids certain foods for a range of reasons, for example because of concerns about food texture or not feeling well when eating.</li><li>​​Some people with ARFID have anxiety disorders that appear as a fear of vomiting or choking.</li><li> ​​ARFID is not the same as picky eating. It involves having a poor appetite overall,​ rather than a rejection of a few foods, and needs medical attention and psychological care.​ ARFID usually develops in childhood but can occur in people of all ages.</li>​</ul><h2>What causes ARFID?</h2> <p>Not a lot of information is currently known about the causes of ARFID. </p> <p>Some children and teens with ARFID will struggle with <a href="/Article?contentid=18&language=English">anxiety disorders</a> that appear as a fear of vomiting or choking. Other children and teens may experience eating issues as part of another disorder, for example <a href="/autism">autism</a>. They would only be diagnosed with ARFID, however, if their food issues were more severe than would be expected with the disorder.</p> <h2>Is ARFID the same as "picky eating"?</h2> <p>No, ARFID is not the same as "picky eating".</p> <ul> <li>Children with ARFID may refuse to eat foods of a certain texture, colour, taste, temperature or smell. Picky eating typically involves only a few foods.</li> <li>If a child has ARFID, they tend to have a poor appetite and experience delayed growth. So-called picky eaters have a normal appetite, eat enough food overall and develop normally.</li> <li>The problems that people with ARFID develop with food continue for a long time and need medical attention and psychological care. The eating patterns found among picky eaters usually resolve on their own eventually.</li> </ul> <h2>Who is affected by ARFID?</h2> <p>ARFID typically begins during childhood but can occur in people of all ages. Unlike those with <a href="/Article?contentid=268&language=English">anorexia nervosa</a> or <a href="/Article?contentid=282&language=English">bulimia nervosa</a>, people with ARFID do not have body image concerns or fears about gaining weight.</p><h2>Further information</h2><p>For more information on avoidant/restrictive food intake disorder (ARFID), please see the following pages:</p><p> <a href="/Article?contentid=275&language=English">ARFID: Signs and symptoms</a></p><p> <a href="/Article?contentid=273&language=English">ARFID: Medical complications</a></p><p> <a href="/Article?contentid=703&language=English">ARFID: Treatment options</a></p><p> <a href="/Article?contentid=272&language=English">ARFID: How to help your child at home</a></p><h2>Resources</h2><p> <a href="http://www.nedic.ca/" target="_blank">NEDIC – National Eating Disorder Infor​mation Centre</a> (Canada)</p><p> <a href="https://www.nationaleatingdisorders.org/" target="_blank">NEDA – National Eating Disorder Association</a> (United States)</p><p>American Academy of Pediatrics – <em><a href="https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Is-Your-Teen-at-Risk-for-Developing-an-Eating-Disorder.aspx" target="_blank">​Eating Disorders in Children</a> ​</em></p><p> <a href="https://www.beateatingdisorders.org.uk/" target="_blank">BEAT – Beating Eating Disorders</a> (United Kingdom)</p><p> <a href="https://keltyeatingdisorders.ca/" target="_blank">Kelty Eating Disorders​</a> (Kelty Mental Health Resource Centre, BC Children's Hospital)</p><p>Children's Hospital of Eastern Ontario – <a href="https://www.cheo.on.ca/en/eating_disorder_info" target="_blank"><em>Eating Disorders​</em></a></p> ​​<img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/avoidant_restrictive_food_intake_overview.jpg" style="BORDER:0px solid;" />https://assets.aboutkidshealth.ca/AKHAssets/avoidant_restrictive_food_intake_overview.jpgARFID: Overview Learn about the possible causes of Avoidant/restrictive food intake disorder (ARFID) and how it differs from picky eating.Main
CancerCancerCancerCEnglishOncologyChild (0-12 years);Teen (13-18 years)NANANAAdult (19+) CaregiversNA2019-09-03T04:00:00ZLanding PageLearning Hub<p>A child's cancer diagnosis and treatment impacts the entire family. This learning hub will help you learn strategies to support your child, yourself and your family; how to support your teen to learn to manage their own health care; and how to manage cancer-related pain in younger children.</p><p>A child's cancer diagnosis and treatment impacts the entire family. This learning hub will help you learn strategies to support your child, yourself and your family; how to support your teen to learn to manage their own health care; and how to manage cancer-related pain in younger children.</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">The impact of cancer</h2></div><div class="panel-body list-group" style="display:none;"><p>It is important to understand how your teenager’s cancer can affect you, your family, and your community. Discover strategies parents and caregivers can learn to cope, how to support your teenager's siblings and how to manage the financial impact of cancer.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3594&language=English">The impact of cancer</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3608&language=English">Learning more about your teenager's cancer</a></li><li><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"><i class="mdi mdi-chevron-down"></i></span> <h3>Family</h3></div><ol class="list-group" style="display:none;"><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3601&language=English">The impact of cancer on your family</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3603&language=English">The impact of cancer on siblings</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3602&language=English">Relationship with your partner</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3604&language=English">The impact of cancer on extended family</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>Managing stress and emotions</h3></div><ol class="list-group" style="display:none;"><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3596&language=English">Coping with emotions</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3597&language=English">Maintaining your mental health</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3598&language=English">Caring for yourself</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3599&language=English">Negative coping</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3600&language=English">Managing daily tasks</a></li></ol></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3605&language=English">The impact of cancer on friendships</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3606&language=English">Setting up a communication system</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3607&language=English">The financial impact of cancer</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3609&language=English">Programs and resources</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">Letting go</h2></div><div class="panel-body list-group" style="display:none;"><p>There are many ways you can support your teenager as they learn to manage their own health care. Supporting your teen to gain more independence will help them make a smoother transition to survivorship, adulthood, and the adult health-care system. </p></div><ol class="list-group" style="display:none;"><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3612&language=English">Talking to your teen</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3613&language=English">Getting through the teen years</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3615&language=English">Anxiety, stress and cancer</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3616&language=English">Loss of control</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3617&language=English">Separation from peers</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3618&language=English">Impact of cancer on sexuality</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3619&language=English">Body image, self-esteem and cancer</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3620&language=English">Steps towards independence</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3621&language=English">Encouraging healthy habits</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3622&language=English">Health care transition</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3623&language=English">Long-term follow-up and late effects</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3624&language=English">Cancer research and your teenager</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">Managing cancer-related pain in children</h2></div><div class="panel-body list-group" style="display:none;"><p>Find information on cancer-related pain, including the different types of pain, methods of assessment and the 3P approach to pain management.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3813&language=English">Cancer-related pain in children</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3814&language=English">Assessing cancer-related pain in children</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3815&language=English">Treating and managing cancer-related pain in children</a></li><li class="list-group-item"> <a class="overview-links" href="/Article?contentid=3816&language=English">Cancer-related pain: Parenting strategies to support the 3P's</a><br></li></ol></div>https://assets.aboutkidshealth.ca/AKHAssets/Coping_with_cancer_diagnosis.jpgmanagingcancermanagingcancer A cancer diagnosis impacts the entire family. This learning hub will help you learn strategies to support your child, yourself and your family.Main

 

 

All About the HeartAll About the HeartAll About the HeartAEnglishhttps://assets.aboutkidshealth.ca/AKHAssets/J4K_all_about_the_heart_promo.pngKids ContentKids<p>Learn about the heart<br></p><figure class="swf-asset-c-80"> <div class="akh-video">src="https://www.youtube.com/embed/-s5iCoCaofc?rel=0"</div></figure><br><br>All about the heart February is Heart Month! Use this video to help your child learn how their heart transports blood around the body.Kidsall-about-the-heart
Mental healthMental healthMental healthMEnglishPsychiatryChild (0-12 years);Teen (13-18 years)NANANACaregivers Adult (19+)NALanding PageLearning Hub<p>Learn how to support your child’s wellbeing with activity, sleep and nutrition; and how to recognize and manage various mental health conditions.</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</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</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">Anxiety: 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">Anxiety: Treatment with medications</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=702&language=English">Anxiety: 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</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">OCD: 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">OCD: Psychotherapy and medications</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=287&language=English">OCD: 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</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">Depression: Signs and symptoms</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=707&language=English">Depression: Treatment with medications</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=708&language=English">Depression: 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">Bipolar disorder: Signs and symptoms</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=704&language=English">Bipolar disorder: Treatment with medications</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=705&language=English">Bipolar disorder: 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</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">Anorexia: Signs and symptoms</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=267&language=English">Anorexia: Medical complications</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=700&language=English">Anorexia: Treatment options</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=266&language=English">Anorexia: 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">Bulimia: Signs and symptoms</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=281&language=English">Bulimia: Medical complications</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=706&language=English">Bulimia: Treatment options</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=294&language=English">Bulimia: 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">ARFID: Signs and symptoms</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=273&language=English">ARFID: Medical complications</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=703&language=English">ARFID: Treatment options</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=272&language=English">ARFID: 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">BED: 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">BED: 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">ADHD: Signs and symptoms</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=1997&language=English">ADHD: How to help your child at home</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=1999&language=English">ADHD: Communicating with your child's school</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=1998&language=English">ADHD: 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">Behavioural disorders: Signs and symptoms</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=2000&language=English">Behavioural disorders: Treatment with psychotherapy and medications</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=2001&language=English">Behavioural disorders: 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">PTSD: Signs and symptoms</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=2005&language=English">PTSD: 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">Brain disorders: Assessing your child for neuropsychological difficulties</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=2003&language=English">Brain disorders: How to help your child cope</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=2004&language=English">Brain disorders: Common treatments</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">Parenting a child with a chronic condition</h2></div><div class="panel-body list-group" style="display:none;"><p>A chronic conditions can affect a child's mental health and everyday routines. Discover how parents and caregivers can help manage both their child's health care and routines, and support their own mental health.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3400&language=English">Living with a chronic condition: Overview</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3401&language=English">Living with a chronic condition: Helping your child manage their health</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3402&language=English">Living with a chronic condition: Maintaining your child's everyday routines</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3403&language=English">Living with a chronic condition: Supporting yourself as a caregiver</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">Substance use disorder</h2></div><div class="panel-body list-group" style="display:none;"><p>Substance use is the use of alcohol, tobacco and other drugs for pleasure or enjoyment. Learn about the signs and symptoms of substance use and how you can help your teen if you suspect they have a substance use disorder.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3663&language=English">Substance use disorder: Overview</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3664&language=English">Substance use disorder: Signs and symptoms</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3665&language=English">Substance use disorder: How to help your teen 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">Understanding somatization</h2></div><div class="panel-body list-group" style="display:none;"><p>Somatization involves expressing distress through physical symptoms. Find out about the mind-body connection, signs of somatization and the various ways to support your child or teen.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3667&language=English">Mind-body connection</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3668&language=English">Somatization: Signs and symptoms</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3669&language=English">Somatization: Common treatments</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3770&language=English">Somatization: How to help your child or teen cope</a></li></ol></div>https://assets.aboutkidshealth.ca/AKHAssets/Mental_health_landing-page.jpgmentalhealthhealthylivingMain
Blocked tear ductsBlocked tear ductsBlocked tear ductsBEnglishOphthalmologyChild (0-12 years);Teen (13-18 years)EyesLacrimal glandsNon-drug treatmentCaregivers Adult (19+)Eye discomfort and rednesshttps://assets.aboutkidshealth.ca/akhassets/Tear_duct_MED_ILL_EN.png2014-07-21T04:00:00ZYasmin Shariff, RN;Robert C. Pashby, MD, FRCSC;Dan D. DeAngelis, MD, FRCSC6.4000000000000073.70000000000001752.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn how your child's blocked tear duct can be treated.</p><h2>How do tears work?</h2><p>Tears clean the eyes and keep the surface of the eyes moist. They are produced all the time by the tear glands (lacrimal glands) and flow down across the surface of the eye. They then drain through a small opening (punctum) near the corner of the eye into the tear sac (lacrimal sac). From there, they flow down a tube called the tear duct (nasolacrimal duct) into the nose and throat.</p><h2>What is a blocked tear duct?<br></h2><p>A tear duct that is blocked stops the flow of tears from the eye down into the nose. It can affect one or both eyes. </p> <figure class="asset-c-80"><span class="asset-image-title">Blocked tear </span> <span class="asset-image-title">duct</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Tear_duct_MED_ILL_EN.png" alt="Eye with normal tear production and eye with blocked tear duct causing tear backup in the lacrimal sac and watery eyes" /> <figcaption class="asset-image-caption">Tears</figcaption> <figcaption class="asset-image-caption"> normally travel from the eyes to the inside of the nose through a tiny pathway. When this pathway becomes blocked it is called a blocked tear duct. </figcaption> </figure><h2>Causes of a blocked tear duct</h2> <p>A blocked tear duct usually occurs when the nasolacrimal duct fails to open at its lower end in the nose.</p> <p>The condition can be congenital (it is present at birth) or acquired (it develops later in life). A congenital blocked tear duct affects about one in 25 babies.</p> <h2>Symptoms of blocked tear ducts</h2> <ul> <li>Your child will have wet eyelashes or extra tears. Since the tears cannot drain out of the tear duct, they spill over the lashes, often onto the cheeks. </li> <li>Your child's eyelids may stick together with mucus, especially in the morning. Mucus is a sticky liquid that is normally dissolved in the tears. When tears do not flow well, however, the mucus stays on the outside of the eye. This mucus is normal. It is not the same as pus (a yellowish or greenish liquid), which is a sign of an infection.</li> <li>Your child may often have a red eye. This is caused by infections, which are more common when tears do not drain properly.</li> </ul> <h3>Extra tears do not always mean the tear ducts are blocked</h3> <p>Extra tears are not always caused by blocked tear ducts. If your child has extra tears, an eye doctor should check your child's eye(s).</p><h2>Key points</h2> <ul> <li>A blocked tear duct stops the flow of tears from the eye down the lacrimal duct into the nose. </li> <li>Extra tears are not always caused by blocked tear ducts.</li> <li>There are many treatments for blocked tear ducts. Your child will only have surgery if other medical treatments do not work.</li> <li>If your child has surgery, follow all after-care instructions properly and attend follow-up appointments.</li> </ul><h2>How to care for your child after tear duct surgery</h2> <h3>Cool water compresses</h3> <p>Some doctors will suggest putting cool water or ice water compresses on the eyes to ease discomfort and reduce swelling after surgery. Ask your child's doctor if your child can have cool compresses.</p> <p>To make a cool compress, follow these steps:</p> <ol> <li>Fill a clean container with cool water. Cool tap water is fine. If you have well water, boil it and cool it in the refrigerator before you use it.</li> <li><a href="https://akhpub.aboutkidshealth.ca/Article?contentid=1981&language=English">Wash your hands</a>.​</li> <li>Soak a clean face cloth in the cool water.</li> <li>Squeeze any extra water out of the cloth, then place the cloth on the swollen eye(s).</li> <li>Leave the cloth on for no more than two minutes at a time.</li> <li>Repeat a few times.</li> <li>Wash your hands again.</li> </ol> <p>Ask the doctor how often your child can have a cool compress. Several times a day for the first one or two days after surgery is often fine. Always wash your hands before and after touching your child's eyes.</p> <h3>Antibiotic drops</h3> <p>Your child's doctor may prescribe antibiotic ointment or eye drops for the affected eye and the surgery site. Make sure you get the prescription and carefully follow the instructions for <a href="https://akhpub.aboutkidshealth.ca/Article?contentid=996&language=English">applying the ointment</a> or <a href="https://akhpub.aboutkidshealth.ca/Article?contentid=995&language=English">putting in the eye drops</a>.</p> <h3>Nose blowing and wiping</h3> <p>Your child should not blow their nose for the first two weeks after surgery. It is fine to wipe the nose gently instead.<br></p> <h3>Tubes</h3> <p>Tubes placed in the tear duct do not generally cause any problem. If your child has a tube and the loop becomes very visible in the corner of the eye, attach it to your child's face with a piece of tape and call your child's doctor to inform them about it.</p> <h3>Gentle play only for the first week </h3> <p>For the first week after surgery, your child should only do light activities such as gentle playing indoors, using computers or watching TV.</p> <p>During this time, your child must avoid rough activities, sandbox play, contact sports such as soccer or hockey or anything else that would cause your child to bump into another child. Your child should also avoid bending and any activities that could cause them to get out of breath.</p> <p>If you have any questions about other possible activities, ask your child's doctor.</p> <h3>School and day care</h3> <p>Generally, children should not go to school or day care for the first two days after surgery, sometimes longer. Please check with your child's doctor. Tell your child's caregiver or teacher about the activities your child must avoid.</p> <h3>Swimming</h3> <p>Generally, swimming is not allowed for one week after the surgery until your child is seen by the doctor. Your child's doctor can tell you when your child can return to swimming.</p> <h3>Baths and showers</h3> <p>Ask your doctor about baths and showers. Some doctors recommend a bath instead of a shower for the first week after surgery.</p> <h3>Sun exposure</h3> <p>Your child should avoid going out in the sun right after surgery. Ask your child's doctor when your child is allowed to go back out in the sun. </p><h2>When to call the doctor</h2> <p>Please call the surgeon after the operation if:</p> <ul> <li>your child cannot see properly</li> <li>your child's pain gets worse</li> <li>your child has a tummy upset</li> <li>your child's eye suddenly gets more puffy</li> <li>your child's eye is bleeding.</li> </ul> <h3>Write down your child's doctor's name and phone number here:</h3> <p>Name: ________________________________________</p> <p>Phone number: _________________________________</p><h2>Follow-up appointments</h2> <p>You will need to bring your child to a follow-up appointment one or two weeks after surgery. Check with your child's doctor about when the follow-up appointment should happen.</p> <h3>Write the date and time of the first appointment here:</h3> <p>_____________________________________________</p> <p>Sometimes, the surgery may need to be repeated. Your child's doctor will tell you if your child needs another operation.</p> <p>If your child has a tube in the tear duct, you will need to make a follow-up appointment a few weeks or months after surgery to have it removed.</p> <h3>Write the date and time of the appointment here:</h3> <p>_____________________________________________</p><h2>Treatments for blocked tear ducts</h2> <p>There are different treatments for blocked tear ducts. Your doctor will explain which treatment is best for your child.</p> <p>Medical treatments include massage and <a href="https://akhpub.aboutkidshealth.ca/Article?contentid=1120&language=English">antibiotics</a> for any infections. If these do not work, your doctor will recommend surgery (an operation).</p> <h3>Massaging the eye<br></h3> <p>Gently rubbing (massaging) the lacrimal sac will often help open the tear duct. You will usually need to do this four to six times a day. Your doctor will explain how to massage the lacrimal sac.</p> <h3>Antibiotics</h3> <p>If your child has an infection, the doctor may prescribe antibiotic drops or ointment​. Make sure you apply the <a href="/Article?contentid=996&language=English">ointment</a> or <a href="/Article?contentid=995&language=English">eye drops</a> correctly.</p> <h3>Surgery for blocked tear ducts</h3> <p>If medical treatments have not worked after several months, your child may need surgery. Your child might also need surgery if the lacrimal sac is infected and the skin between the eyeball and the side of the nose is red and swollen.</p> <p>Different types of surgery are available. Your doctor will discuss with you which surgery is best for your child. This will be based on your child's age and how serious the blockage is. Your doctor will also discuss the risks involved with any surgery.</p><h2>What happens during tear duct surgery?</h2> <p>Before the surgery, your child will have a special "sleep medicine" called a <a href="/Article?contentid=1261&language=English">general anaesthetic</a>. This will make sure your child sleeps through the operation and does not feel any pain.</p> <p>Three types of surgery are available:</p> <ul> <li>probing and irrigating</li> <li>silicone tube insertion</li> <li>dacryocystorhinostomy.</li> </ul> <h3>Probing and irrigating</h3> <p>Probing and/or irrigating is the most common surgery for blocked tear ducts.</p> <ol> <li>A thin blunt probe is inserted from the punctum into the lacrimal duct to open the blockage.</li> <li>A second probe is inserted into the nose to make contact with the first probe and make sure the duct is open.</li> <li>If the surgeon decides to irrigate (flush) the duct, a blunt needle will be inserted and saline solution (sterile salt water) will be flushed through it.</li> <li>The needle and probes are removed.</li> </ol> <h3>Silicone tube insertion</h3> <p>In this type of surgery, the surgeon puts a thin tube into the lacrimal duct. The tube is left in for a number of weeks to stop the tear duct from blocking again.</p> <h3>Dacryocystorhinostomy</h3> <p>Dacryocystorhinostomy (say: DACK-ree-oh-SISS-toe-rye-NOSS-toe-mee) is surgery to make a new opening in the tear sac and through the bone into the nose. This lets the tears drain into the nose.</p> <p>All three types of operation are done as day surgery. This means that your child does not stay in the hospital overnight afterwards.</p><h2>What to expect after surgery</h2> <h3>Pain or discomfort</h3> <p>Your child may have some pain in and near the operated eye. Ask your doctor if you can give your child any pain relief medicine.</p> <h3>Discharge from the eyes</h3> <p>Your child's tears and the discharge coming out of the nose may be stained with blood for a day or two. This is normal.</p> <p>There will also be some blood-stained discharge from the area that was operated on. If this happens, apply slight pressure to the operated area with a clean dressing.</p> <p>Tell your doctor if the discharge or bleeding continues for more than a couple of days or if the discharge becomes yellow or green.</p> <h3>Eye patch</h3> <p>Your child does not usually need a patch after this surgery. If your child does get an eye patch, however, your child's doctor will tell you when to remove it.</p> <h3>Tubes in the eye</h3> <p>If your child has a tube placed in the tear duct, they will return to the doctor usually a few weeks or months after surgery to have it taken out while they are awake. Your doctor will give you instructions to follow while the tube is in place.</p><h2>At SickKids</h2> <p>If your child's doctor is not available, call the hospital at 416 813-7500 and ask to speak to the eye doctor on call.</p> A blocked tear duct stops the flow of tears from the eye down into the nose. Learn how a blocked tear duct can be treated.Main
Slings: How to make a basic slingSlings: How to make a basic slingSlings: How to make a basic slingSEnglishOrthopaedics/MusculoskeletalPreschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)ArmBonesNon-drug treatmentCaregivers Adult (19+)NAhttps://assets.aboutkidshealth.ca/akhassets/IMD_slings_forearm_03_EN.jpg2015-02-12T05:00:00ZElizabeth Berger, BA, MD, FRCPC, FAAP, MHPE​6.3000000000000078.8000000000000725.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn how to make simple but effective forearm and collarbone slings.</p><p>If your child injures their arm, they may need to wear a sling while it heals. A sling will keep the arm still to relieve any pain and prevent an injury from getting worse.</p><h2>Key points</h2> <ul> <li>Before applying a sling, check for any serious cuts and make sure any bleeding is under control.</li> <li>For forearm slings, use padding for the injured arm and tie the sling around your child’s neck on the uninjured side.</li> <li>For shoulder or collarbone slings, drape the long side of the bandage down from the shoulder on the uninjured side, bring it over your child’s arm and tie it behind their back.</li> <li>Make sure the sling keeps your child’s arm in place but is not so tight that it limits blood flow.</li> <li>See a doctor if there is severe bleeding or if your child has dislocated a joint or broken a bone.</li> </ul><h2>When to see a doctor for an arm injury</h2><p>See a doctor if you think your child has dislocated a joint or if they have a broken bone or severe bleeding.</p><h2>How to put on a sling</h2><p>There are two main types of sling: one for a forearm injury and one for a collarbone or shoulder injury.</p><h3>Forearm sling</h3><ol class="akh-steps"><li> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_slings_forearm_01_EN.jpg" alt="Holding triangular bandage at one corner up to child’s shoulder on uninjured side" /> </figure> <p>Place the triangular bandage lengthwise against your child’s upper body. The long side of the bandage should extend down from their shoulder on the uninjured side. The shorter sides should point to the injured arm and meet near the elbow. Leave the top of the bandage over your child’s shoulder for now.</p></li><li> <figure><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_slings_forearm_02_EN.jpg" alt="Placing child's injured arm over the bandage across their chest" /> </figure> <p>Gently place your child’s injured arm over the bandage and across their chest. Their wrist should be slightly higher than their elbow and at the middle of the cloth’s long edge.</p></li><li> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_slings_forearm_03_EN.jpg" alt="Wrapping towel around child's injured arm, keeping the arm held over triangular bandage" /> </figure> <p>Support the injured arm with one hand. With your other hand, place a generous layer of padding, such as a rolled newspaper or folded towel, around the injured arm. </p></li><li> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_slings_forearm_04_EN.jpg" alt="Passing triangular bandage under and over the child’s injured arm and tying the corners behind the neck to create a sling" /> </figure> <p>Bring the bottom of the bandage up over the injured arm and behind your child’s neck.</p></li><li><p>Tie the two ends of the bandage behind your child’s neck on the uninjured side. This will avoid placing any strain on their injury.</p></li><li> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_slings_forearm_05_EN.jpg" alt="Child wearing a sling tied behind the neck and held together at the elbow with safety pins to hold the arm across their chest" /> </figure> <p>To stop your child’s arm from slipping out of the sling, use paper tape or safety pins to secure the point of the sling at your child’s elbow.</p></li></ol><h3>Collarbone or shoulder sling</h3><ol class="akh-steps"><li> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_slings_collarbone_01_EN.jpg" alt="Child holding the hand of their injured arm up to their shoulder on the opposite side" /> </figure> <p>Gently place your child’s fingertips on their shoulder on the uninjured side. </p></li><li> <figure><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_slings_collarbone_02.jpg" alt="Triangular bandage held up to child with one corner held over their fingertips" /> </figure> <p>Take one end of the triangular bandage and hold it near your child’s fingertips.</p></li><li><p>Tuck the bandage under the elbow so it supports your child’s arm on the injured side.</p></li><li> <figure><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_slings_collarbone_03.jpg" alt="Bandage held over shoulder of uninjured side and wrapped under elbow of injured arm, up to the opposite shoulder" /> </figure> <p>Bring the other end of the bandage behind your child’s back and tie the two ends behind their neck.</p></li><li> <figure><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_slings_collarbone_04.jpg" alt="Child wearing sling tied over shoulder on uninjured side and held together at the elbow of the other arm with safety pins" /> </figure> <p>Tuck any extra fabric behind the sling, near the elbow, or use paper tape or safety pins to keep it in place. </p> </li></ol><p>A first aid course can teach you more about applying different types of slings.</p><h2>Check the fit of the sling</h2> <p>Once the sling is in place, occasionally check that there is enough blood flow in your child’s injured arm.</p> <p>You will need to loosen the sling if: </p> <ul> <li>your child’s skin appears pale or blue or feels cool</li> <li>your child’s arm becomes numb or starts to tingle</li> <li>there is a weak pulse.</li> </ul> <h2>How to keep your child’s arm completely still</h2> <p>Depending on your child’s injury, you might need to tie the sling to their chest to keep their arm completely still. To do this, wrap a second cloth around your child’s body and tie it on the uninjured side.<br></p><h2>What to use for a sling</h2> <p>A sling is a triangular bandage that you can find in most <a href="/Article?contentid=1038&language=English">first aid kits</a>. If you do not have a special first aid sling, you can make one from a piece of cloth. In emergencies, you can use a shirt or a sweater. Whatever material you use, make sure it does not stretch.</p> <h2>Checking your child for cuts and bleeding</h2> <p>Before you put a sling on your child, check their arm for any serious cuts that need to be treated. Make sure any <a href="/Article?contentid=1043&language=English">bleeding</a> is under control and clean the skin as well as possible before applying the sling.</p> Learn how to make simple but effective forearm and collarbone slings with this illustrated step-by-step guide.Main