BMT: Transitioning into adulthoodBBMT: Transitioning into adulthoodBMT: Transitioning into adulthoodEnglishHaematology;Immunology;OncologyTeen (13-18 years)BodyImmune systemNATeen (13-18 years) Adult (19+)NA2010-03-12T05:00:00ZJohn Doyle, MD, FRCPC, FAAPChristine Armstrong, RN, MScN, NP Peds9.8000000000000054.6000000000000982.000000000000Flat ContentHealth A-Z<p>Learn how to help your child transition into adult care, after surviving a transplant.</p><p>Each age and stage of life brings a different set of challenges. Parenting an infant or toddler blood and marrow transplant (BMT) survivor can be very different from parenting a school-aged child. Likewise, being a teenage survivor is different from being nine or ten years old. As teenagers reach adulthood, they are faced with new challenges, both physical and social, that further affect their care.</p><h2>Key points</h2><ul><li>When your child turns 18 they will transition to adult care, meaning they will have a new oncologist and health-care team.</li><li>It is important to prepare for the transition to adult care early on, and ensure your child and family are communicating with the paediatric and adult health-care providers.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/BMT_transitioning_into_adulthood.jpg
Babies: How can you tell if your baby is ill?BBabies: How can you tell if your baby is ill?Babies: How can you tell if your baby is ill?EnglishNAPremature;Newborn (0-28 days);Baby (1-12 months);Toddler (13-24 months)BodyNAHealthy living and preventionCaregivers Adult (19+)Diarrhea;Fever;Rash;Vomiting2019-01-07T05:00:00ZDouglas Campbell, MD, FRCPC;Hazel Pleasants, RN, MN;Andrew James, MBChB, FRACP, FRCPC9.0000000000000059.3000000000000728.000000000000Flat ContentHealth A-Z<p>Discover the physical and behavioural signs that your baby may be ill and learn when to take your baby to a doctor.<br></p><p>A change in behaviour is often a sign of illness in babies. If your baby is ill, they may cry more or have a change in activity level. </p><h2>Key points<br></h2> <ul> <li>Fever is usually a sign that your baby’s body is fighting an infection.</li> <li>One of the first signs of illness in babies is a change in behaviour such as being more sleepy or more fussy.​</li> <li>In newborn babies and young infants three months of age or under, fever may be the first and only sign of a serious infection.​ All babies less than three months of age with a fever should see a doctor right away.<br></li> </ul>https://assets.aboutkidshealth.ca/AKHAssets/how_can_you_tell_baby_ill.jpg
Babies: Phasing out nighttime feedingsBBabies: Phasing out nighttime feedingsBabies: Phasing out nighttime feedingsEnglishDevelopmentalBaby (1-12 months)NANAHealthy living and preventionCaregivers Adult (19+)NA2010-05-19T04:00:00ZDebbie Stone, RN, IBCLC, RLC;Joyce Touw, BScN, PNC(C), RN, IBCLC, RLC6.9000000000000070.3000000000000607.000000000000Flat ContentHealth A-Z<p>An overview on how to make nighttime feedings easier on mother and child, and eventually to do away with them completely.</p><p>Typically, newborn babies have one long four- to five-hour sleep period per 24 hours. This may or may not occur at night. Babies are not born with a "circadian rhythm." The circadian rhythm is when the body knows to sleep at night and stay awake during the day. This rhythm begins at around eight weeks of age. Until then, you should follow your baby’s cues for feeding and sleeping.</p> <p>In general, babies will sleep through the night by six months of age. Night sleeping may occur much sooner for some. Even if your baby sleeps through the night earlier than other babies, illnesses, teething, or separation anxiety may cause your baby’s sleep routine to change.</p><p>Each baby has different feeding and sleeping behaviours. During the first few weeks, most breastfed babies wake up every 2 to 3 hours, day or night, to feed.<br></p><h2>Key points</h2> <ul> <li>Babies are not born knowing that they should sleep at night and be awake during the day.</li> <li>In the early months, allow the baby to decide their own schedule of feedings.</li> <li>Adjust activity and noise levels at feeding time so that there are more during the day, less at night.</li> <li>Mothers’ available milk volume and baby’s feeding behavior determine the number of nighttime feedings.</li> </ul>https://assets.aboutkidshealth.ca/AKHAssets/babies_phasing_out_nighttime_feeding.jpg
BabyBBabyBabyYourBabyEnglishNABaby (1-12 months)NANANACaregivers Adult (19+)NALanding PageLearning Hub<p>Your baby will go through many changes in their first year of life. Find out how their nutrition needs change and how you can support their physical development, communication and transition to other caregivers.</p><p>Your baby will go through many changes in their first year of life. Find out how their nutrition needs change as they start on textured foods and how you can support their physical development, communication and transition to other caregivers.</p>yourbabyhttps://assets.aboutkidshealth.ca/AKHAssets/baby_landing_Page.jpg
Baby blues and postpartum depressionBBaby blues and postpartum depressionBaby blues and postpartum depressionEnglishPregnancy;PsychiatryAdult (19+)NANANAPrenatal Adult (19+)NA2009-09-11T04:00:00ZNicolette Caccia, MEd, MD, FRCSCRory Windrim, MB, MSc, FRCSC9.6000000000000055.10000000000001492.00000000000Flat ContentHealth A-Z<p>Learn about baby blues and postpartum depression after giving birth. The causes and management of both baby blues and depression are discussed.</p><p>The first emotions that you will probably experience after giving birth are elation and an all-encompassing love for your newborn baby. Soon after, your elation may start to dissipate and lead into other emotions such as the "baby blues" and possibly even postpartum depression. Know that you are not alone; many women experience feelings of sadness, mood swings and depression after childbirth. If your feelings do not go away or are interfering with your life, talk to your health-care provider.</p><h2>Key points</h2> <ul><li>The "baby blues" affect about 80% of women, causing feelings of irritability, indecision, anxiety and mood swings.</li> <li>Postpartum depression is a pronounced and continuing sadness that disrupts normal functioning after a woman gives birth.</li> <li>Symptoms of postpartum depression include feeling out of control, overwhelming sense of worthlessness, withdrawal from your baby or a feeling you may harm yourself or your baby.</li> <li>If you experience any of the symptoms of postpartum depression, with or without anxiety, see your doctor right away.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/baby_blues_postpartum_depression.jpg
Baby's first breathBBaby's first breathBaby's first breathEnglishNeonatologyNewborn (0-28 days)NARespiratory systemNAAdult (19+)NA2009-10-18T04:00:00ZAndrew James, MBChB, MBI, FRACP, FRCPC9.3000000000000062.8000000000000493.000000000000Flat ContentHealth A-Z<p>Read about the most profound and difficult change in a newborn baby's body at birth: their first breath.</p><p>The most profound change at birth is your baby’s first breath. The first few breaths your baby takes may be shallow and irregular but they will soon become deeper and regular as you baby adjusts to breathing on their own.</p><h2>Key points</h2> <ul><li>Hormonal and other changes during birth, as well as physical stimulation and handling during delivery will encourage your baby to breathe.</li> <li>The first few breaths your baby takes will be shallow and irregular until they accumulate more air in their lungs making it easier to breathe.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/babys_first_breath.jpg
Back in the classroomBBack in the classroomBack in the classroomEnglishDevelopmentalPreschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-15 years);Late Teen (16-18 years)NANANAPrenatal Adult (19+)NA2009-10-31T04:00:00ZVirginia Frisk, Ph.D., C. Psych8.5000000000000064.4000000000000803.000000000000Flat ContentHealth A-Z<p>Discover general strategies that you can use to help make sure that your child has a successful experience in school.</p><p>Whether your child has been identified with a disability or not, uneven development due to their condition could affect their school performance, their behaviour, their friendships, and other activities that revolve around school. <br></p><h2>Key points</h2> <ul><li>Discuss with your child whether they want their classmates and their parents to know about their disability.</li> <li>Inviting a responsible peer to support your child sets an example for classmates.</li> <li>Balance concerns about your child's success with the fact that they need to have a normal childhood experience of attending school.</li> <li>Monitor your child's progress at school and talk to your child and their teacher if you have concerns.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/back_in_the_classroom.jpg
Back in the classroom after brain tumour treatmentBBack in the classroom after brain tumour treatmentBack in the classroom after brain tumour treatmentEnglishNeurology;DevelopmentalChild (0-12 years);Teen (13-18 years)BrainNervous systemNAAdult (19+)NA2009-07-10T04:00:00ZLaura Janzen, PhD, CPsych, ABPP-CN7.7000000000000068.60000000000002014.00000000000Flat ContentHealth A-Z<p>Detailed information on the steps required to re-introduce your child back into the classroom after brain tumour treatment.</p><p>There are many things you can do to make sure that your child has a successful experience in school. It is important to keep in touch with your child’s teacher to see how they are doing in schoolwork, but also how they are keeping up with their friendships and readjusting to school. For example, some children may show more emotions than they did before, while others may become more quiet and withdrawn. Children with brain tumours can feel very tired, and this can affect their experience in school. Let the treatment team know if there are any changes that you are concerned about, because they can help find solutions. </p><h2>Key points</h2> <ul><li>When your child is returning to school get in touch with school staff to explain your child's needs and determine any accessibility issues.</li> <li>Work with your child's teacher to make sure your child is well supported and receiving the best education possible.</li></ul>
Back to schoolBBack to schoolBack to schoolEnglishNAPreschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)NANAHealthy living and preventionCaregivers Adult (19+)NA2018-01-19T05:00:00Z000Landing PageLearning Hub<p>From homework tips to keeping kids active, our back to school tips will help you prepare for a fun and successful year ahead.</p><p>To most parents, September means one thing: time to send kids back to school. From homework tips, to dealing with bullying, to keeping kids active and healthy, our back to school tips will help you and your child prepare for a fun and successful year ahead.</p>backtoschoolhttps://assets.aboutkidshealth.ca/AKHAssets/back_to_school_learning_hub.jpg
Bacterial infections in pregnancyBBacterial infections in pregnancyBacterial infections in pregnancyEnglishPregnancyAdult (19+)BodyReproductive systemConditions and diseasesPrenatal Adult (19+)Pain;Fever;Painful urination2009-09-11T04:00:00ZNicolette Caccia, MEd, MD, FRCSCRory Windrim, MB, MSc, FRCSC11.100000000000043.10000000000001745.00000000000Flat ContentHealth A-Z<p>Learn about bacterial infections in pregnancy. Group B strep, listeria, urinary tract infections, and sexually transmitted diseases are discussed.</p><p>When you are pregnant, you need to careful about infections and infectious diseases. Unborn and newborn babies have weak immune systems compared with older children and adults, and therefore are very susceptible to infection. </p> <p>Infections in pregnancy can be caused by bacteria, viruses, or other organisms called protozoa. Below is a description of the numerous bacterial infections that can affect the growing baby during pregnancy. </p><h2>Key points</h2> <ul><li>Unborn and newborn babies have weak immune systems and are highly susceptible to infection.</li> <li>Group B streptococcus infections are the most common cause of life-threatening infections in newborn babies.</li> <li>Seek medical attention if you feel unwell or suspect you have a bacterial infection.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/bacterial_infections_in_pregnancy.jpg
Balancing blood sugar levelsBBalancing blood sugar levelsBalancing blood sugar levelsEnglishEndocrinologyChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemNon-drug treatmentAdult (19+)NA2016-10-17T04:00:00ZCatherine Pastor, RN, MN, HonBSc;Vanita Pais, RD, CDE;Danielle van der Kaay, MD, PhD​​​​10.200000000000049.1000000000000755.000000000000Flat ContentHealth A-Z<p>Although there is no cure for diabetes, the condition can be effectively managed. Learn how to properly test and manage blood sugar levels.<br></p><p>The key to managing diabetes is balancing blood sugar levels. There are several ways to control and manage blood sugar, starting with how to measure blood sugar levels.<br></p><h2>Key points</h2><ul><li>To effectively manage your child's blood sugar levels, you will need to learn how to measure them and how often to do so.<br></li><li>Taking the correct amount of insulin required, maintaining a healthy diet, and getting enough exercise are the best ways to manage diabetes.<br><br></li></ul>
Balloon angioplastyBBalloon angioplastyBalloon angioplastyEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartCardiovascular systemProceduresAdult (19+)NA2009-12-11T05:00:00ZFraser Golding, MD, FRCPC8.3000000000000059.3000000000000372.000000000000Flat ContentHealth A-Z<p>Balloon angioplasty, also known as balloon dilation, is used to expand narrowed blood vessels. Read more about angioplasty.<br></p><p> Balloon angioplasty expands narrowed blood vessels. This page explains how this procedure will help your child with a heart condition. </p><h2> Key points </h2> <ul><li>During this procedure, a balloon is inflated to open narrow blood vessels and improve blood flow.</li> <li>This procedure can be used in coarctation of the aorta, pulmonary stenosis, and narrowing of veins such as the superior or inferior vena cava.</li> <li>Your child will be under a general anaesthetic during a balloon angioplasty.</li></ul>https://assets.aboutkidshealth.ca/akhassets/Coarctation_aorta_balloon_angio_MED_ILL_EN.png
Balloon atrial septostomyBBalloon atrial septostomyBalloon atrial septostomyEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartCardiovascular systemProceduresAdult (19+)NA2016-07-11T04:00:00ZFraser Golding, MD, FRCPC10.300000000000051.5000000000000823.000000000000Flat ContentHealth A-Z<p>Balloon atrial septostomy is a procedure to expand an atrial septal defect and improve oxygenation of the blood. It is often performed for children with transposition of the great arteries.<br></p><p>Almost all babies with <a href="/Article?contentid=1611&language=English">transposition of the great arteries</a> (TGA) will need to undergo a procedure called balloon atrial septostomy.</p><h2>Key Points</h2><ul><li>A balloon atrial septostomy is a procedure that will help your baby’s body get oxygen-rich blood.</li><li>A balloon atrial septostomy enlarges the foramen ovale (the hole between the left and right atrium). This allows blood from both sides of the heart to mix together.</li><li>A balloon atrial septostomy is usually performed at the child's bedside, guided by ultrasound, or in a special procedure room called the cardiac catheterization laboratory.</li></ul>https://assets.aboutkidshealth.ca/akhassets/IMD_TGA_balloon_septostomy_EN.jpg
Balloon valvuloplastyBBalloon valvuloplastyBalloon valvuloplastyEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartCardiovascular systemProceduresAdult (19+)NA2009-12-11T05:00:00ZFraser Golding, MD, FRCPC8.4000000000000060.0000000000000566.000000000000Flat ContentHealth A-Z<p>Valve dilation uses heart catheterization to open a narrowed valve in the heart. Read about valve dilation, possible complications and recovery.</p><p> A balloon valvuloplasty uses an inflated balloon to open up a heart valve. This page explains what the procedure entails and how it will help your child's heart condition.</p><h2> Key points </h2> <ul><li> A balloon valvuloplasty opens a heart valve that is abnormally obstructed or narrow (stenotic).</li> <li> Your child will be under a general anaesthetic during this procedure.</li> <li> Complications include a leaky pulmonary or aortic valve.</li></ul>https://assets.aboutkidshealth.ca/akhassets/Valve_dilation_MED_ILL_EN.png
Bath time for babiesBBath time for babiesBath time for babiesEnglishNABaby (1-12 months)NANANAAdult (19+)NA2009-10-18T04:00:00ZHazel Pleasants, RN, MNAndrew James, MBChB, FRACP, FRCPC6.2000000000000079.5000000000000853.000000000000Flat ContentHealth A-Z<p>How to effectively give a baby a bath, either in the baby tub or the "big" tub. Considerations for bathtub safety are provided.</p><p>When it comes to normal baby care, nothing is as scary to new parents as bath time. Don't worry about putting baby in a tub for the first couple of weeks, until the umbilical stump has fallen off. During these early days, a sponge bath will do. After your baby's umbilical cord stump has fallen off and the area has healed, you can start to put them into the baby tub for baths. Your baby will not be ready to use the "big" bathtub until they are three to six months old, when they can hold their head up properly. </p><h2>Key points</h2> <ul><li>Once your baby's umbilical cord stump has fallen off and the area has healed, you can start to put them into the baby tub for baths.</li> <li>Once your baby is able to sit up by themselves or with minimal help (around three to six months), you may want to switch them to the family tub.</li> <li>Remain within arm's reach of your baby — never leave them alone in the tub and remember that hot water can burn your baby's fragile skin.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/bath_time_for_babies.jpg
Bath time for newborn babiesBBath time for newborn babiesBath time for newborn babiesEnglishNeonatologyNewborn (0-28 days)NANANAAdult (19+)NA2009-10-18T04:00:00ZHazel Pleasants, RN, MNAndrew James, MBChB, FRACP, FRCPC6.5000000000000077.3000000000000864.000000000000Flat ContentHealth A-Z<p>How to effectively make bath time easier for your newborn. Information on giving a newborn baby a sponge bath is provided, as well as safety tips.</p><p>When it comes to normal newborn baby care, nothing is as scary for new parents as bath time. Don’t worry about putting baby in a tub for the first couple of weeks, until the umbilical cord stump has fallen off and the navel area has healed. During these early days, a sponge bath will do. </p><h2>Key points</h2> <ul><li>A newborn baby only needs a sponge bath two or three times per week.</li> <li>Always make sure to hold your newborn baby when they are in the bathtub and never leave them alone or in the care of another child while they are being bathed.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/bathtime_for_newborn_babies.jpg
Becoming independentBBecoming independentBecoming independentEnglishDevelopmentalPremature;Newborn (0-28 days);Baby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years)NANANAPrenatal Adult (19+)NA2009-10-31T04:00:00ZAndrew James, MBChB, MBI, FRACP, FRCPC11.000000000000053.4000000000000407.000000000000Flat ContentHealth A-Z<p>Read about how a premature baby may develop into a toddler, through separating themselves from their parents and gaining more autonomy and independence.</p><p>Parents of premature babies may find it difficult to allow their child to be independent as they grow. They may be overprotective of their children; however, this is not always a good thing.</p><h2>Key points</h2> <ul><li>It is important for parents to find a balance between protecting their child and allowing them to take risks and explore.</li> <li>Overindulging and overprotecting can be detrimental to a child and can have profound and long lasting negative consequences.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/becoming_independent_premature_babies.jpg
Bed-wetting (nocturnal enuresis)BBed-wetting (nocturnal enuresis)Bed-wetting (nocturnal enuresis)EnglishUrologyChild (0-12 years);Teen (13-18 years)BladderBladderConditions and diseasesCaregivers Adult (19+)NA2014-10-06T04:00:00ZElizabeth Berger​, BA, MD, FRCPC, FAAP, MHPE​8.2000000000000063.4000000000000838.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Find information about how old most children are when they develop good bladder control at night. Also learn about some of the causes of bed-wetting and what you can do to help your child.</p><h2>What is bed-wetting?</h2><p>Bed-wetting, also known as nocturnal enuresis, is urination (peeing) at night that your child cannot control. It is a very different condition from diurnal enuresis (daytime wetting).</p> ​<h2>Key points</h2><ul><li>Bed-wetting is common in young children.</li><li>Every child develops bladder control at a different pace.</li><li>Speak to a doctor if your child suddenly wets the bed after an extended dry period or has difficulty controlling their bladder during the day and night after six years of age.</li><li>Help your child by reassuring them and offering gentle reminders about bathroom routine.</li><li>Punishing or humiliating a child will not help them develop better bladder control.</li></ul><h2>Causes of bed-wetting</h2> <p>In most cases, bed-wetting occurs because your child is simply a deep sleeper and does not wake up when their bladder is full.</p> <p>Often, the tendency to wet the bed can run in families. If you were a bed-wetter, your child is more likely to do the same.</p> <p>In very rare cases, bed-wetting can be caused by type 1 diabetes or a congenital (from birth) defect of the urinary tract. However, these conditions also cause daytime symptoms too. If your child does not experience daytime wetting, you can rest assured that they are likely to be completely healthy.</p> <p>Some children can start to wet the bed when they had previously been dry at night as a response to changes in their lives. These changes may include moving to a new home, the birth of a brother or sister or new child-care arrangements. If your child has suddenly started to wet the bed after an extended dry period, talk to them about what is bothering them and try to help them cope with the change.</p> <h2>How common is bed-wetting?</h2> <p>Bed-wetting is common in young children. It is found in about 20 per cent of five-year-olds but falls to about two per cent of fifteen-year-olds.</p> <p>Very few children have dry nights before they are three years old. Most children start to stay dry at night between ages three and eight. Until your child achieves this milestone, they will benefit from your patience and understanding.</p> <p>Unintentional and unconscious urination at night is a normal stage in your child's development. Most children will be toilet trained for the daytime long before they are able to be toilet trained for night time. Do not look at bed-wetting as failed toilet training. Each child matures and develops good bladder control at a different pace.</p> <h2>How bed-wetting is treated</h2><p>If your child is experiencing bed-wetting, your child's doctor may prescribe a hormone called <a href="/Article?contentid=122&language=English">desmopressin</a> (DDAVP). However, this is only for temporary use for sleepovers or overnight camp.</p><p>If your child's doctor finds a physical cause for daytime wetting, such as a <a href="/article?contentid=935&language=English">urinary tract infection</a>, they may prescribe medication such as <a href="/Article?contentid=1120&language=English">antibiotics</a>.</p><h2>When to see a doctor about bed-wetting</h2> <p>Your child should see a doctor if there is a sudden onset of bed-wetting following a six-month, completely dry period. Although some cases of sudden bed-wetting are caused by life changes, a doctor should also check your child for any underlying medical condition or illness. </p> <p>Your child may also need to see a doctor if:</p> <ul> <li>enuresis occurs during the day and night after the age of six</li> <li>the bed-wetting bothers your child and prevents them from going to sleepover parties or staying overnight at camp. </li> </ul> <p>Your child's doctor will advise you about treatment options.</p> https://assets.aboutkidshealth.ca/AKHAssets/bed-wetting.jpg
Before the heart transplantBBefore the heart transplantBefore the heart transplantEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartCardiovascular systemProceduresAdult (19+)NA2009-12-11T05:00:00ZAnne Dipchand, MD, FRCPC7.3000000000000070.3000000000000886.000000000000Flat ContentHealth A-Z<p>It is important to keep your child as healthy as possible before a heart transplant. Learn about what happens while you are waiting for a donor heart to become available.<br></p><p> This page explains what to expect while you wait for a donor heart. </p><h2> Key points </h2> <ul><li>Keeping your child as healthy as possible before the heart transplant is very important.</li> <li>Your child may need to stay in hospital while they wait for a heart if their condition is very severe.</li> <li>There is no way of knowing how long your child may have to wait for a donor heart.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/before_the_heart_transplant.jpg
Behaviour changes and brain tumoursBBehaviour changes and brain tumoursBehaviour changes and brain tumoursEnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemNAAdult (19+)NA2009-08-14T04:00:00ZDavid Brownstone, MSW, RSWDeborah S. Berlin-Romalis, BSW, MSW, RSWHeather Young, MSW, RSWLaura Janzen, PhD, CPsych, ABPP-CN8.8000000000000057.1000000000000470.000000000000Flat ContentHealth A-Z<p>In-depth information concerning behavior changes you might see in your child during brain tumour treatment.</p><br><p>Many children who have a serious illness such as a brain tumour learn to adjust to their situation over time, with the right support. But like adults, children have good days and bad days. If your child is having a bad day, it may be hard to tell whether the cause is the tumour, the treatment or your child just being a child. Crying, anger, fussiness, acting out, tantrums or withdrawing can all be normal behaviours for children at certain times. Some children may show more serious behaviours, such as becoming depressed, anxious, not sleeping well, having problems with relationships or in school or refusing to have treatments. More serious behaviour changes need to be attended to quickly. Talk to your treatment team if you are concerned. </p><h2>Key points</h2> <ul><li>It can be difficult to tell if your child's behaviour is due to the tumour, the treatment, or your child just being a child.</li> <li>More serious behaviour changes need to be attended to quickly and should be discussed with the treatment team.</li> <li>There are several approaches you can take at home to reduce problem behaviours.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/behaviour_changes_and_brain_tumours.jpg
Behaviour changes and congenital heart diseaseBBehaviour changes and congenital heart diseaseBehaviour changes and congenital heart diseaseEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartCardiovascular systemConditions and diseasesAdult (19+)NA2009-12-14T05:00:00ZRoss Hetherington, PhD, C.Psych10.500000000000050.0000000000000562.000000000000Flat ContentHealth A-Z<p>If your child has a heart condition, you may notice changes in their behaviour or that they display behavioural problems from time to time.</p><p>This page explains why a child with congenital heart disease may display behavioural problems.</p><h2> Key points </h2> <ul><li>If your child has a heart condition and you are concerned about their behaviour, their doctor, nurse, social worker, or a child psychiatrist can work to find and address the cause of the behaviour.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/behaviour_changes_and_congenital_heart_disease.jpg
Behaviour changes in babiesBBehaviour changes in babiesBehaviour changes in babiesEnglishNeonatologyNewborn (0-28 days)BodyNANAAdult (19+)Fatigue2009-10-18T04:00:00ZHazel Pleasants, RN, MNAndrew James, MBChB, FRACP, FRCPC10.200000000000048.9000000000000517.000000000000Flat ContentHealth A-Z<p>Learn about behaviour changes your infant might display, such as lethargy and irritability. These mood changes may indicate that your baby is ill.</p><p>One of the first signs of illness in babies is a change in behaviour. The baby may cry more or have a change in activity level. Generally, if your baby is active when awake, feeding well, and can be comforted when crying, small differences in activity level or crying are normal. However, if your baby becomes lethargic or irritable, it may be time to see a doctor. Lethargy or irritability may be signs that an illness is present. </p><h2>Key points</h2> <ul><li>Change in behaviour, such as lethargy or irritability, can be a sign of illness in babies.</li> <li>Lethargy may be a sign of a common infection such as a cold, or a serious type of infection such as influenza or meningitis.</li> <li>Irritability may be a sign that your baby has constipation, abdominal pain, an earache, or a viral or bacterial infection. </li></ul>https://assets.aboutkidshealth.ca/AKHAssets/behaviour_changes_in_babies.jpg
Behaviour changes in childrenBBehaviour changes in childrenBehaviour changes in childrenEnglishNAChild (0-12 years);Teen (13-18 years)NANASupport, services and resourcesCaregivers Adult (19+)NA2012-06-13T04:00:00ZNA7.7000000000000060.9000000000000297.000000000000Flat ContentHealth A-Z<p>Parents can learn helpful tips on how to manage behaviour changes in children who are ill. </p><p>Behaviour changes in children who are ill are normal. Talk to your child's nurse, <a href="/Article?contentid=1168&language=English">social worker</a>, or child life specialist if you are concerned about your sick child's behaviour changes. They may be able to suggest strategies to help you.</p><h2>Key points</h2><ul><li>It can be normal for a child who is ill to have behaviour changes.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/behaviour_changes_in_children.jpg
Behavioural and learning issuesBBehavioural and learning issuesBehavioural and learning issuesEnglishDevelopmentalPremature;Newborn (0-28 days);Baby (1-12 months)NANANAPrenatal Adult (19+)NA2009-10-31T04:00:00ZAndrew James, MBChB, MBI, FRACP, FRCPC14.400000000000031.4000000000000572.000000000000Flat ContentHealth A-Z<p>Read about various behavioral problems that premature babies may develop as they grow. In general, the most premature babies are more at risk.</p><p>As they grow, some premature babies will develop behavioural problems. While it can be difficult to predict which premature babies will have lasting issues of this nature, in general, the most premature and the lowest birth weight babies are most at risk. Disabilities that affect the brain are also likely to have an effect on learning and education. </p><h2>Key points</h2> <ul><li>On average, extremely and moderately premature babies are more likely to have behavioural issues.</li> <li>Each child is different and not all children born prematurely will grow up to have behavioural issues or learning disabilities.</li> <li>Behavioural problems that may affect a child include ADHD, internalizing and externalizing behaviours and autism spectrum disorder.</li> <li>Knowing a premature baby is more at risk to have a learning disability as a child allows parents, health professionals, and educators to take steps to diminish the effect of the disability.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/behavioural_and_learning_issues_premature_babies.jpg
Behavioural disorders: How to help your child at homeBBehavioural disorders: How to help your child at homeBehavioural disorders: How to help your child at homeEnglishPsychiatryPreschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)NANANon-drug treatmentCaregivers Adult (19+)NA2017-06-20T04:00:00ZAlice Charach, MD, MSc, FRCPC11.300000000000044.8000000000000552.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn how to manage your child's difficult behaviour.</p><p>A healthy parent-child relationship is the starting point for managing any behavioural difficulties. The main features of a healthy relationship include:</p><ul><li>maintaining a positive nurturing relationship with your child</li><li>providing consistent rules and expectations</li><li>knowing what your child likes to do and with whom they spend their time</li></ul><p>It is important to have these firmly in place before you introduce anything to manage any problematic behaviour.</p> <h2>Key points</h2> <ul> <li>A healthy parent/child relationship is positive and nurturing, includes consistent rules and expectations and is based on knowing what a child likes to do and with whom they spend their time.</li> <li>If your child shows signs of a possible behavioural disorder, try some behaviour modification strategies. These approaches are intended to change your child’s behaviour over time.</li> <li>Behaviour modification strategies include setting clear and consistent rules, expectations and consequences, explaining your values, understanding your child’s point of view and praising positive behaviour.</li> <li>If your child’s behaviour does not improve, consider seeing your child’s doctor and, if needed, seek support for your own wellbeing.</li> </ul><h2>Further information</h2> <p>For more information on behavioural disorders, please see the following pages:</p> <p><a href="/Article?contentid=1924&language=English">Behavioural disorders: Overview</a></p> <p><a href="/Article?contentid=1925&language=English">Behavioural disorders: Signs and symptoms</a></p> <p><a href="/Article?contentid=2000&language=English">Behavioural disorders: Treatment with psychotherapy and medications</a></p>https://assets.aboutkidshealth.ca/AKHAssets/PST_MH_Behavioural_Help.jpg
Behavioural disorders: OverviewBBehavioural disorders: OverviewBehavioural disorders: OverviewEnglishPsychiatryPreschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)NANAConditions and diseasesCaregivers Adult (19+)NA2017-06-20T04:00:00ZAlice Charach, MD, MSc, FRCPC12.500000000000029.7000000000000674.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Discover the causes of behavioural disorders and when to seek help about a child's behaviour.</p><h2>What is a behavioural disorder?</h2><p>It is common for children and teens to get into trouble and be irritable or aggressive from time to time, especially during the toddler and early teen years. For instance, a young child may have a temper tantrum or a teenager may talk back or argue with you now and then. </p><p>Disordered behaviour is different from typical developmental behaviour because it happens more often than not and causes problems in more than one setting. For example, the behaviour not only affects school and home life but can make friendships and other peer relationships difficult.</p><p>There are two main types of behavioural disorder: oppositional defiant disorder and conduct disorder. Your child may have <a href="/Article?contentid=1925&language=English">symptoms of one of these disorders</a> if:</p><ul><li>they have frequent outbursts, often at unexpected times (for example not just when tired or hungry)</li><li>have great difficulty following rules and expectations</li><li>their behaviour causes a lot of distress or trouble at home and school</li></ul><p>If you are concerned about your child or teen’s behaviour, consider if the frequency, duration and intensity of the behaviour are different than what would be expected for their particular developmental stage.</p><h2>Key points</h2> <ul> <li>Challenging behaviour becomes a concern when it is frequent and unexpected and leads to trouble at home, at school and with peers.</li> <li>Behavioural disorders generally fall into two categories: oppositional defiant disorder and conduct disorder.</li> <li>Behavioural disorders can be associated with a family history of challenging behaviour, family stresses and a poor ability to manage emotions and activity levels.</li> <li>See your child’s doctor if your child’s behaviour changes suddenly or if their behaviour is more challenging than expected for their developmental stage.</li> </ul><h2>What causes behavioural disorders?</h2> <p>Behavioural disorders can be caused by:</p> <ul> <li>biological factors</li> <li>social and environmental factors</li> <li>psychological factors.</li> </ul> <h3>Biological factors</h3> <p>Some traits seen in behavioural disorders can run in families. Children with a family history of behaviour problems, learning problems, <a href="/Article?contentid=18&language=English">anxiety</a>, <a href="/Article?contentid=19&language=English">depression</a> or <a href="/Article?contentid=279&language=English">bipolar disorder</a> may be more likely to have a behaviour problem.</p> <h3>Social and environmental factors</h3> <p>Children who come from families that regularly experience a lot of stress may be more likely to show signs of a behavioural disorder. Some common family stressors might include:</p> <ul> <li>financial difficulties</li> <li>exposure to violence</li> <li>family breakup</li> <li>harsh or inconsistent parenting</li> <li>inconsistent supervision, for example due to a parent’s mental health challenges or different styles of caregiving from a number of people</li> </ul> <h3>Psychological factors</h3> <p>Children with behavioural disorders often have other mental health conditions (see below). How a child manages their emotions, activity level and attention may suggest vulnerability to certain behavioural disorders.</p> <h2>How common are behavioural disorders in children?</h2> <p>Behavioural disorders are common, occurring in 16 to 24 per cent of children and youth, from pre-schoolers through to teens.</p><h2>When to seek help about your child’s behaviour</h2> <p>Consider speaking to a guidance counsellor or social worker in your child’s school about your child or teen’s behaviour if:</p> <ul> <li>you notice sudden or unexpected behavioural changes (increased irritability or aggression with no known cause)</li> <li>your child’s behaviour is more challenging than expected based on their developmental stage</li> <li>your child’s behaviour continually prevents them from succeeding at school or maintaining positive relationships at home or in the community</li> </ul> <p>See a doctor if you would like to request a referral to a mental health professional such as an educational psychologist.</p><h2>Further information</h2> <p>For more information on behavioural disorders, please see the following pages:</p> <p><a href="/Article?contentid=1925&language=English">Behavioural disorders: Signs and symptoms</a></p> <p><a href="/Article?contentid=2000&language=English">Behavioural disorders: Treatment with psychotherapy and medications</a></p> <p><a href="/Article?contentid=2001&language=English">Behavioural disorders: How to help your child at home</a></p> <h2>​​Resources</h2> <p>Greene, R. (2014). <i>The Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated, Chronically Inflexible Children.</i> Fifth edition. New York, NY: HarperCollins.</p> <p>Phelan, T. (2014). <i>1-2-3 Magic: Effective Discipline for Children 2-12.</i> Sixth edition. Naperville, IL: Sourcebooks, Inc.​</p>https://assets.aboutkidshealth.ca/AKHAssets/behavioural_disorders_overview.jpg
Behavioural disorders: Signs and symptomsBBehavioural disorders: Signs and symptomsBehavioural disorders: Signs and symptomsEnglishPsychiatryPreschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)NANAConditions and diseasesCaregivers Adult (19+)NA2017-06-20T04:00:00ZAlice Charach, MD, MSc, FRCPC12.900000000000031.1000000000000932.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Learn about the main symptoms of oppositional defiant disorder and conduct disorder.</p><h2>What are the main symptoms of a behavioural disorder?</h2><p>Symptoms depend on the type of <a href="/Article?contentid=1924&language=English">behavioural disorder</a> a child or teen is experiencing:</p><ul><li> <a href="#opposite">oppositional defiant disorder (ODD)</a></li><li> <a href="#conduct">conduct disorder (CD)</a></li></ul> <h2>Key points</h2> <ul> <li>Symptoms of oppositional defiant disorder include anger or irritability, being argumentative or defiant and spitefulness.</li> <li>Symptoms of conduct disorder include aggression to people and animals, property damage, deception and intentionally breaking rules.</li> <li>Ask your child’s doctor to connect you with the right resources for assessment and treatment.</li> <li>Behavioural disorders are diagnosed through a thorough assessment by an experienced mental health professional.</li> </ul><h2 id="opposite">Oppositional defiant disorder </h2> <p>The behaviour associated with oppositional defiant disorder leads to struggles at school, at home and in the community for the child or teen or for the people that they interact with.</p> <p>ODD has a number of symptoms under the following three main categories:</p> <ul> <li>anger or irritability</li> <li>argumentative or defiant behaviour</li> <li>spitefulness</li> </ul> <p>A child or teen with ODD must experience four symptoms from across these categories and demonstrate them with at least one person who is not a brother or sister.</p> <h3>Anger or irritability</h3> <p>A person with ODD may, for example:</p> <ul> <li>lose their temper often</li> <li>be frequently touchy or easily annoyed</li> <li>be frequently angry and resentful</li> </ul> <h3>Argumentative or defiant behaviour</h3> <p>A child or teen with ODD:</p> <ul> <li>often argues with authority figures such as teachers, parents or other adults</li> <li>refuses to follow rules or comply with authority figures</li> <li>often sets out to deliberately annoy others</li> <li>often blames others for their mistakes or misbehaviour</li> </ul> <h3>Spitefulness</h3> <p>A child or teen with ODD might demonstrate spitefulness on at least two occasions within the previous six months. If they felt betrayed or hurt, for example, their actions might focus on feeling better about themselves at another person’s expense rather than correcting the negative behaviour.</p> <h2 id="conduct">Conduct disorder</h2> <p>Conduct disorder is a pattern of behavioural and emotional problems that is beyond what is considered to be typical child or teenage behaviour. A child with conduct disorder usually shows little or no concern for the rights of others. Many also do not understand, or feel any guilt about, how their actions affect others.</p> <p>The symptoms associated with conduct disorder fall into four categories:</p> <ul> <li>aggression to people and animals</li> <li>property damage</li> <li>deception (lying)</li> <li>intentionally breaking rules</li> </ul> <h3>Aggression to people and animals</h3> <p>A person with conduct disorder can show aggression by, for example:</p> <ul> <li>bullying, threatening or intimidating others</li> <li>starting physical fights</li> <li>being physically cruel to people or animals</li> <li>mugging or otherwise stealing from a victim while confronting them</li> <li>using a weapon to cause serious physical harm</li> <li>forcing someone to engage in sexual activity</li> </ul> <h3>Destruction of property</h3> <p>Someone with conduct disorder may, for example, deliberately destroy or set fire to property.</p> <h3>Deception, lying or stealing</h3> <p>For a child or teen with conduct disorder, deception, lying or stealing can include:</p> <ul> <li>breaking into a building, house or car</li> <li>lying to get what they want or avoid obligations</li> <li>stealing items without confronting a victim (shoplifting)</li> </ul> <h3>Intentionally breaking rules</h3> <p>When someone has conduct disorder, they have little respect for rules set by others. As a result, it is not unusual for them to, for example:</p> <ul> <li>stay out at night against parents’ wishes</li> <li>run away from home</li> <li>skip school</li> </ul><h2>How behavioural disorders are diagnosed</h2> <p>Behavioural disorders are diagnosed through a thorough assessment by an experienced mental health professional, usually a psychiatrist or psychologist.</p> <p>The professional will talk to you, your child or teen and, sometimes, your child's school teachers. They will take your child's medical history and family history into account and look at all factors that might contribute to your child's behaviour, such as:</p> <ul> <li>any other mental health problems</li> <li>learning difficulties</li> <li>family stressors</li> </ul> <p>It may take a few appointments for the psychiatrist or psychologist to gather this information. Once they do, they will decide if your child's behaviour fits within the criteria for a diagnosis of a specific behavioural disorder. They may diagnose a behavioural disorder if your child's challenging behaviours persist after other factors are addressed.</p><h2>What your child's doctor can do for a behavioural disorder</h2> <p>Your child's doctor can help identify if your child's behaviour is normal for their developmental stage, if they are acting out in response to another stressor in their life or if their behaviour indicates a behavioural disorder. When requested, your child's doctor will be able to help connect you with the most appropriate treatment for your child or teen.</p> <p>Your doctor may sometimes need to refer your child for a more detailed assessment by a mental health professional. A thorough assessment can help you obtain a clear diagnosis and an <a href="/Article?contentid=2000&language=English">appropriate treatment</a> plan for your child or teen.</p><h2>Further information</h2><p>For more information on behavioural disorders, please see the following pages:</p><p> <a href="https://akhpub.aboutkidshealth.ca/article?contentid=1924&language=English">Behavioural disorders: Overview</a></p><p> <a href="https://akhpub.aboutkidshealth.ca/article?contentid=2000&language=English">Behavioural disorders: Treatment with psychotherapy and medications</a></p><p> <a href="https://akhpub.aboutkidshealth.ca/article?contentid=2001&language=English">Behavioural disorders: How to help your child at home</a></p><h2>Resources</h2><p>Stringaris, A. et al (2010). <a href="https://www.jaacap.org/article/S0890-8567%2810%2900206-6/abstract" target="_blank">What’s in a Disruptive Disorder? Temperamental Antecedents of Oppositional Defiant Disorder: Findings from the Avon Longitudinal Study</a>. <em>Journal of the American Academy of Child & Adolescent Psychiatry</em>. 49 (5): 474-483. doi:10.1016/j.jaac.2010.01.021.</p><p>Stringaris, A. & Goodman, R. (2009). Three dimensions of oppositionality in youth. <em>Journal</em><em> of Child Psychology and Psychiatry</em>. 50: 216-223. doi:10.1111/j.1469-7610.2008.01989.x.</p><p>Stringaris, A. & Goodman, R. (2009). <a href="https://www.jaacap.org/article/S0890-8567%2809%2960048-4/fulltext" target="_blank">Longitudinal Outcome of Youth Oppositionality: Irritable, Headstrong, and Hurtful Behaviours Have Distinctive Predictions</a>. <em>Journal of the American Academy of Child and Adolescent Psychiatry.</em> 48 (4): 404-412. doi:10.1097/chi.0b013e3181984f30.</p><p>Pardini, D. (2013). <a href="https://www.cacap-acpea.org/wp-content/uploads/Multiple-Developmental-Pathways-Pardini.pdf" target="_blank">Multiple Developmental Pathways to Conduct Disorder: Current Conceptualizations and Clinical Implications</a>. <em>Journal of the Canadian Academy of Child and Adolescent Psychiatry</em>. 22 (1): 20-24.<br></p>https://assets.aboutkidshealth.ca/AKHAssets/behavioural_disorders_signs_and_symptoms.jpg
Behavioural disorders: Treatment with psychotherapy and medicationsBBehavioural disorders: Treatment with psychotherapy and medicationsBehavioural disorders: Treatment with psychotherapy and medicationsEnglishPsychiatryPreschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)NANANon-drug treatmentCaregivers Adult (19+)NA2017-06-20T04:00:00ZAlice Charach, MD, MSc, FRCPC14.900000000000021.7000000000000425.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Find out which treatments are most effective for behavioural disorders.</p><p>For children diagnosed with a <a href="https://akhpub.aboutkidshealth.ca/Article?contentid=1924&language=English">behavioural disorder</a>, appropriate treatment at the right time can make the difference between "outgrowing" the disorder and being more likely to exhibit more challenging behaviours when they are older.</p><p>Often, treatments for behavioural disorders can be accessed through an accredited children's mental health agency or a private therapist such as a psychologist or social worker.</p> <h2>Key points</h2> <ul> <li>Behavioural treatment through parent management training or individual and family therapy can be very effective for managing behavioural disorders.</li> <li>Medication may be helpful in treating underlying or co-occurring disorders.</li> <li>If left untreated, behavioural disorders can make it difficult to adjust to the responsibilities of adulthood, such as holding down a job, maintaining relationships or obeying the law.</li> </ul><h2>What treatments are available for behavioural disorders?</h2> <p>Treatments for behavioural disorders focus mainly on:</p> <ul> <li>behavioural treatments</li> <li>medications</li> </ul> <h3>Behavioural treatment</h3> <p>There are two main types of behavioural treatment: parent management training and psychotherapy.</p> <p>Parent management training has been shown to work very well for children and teens with behavioural disorders. It is most effective when started early in childhood or the pre-teen years, but it is never too late to change the way you handle your child or teen's behaviour. In many cases, you can access parent management training through a children's mental health agency, a parenting group or a private therapist.</p> <p>Individual therapy or family therapy can also be effective in helping to manage behavioural disorders. Therapy can help change how a family functions and support parents and children or teens with figuring out the causes of challenging behaviour and talking about other ways of handling them.</p> <p>Sometimes more intensive behavioural treatment is required. School-based treatment programs or residential therapy programs can be effective for some children or teens.</p> <h3>Medications for behavioural disorders</h3> <p>Medication treatment for behavioural disorders is targeted towards treating underlying or co-occurring disorders such as <a href="https://akhpub.aboutkidshealth.ca/Article?contentid=1922&language=English">attention deficit hyperactivity disorder (ADHD)</a>, <a href="https://akhpub.aboutkidshealth.ca/article?contentid=19&language=English">depression</a> or <a href="https://akhpub.aboutkidshealth.ca/article?contentid=18&language=English">anxiety</a>.</p><h2>Further information</h2> <p>For more information on behavioural disorders, please see the following pages:</p> <p><a href="https://akhpub.aboutkidshealth.ca/article?contentid=1924&language=English">Behavioural disorders: Overview</a></p> <p><a href="https://akhpub.aboutkidshealth.ca/article?contentid=1925&language=English">Behavioural disorders: Signs and symptoms</a><br></p> <p><a href="https://akhpub.aboutkidshealth.ca/article?contentid=2001&language=English">Behavioural disorders: How to help your child at home</a><br></p>https://assets.aboutkidshealth.ca/AKHAssets/PST_MH_Behavioural_Treatment.jpg
Behavioural resources for autism spectrum disorder (ASD)BBehavioural resources for autism spectrum disorder (ASD)Behavioural resources for autism spectrum disorder (ASD)EnglishNeurologyChild (0-12 years)NANervous systemConditions and diseasesAdult (19+)NA2009-03-09T04:00:00ZJanice Mulligan MSW, RSWRadha MacCulloch, MSWWendy Roberts MD. FRCPCLee Steel13.600000000000032.3000000000000389.000000000000Flat ContentHealth A-Z<p>Provides resources that parents can access to help their child with autism who has behavioural problems.</p><br><p>Behavioural intervention services can be provided to children on the autism spectrum under certain conditions.</p><h2> Key points</h2> <ul><li>Your child can be referred to an Autism Intervention Program if they live within the geographic boundaries of the program area and have been diagnosed with autism spectrum disorder (ASD) by a doctor or psychologist.</li> <li> Staff working with your regional ASD service provider will then assess your child to determine if intensive behavioural intervention (IBI) services will be provided. </li></ul>
Behavioural strategies for pain managementBBehavioural strategies for pain managementBehavioural strategies for pain managementEnglishPain/AnaesthesiaChild (0-12 years);Teen (13-18 years)BodyCentral nervous system;Peripheral nervous system;Autonomic nervous systemSymptomsCaregivers Adult (19+)Pain2009-09-15T04:00:00ZMichael Jeavons, MD10.500000000000051.10000000000001246.00000000000Flat ContentHealth A-Z<p>Learn about behavioural strategies such as biofeedback and CBT. These strategies can be used for effective pain management for children.</p><p>Many behavioural strategies have been shown to reduce pain and disability. Many of these strategies have positive effects on parents as well as children. Behavioural strategies can calm both parent and child, and reduce the need for restraint during procedures such as injections. </p>
Being part of your baby's health-care teamBBeing part of your baby's health-care teamBeing part of your baby's health-care teamEnglishNeonatologyPremature;Newborn (0-28 days);Baby (1-12 months)NANASupport, services and resourcesPrenatal Adult (19+)NA2009-10-31T04:00:00ZThe Reverend Michael Marshall, M. Div. M10.100000000000055.90000000000001188.00000000000Flat ContentHealth A-Z<p>How parents can effectively participate in the care of a premature baby in the NICU. In most cases, parents can do more than they imagine.</p><p>How much parents can participate in the care of their premature baby and interact with their baby depends on several things, not the least of which is the condition of the baby. In most cases, parents can do more than they imagine.</p><h2>Key points</h2> <ul><li>How involved parents can be in the care of their premature baby will depend on the condition of their baby as well as the amount of time they are able to spend in the NICU.</li> <li>Some ways parents can help care for their child include through kangaroo care (skin-to-skin contact) and breastfeeding.</li></ul>https://assets.aboutkidshealth.ca/akhassets/mom-looking-up-cuddling-bab_EN.jpg
Bell's palsyBBell's palsyBell's palsyEnglishNeurologyChild (0-12 years);Teen (13-18 years)Eyes;Mouth;MandibleNervesConditions and diseasesCaregivers Adult (19+)NA2010-05-07T04:00:00ZMark Feldman, MD, FRCPC7.1000000000000066.7000000000000693.000000000000Health (A-Z) - ConditionsHealth A-Z<p>An overview of the symptoms, causes and treatment of this sudden partial facial paralysis.</p><h2>What is Bell's palsy?</h2> <p>Bell's palsy is sudden loss of feeling and muscle control on one side of the face. While this condition is more common in adults, children and adolescents can have Bell's palsy. Usually, Bell's palsy goes away by itself within a few weeks or months. A very small number of children will have the symptoms for life. </p> <p>Bell's palsy can be mistaken for a stroke.</p><h2>Key points</h2> <ul> <li>Bell's palsy is sudden partial facial paralysis. Usually the symptoms improve within a few weeks or months.</li> <li>If your child starts showing symptoms of Bell's palsy, see your child's doctor right away. </li> <li>Bell's palsy occurs when the nerve controlling facial muscles becomes inflamed or swollen. </li> <li>The cause of the swelling is a viral infection. </li> <li>Most children with Bell's palsy recover fully, with or without treatment.</li> </ul><h2>Signs and symptoms of Bell's palsy</h2> <p>The signs and symptoms of Bell's palsy come on unexpectedly. The most obvious sign of Bell's palsy is facial paralysis on one side of the face. In rare cases, both sides of the face are affected. Other signs and symptoms may include:</p> <ul> <li>mild weakness to total paralysis on one side of the face</li> <li>difficulty smiling or closing the eye on the affected side</li> <li>face appears to droop</li> <li>pain around the jaw</li> <li>pain near the ear on the affected side</li> <li>headache</li> <li>cannot taste food</li> <li>drooling</li> </ul> <p>If your child is showing some of these signs or symptoms, contact your child's doctor right away.</p><h2>Causes</h2> <p>Doctors believe Bell's palsy occurs when the nerve controlling facial muscles becomes inflamed or swollen. The inflamed nerve cannot do its job of sending messages to your child's facial muscles. Nerves that control tears, saliva and taste are also affected.</p> <p>The cause of the swelling is a viral infection. Most doctors believe the herpes simplex virus, the same infection that causes cold sores, triggers Bell's palsy. </p> <h2>Risk factors</h2> <p>Bell's palsy occurs more often in children who have diabetes or have a flu or cold.</p> <p>What a doctor can do to help your child </p> <p>Your child's doctor will examine your child and try to find out the cause of the facial paralysis. Your child's doctor may suggest medications or physical therapy. Most children with Bell's palsy recover fully, even without treatment.</p><h2>Treatment</h2> <p>Your child's doctor may prescribe corticosteroids to reduce the swelling of the facial nerve. The doctor may also prescribe an antiviral drug to stop the progress of the infection that caused the Bell's palsy. If your child cannot close their eye on the affected side, your doctor may prescribe an eye patch or eye drops.</p> <p>Surgery is rarely used to treat this condition.</p><h2>When to seek medical assistance</h2> <p>If your child is showing some of the signs or symptoms of Bell's palsy, contact your child's doctor right away. </p>https://assets.aboutkidshealth.ca/AKHAssets/bells_palsy.jpg
Benign partial epilepsy of childhood with centrotemporal spikes (BECTS)BBenign partial epilepsy of childhood with centrotemporal spikes (BECTS)Benign partial epilepsy of childhood with centrotemporal spikes (BECTS)EnglishNeurologyChild (0-12 years)BrainNervous systemConditions and diseasesCaregivers Adult (19+) EducatorsNA2010-02-04T05:00:00ZElizabeth J. Donner, MD, FRCPC9.7000000000000055.50000000000001435.00000000000Flat ContentHealth A-Z<p>Read about the causes and symptoms of benign partial epilepsy of childhood with centrotemporal spikes (BECTS) as well as treatments and long-term outlook.</p><p>Benign partial epilepsy of childhood with centrotemporal spikes (BECTS) is one of the most common forms of epilepsy in children. Most seizures occur from sleep. The child has partial seizures with a characteristic EEG pattern in the centrotemporal region of the brain.</p> <p>The outlook for a child with BECTS is very good. It is usually easy to control with medications, and in most cases it goes away by age 16. </p><h2>Key points</h2> <ul><li>BECTS is one of the most common childhood epilepsy syndromes and usually begins between the age of two and 13.</li> <li>Seizures start in a specific area of the brain, mostly while a child is asleep, and may involve gurgling sounds, trouble swallowing or speaking, numbness in the tongue or jaw, facial twitches or sensory problems on one side of the body.</li> <li>Treatment depends on the severity of the syndrome, but seizures are usually easy to control with medications.</li> <li>BECTS seizures nearly always disappear by age 16.</li></ul>
Bi-directional cavopulmonary anastomosis (Glenn procedure)BBi-directional cavopulmonary anastomosis (Glenn procedure)Bi-directional cavopulmonary anastomosis (Glenn procedure)EnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartCardiovascular systemProceduresAdult (19+)NA2009-12-11T05:00:00ZJennifer Russell, MD, FRCPC10.300000000000047.2000000000000251.000000000000Flat ContentHealth A-Z<p>The Glenn procedure is done when not enough blood is getting to the lungs. Learn about this procedure and the risks associated with it.</p><p> The Glenn procedure is formally known as the bi-directional cavopulmonary anastomosis.</p><h2>Key points</h2><ul><li>The Glenn procedure is performed when only one ventricle works properly and not enough blood is getting to the lungs.</li><li> This procedure allows deoxygenated blood to flow directly to both lungs.</li><li> This procedure is usually one in a series of operations and tends to be done as an open-heart procedure.</li></ul>
Bicuspid aortic valveBBicuspid aortic valveBicuspid aortic valveEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartCardiovascular systemConditions and diseasesAdult (19+)NA2009-12-04T05:00:00ZFraser Golding, MD, FRCPC9.4000000000000052.1000000000000281.000000000000Flat ContentHealth A-Z<p>Learn about bicuspid aortic valve; a defect of the valve between the left pumping chamber of the heart and the main artery that delivers blood to the body.</p><p>Bicuspid aortic valve is a defect of the valve between the left pumping chamber of the heart (the left ventricle) and the main artery that delivers blood to the body (the aorta). The valve has only two leaflets instead of the usual three. </p><h2> Key points </h2> <ul><li>Bicuspid aortic valve occurs when one leaflet does not develop when the heart is forming before birth.</li> <li> This condition may be diagnosed by a heart murmur. </li> <li> Most children do not require any treatment as generally this condition does not noticeably effect the heart during childhood.</li></ul>
Binge eating disorder: How to help your childBBinge eating disorder: How to help your childBinge eating disorder: How to help your childEnglishPsychiatryTeen (13-18 years)BodyNAConditions and diseasesCaregivers Adult (19+)NA2016-02-02T05:00:00Z​Se​ena Grewal, MD, MSc, FRCP(C);Robyn Legge, PhD;Jessica Watts, RN8.9000000000000061.5000000000000796.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Learn about the steps you can take to help your child as they recover from binge eating disorder.</p><p>As a parent, you know your child best. If you suspect your child has a <a href="/Article?contentid=277&language=English">binge eating disorder (BED) </a> , there are a number of steps that you can take to support their recovery.</p>​<h2>Key points</h2> <ul> <li>It is important to seek treatment for binge eating disorder as soon as you suspect it. Treatment can include therapy to help bring more structure to a person's eating habits and help them feel more in control with food.</li> <li>Other ways to help your child include being a healthy role model, sharing healthy messages about food and creating structured mealtimes and snacks.</li> <li>You may also need to make smaller but more frequent shopping trips and improve your child's sleep routine to help support their recovery.</li> </ul><h2>Seek treatment</h2> <p>It is important to seek treatment as soon as you suspect BED. ​​Early treatment is the best possible way to recovery.</p> <p>The three main goals of treatment for binge eating disorder are to:</p> <ul> <li>reduce binges</li> <li>create structure and stability around your child's meals and snacks</li> <li>help someone with the disorder feel more in control of their eating</li> </ul> <p>Different types of therapy are available for binge eating disorder. The most common one is <a href="/Article?contentid=702&language=English">cognitive behavioural therapy (CBT)</a>. Through therapy, a child or teen can learn to regulate their eating patterns and identify possible emotional triggers for binge episodes.</p><h2>Further information</h2><p>For more information on binge eating disorder (BED), please see the following pages:</p><p> <a href="/Article?contentid=277&language=English">BED: Overview</a></p><p> <a href="/Article?contentid=278&language=English">BED: Signs and symptoms</a></p><p> <a href="/Article?contentid=640&language=English">Obesity: Medical complications</a></p><h2>Resources</h2><p> <a href="http://www.nedic.ca/" target="_blank">NEDIC – National Eating Disorder Information Centre</a> (Canada)<br></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/Eating-Disorders-in-Children.aspx" target="_blank">​Eating Disorders in Children</a> ​</em></p><p> <a href="http://www.b-eat.co.uk/" target="_blank">B-EAT – Beating Eating Disorders</a> (United Kingdom)</p><p> <a href="http://www.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> ​​​​​https://assets.aboutkidshealth.ca/AKHAssets/binge_eating_disorder_how_to_help_your_child.jpg
Binge eating disorder: OverviewBBinge eating disorder: OverviewBinge eating disorder: OverviewEnglishPsychiatryTeen (13-18 years)BodyNAConditions and diseasesCaregivers Adult (19+)NA2016-02-02T05:00:00Z​Se​ena Grewal, MD, MSc, FRCP(C);Robyn Legge, PhD;Jessica Watts, RN10.300000000000045.0000000000000560.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Discover the main features and causes of binge eating disorder and who is most likely to be affected by it.</p><h2>What is binge eating disorder?</h2><p>Binge eating disorder occurs when someone has recurring episodes of binge-eating and related psychological distress.</p><h2>Key points</h2><ul><li>Binge eating disorder involves repeated episodes of eating a larger than usual amount of food in a limited time and feeling psychological distress as a result. It is not the same as overeating.</li><li>People who experience binge eating disorder often feel out of control. However, they do not compensate for their binge episodes through purging or excessive exercise.</li><li>Binge eating disorder is usually caused by social and psychological factors and/or genetics.</li><li>Binge eating usually starts in late adolescence or early adulthood. Teens with depression or anxiety might be at increased risk of developing BED.</li></ul><h2>What causes binge eating disorder?</h2><p>The exact causes of binge eating disorder are unknown, but a number of factors are thought to contribute.</p><h3>Social factors</h3><p>Some studies have shown that social pressures or messages to be thin can contribute to emotional eating.</p><h3>Psychological factors</h3><p>Emotional eating, poor self-esteem and body dissatisfaction are all associated with binge eating disorder. It is unclear if these activities or feelings cause BED, but someone who starts to diet to manage these feelings may be at risk of developing BED.</p><p>Teens who struggle with <a href="/Article?contentid=19&language=English">depression</a> or <a href="/Article?contentid=18&language=English">anxiety</a> may also be at increased risk of developing BED.</p><h3>Genetics </h3><p>A family history of eating disorders may make someone more vulnerable to developing binge eating disorder.</p><h2>Who is affected by binge eating disorder?</h2><p>Binge eating most commonly starts in a person's late teens or early adulthood. It usually follows a period of extreme dieting or weight loss. </p><p>Psychiatric disorders that are often linked with binge eating disorder include:</p><ul><li><a href="/Article?contentid=19&language=English">depression</a></li><li><a href="/Article?contentid=279&language=English">bipolar disorder</a></li><li><a href="/Article?contentid=18&language=English">anxiety​</a><br></li><li>substance use disorders.</li></ul><h2>Further information</h2><p>For more information on binge eating disorder (BED), please see the following pages:</p><p> <a href="/Article?contentid=278&language=English">BED: Signs and symptoms</a></p><p> <a href="/Article?contentid=640&language=English">Obesity: Medical complications</a></p><p> <a href="/Article?contentid=276&language=English">BED: 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 Information Centre</a> (Canada)<br></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> ​​​​https://assets.aboutkidshealth.ca/AKHAssets/chocolate_chip_cookies.jpg
Binge eating disorder: Signs and symptomsBBinge eating disorder: Signs and symptomsBinge eating disorder: Signs and symptomsEnglishPsychiatryTeen (13-18 years)BodyNAConditions and diseasesCaregivers Adult (19+)NA2016-02-02T05:00:00Z​Se​ena Grewal, MD, MSc, FRCP(C);Robyn Legge, PhD;Jessica Watts, RN8.0000000000000065.2000000000000419.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Discover the main signs of a binge eating disorder.</p><p> <a href="/Article?contentid=277&language=English">Binge eating disorder (BED)</a> has a range of signs and symptoms. Below are some of the most common physical and behavioural signs that a child or teen may be bingeing.</p><h2>Key points</h2> <ul> <li>If someone has binge eating disorder, they may eat very quickly, eat until uncomfortably full or eat alone.</li> <li>BED is also linked with feeling out of control with eating, depression and problems at school and with friends.</li> <li>Because binge eating is often done in secret, the only physical sign may be rapid weight gain.</li> <li>It is important to seek help for binge eating as soon as you suspect it. If left untreated, it can lead to obesity, which carries a range of complications.</li> </ul><h2>​​Behavioural symptoms of binge eating disorder</h2><p>People with binge eating disorder may:</p><ul><li>eat very quickly</li><li>eat regardless of hunger cues, even if they are already full</li><li>eat until uncomfortably or painfully full</li><li>eat alone due to embarrassment about the type and quantity of food they are consuming</li><li>experience feelings of self-disgust, guilt and <a href="/Article?contentid=19&language=English">depression​</a></li><li>have problems at school, with their personal life or in social situations</li><li> feel out of control with their eating</li></ul> <br> <p>Related signs of this behaviour include:</p><ul><li>taking food from the kitchen or pantry</li><li>hiding wrappers around the house</li><li>eating separately from the family or in secret</li><li>eating in the middle of the night</li><li>avoiding social situations</li></ul><h2>Physical signs of binge eating disorder</h2><p>People who have BED are typically overweight or obese. One physical sign that binge eating is occurring is rapid weight gain that is out of keeping with a child's or teen's expected growth curve. Because binge eating may be done in secret, parents may see very few other signs that it is happening.</p><p>If left untreated, binge eating disorder can lead to significant weight gain. This can cause a range of psychological and <a href="/Article?contentid=640&language=English">medical complications​</a>. Because of this, it is important to seek help for binge eating disorder as soon as you suspect it in your child or teen.</p><h2>Further information</h2><p>For more information on binge eating disorder (BED), please see the following pages:</p><p> <a href="/Article?contentid=277&language=English">BED: Overview</a></p><p> <a href="/Article?contentid=640&language=English">Obesity: Medical complications</a></p><p> <a href="/Article?contentid=276&language=English">BED: 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 Information Centre</a> (Canada)<br></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><br></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> ​​​ ​https://assets.aboutkidshealth.ca/AKHAssets/Binge_eating_disorder_signs_symptoms.jpg
Biofeedback to help your child's bladder control problemsBBiofeedback to help your child's bladder control problemsBiofeedback to help your child's bladder control problemsEnglishUrologySchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)BladderBladderNon-drug treatmentCaregivers Adult (19+)NA2009-11-06T05:00:00ZCathy Daniels, RN, MS, ACNP;Dalia Bozic, RN, BScN6.9000000000000069.60000000000001081.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Biofeedback is a system that helps children identify and control certain muscles while urinating. Read about biofeedback for bladder control problems.</p><h2>What are bladder control problems?</h2> <p>Bladder control problems mean that a child has trouble holding their urine (pee). A child with bladder control problems may have some of the following problems: </p> <ul> <li><a href="/Article?contentid=935&language=English">urinary tract infections</a></li> <li>peeing before reaching the toilet </li> <li><a href="/Article?contentid=16&language=English">wetting the bed at night</a></li> </ul> <p>Bladder control problems can happen once in a while or very often. They can have several different causes.</p> <p>Several different treatments can help children learn to hold their pee until they get to the toilet. Which treatment might help a child depends in part on the cause of the problem. </p> <p>If a child's bladder problem has to do with the <a href="https://pie.med.utoronto.ca/htbw/module.html?module=bladder-child">muscles of the bladder</a>, biofeedback may be useful. Biofeedback can help the child learn to better control the muscles that are used for bladder control. </p> <h2>What is biofeedback?</h2> <p>Biofeedback is a system that monitors changes in a person's body and displays them to the person. Biofeedback can help people become more aware of body functions that are normally automatic, such as peeing. As a result, people can sometimes get more control over those functions. </p> <p>Biofeedback for bladder control problems uses a special computer game to help your child learn to control the muscles that are used for holding urine and peeing. </p><h2>Key points</h2> <ul> <li>Children can have bladder control problems for several reasons. </li> <li>If the cause of the problem has to do with the bladder muscles and the sphincter, biofeedback sessions may help the child. </li> <li>A flow rate test with EMG will help doctors decide if biofeedback may be useful. </li> <li>Biofeedback uses electrodes and video games to help your child learn to control the muscles needed for bladder control. </li> <li>Your child should practice pelvic floor muscle exercises between biofeedback sessions. </li> </ul><h2>After the test, the doctor may recommend biofeedback</h2> <p>After the flow test with EMG, you will meet with the doctor in the clinic. They will talk to you about the results of your child's test. </p> <p>Depending on the results of the test and your child's medical history, the doctor may recommend biofeedback for your child.</p> <p>Biofeedback can help the urinary symptoms of children who have one or more of the following:</p> <ul> <li>Squeeze their pelvic floor muscles instead of relaxing when urinating. </li> <li>Have had more than one urinary tract infection. </li> <li>Do not get better after a lot of <a href="/Article?contentid=49&language=English">bladder retraining</a>. </li> <li>Are not able to control their bladder during the day and do not get better from other therapies. </li> </ul> <h2>How biofeedback works</h2> <p>Biofeedback uses electrodes placed on your child's buttocks and hip. These electrodes are connected to a special computer game that your child will play. The game will help your child learn to relax her pelvic floor muscles. </p> <p>At the end of each session, your child will be sent home with pelvic floor exercises. These exercises will help her practice what she learns during the biofeedback sessions. </p> <p>It usually takes several biofeedback visits for a child to learn the skills needed to urinate properly. Some children need several weeks or even a few months of biofeedback sessions to learn the skills. </p><h2>Flow rate test with electromyography (EMG)</h2> <p>A <a href="/Article?contentid=1269&language=English">flow rate test</a> with EMG will help doctors decide whether biofeedback may be a good therapy for your child to try.</p> <p>A flow rate test is a test that checks how your child urinates. Electromyography (EMG) is a test that looks at how muscles and nerves work together. </p> <p>Your child will have electrodes gently applied on the buttocks and hip. Electrodes are like stickers. They are connected to the EMG machine with wires. These electrodes let doctors check what your child's pelvic floor muscles are doing while they are peeing. The sphincter is part of the pelvic floor. </p> <p>Your child will pee into a special toilet.</p> <h3>Preparing for the test with a full bladder</h3> <p>Your child will need to have a full bladder and will really need to urinate. Please make sure your child has something to drink before the test, such as water. It can take between 20 to 30 minutes for liquid to get down to the bladder. Your child can eat before the test if they are hungry. </p> <p>When your child's bladder is full, the test will take about 10 minutes.</p><h2>At SickKids</h2> <p>Your child will need to register in the Urology Clinic. The Urology Clinic is located on 6B in the Atrium.</p> <p>The unit clerks will let the nurses know when you have arrived at the clinic.</p> <h3>Useful websites</h3> <p><a target="_blank" href="http://www.sickkids.ca/">www.sickkids.ca</a></p> <p><a target="_blank" href="/">www.aboutkidshealth.ca</a></p> <p><a target="_blank" href="http://www.cua.org/">www.cua.org</a></p>https://assets.aboutkidshealth.ca/akhassets/Urinary_female_MED_ILL_EN.jpg
Biologic agents for JIABBiologic agents for JIABiologic agents for JIAEnglishRheumatologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemDrug treatmentAdult (19+)NA2017-01-31T05:00:00ZJennifer Stinson RN-EC, PhD, CPNPLori Tucker, MDAdam Huber, MSc, MD, FRCPCMichael Rapoff, PhDShirley Tse, MD, FRCPCLynn Spiegel, MD, FRCPC9.8000000000000051.20000000000001458.00000000000Flat ContentHealth A-Z<p>Find out about the use of biologic agents in the treatment of JIA including what biologics are, how they work, safety considerations and side effects, and the biologics that are currently available to treat JIA.</p><p>Biologic agents are a new group of highly effective drugs for JIA. They target key steps in the immune system that cause inflammation in the joints. </p><h2>Key points</h2> <ul><li>Improvement from biologics use can often be seen quickly, within the first one to two weeks of starting the drug.</li> <li>Before starting any biologic for JIA, a child or teenager must be tested to make sure they have not been exposed to tuberculosis (TB). </li><li>Treatment with biologics make it harder to fight infections like colds, flu, and skin infections and can cause irritation at the injection site.</li> <li>Side effects will depend on the biologic agent your child is taking.</li></ul>
Bipolar disorder: OverviewBBipolar disorder: OverviewBipolar disorder: OverviewEnglishPsychiatryTeen (13-18 years)NANAConditions and diseasesCaregivers Adult (19+)NA2016-07-15T04:00:00Z​Marijana Jovanovic, MD, FRCPC;Daphne Korczak MD, MSc, FRCPC (Paediatrics), FRCPC (Psychiatry)​;Irfan Mian, MD, FRCPC, DABPN11.900000000000041.30000000000001002.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Learn about the different types of bipolar disorder and how they differ from everyday mood swings.</p><h2>What is bipolar disorder?</h2><p>Bipolar disorder is a mood disorder consisting of episodes of:</p><ul><li>elevated or irritable mood (called manic or hypomanic episodes)</li><li>low mood (depressive episodes)</li></ul><p>Bipolar disorder cannot be diagnosed until a person has experienced a manic or hypomanic episode.</p><h2>Key points</h2><ul><li>Mood changes that are severe or sustained, interfere with everyday activities, pose a safety risk or include symptoms of psychosis can be a sign that a child or teen has developed bipolar disorder.</li><li>A manic episode (lasting at least seven days) must occur before a child is diagnosed with bipolar disorder, type 1. A hypomanic episode (lasting at least four days) must be present before a child is diagnosed with bipolar disorder, type 2.</li><li>See your doctor if your child is experiencing symptoms of hypomania or mania.</li><li>Go to the nearest emergency department if your child is voicing suicidal thoughts, engaging in significant risk-taking behaviours or showing symptoms of psychosis.</li></ul> ​​​<h2>What causes bipolar disorder?</h2> <p>There is no single known cause of bipolar disorder but rather a number of possible factors. For example, children who have a parent or sibling with bipolar disorder are up to six times more likely to develop the disorder themselves.</p> <p>In addition, bipolar disorder can be more likely to occur in response to various stressors in a child's environment, such as the loss of a parent or caregiver, school difficulties, bullying, poverty or early life abuse or neglect. Some substances, such as cannabis, may also increase the risk of or unmask bipolar disorder.</p> <h2>How common is bipolar disorder in children and teens?</h2> <p>Bipolar disorder spectrum affects between 1 and 3 per cent of teens. It is not yet clear how common it is among younger children.</p><h2>When to see a doctor about bipolar disorder</h2> <p>See your child's doctor once you suspect that your child or teen has bipolar disorder (typically, after a first episode of mania).</p> <p>Go to your nearest emergency department if there are concerns about your child's safety (for instance if your child <a href="/Article?contentid=292&language=English">expresses suicidal thoughts</a> or engages in risk-taking behaviour) or if your child is experiencing psychosis.</p> <h2>Does bipolar disorder occur with other conditions?</h2> <p>Bipolar disorder often occurs with other conditions, especially <a href="/Article?contentid=270&language=English">anxiety disorders</a>. Other conditions that commonly occur with bipolar disorder include:</p> <ul><li>substance use disorders</li> <li><a href="/Article?contentid=1922&language=English">attention deficit hyperactivity disorder (ADHD) </a></li> <li>disruptive behaviour disorders such as oppositional defiant disorder.</li></ul><h2>When to see a doctor about bipolar disorder</h2> <p>See your child's doctor once you suspect that your child or teen has bipolar disorder (typically, after a first episode of mania).</p> <p>Go to your nearest emergency department if there are concerns about your child's safety (for instance if your child <a href="/Article?contentid=292&language=English">expresses suicidal thoughts</a> or engages in risk-taking behaviour) or if your child is experiencing psychosis.</p><h2>Further information</h2><p>For more information on bipolar disorder, please see the following pages:</p><p><a href="/Article?contentid=280&language=English">Bipolar disorder: Signs and symptoms</a></p><p><a href="/Article?contentid=704&language=English">Bipolar disorder: Treatment with medications</a></p><p><a href="/Article?contentid=705&language=English">Bipolar disorder: Treatment with psychotherapy and lifestyle changes</a></p> https://assets.aboutkidshealth.ca/AKHAssets/bipolar_disorder_overview.jpg
Bipolar disorder: Signs and symptomsBBipolar disorder: Signs and symptomsBipolar disorder: Signs and symptomsEnglishPsychiatryTeen (13-18 years)NANAConditions and diseasesCaregivers Adult (19+)NA2016-07-15T04:00:00Z​Marijana Jovanovic, MD, FRCPC;Daphne Korczak MD, MSc, FRCPC (Paediatrics), FRCPC (Psychiatry)​;Irfan Mian, MD, FRCPC, DABPN12.400000000000038.2000000000000826.000000000000Health (A-Z) - ConditionsHealth A-Z<p>​Discover the main symptoms of bipolar disorder and how they appear in children and teens.</p> <h2>What are the main symptoms of bipolar disorder?</h2><p>The main symptoms of bipolar disorder are alternating episodes of <a href="/Article?contentid=19&language=English">depression</a> and mania, and, sometimes, symptoms of psychosis.</p><h2>Key points</h2> <ul> <li>Bipolar disorder has a number of emotional, physical, cognitive and behavioural symptoms.</li> <li>Your child's doctor will interview you and your child to reach a diagnosis.</li> <li>The doctor will likely recommend that your child or teen see a specialist for further evaluation and may do other tests to rule out other causes of symptoms.</li> </ul><h2>Symptoms of depression</h2><p>Depression has a range of emotional, cognitive (mental), behavioural and physical <a href="/Article?contentid=284&language=English">symptoms</a>. These include low mood, feelings of hopelessness, negative thoughts, loss of interest in enjoyable activities and changes in sleep patterns.</p><h2>Symptoms of mania and hypomania</h2><p>Much like the symptoms of depression, the symptoms of mania and hypomania fall into the following categories:</p><ul><li>emotional</li><li>cognitive</li><li>behavioural</li><li>physical</li></ul><h3>Emotional symptoms</h3><p>During an episode of mania or hypomania, a child or teen may feel:</p><ul><li>elevated, euphoric or irritable</li><li>grand or on top of the world</li></ul><h3>Cognitive symptoms</h3><p>Someone experiencing mania or hypomania may:</p><ul><li>believe they have special powers or talents that are not based in reality</li><li>suffer reduced concentration</li><li>have racing thoughts</li></ul><h3>Behavioural symptoms</h3><p>An episode of mania or hypomania can often involve:</p><ul><li>starting many different activities or projects</li><li>engaging in risky behaviour such as increased spending or substance use, increased sexual activity or reckless driving</li><li>talking more than usual and more rapidly than usual, sometimes not allowing interruptions</li><li>jumping from one topic to another when speaking</li></ul> ​ <h3>Physical symptoms</h3><p>During an episode of mania or hypomania, a child or teen may:</p><ul><li>have high energy levels</li><li>be agitated</li><li>sleep much less than usual (typically one or two hours a night) without feeling tired</li></ul><h2>Symptoms of psychosis</h2><p>When someone experiences psychosis, they tend to develop beliefs that are not rooted in reality.</p><ul><li>During an episode of mania, their beliefs are typically positive, such as being better than others.</li><li>During depressive episodes, the beliefs are typically negative, such as being responsible for catastrophic events.</li></ul><p>Someone experiencing psychosis will also often sense things that do not really exist, for instance hearing voices or seeing things that are not visible to others. They may also speak in a way that is difficult or impossible to follow or develop new behaviours that seem bizarre and pointless.</p><h2>How children experience bipolar disorder</h2><p>In younger (pre-teen) children, the symptoms of ADHD and bipolar disorder can often be confused. Children with bipolar disorder show signs of dramatic mood changes that last for several days to several weeks at a time. The elevated, irritable or depressed mood lasts for most of the day, every day of that episode.</p><ul><li>During a manic or hypomanic episode, the child might appear sillier than usual, speak more often and more quickly than usual, sleep much less than usual and not feel tired and engage in many activities, especially enjoyable or risky activities.</li><li>During a depressed or mixed episode (an episode with both manic and depressive symptoms), the child might experience prolonged sadness, crying, irritability, increased sleep, fatigue or thoughts of <a href="/Article?contentid=291&language=English">suicide</a>.</li></ul><h2>How teens experience bipolar disorder</h2><p>Teens display similar symptoms of bipolar disorder as adults, but they may have more frequent episodes of mania or hypomania and depression. They will often have symptoms of psychosis as well.</p><ul><li>During an episode of mania or hypomania, teens may present as excitable and/or irritable, speak quickly and start many activities (especially pleasurable activities that can be risky, such as substance use, excessive spending and sexual activity).</li><li>During a depressive or mixed episode, teens should be carefully monitored for <a href="/Article?contentid=291&language=English">suicidal thoughts or behaviours </a>.</li></ul><h2>How bipolar disorder is diagnosed</h2> <p>Your child's doctor will speak to you and your child and ask you both about:</p> <ul> <li>your concerns and the symptoms that are interfering with your child's functioning</li> <li>any current stressors in your child's life</li> <li>any medications or substances that your child may have taken</li> <li>your child's development (from pregnancy onwards)</li> <li>your family's mental health history</li> <li>family stressors</li> </ul> <p>If your child has experienced an episode of mania or hypomania, they might meet the criteria for bipolar disorder.</p> <p>Your child's doctor may also want to do other tests to check for possible causes of your child's symptoms. </p><h2>What your child's doctor can do for bipolar disorder</h2> <p>If your child is diagnosed with bipolar disorder, your doctor will discuss the most appropriate course of action with you and your child. This decision may need input from other members of your family or your child's teachers.</p> <p>Your child's doctor may also suggest that your child see a <a href="/Article?contentid=705&language=English">therapist or a psychiatrist</a>. They may also recommend <a href="/Article?contentid=704&language=English">medications​</a> or <a href="/Article?contentid=705&language=English">lifestyle changes</a>. Medications are often necessary for treating bipolar disorder.</p><h2>Further information</h2><p>For more information on bipolar disorder, please see the following pages:</p><p><a href="/Article?contentid=279&language=English">Bipolar disorder: Overview</a></p><p><a href="/Article?contentid=704&language=English">Bipolar disorder: Treatment with medications</a></p><p><a href="/Article?contentid=705&language=English">Bipolar disorder: Treatment with psychotherapy and lifestyle changes</a></p>https://assets.aboutkidshealth.ca/AKHAssets/bipolar_disorder_warning_signs.jpg
Bipolar disorder: Treatment with medicationsBBipolar disorder: Treatment with medicationsBipolar disorder: Treatment with medicationsEnglishPsychiatryTeen (13-18 years)NANADrug treatmentCaregivers Adult (19+)NA2016-07-15T04:00:00Z​Marijana Jovanovic, MD, FRCPC;Daphne Korczak MD, MSc, FRCPC (Paediatrics), FRCPC (Psychiatry)​;Irfan Mian, MD, FRCPC, DABPN11.000000000000045.90000000000001214.00000000000Health (A-Z) - ProcedureHealth A-Z<p>​Learn about the medications that can treat bipolar disorder, including their side effects and how your child will be monitored while they take them.</p>​<p>Bipolar disorder is a medical condition with many different treatment options to help your child or teen. Medications are usually a central part of treatment and are often very effective at stabilizing the mood and managing other symptoms of the disorder.</p><h2>Key points</h2> <ul> <li>Bipolar disorder is a chronic condition that most often requires long-term treatment with medications.</li> <li>Due to the complexity of symptoms, a child or teen may need to take more than one medication at a time.</li> <li>To give your child's doctor time to judge a medication's effectiveness, your child or teen usually needs to take the medication for several weeks to months.</li> <li>The most common medications for treating bipolar disorder in children and teens are antipsychotics, lithium and anticonvulsants. Antidepressants are sometimes used to treat depression in bipolar disorder but usually at the same time as a mood stabilizer.</li> <li>Medications for bipolar disorder have various adverse effects that require careful monitoring by a doctor through a physical exam and blood tests.</li> </ul><h2>How does my child's doctor know which medications to prescribe for bipolar disorder?</h2> <p>Before starting any medication, your child's doctor will assess your child's mental and physical health. This is called finding out your child's "baseline" and may involve taking blood tests. Your child or teen will have regular follow-up appointments so their doctor can monitor their progress and check if medications have adverse side effects.</p> <h2>How long will my child need to take medications?</h2> <p>Most children and teens with bipolar disorder need to take medications for a long time. Usually, they start with low doses and then increase them gradually as needed.</p> <p>Because the symptoms of bipolar disorder are quite complex, it is not unusual to need more than one medication to manage them. Your child may also need to take a medication for several weeks or months to give their doctor a chance to assess if it is suitable.</p> <h2>What types of medications are usually prescribed for bipolar disorder?</h2> <p>Doctors typically prescribe one or more of the following classes of medications to treat bipolar disorder in children and teens:</p> <ul> <li>mood stabilizers</li> <li>anticonvulsant medications</li> <li>atypical (second generation) antipsychotics</li> <li>antidepressants</li> </ul> <p>These medications can sometimes come in different formulations (for example, in pill, powder or liquid). You can discuss the options with your child's doctor.</p><h2>Mood stabilizers</h2> <h3>Lithium</h3><p>Lithium is approved by Health Canada to treat and prevent symptoms of mania or hypomania in children aged 12 and older. Lithium can also act as an antidepressant and help prevent <a href="/Article?contentid=291&language=English">suicidal behaviour</a>.</p><p>If your child is prescribed lithium, they will need regular tests to monitor its level in their blood. If the level is too low, lithium will not be effective. If it is too high, it can cause toxicity (poisoning), which is a medical emergency. Caffeine intake can affect the blood lithium level, as can other over-the-counter and prescribed medications.</p><p> <em>Adverse effects of lithium</em></p><p>Lithium may cause:</p><ul><li>a fine (very slight) tremor</li><li>cognitive dulling (slowed thinking)</li><li>frequent urination</li><li>stomach upset (pain, nausea, <a href="/Article?contentid=746&language=English">vomiting</a>, <a href="/Article?contentid=7&language=English">diarrhea</a>)</li><li> <a href="/Article?contentid=29&language=English">headaches</a></li><li> <a href="/Article?contentid=770&language=English">acne</a></li><li>rash</li><li>weight gain</li></ul><p> <em>Signs of lithium toxicity</em></p><p>Lithium toxicity is more likely to happen if a child is dehydrated. The signs of toxicity include:</p><ul><li>diarrhea</li><li>drowsiness</li><li>difficulty speaking</li><li>a severe <a href="/Article?contentid=852&language=English">tremor</a></li><li>muscle weakness</li><li>lack of co-ordination</li></ul><p>Assuming the lithium level in the blood is within a safe range, most teenagers do not experience significant adverse effects. However, they do need regular blood tests to check for thyroid and kidney function, as lithium can affect these organs over longer periods of time.</p><h2>Anticonvulsant medications</h2><p>Anticonvulsants are sometimes used as mood stabilizers in bipolar disorder, but they were originally developed to treat seizures. These medications are not approved by Health Canada to treat bipolar disorder in children and teens. However, your doctor may prescribe these medications "off label", as they may work for some children.</p><p>The most common anticonvulsant medications for bipolar disorder are:</p><ul><li> <a href="/Article?contentid=258&language=English">valproic acid/divalproex sodium</a></li><li> <a href="/Article?contentid=168&language=English">lamotrigine</a></li></ul><h3>Valproic acid</h3><p>Valproic acid treats manic and depressive episodes.</p><p> <em>Adverse effects of valproic acid</em></p><p>Possible adverse effects include:</p><ul><li> <a href="/Article?contentid=852&language=English">tremor</a></li><li>stomach upset</li><li>hair thinning</li><li>weight gain</li><li>polycystic ovarian syndrome (PCOS) in females, which can lead to obesity, excess body hair and an irregular menstrual cycle</li></ul><p>Your doctor may order blood tests to monitor for adverse effects. In rare cases, valproic acid is also linked with serious side effects involving the liver.</p><p>Valproic acid carries a warning around the possibility of increased suicidal ideation (thoughts of suicide). In addition, it can change the levels of other medications that your child might be taking at the same time. As a result, it is important to tell your doctor about all the medications that your child or teen is taking. Girls taking valproic acid should be carefully monitored by a doctor for symptoms or signs of PCOS.</p><h3>Lamotrigine</h3><p>Lamotrigine is used mainly to treat the depressive episodes of bipolar disorder.</p><p> <em>Adverse effects of lamotigrine</em></p><p>Possible adverse effects include:</p><ul><li>fatigue</li><li>blurred vision</li><li> <a href="/Article?contentid=29&language=English">headaches</a></li><li>lack of co-ordination</li><li>stomach upset</li><li>painful periods</li><li>rashes</li></ul><p>In rare cases, lamotigrine may also be linked with serious side effects involving the skin. If your child develops a new rash after they start on this medication, tell your child's doctor as soon as possible.</p><p>Lamotrigine may also change the blood levels of other medications that your child is taking at the same time. It is important to tell your doctor about all the medications that your child or teen is taking.</p><h2>Atypical (second generation) antipsychotics</h2><p>Atypical antipsychotics are used more frequently than anticonvulsants to treat bipolar disorder in children and teens. They include:</p><ul><li>aripiprazole (Abilify)</li><li>risperidone (Risperdal)</li><li>quetiapine (Seroquel)</li><li> <a href="/Article?contentid=203&language=English">olanzapine</a> (Zyprexa)</li><li>ziprasidone (Zeldox)</li><li>lurasidone (Latuda)</li><li>clozapine (Clozaril)</li></ul><p>Only aripiprazole has been approved by Health Canada for treating bipolar disorder (in teens aged 13 to 17). The rest are not approved and so may be prescribed "off label".</p><p> <em>Adverse effects of atypical antipsychotics</em></p><p>Adverse effects may include:</p><ul><li>drowsiness</li><li>light headedness</li><li>menstrual problems for girls (with certain medications)</li><li>weight gain (sometimes significant, especially in children, depending on the medication)</li></ul><p>The significant weight gain and changes in metabolism from some antipsychotics can increase a child's risk of developing <a href="/article?contentid=1717&language=English">diabetes</a> and <a href="/Article?contentid=891&language=English">high cholesterol</a>. If your child is taking antipsychotics, their doctor should carefully monitor their weight and the levels of glucose and lipids (fats) in their blood.</p><p>In rare cases, long-term use of antipsychotics can lead to a neurological condition called tardive dyskinesia (TD). This involves uncontrolled muscle movements, most often around the mouth. Some children who reduce the dose or stop the antipsychotic may recover partially or fully, but others do not.</p><h2>Antidepressants</h2><p>Antidepressants, such as <a href="/Article?contentid=707&language=English">selective serotonin reuptake inhibitors (SSRIs)​</a>, are sometimes prescribed to treat depression in bipolar disorder. They are usually used at lower doses and for shorter periods of time in bipolar disorder than they are for depression.</p><p>If a doctor prescribes an antidepressant for bipolar disorder, they will often prescribe a mood stabilizer at the same time. This is to reduce the risk of a child or teen switching to mania or hypomania.</p> ​​​​<h2>Further information</h2><p>For more information on bipolar disorder, please see the following pages:</p><p><a href="/Article?contentid=279&language=English">Bipolar disorder: Overview</a></p><p><a href="/Article?contentid=280&language=English">Bipolar disorder: Signs and symptoms</a></p><p><a href="/Article?contentid=705&language=English">Bipolar disorder: Treatment with psychotherapy and lifestyle changes</a></p>https://assets.aboutkidshealth.ca/AKHAssets/bipolar_disorder_medication.jpg" width="2576
Bipolar disorder: Treatment with psychotherapy and lifestyle changesBBipolar disorder: Treatment with psychotherapy and lifestyle changesBipolar disorder: Treatment with psychotherapy and lifestyle changesEnglishPsychiatryTeen (13-18 years)NANANon-drug treatmentCaregivers Adult (19+)NA2016-07-15T04:00:00Z​Marijana Jovanovic, MD, FRCPC;Daphne Korczak MD, MSc, FRCPC (Paediatrics), FRCPC (Psychiatry)​;Irfan Mian, MD, FRCPC, DABPN12.500000000000037.9000000000000539.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Discover the different types of psychotherapy and lifestyle changes that can help a child or teen with bipolar disorder.</p> <p>If your child is diagnosed with bipolar disorder, <a href="/Article?contentid=704&language=English">medications</a> will be an important part of their treatment. Your child's doctor may also recommend psychotherapy and lifestyle changes to manage symptoms.</p><h2>Key points</h2> <ul> <li>Although treatment for bipolar disorder most often includes medications, your child may also be advised to take part in psychotherapy or make lifestyle changes.</li> <li>Psychotherapies for bipolar disorder include CBT, IPSRT, FFT and DBT. Some of these therapies focus on helping the child on their own and others focus on helping the whole family.</li> <li>Some healthy lifestyle changes, such as getting enough sleep and eating a balanced diet, may help to improve some symptoms of bipolar disorder.</li> </ul><h2>Psychotherapy for bipolar disorder</h2> <p>Psychotherapy, also known as "talk therapy", involves a trained therapist working with an individual or a group of people on common objectives. Depending on the type of psychotherapy, the therapist can offer support, teach coping skills or help the patient(s) explore relationships.</p> <p>Some psychotherapy treatments for bipolar disorder include:</p> <ul> <li>cognitive behavioural therapy (CBT)</li> <li>interpersonal and social rhythms therapy (IPSRT)</li> <li>family-focused therapy (FFT)</li> <li>dialectical behavioural therapy (DBT)</li> </ul> <h3>Cognitive behavioural therapy (CBT)</h3> <p><a href="/Article?contentid=708&language=English">CBT</a> has been well studied in children and teens with depression, and is particularly helpful for the depressive episodes in bipolar disorder.</p> <h3>Interpersonal and social rhythms therapy (IPSRT)</h3> <p>This type of psychotherapy originated from interpersonal therapy for depression, and was adapted for bipolar disorder.</p> <p>IPSRT helps children and teens work on improving their relationships and managing their daily routines by using charts. Regular routines and sleep schedules may help prevent manic or hypomanic episodes or lengthen the time between them.</p> <h3>Family-focused therapy (FFT)</h3> <p>FFT involves a child's family and focuses on enhancing the family's ability to cope with a depressive or manic/hypomanic episode and recognizing new episodes earlier. FFT helps to improve communication and problem solving in the family.</p> <h3>Dialectical behavioural therapy (DBT)</h3> <p>DBT is a therapy that teaches teens skills to help them regulate their emotions and change any maladaptive (unhelpful) behaviour.</p> <h3>Importance of patient/therapist relationship</h3> <p>Psychotherapy is more helpful when there is a good relationship between the therapist and the child. If there is a poor fit, you may need to talk to the therapist or switch to another therapist.</p><h2>Further information</h2><p>For more information on bipolar disorder, please see the following pages:</p><p><a href="/Article?contentid=279&language=English">Bipolar disorder: Overview</a></p><p><a href="/Article?contentid=280&language=English">Bipolar disorder: Signs and symptoms</a></p><p><a href="/Article?contentid=704&language=English">Bipolar disorder: Treatment with medications</a></p>https://assets.aboutkidshealth.ca/AKHAssets/bipolar_psychotherapy.jpg
Bladder augmentationBBladder augmentationBladder augmentationEnglishUrologySchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)BladderBladderProceduresCaregivers Adult (19+)NA2009-11-06T05:00:00ZCathy Daniels, RN, MS, ACNP;Dalia Bozic, RN, BScN6.1000000000000075.00000000000001524.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Bladder augmentation is an operation that uses a piece of bowel to make the bladder bigger. Read how you can prepare your child for bladder augmentation.</p><h2>What is bladder augmentation?</h2> <p>A bladder augmentation (say: ogg-men-TAY-shun) is an operation to make the bladder bigger. A bigger bladder means it will be easier for your child to store and hold urine (pee). To make the bladder bigger, surgeons will remove a small piece of your child's bowel and attach it to the top of the bladder. </p><h2>Key points</h2> <ul> <li>Bladder augmentation is a surgery to make the bladder bigger, using a piece of your child's bowel. </li> <li>Before the operation, the bowel must be as clean as possible. This will take a few days to do. </li> <li>After the operation, your child will stay in the hospital for a few days. </li> <li>It may take a little while for your child to learn to control their peeing. </li> </ul><h2>Before the operation</h2> <p>The nurse will take a small amount of blood from a vein in your child's arm, using a small needle. <a href="/Article?contentid=990&language=English">If your child is afraid of needles</a>, you can encourage them to do deep breathing. This will help your child stay calm and it will reduce pain. </p> <p>Your child will have a special "sleep medicine" called a <a href="/Article?contentid=1261&language=English">general anesthetic</a> before the operation. This will make sure that your child will sleep and feel no pain during the operation. </p> <h2>During the operation</h2> <p>The operation takes between about three to seven hours. It depends what kind of operation the surgeon uses. The surgeon will explain this to you before the operation.</p><h2>After the operation</h2> <p>Your child is taken to the Post-Anesthetic Care Unit, or the hospital's recovery room. In a few hours, your child will become more awake. Then they will be taken to the urology unit. </p> <p>Your child will have an IV tube in the arm. This lets the doctors and nurses give your child liquids, food and medicine. Your child will not be eating through the mouth for about a week. This gives your child's bladder and bowel time to heal. </p> <p>Your child will also have a nasogastric (NG) tube. An NG tube is a small hose that is put into your child's stomach through the nose. The tube keeps your child's stomach empty. Your child will still be able to breathe normally while the NG tube is in place. After a few days, the tube is removed and your child can start eating by mouth again. </p> <p>Your child will have some stitches on their tummy. The stitches keep the incision site closed so it can heal. The incision site is where the doctors cut the skin to do the operation. </p> <p>Your child will also have a few tubes on their tummy. These may include a suprapubic catheter, a foley catheter and a Penrose drain. The foley catheter and the Penrose drain will be removed before your child goes home. The suprapubic catheter will be removed later at a follow-up appointment at the urology clinic. </p> <h2>Pain management after the operation</h2> <p>Your child's tummy will be sore after the operation. Pain medications will be given as needed. If you see your child in pain, please speak to the nurse about pain medication. </p> <p>You can help your child cope with pain by using deep breathing and by distracting your child. Ask the nurse how you can help. Your child will have to stay in the hospital for a few days. A child life specialist can help keep your child busy with toys and games. </p> <p>While your child is in bed, it is important to exercise the lungs. One way is to take slow, deep breaths and then cough. Your nurse will show your child how to do this. </p> <h2>Learning to use the bladder again</h2> <p>After the operation, your child will have a tube called a suprapubic catheter. This takes urine (pee) from your child's bladder to the outside of the body. It will be taken out when your child is comfortable peeing or self-catheterizing. </p> <p>Sometimes after the operation, your child's urine may have some mucus in it. Mucus looks white and thick, and it may block the suprapubic catheter. To keep the suprapubic catheter clear, you will need to irrigate your child's catheter every day. Your nurse will show you how to do this before your child goes home. </p> <p>After a few days, your child will be able to start peeing normally again. At first, your child may not have full control of their bladder. Your child may also have bladder spasms and cramping. If this becomes a problem, your child may need to take medicine to reduce these symptoms. </p> <p>Sometimes your child's bladder will need help to empty properly. This is done with a small tube, called a catheter, that is put through the urethra into the bladder to drain the urine. This is called self-catheterizing. Your nurse will explain how to do this. </p><h2>Talk to your child about the operation</h2> <p>Once you have read this page and have spoken to the doctors about your child's operation, speak to your child. Using words that they will understand, <a href="/Article?contentid=1108&language=English">explain what the surgery is for</a> and what is going to happen. When children know what to expect, they are usually less anxious and more cooperative. </p> <p>Many hospitals have pre-admission programs meant for children. These programs let parents and kids know what to expect. It is a good idea for parents and children to participate in these programs before any operation. Ask the nurse at the urology clinic about these types of programs for children. </p> <h2>Preparing the bowel before the operation</h2> <p>Your child's bowel needs to be as clean as possible before the surgery. This preparation takes about three days. Most families choose to do the first two days at home and then come to the hospital for the last day. A urology nurse will meet with you to describe how to prepare the bowel at home. </p> <h3>Eating and drinking</h3> <p>For two to three days before the operation, your child should only have clear fluids to drink. Clear fluids are liquids you can see through, like water, apple juice, ginger ale, Sprite, Jello and freezies. Your child cannot have anything else to eat or drink. </p> <p>Write the date of your child's operation here:</p> <p>Write the date your child must start having only clear fluids here:</p> <h3>Enemas</h3> <p>Your child will need to have several enemas. An enema means that a small tube is put into your child's anus and water is flushed inside. Then, your child will go to the bathroom and expel the water and feces (poo) from the bowel. Usually, enemas are a bit uncomfortable but they do not hurt. </p> <h3>Coming to the hospital</h3> <p>On the day before the surgery, your child will come to hospital and be admitted to the unit. The nurses will keep on preparing your child's bowel for the operation. They may give your child laxatives and enemas to clean out the bowel. </p> <p>Your child will also get an intravenous (IV) tube in the arm while they are in hospital. This is used to give your child liquids, foods and medicine. </p><h2>At SickKids</h2> <h3>Supporting your child</h3> <p>When preparing your child for an operation, the urology team recommends that whenever possible, your child and family members attend the Pre-Admission Program offered at SickKids.</p> <p>A <a href="/Article?contentid=1153&language=English">child life specialist</a> can also help to prepare and support your child if they are anxious about the operation.</p> <h3>Useful websites</h3> <p><a href="http://www.sickkids.ca/" target="_blank">www.sickkids.ca</a> </p> <p><a href="/" target="_blank">www.aboutkidshealth.ca</a> </p> <p><a href="http://www.cua.org/" target="_blank">www.cua.org</a> </p>https://assets.aboutkidshealth.ca/akhassets/Urinary_female_MED_ILL_EN.jpg
Bladder retrainingBBladder retrainingBladder retrainingEnglishUrologySchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)BladderBladderNon-drug treatmentCaregivers Adult (19+)NA2009-07-29T04:00:00ZCathy Daniels, RN, MS7.1000000000000068.00000000000001105.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Bladder retraining can help your child follow a voiding routine, stay dry and avoid accidents.</p><h2>What is bladder retraining?</h2><p>Learning to follow a bladder routine can help make your child's voiding habit more regular. This can help your child in several ways: </p><ul><li>Your child may avoid wetting and stay dry for a longer time. </li><li>Your child's feelings of having to void frequently and urgently may be less. </li><li>A regular voiding habit can help prevent bladder infections. </li></ul><p>The following instructions are designed to guide you in helping your child retrain their bladder. Other family members may want to use some of these tips as well. </p><div class="asset-video"> <iframe src="https://www.youtube.com/embed/E8Khck8lWak?rel=0" frameborder="0"></iframe> </div><h2>Key points</h2> <ul> <li>Good bladder control means the brain and the bladder are working together. </li> <li>Learning to follow a bladder routine can help make your child's voiding habits more regular and avoid wetting. </li> <li>Retraining your child's bladder takes time, understanding, and patience. </li> </ul><h2>Tips for bladder retraining</h2> <h3>Your child should drink more during the day</h3> <p>Your child should drink more fluids (liquids) during the day. Water is the best clear fluid that your child can drink. It helps to flush the kidneys and bladder naturally. </p> <ul> <li>As well as the milk and juice that your child normally drinks with meals, slowly increase the amount of water. Eventually, your child should drink two litres (eight 8-ounce glasses) of water during the day. </li> <li>Large amounts of fruit juices may irritate your child's bladder. Most fruit juices are acidic. They may cause burning and itching when voiding. Try limiting fruit juice or diluting it with water. </li> <li>You may need to ask your child's teacher to allow your child to drink more during the day. For example, ask the teacher if your child may keep a water bottle on their desk. </li> <li>Your child may need special bathroom privileges at school until they have enough bladder control to go to the bathroom during regular school times. Ask the urology nurse or doctor for a school letter that explains this. </li> </ul> <h3>Your child should not drink much after 6:00 in the evening</h3> <p>Your child should drink most of their fluids between waking up and late afternoon (4:00 to 6:00).</p> <ul> <li>A large amount of fluid in the morning helps to make sure there is enough urine in the bladder. </li> <li>Drinking after 6:00 in the evening may make bedwetting worse. </li> </ul> <h3>Your child should try to void every two to three hours</h3> <p>Your child needs to develop a regular voiding schedule. Encourage your child to try to void every two to three hours, whether they feel the need to or not. </p> <ul> <li>Your child should not hold urine for long periods of time. This may stretch the bladder muscles. </li> <li>You may want to have the voiding schedule match the breaks in your child's school day (morning, mid-morning/recess, noon, mid-afternoon) and afterwards (early evening, late evening). </li> </ul> <h3>Your child should avoid caffeine</h3> <p>Your child should not eat or drink foods and drinks that contain caffeine.</p> <ul> <li>Caffeine may irritate the bladder and cause frequency and urgency in voiding. </li> <li>Common foods and drinks that contain caffeine are colas, Mountain Dew, tea, coffee and chocolate. </li> </ul> <h3>Fibre is important</h3> <p>A <a href="/Article?contentid=964&language=English">high-fibre diet</a> will help your child have a regular bowel routine and avoid <a href="/Article?contentid=6&language=English">constipation</a>.</p> <ul> <li>If your child is constipated, it is more difficult for the bladder to fill up with urine. It is also hard to empty the bladder completely. Constipation is a major contributing factor in children who have urinary tract infections and/or incontinence. </li> <li>Foods that are high in fibre are fruits, vegetables, bran, cereals, whole wheat bread, rice, beans and lentils. </li> </ul> <h3>Your child should do Kegel exercises</h3> <p>Bladder exercises can help to strengthen the muscles around the outlet of the bladder (the urethral sphincter). These exercises are known as Kegel exercises. </p> <ul> <li>To help your child understand this exercise and feel these muscles, ask them to squeeze a ball the size of your fist between their legs, right above their knees. </li> <li>When your child can feel these muscles, he should practice the Kegel exercises when he is not voiding. </li> <li>Your child should practice the Kegel exercises twice a day. To help your child remember, try doing them after something they do every day. For example, your child could do the exercises after breakfast and dinner, or after homework. </li> </ul> <h3>Use a diary or calendar to track your child's progress</h3> <p>A diary or calendar helps to reinforce your child's efforts to retrain the bladder and stay dry. You can use stickers or checkmarks to keep track of when your child voids. </p> <ul> <li>Help your child to make their own calendar. This will help your child develop a daily routine. </li> <li>The stickers and praise help reinforce your child's efforts to stay dry. </li> <li>The diary can also be used to keep track of your child's progress over a period of time, such as six months. </li> </ul> <p>If you have further questions, please speak to your doctor or the urology clinic nurse.</p><h2>Before you start bladder retraining</h2> <p>Retraining your child's bladder takes time, understanding and patience. Create a safe and supportive environment for your child. Together, you are developing strategies to overcome the problem. A relaxed, matter-of-fact approach will help. </p><h2>At SickKids</h2> <p>If your child has been referred to the urology program at SickKids for dysfunctional voiding (including recurrent urinary tract infections, incontinence, urinary frequency, or urinary urgency) and bladder retraining has been suggested, please:</p> <ul> <li>follow this bladder retraining information</li> <li>keep a voiding diary as described</li> </ul> <p>If you have questions or concerns, please contact the Advanced Practice Nurses by calling the urology clinic at 416-813-6661.</p>https://assets.aboutkidshealth.ca/akhassets/bladder_control_baby_vs_child_MED_ILL_EN.png
Blalock-Taussig (BT) shuntsBBlalock-Taussig (BT) shuntsBlalock-Taussig (BT) shuntsEnglishCardiologyChild (0-12 years)HeartCardiovascular systemProceduresAdult (19+)NA2009-12-11T05:00:00ZJennifer Russell, MD, FRCPC8.6000000000000060.0000000000000310.000000000000Flat ContentHealth A-Z<p>The Blalock-Taussig (BT) shunt helps babies with certain heart defects get enough oxygen until they can have surgery to fix the defect.</p><p>Blalock-Taussig shunts, or BT shunts, are used for defects that affect the flow of blood from the right ventricle, through the pulmonary artery, and to the lungs. These include pulmonary atresia, pulmonary stenosis, and tricuspid atresia. <br></p><h2> Key points </h2> <ul><li>Blalock-Taussig (BT) shunts helps resolve symptoms of the defect until the child is older or the defect can be repaired.</li> <li>The shunt creates a detour that allows enough blood to pass through the lungs and pick up more oxygen.</li> <li> The shunt is inserted in a closed-heart procedure.</li> <li> Shunts are typically used for four to five months until definitive repair is required.</li></ul>
Bleeding after a blood and marrow transplantBBleeding after a blood and marrow transplantBleeding after a blood and marrow transplantEnglishHaematology;Immunology;OncologyChild (0-12 years);Teen (13-18 years)BodyImmune systemConditions and diseasesAdult (19+)NA2010-01-06T05:00:00ZJohn Doyle, MD, FRCPC, FAAPChristine Armstrong, RN, MScN, NP Peds7.5000000000000065.6000000000000257.000000000000Flat ContentHealth A-Z<p>Information for parents about bleeding, a possible complication which may occur after a child's blood and marrow transplant (BMT).</p><p>Before your child’s transplant, they are treated with chemotherapy and radiation to destroy the diseased bone marrow cells. The treatment also destroys a type of blood cell that prevents heavy bleeding, called platelets. Platelets make blood clot to close up wounds at a site of injury or cut on the body. When our bodies do not have enough platelets, we are more prone to bleeding. </p><h2>Key points</h2> <ul><li>Chemotherapy and radiation treatment destroy platelets, which form blood clots.</li> <li>The most common problem is nosebleeds.</li> <li>Platelet and haemoglobin cells will be monitored daily and a transfusion may be given if counts are too low.</li></ul>
Bleeding: First aidBBleeding: First aidBleeding: First aidEnglishHaematologyChild (0-12 years);Teen (13-18 years)NACardiovascular systemNon-drug treatmentCaregivers Adult (19+)NA2013-05-04T04:00:00ZElizabeth Berger, BA, MD, FRCPC, FAAP, MHPE5.7000000000000078.3000000000000622.000000000000Health (A-Z) - ProcedureHealth A-Z<p>An overview of the first aid treatment of bleeding and the prevention of shock.</p><p>In most cases, when your child scrapes or cuts themselves, the bleeding will stop quickly. Although the amount of bleeding may seem like a lot, most minor wounds do not result in major blood loss or complications. However, if the bleeding does not stop, you will have to act quickly to prevent too much blood loss and maybe even shock. Shock occurs when the circulatory system fails to provide enough blood to all parts of the body. </p> ​<h2>Key points </h2> <ul> <li>If your child's wound does not stop bleeding on its own, act quickly to prevent too much blood loss and shock. </li> <li>Signs of shock include pale skin, a drop in temperature, sweating, fast breathing and loss of consciousness. </li> <li>If your child is showing any sign of shock, call 911 right away.</li> <li>Raise the wound so it is above the heart. This will reduce the amount of blood flowing to the wounded area. </li> <li>Be sure your hands are clean, or wear disposable gloves, when treating your child's wound. </li> <li>If an object is embedded in your child's body, do not remove it. Cover the area with clean bandage rolls and seek medical attention right away. </li> </ul><h2>When to see a doctor</h2> <ul> <li>If the bleeding continues for more than five minutes, despite applying firm pressure to the area. </li> <li>If you are unable to properly clean the wound or if it appears dirty. </li> <li>If there are signs of shock. </li> <li>If the wound is on the child's neck or face. </li> <li>If the injury was caused by an electrical burn, an animal or human bite, a burn or a puncture wound (ex. a nail piercing the skin). </li> <li>If there is an object embedded in the wound. </li> <li>If the cut is deep and looks like it might need stitches. </li> <li>If the child has not had a shot for tetanus or if it has been longer than 10 years since the last tetanus shot. </li> </ul><h2>Treatment </h2> <h3>Rest </h3> <p>When treating any type of wound, minor or severe, have your child rest. Encourage them to sit or lie down. </p> <h3>Elevate </h3> <p>Be sure to raise the wounded area above their heart. This will reduce the amount of blood flowing to the wound. If the wound is dirty, you can rinse it gently with clean, cool or warm tap water. Do not use hot water. You can also use bottled water or a saline wound spray to clean the wound. Do not use alcohol, iodine, mercurochrome, hydrogen peroxide or other similar agents to clean the wound. These solutions will cause pain and/or irritation. </p> <h3>Direct pressure </h3> <p>Before you try to stop the bleeding, clean your hands to reduce the risk of infection. If you do not know the person that you are helping, wear gloves to protect yourself from any potential, transmissible diseases. Take sterile gauze or a clean cloth and press firmly on the wound to stop the bleeding. Continue to apply pressure to the area for at least five minutes. When the bleeding has slowed or stopped, secure the dressing with tape. </p> <p>If your child is showing any signs of shock, call 911 right away. </p> <h3>Embedded Object </h3> <p>If an object is embedded, or stuck in your child's body, do not take it out. Pulling it out could cause the bleeding to worsen. Instead, protect and cover the area with sterile gauze. Make sure to not push the object deeper into the wound. Wrap bandage rolls over the wound. Secure the bandage rolls above and below the wound. Seek medical attention right away to have the object removed and the wound cared for. </p>https://assets.aboutkidshealth.ca/AKHAssets/bleeding_first_aid.jpg
Blocked tear ductsBBlocked tear ductsBlocked tear ductsEnglishOphthalmologyChild (0-12 years);Teen (13-18 years)EyesLacrimal glandsNon-drug treatmentCaregivers Adult (19+)Eye discomfort and redness2014-07-21T04:00:00ZYasmin 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>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>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>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>https://assets.aboutkidshealth.ca/akhassets/Tear_duct_MED_ILL_EN.png

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