E-cigarettes and vapingEE-cigarettes and vapingE-cigarettes and vapingEnglishRespiratoryTeen (13-18 years)Lungs;BrainRespiratory systemHealthy living and preventionAdult (19+) CaregiversNA2019-11-04T05:00:00Z10.900000000000048.20000000000001075.00000000000Flat ContentHealth A-Z<p>Learn about e-cigarettes, how they work and who is using them. Also find information about the health risks associated with vaping.</p><h2>About e-cigarettes</h2><p>E-cigarettes belong to a group of devices commonly known as electronic nicotine delivery systems (ENDS). While there are many types of ENDS, they have a few things in common including a:</p><ul><li>battery</li><li>heating coil or atomizer</li><li>mouthpiece</li><li>reservoir or tank</li><li>sensor or button to activate the heating coil</li></ul><p>E-cigarettes can be disposable, or have a reloadable cartridge or a refillable reservoir for the vaping solution. In some e-cigarettes the wattage and voltage can also be modified.</p><p>E-cigarettes are known by many different names, such as:</p> <figure> <img alt="Small vaping device that looks like a flash drive" src="https://assets.aboutkidshealth.ca/AKHAssets/vaping.jpg" /></figure> <ul><li>cig-a-like</li><li>vape/dab pen</li><li>box-mod</li><li>pod device (JUUL, Blu, Phix, Suorin, STIG)</li><li>Chronic/Dank Vapes</li></ul><p>E-cigarettes are available in many different shapes and sizes. Some are small and look like a flash drive or pen, while others are much larger.</p><h2>Key points</h2><ul><li>The use of e-cigarettes, or vaping, is very common among teens and young adults and has been increasing over the past several years.</li><li>Vaping solutions can contain nicotine and other chemicals such as tetrahydrocannabinol (THC) and cannabidiol (CBD) oil.</li><li>Nicotine is highly addictive and can quickly become a long-term addiction, especially for teens and young adults whose brains are still developing.</li><li>The chemicals in vaping solutions can lead to short-term health problems and increase the risk of long-term health problems.</li><li>If you are trying to quit using tobacco cigarettes, talk to your health-care professional to come up with a plan that makes sense for you.</li></ul> <h2>Resources</h2><p>The Substance Abuse Program at the Hospital for Sick Children is for teens up to 18 years of age to help them with alcohol and other substance abuse related issues: <a href="http://www.sickkids.ca/adolescentmedicine/programs/substance-abuse-program/substance-abuse-program.html">http://www.sickkids.ca/adolescentmedicine/programs/substance-abuse-program/substance-abuse-program.html</a></p><p>The Nicotine Dependence Clinic located at CAMH is for anyone who wants to quit or reduce their tobacco use: <a href="https://www.camh.ca/en/your-care/programs-and-services/nicotine-dependence-clinic">https://www.camh.ca/en/your-care/programs-and-services/nicotine-dependence-clinic</a></p><p>The Youth Addiction and Concurrent Disorders Service at CAMH is for teens and young adults (ages 14-24) who have substance use challenges and/or concerns, with or without concurrent mental health concerns: <a href="https://www.camh.ca/en/your-care/programs-and-services/youth-addiction--concurrent-disorders-service">https://www.camh.ca/en/your-care/programs-and-services/youth-addiction--concurrent-disorders-service</a></p><p>Find resources from the Canadian Cancer Society to help you to quit using tobacco cigarettes: <a href="https://www.smokershelpline.ca/">https://www.smokershelpline.ca/</a></p> <h2>References</h2><p>Dai, H. & Leventhal, A.M. (2019, September 16). Prevalence of e-Cigarette Use Among Adults in the United States, 2014-2018. <em>The Journal of the American Medical Association</em>. Retrieved from <a href="https://doi.org/10.1001/jama.2019.15331">https://doi.org/10.1001/jama.2019.15331</a></p><p>Government of Canada. (2019, July 25). Talking with your teen about vaping: a tip sheet for parents. Retrieved from <a href="https://www.canada.ca/en/services/health/publications/healthy-living/talking-teen-vaping-tip-sheet-parents.html">https://www.canada.ca/en/services/health/publications/healthy-living/talking-teen-vaping-tip-sheet-parents.html</a></p><p>Government of Canada. (2019, August 6). About vaping. Retrieved from <a href="https://www.canada.ca/en/health-canada/services/smoking-tobacco/vaping.html">https://www.canada.ca/en/health-canada/services/smoking-tobacco/vaping.html</a></p><p>Hammond, D., Reid, J.L., Rynard, V.L., Fong, G.T., Cummings, K.M., McNeill, A.,…White, C.M. (2019). Prevalence of vaping and smoking among adolescents in Canada, England, and the United States: repeat national cross sectional surveys. <em>The British Medical Journal, 365</em>. <a href="https://doi.org/10.1136/bmj.l2219">https://doi.org/10.1136/bmj.l2219</a></p><p>Stanwick, R. (2018, February 28). E-cigarettes: Are we renormalizing public smoking? Reversing five decades of tobacco control and revitalizing nicotine dependency in children and youth in Canada. <em>Canadian Paediatric Society</em>. Retrieved from <a href="https://www.cps.ca/en/documents/position/e-cigarettes">https://www.cps.ca/en/documents/position/e-cigarettes</a></p><p>US Department of Health and Human Services. (2016). E-cigarette Use Among Youth and Young Adults: A Report of the Surgeon General. Retrieved from <a href="https://www.cdc.gov/tobacco/data_statistics/sgr/e-cigarettes/pdfs/2016_sgr_entire_report_508.pdf">https://www.cdc.gov/tobacco/data_statistics/sgr/e-cigarettes/pdfs/2016_sgr_entire_report_508.pdf</a></p><p>Walley, S.C., Wilson, K.M., Winickoff, J.P., & Groner, J. (2019). A Public Health Crisis: Electronic Cigarettes, Vape, and JUUL. <em>Pediatrics, 145</em>. Retrieved from <a href="https://pediatrics.aappublications.org/content/143/6/e20182741">https://pediatrics.aappublications.org/content/143/6/e20182741</a></p>https://assets.aboutkidshealth.ca/AKHAssets/vaping_devices.jpg
ESD and ESSB testsEESD and ESSB testsESD and ESSB testsEnglishOtherChild (0-12 years);Teen (13-18 years)Esophagus;Stomach;Small IntestineEsophagus;Stomach;Small intestineTestsCaregivers Adult (19+)NA2009-11-06T05:00:00Z6.6000000000000073.50000000000001196.00000000000Health (A-Z) - ProcedureHealth A-Z<p>ESD and ESSB tests use X-rays and barium contrast to image a child's digestive tract. Find out what to expect during an ESD or ESSB test. </p><h2>What are ESD and ESSB tests?</h2> <figure> <span class="asset-image-title">Contrast </span> <span class="asset-image-title">medium</span> <img src="https://assets.aboutkidshealth.ca/akhassets/ESD_contrast_MEDIMG_PHO_EN.jpg" alt="X-ray of esophagus" /> <figcaption class="asset-image-caption">The</figcaption> <figcaption class="asset-image-caption"> X-ray shows contrast medium travelling down the esophagus and eventually to the stomach.</figcaption> </figure> <p>ESD and ESSB are tests that use X-rays and a contrast medium to show doctors what is going on in your child's digestive system. A contrast medium is a liquid your child will drink. It helps the digestive system show up in X-ray pictures.</p><ul><li>ESD is short for esophagus, stomach and duodenum. These are the first three parts of your body's digestive system. When you eat, food goes from your esophagus to your stomach, then out of the stomach to your duodenum. An ESD test shows the doctor how these three body parts work as your child eats and drinks.</li><li>ESSB is short for esophagus, stomach, and small bowel. The small bowel (intestine) is the longest part of your body's digestive system. The duodenum is the first section of the small bowel, and there are two other sections called the jejunum and the ileum. This test is the same as an ESD, except that it shows doctors what is going on further along your child's digestive system.</li></ul><h2>Key points</h2> <ul> <li>ESD and ESSB are tests that use X-rays and a contrast medium to look at parts of the digestive system. </li> <li>An ESD takes about an hour. An ESSB can take anywhere from three to six hours. </li> <li>The test does not hurt and will not harm your child. </li> <li>Your child's stools (poo) may be a little white for a few days after the test. </li> <li>Your child should drink a lot of water for the first few days after the test. </li> </ul><h2>ESD and ESSB tests are usually done in a hospital</h2> <p>In the hospital, the tests are usually done in the Department of Diagnostic Imaging, Gastrointestinal and Genitourinary (GI/GU) area. </p> <ul> <li>The ESD test usually takes about 30 minutes. However, you can expect to be in the department for about 45 to 60 minutes to allow time for the X-ray images to be prepared, processed and checked by a radiologist. </li> <li>The ESSB test can take between three to six hours. This depends on your child's digestive system. </li> </ul><h2>Three people will be involved in the test</h2><p>A doctor, an X-ray technologist and a nurse will all help conduct the test, care for your child, and let you know what is happening during the test. </p><ul><li>The doctor is a radiologist, who specializes in carrying out X-ray procedures and interpreting (reading) the results. </li><li>The X-ray technologist will help the doctor operate the equipment. </li><li>The nurse will help your child throughout the test. </li></ul><h2>During the test</h2> <figure><img src="https://assets.aboutkidshealth.ca/akhassets/ESSB_contrast_MEDIMG_PHO_EN.jpg" alt="X-ray of stomach and intestines" /><figcaption class="asset-image-caption">After 30 minutes, the contrast medium can be seen in the stomach, small intestine and large intestine.</figcaption> </figure> <p>After checking into the GI/GU area of the Department of Diagnostic Imaging, your child will need to change into a hospital gown, using the change rooms provided. The X-ray technologist or nurse will then greet you in the waiting room and ask you to come into the X-ray room. Usually, one parent can go into the X-ray room with the child. </p><h3>In the X-ray room</h3><p>The room contains an X-ray table, a large camera that takes the X-ray pictures, and a television monitor. Your child will lie down on the table underneath the television camera.</p><p>Your child will be given a "barium shake" to drink. Barium is thick white liquid that will coat the inside of the esophagus, stomach, and duodenum. This coating gives a contrast so that these parts of the digestive system can be seen on X-rays. This is why the drink is called a contrast medium. The shake may be flavoured and your child may get to choose between several flavours. Some children may have trouble drinking the barium shake because it does not taste good to them, it may be hard to drink while lying down or both. </p><p>While your child is drinking, the doctor will be using the television camera to watch the barium. X-ray pictures will also be taken during and after drinking. </p><p>Although the camera makes beeping noises as the X-rays are taken, it does not touch your child. The X-rays do not hurt.</p><p>During the test, the doctor will place your child in different positions to get the best look at what is happening to the barium as your child drinks. Once your child has finished the drink and the doctor has finished taking the X-rays, the technologist or nurse will help your child off the table. </p><h2>After the test</h2> <h3>ESSB</h3> <p>You and your child will be sent to the waiting area. More X-rays will be taken about every 30 minutes, until the barium can be seen at the end of the small bowel. </p> <h3>ESD</h3> <p>The technologist or nurse will direct you to the change room and waiting area. You can have your child change into their clothes. You will then need to wait until the X-rays have been processed and checked by the doctor. </p> <p>The receptionist or technologist will let you know when you can leave.</p> <p>Outpatients may go to other appointments in the hospital or return home. The radiologist will review the ESD/ESSB study results and a report will be sent to your doctor. Your doctor will discuss the results with you at a follow-up appointment. </p> <h2>After-effects from the test</h2> <p>Because of the barium drink, your child's stools (poo) may look a little white the next few times they go to the bathroom. This is normal. Drinking lots of water for the next day or so will help your child pass the barium more easily. </p><h2>Your child needs to stop eating and drinking before the test</h2> <p>Children two years of age and younger should have nothing to eat or drink for four hours before the test.</p> <p>Children over two years of age should have nothing to eat or drink from midnight the night before the test.</p> <h2>Explaining the test to your child</h2> <p>Take time to read this information carefully. Describe the test in words you know your child will understand. Use the words your family uses to describe how your body works. Children who know what to expect are usually less anxious. The test is easier and faster when your child is fully co-operative. </p> <p>Young children may want to bring something comfortable to hold during the test. Your child may want to bring a stuffed toy or a blanket from home. </p> <p>One parent can be with the child at all times during the test. If you are pregnant, you must leave the room when your child has the X-ray. </p><h2>At SickKids</h2> <p>Outpatients must first register at Diagnostic Imaging on the 2nd floor of The Elm Street Wing. You will then be directed to the GI/GU Patient Check-in desk.</p> <p>If you need to cancel your child's ESD/ESSB test, please call 416-813-6068 as soon as possible. We need to give your child's appointment to another child on our waiting list. There is a long waiting list for these tests. If you are late, your child's appointment may be delayed or rescheduled.</p>https://assets.aboutkidshealth.ca/akhassets/ESD_contrast_MEDIMG_PHO_EN.jpg
Ear cleaning: How to clean your child's earsEEar cleaning: How to clean your child's earsEar cleaning: How to clean your child's earsEnglishOtolaryngologyChild (0-12 years);Teen (13-18 years)EarsNervous systemNon-drug treatmentCaregivers Adult (19+)NA2019-07-22T04:00:00Z6.0000000000000078.3000000000000403.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn how to safely clean your child's ears.</p><p>Your ears are divided into three parts: the outer ear, the middle ear and the inner ear. The outer ear includes the pinna (the part of the ear we can see) and the ear canal. The eardrum separates the ear canal from the midle ear. Together, these capture sounds and channel them into the middle ear.<br></p><p>The ear canal contains glands that produce earwax (cerumen). It is normal to have a lining of earwax in the ear canal, as the wax protects the middle ear from everyday dust and dirt.</p> <figure class="asset-c-100"> <span class="asset-image-title">Ear anatomy</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Ear_anatomy_V2_MED_ILL_EN.jpg" alt="Parts of the inner ear, middle ear and outer ear" /> <figcaption class="asset-image-caption">The ear has three sections: the outer ear, the middle ear, and the inner ear. Each section is made up of smaller parts that work together to help you hear.</figcaption> </figure><h2>Key points</h2> <ul> <li>Clean the outside of your child’s ears with a wash cloth.</li> <li>Don't put anything, such as cotton swabs or hair pins, in your child's ear canal.</li> <li>See your doctor about anything abnormal such as blood, oozing, pain or changes in hearing.</li> </ul><h2>When to see a doctor</h2><p>See your doctor if:</p><ul><li>you notice any blood, oozing or pus coming from the ear<br></li><li>your child has <a href="/article?contentid=750&language=English">ear pain</a> or experiences any change in their hearing</li><li>you see anything stuck in your child's ear</li></ul><h2>How to do routine ear cleaning</h2><p>Your child’s outer ears can be cleaned regularly to remove any dirt. The safest way to do this is to use a soft washcloth.</p><p>Remember, “nothing smaller than your elbow” should be put in your child’s ear. Items such as cotton swabs or hair pins should not be put in the ear canal. Using these items in the ear canal will pack the wax in further or cause damage to the ear canal.<br></p><p>Ear candling and peroxide cleaners are not recommended for cleaning your child’s ears. Ear candling has no clear benefit and can be risky.</p><h2>How to remove hardened earwax</h2><p>If you think your child has a build-up of hardened earwax, you can soften it with two to four drops of olive oil or mineral oil.</p><ol><li>Warm up some oil to skin temperature by holding it in a small container in your hands.</li><li>Use a dropper to apply the oil to the affected ear.</li><li>Have your child lie down with the affected ear facing up and leave the oil in the ear for a few minutes.</li><li>When your child sits up, the wax should work its way out.<br></li></ol><p>If the wax does not work its way out, your doctor may be able to remove it with a special instrument called a curet or with a warm water flush.</p>https://assets.aboutkidshealth.ca/akhassets/Ear_anatomy_V2_MED_ILL_EN.jpg
Ear infection (otitis media)EEar infection (otitis media)Ear infection (otitis media)EnglishOtolaryngologyBaby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years)EarsNAConditions and diseasesCaregivers Adult (19+)Earache;Fever2014-12-15T05:00:00Z7.7000000000000064.90000000000001456.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Otitis media is a middle ear infection caused by a backup of fluid behind the eardrum. Learn the causes, symptoms, prevention and treatment of otitis media. </p><h2>What is otitis media?</h2><p>Otitis media is another name for an infection of the middle ear. The middle ear is the space behind the eardrum. It can become infected by bacteria or viruses. </p> <figure class="asset-c-80"> <span class="asset-image-title">Ear anatomy</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Ear_anatomy_V2_MED_ILL_EN.jpg" alt="Identification of each of the parts in the outer, middle, and inner ear" /> <figcaption class="asset-image-caption">The ear has three sections: the outer ear, the middle ear, and the inner ear. Each section is made up of smaller parts that work together to help you hear.</figcaption> </figure><h2>Key points</h2> <ul> <li>Otitis media is an infection of the middle ear. It is common in children, especially between the ages of six months and two years.</li> <li>The infection can occur because of bacteria or viruses.</li> <li>Give pain and fever medicine as needed. Wait and monitor your child before starting any antibiotics if they are usually healthy and aged over six months.</li> <li>You can prevent repeat middle ear infections by washing your hands and your child's toys, following routine vaccination schedules and protecting your child from second-hand smoke.</li> <li>See your doctor if your child's symptoms do not ease after taking an antibiotic for 48 hours. Go to your nearest emergency department if your child's pain gets worse or your child is lethargic or vomiting.</li> </ul> <h2>Symptoms of otitis media</h2> <p>If a child develops otitis media, it usually happens after they have first had an upper respiratory tract infection such as a <a href="/Article?contentid=12&language=English">cold</a>. In children, the signs and symptoms of otitis media include:</p> <ul> <li><a href="/Article?contentid=30&language=English">fever</a></li> <li><a href="/Article?contentid=750&language=English">earache</a></li> <li>pulling or rubbing the ear</li> <li>crying</li> <li>not sleeping well</li> <li>fluid draining from the ear.</li> </ul> <p>In some children, the eardrum develops a small perforation (hole) because of the pressure in the ear. The ear then drains a cloudy or yellow fluid. The hole usually heals within a week or so. In some children, repeated ear infections and perforations can lead to scarring of the eardrum and longer-term hearing problems.</p><h2>Causes of otitis media</h2><p>The Eustachian tube connects the ear to the back of the throat and helps ventilate (air) and drain the middle ear. Otitis media occurs when mucus or swollen tissues from a cold block the Eustachian tube. The blockage has two main results.</p><ul><li>It prevents the tube from ventilating the middle ear. This leads to changes in air pressure and possible pain, much like what occurs in an airplane during take-off or landing.</li><li>It causes fluid to build up in the ear and trap any bacteria that are already there. The fluid build-up can become infected and put pressure on the eardrum, which makes it bulge. This can be painful.<br></li></ul> <figure class="asset-c-80"> <span class="asset-image-title">Otitis media</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_otitis_media_EN.jpg" alt="Eardrum bulging outward due to fluid buildup in middle ear from swelling and mucus blocks in Eustachian tube" /> <figcaption class="asset-image-caption">In otitis media, the Eustachian tube is blocked. Fluid and pressure then build up in the middle ear. This makes the eardrum bulge outward and causes pain.</figcaption> </figure> <h2>Who is most at risk for otitis media?</h2><p>Otitis media is most common in children between the ages of six months and two years, but it can occur throughout childhood. Most children will have at least one ear infection. Some children will have many of them.</p><p>Children are at higher risk for middle ear infections because their Eustachian tubes are shorter and more likely to be blocked by <a href="/Article?contentid=831&language=English">enlarged adenoids</a>. However, as a child gets older, their ear structures change and they grow out of the tendency to have ear infections.</p><h2>How your child's doctor diagnoses otitis media</h2> <p>Your child's doctor will need to examine your child to properly diagnose otitis media. They will look for any fluid in your child's ear and any change in the eardrum. The physical exam will also include a check of your child's neck and throat to see if there are any <a href="/Article?contentid=777&language=English">swollen lymph nodes</a>.</p><h2>When to see a doctor about otitis media</h2> <p>Call your child's doctor if:</p> <ul> <li>your child's fever or pain is not better after taking an antibiotic for 48 hours</li> <li>fluid is always draining from their ear</li> <li>you are concerned about your child's hearing.</li> </ul> <p>Take your child to the nearest emergency department or call 911 if:</p> <ul> <li>the pain gets worse, even after your child takes pain medicine</li> <li>your child's neck gets painful or stiff</li> <li>your child seems lethargic (sleepy) or very irritable (cranky)</li> <li>your child is <a href="/Article?contentid=746&language=English">vomiting​</a> (throwing up) repeatedly and cannot keep down their medicines or enough fluids</li> <li>your child has redness and swelling behind their ear</li> <li>your child's ear seems to stick out</li> <li>your child develops a rash, a puffy face or puffy lips while taking the antibiotic.</li> </ul>earinfectionhttps://assets.aboutkidshealth.ca/akhassets/Ear_anatomy_V2_MED_ILL_EN.jpg
Ear infection and sore throatEEar infection and sore throatEar infection and sore throatEnglishNABaby (1-12 months)EarsNAConditions and diseasesAdult (19+)Earache;Decreased hearing;Sore throat;Cough2009-10-18T04:00:00Z8.5000000000000062.3000000000000905.000000000000Flat ContentHealth A-Z<p>Read about the symptoms, causes, treatment and prevention of ear infections and sore throats. <br></p><p>Ear infections and sore throats are common in infancy and occur frequently with colds. Babies cannot communicate that they have a sore ear or throat, so it is important to know the signs to look for.</p><h2>Key points</h2><ul><li>Ear infection is a viral or bacterial infection of the middle ear, which is the area just behind the eardrum, and frequently occur after a cold.</li><li>Treatment for ear infection includes antibiotics and giving acetaminophen or ibuprofen to treat fever.</li> <li>Seek medical attention if the baby develops a stiff neck, acts very sick, or if the fever and pain do not go away after taking antibiotics for 48 hours.</li><li>A sore throat is a symptom of an illness such as a cold.</li><li>Sore throats are often caused by viruses, so taking antibiotics are not effective.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/ear_infections_sore_throat_babies.jpg
Ear problemsEEar problemsEar problemsEnglishPregnancyAdult (19+)Body;EarsReproductive systemConditions and diseasesPrenatal Adult (19+)NA2009-09-10T04:00:00Z11.800000000000040.2000000000000250.000000000000Flat ContentHealth A-Z<p>Learn about various types of ear abnormalities that can arise in the developing fetus during pregnancy. Answers from Canadian Paediatric Hospitals.</p><p>Some babies are born with congenital abnormalities, or birth defects of the ear. These abnormalities form as the result of something going wrong with the development of the baby’s ear during pregnancy. The main examples are: </p><h2>Key points</h2> <ul><li>Congenital hearing loss is a partial or complete loss of hearing in one or both ears, due to abnormal development of the ears in pregnancy.</li> <li>Outer ear malformations are common and usually minor, but sometimes severe.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/ear_problems_babies.jpg
Ear, nose & throat disordersEEar, nose & throat disordersEar, nose & throat disordersEnglishOtolaryngologyChild (0-12 years);Teen (13-18 years)Ears;Nose;TracheaNose;Nasopharynx;TracheaConditions and diseasesCaregivers Adult (19+)NA2018-01-19T05:00:00Z000Landing PageLearning Hub<p>Find information about common problems such as ear infections, strep throat, croup and nosebleeds. Also learn about cochlear implants, choanal atresia, adenoid surgery and tonsillectomy.</p><p>Find information about common problems such as ear infections, strep throat, croup and nosebleeds. Also learn about cochlear implants, choanal atresia, adenoid surgery and tonsillectomy and how to care for your child after surgery.</p>enthttps://assets.aboutkidshealth.ca/AKHAssets/ear_nose_throat_learning_hub.jpg
EaracheEEaracheEaracheEnglishOtolaryngologyChild (0-12 years);Teen (13-18 years)EarsNervous systemConditions and diseasesCaregivers Adult (19+)Decreased hearing;Earache;Fever;Pain2015-04-24T04:00:00Z7.5000000000000069.3000000000000645.000000000000Health (A-Z) - ConditionsHealth A-Z<p>An earache can develop because of an infection, impacted earwax or an injury. Learn how to treat an earache at home and when to see a doctor.<br></p><h2>What is earache?</h2> <p>Earache can be a sharp, dull or burning pain in one or both ears. This pain can last for a short or long time. Earache is common in children.</p><h2>Key points</h2> <ul> <li>An earache can be a sharp, dull or burning pain in one or both ears that can last for a short or long time.</li> <li>Earaches are often caused by ear and other upper respiratory infections. Other causes include impacted earwax or injury.</li> <li>You can help relieve a child's earache by encouraging them to swallow if the earache is due to changes in altitude. You can give over-the-counter pain medications if the earache is due to infection or injury.</li> <li>Get medical help right away if your child has severe pain and fever, if they have new or worsening symptoms or if they have fluid or blood oozing from the ear. </li> </ul><h2>Causes of earache</h2><p>The Eustachian tubes connect the ears to back of the mouth, near the throat. Short-term changes in pressure in one or both Eustachian tubes are one of the most common causes of earache. The changes in pressure occur when a child has an <a href="/article?contentid=12&language=English">upper respiratory infection</a>, such as the common cold or a throat, ear or sinus infection.</p><h3>Ear infections</h3><p>An <a href="/article?contentid=8&language=English">ear infection</a> occurs when there is swelling or build-up of fluids in the middle ear, most often from a viral or bacterial infection. It is also called otitis media. The middle ear is the space between the eardrum and inner ear.</p> <figure class="asset-c-80"><span class="asset-image-title">Otitis </span> <span class="asset-image-title"> </span><span class="asset-image-title"></span><span class="asset-image-title">media</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_otitis_media_EN.jpg" alt="Eardrum bulging outward due to fluid buildup in middle ear from swelling and mucus blocks in Eustachian tube" /><figcaption class="asset-image-caption">In</figcaption><figcaption class="asset-image-caption"></figcaption><figcaption class="asset-image-caption"></figcaption><figcaption class="asset-image-caption"> otitis media, the Eustachian tube is blocked. Fluid and pressure then build up in the middle ear. This makes the eardrum bulge outward and causes pain.</figcaption> </figure> <p>A child with an ear infection displays some of the following common signs and symptoms:</p><ul><li>ear pain</li><li> <a href="/Article?contentid=30&language=English">fever</a></li><li>fussiness</li><li>irritability</li><li>pulling or rubbing the ear</li><li>increased <a href="/Article?contentid=448&language=English">crying</a></li><li>trouble sleeping</li><li>fluid draining from the ear</li><li>difficulty hearing.<br></li></ul><h3>Other possible causes of earache</h3><ul><li>Pressure changes in the ears (for example during take-off or landing in a plane or if there is a lot of mucus in the sinuses)</li><li>Injury to the ear</li><li>Irritation from a foreign object in the ear</li><li>Impacted (packed-in) ear wax in the ear canal, usually caused by using cotton swabs incorrectly</li><li> <a href="/Article?contentid=747&language=English">Swimmer's ear (otitis externa)</a></li></ul><h2>How to treat your child’s earache</h2> <p>If your child has an earache on an airplane, have them chew gum or swallow to help relieve the pressure in their ears. If your child is an infant, allowing them to suck on a bottle or breastfeed while the plane lands may ease their discomfort.</p> <p>If your child is diagnosed with an ear infection, and they are under six months of age, the doctor will prescribe antibiotics. If your child is older than six months and they have only mild discomfort and a low-grade fever, your doctor might decide to wait for two or three days to see if the ear infection gets better on its own. If your child is older than six months, but they are in a lot of pain or have a high fever, the doctor might decide to start the antibiotic treatment right away.</p> <p>You can give over-the-counter pain medications such as <a href="/Article?contentid=62&language=English">acetaminophen</a> or <a href="/article?contentid=153&language=English">ibuprofen</a> to reduce your child’s pain. Only give ibuprofen if your child is drinking reasonably well. Do not give ibuprofen to babies younger than 6 months without first talking to your doctor.</p><h2>When to call a doctor for earache</h2> <p>See a doctor if:</p> <ul> <li>your child has severe pain and fever</li> <li>your child's symptoms get worse over the next 24 to 48 hours</li> <li>your child has dizziness, severe headaches, stiff neck or swelling around or behind the ear</li> <li>your child has fluid or blood oozing from the ear.<br></li> </ul>https://assets.aboutkidshealth.ca/akhassets/IMD_otitis_media_EN.jpg
Early language development in babies and toddlersEEarly language development in babies and toddlersEarly language development in babies and toddlersEnglishDevelopmentalBaby (1-12 months);Toddler (13-24 months)NANANAAdult (19+) CaregiversNA2020-11-03T05:00:00ZFlat ContentHealth A-Z<p>Learn about the different activities and interventions parents and caregivers can use to help babies and toddlers develop their speech and language. </p><p>While babies and toddlers will develop speech and language skills at different times, there are certain activities and interventions parents and caregivers can use to help their child learn to communicate.</p><h2>Key points</h2><ul><li>Babies and toddlers will develop speech and language skills at different times.</li><li>There are different interventions parents and caregivers can use to encourage speech and language development such as gestures, using simple language and repetition.</li><li>Parents and caregivers can use different activities to encourage language development, including play time, singing and gesture games.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/Early_language_development_in_babies_and_toddlers.jpg
Eating disorders and pregnancyEEating disorders and pregnancyEating disorders and pregnancyEnglishPregnancyAdult (19+)BodyReproductive systemConditions and diseasesPrenatal Adult (19+)NA2009-09-11T04:00:00Z10.400000000000051.8000000000000507.000000000000Flat ContentHealth A-Z<p>Learn about the effect of eating disorders such as anorexia on pregnancy. It is important to have a positive attitude about weight gain during pregnancy.</p><p>Anorexia and bulimia are eating disorders and mental health conditions that involve distorted body image and cause sufferers to be obsessed with being thin or losing weight. They lose a lot of weight and are afraid to gain weight. People with anorexia under-eat to maintain an unhealthy low weight. Bulimia involves binge eating followed by purging (vomiting, use of laxatives or other pills) to rid their body of calories they consumed. Anorexia and bulimia can cause complications during pregnancy for the unborn baby and the mother.</p><h2>Key points</h2> <ul><li>If you have anorexia or bulimia and you are pregnant, your baby will have a hard time getting nutrients which can result in malnourishment.<br></li> <li>Laxatives and water pills can damage the developing baby and should not be taken during pregnancy.</li> <li>Seek medical attention if you are pregnant and have an eating disorder so that your health-care professional can help you take control of the condition.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/eating_disorders_and_pregnancy.jpg
Eating out and special occasionsEEating out and special occasionsEating out and special occasionsEnglishEndocrinology;NutritionChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemHealthy living and preventionAdult (19+)NA2016-10-17T04:00:00Z8.4000000000000064.1000000000000577.000000000000Flat ContentHealth A-Z<p>Eating out and special occasions can be tricky when a family member has diabetes. Find out how to navigate these events to keep everyone healthy.<br></p><p>For the first weeks after diagnosis, you may be nervous about taking your child out for dinner. But many restaurants will supply nutritional information about their dishes if you ask. You should not feel shy about explaining to waiters that someone in the family has diabetes and that you need to know if the meal will be delayed. If so, eating a breadstick or some crackers while you wait for the meal to arrive is a good idea. These foods should be included as carbohydrate choices or <a href="/Article?contentid=1742&language=English">exchanges</a> or as part of the meal’s carbohydrates.<br></p><h2>Key points</h2> <ul><li>Most restaurants will supply nutritional information if you ask for it.</li> <li>If your child's insulin regimen allows, rapid-acting insulin can be given when the meal is served, with the dose adjusted to the meal's carbohydrate amount.</li></ul>
Ebstein's anomalyEEbstein's anomalyEbstein's anomalyEnglishCardiologyChild (0-12 years)HeartCardiovascular systemConditions and diseasesAdult (19+)NA2009-12-04T05:00:00Z9.6000000000000049.3000000000000226.000000000000Flat ContentHealth A-Z<p>Learn about Ebstein's anomaly in children. This condition can result in heart failure or cyanosis, but it can also resolve itself without treatment.</p><p>In Ebstein’s anomaly, the tricuspid valve is in the right ventricle, instead of between the right atrium and right ventricle where it should be. As a result, the right atrium gets stretched and gets bigger, while the right ventricle is smaller than usual. </p> <p>Children with Ebstein's anomaly often have an atrial septal defect as well. This lets blood flow from the right to the left atrium. </p><h2> Key points </h2> <ul><li>Children with this condition can experience cyanosis, congestive heart failure, and a heart murmur.</li> <li>Some children with Ebstein's anomaly improve without treatment, while others need drugs or surgery.</li></ul>
Echocardiogram (heart ultrasound)EEchocardiogram (heart ultrasound)Echocardiogram (heart ultrasound)EnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartHeartTestsCaregivers Adult (19+)NA2021-05-04T04:00:00Z9.4000000000000064.00000000000002022.00000000000Health (A-Z) - ProcedureHealth A-Z<p>An echocardiogram (or ‘echo’) is a special test that uses ultrasound (sound waves) to take pictures of the heart. Learn about how they are done, and how to help your child prepare for one.  </p><h2>What is an echocardiogram?</h2> <figure><span class="asset-image-title">Echocardiogram</span><img alt="Echocardiogram" src="https://assets.aboutkidshealth.ca/AKHAssets/Echocardiogram.png" /> </figure> <p>An echocardiogram (or 'echo' for short) is an ultrasound test of the heart which uses a special ultrasound camera placed on top of the skin and emits sound waves into the body. These sound waves meet structures in the body and reflect (or echo) back to the camera, allowing the health-care team to visualize and assess your child’s heart. </p><h2>Key points</h2><ul><li>An echocardiogram is an ultrasound test of the heart performed by cardiac sonographers or physicians and interpreted by specialized cardiologists. </li><li>Heart rhythm stickers (electrodes), an ultrasound camera and ultrasound jelly over the chest and stomach are used to take pictures of the heart. </li><li>This test lasts between 30 minutes to 90 minutes or more.  </li><li>A child needs to lie still during the test, so some children may need to be sedated or put to sleep for the test. </li></ul><h2>What will happen during the echocardiogram</h2> <figure> <span class="asset-image-title">Echocardiogram room set up</span><img alt="Sonographer doing echocardiogram ultrasound in echo room on patient" src="https://assets.aboutkidshealth.ca/AKHAssets/Echocardiogram%20room%20set%20up.jpg" /><figcaption>The cardiac sonographer uses the ultrasound machine (or echo machine) to take pictures of the heart.</figcaption> </figure> <p>The person who will do the test is specially trained to perform echocardiograms. This person is called a cardiac sonographer. </p><p>The sonographer will first measure your child's weight and height. Then, they will bring you and your child to an echo test room. </p><p>Your child will change from their sweater, shirt and other clothes above the waist and into a gown provided by the sonographer. There are private areas in the echo room to change. </p><p>Your child will lie on a special bed that can move up and down. The sonographer will put three stickers on your child's chest or arms. These stickers are called electrodes. They are connected by wires to the echo machine. They record your child's heartbeat during the test. </p><p>Next, the sonographer will put some warmed ultrasound jelly on your child's chest and belly so that the ultrasound camera can move easily over your child's skin. The sonographer will take pictures of your child's heart from different angles. Your child may feel some gentle pressure from the camera position and movement. Pictures are taken from the stomach, over the chest and from the neck. Your child may also be asked to lie in different positions throughout the test: on their back, on their side, on their back with their head tilted up. At times, your child may hear a loud swooshing noise when the echo machine records the flow of the blood through the heart. </p> <figure> <img alt="Sleeping baby with ultrasound camera on belly" src="https://assets.aboutkidshealth.ca/AKHAssets/Ultrasound%20camera%20on%20infant.jpg" /> <figcaption>The ultrasound camera is placed on the belly of a baby who is comfortably bundled for the echo test. </figcaption> </figure> <p>The lights in the room will be dimmed so the sonographer can see the pictures on the computer screen. </p><p>After the sonographer completes the pictures, they will make a report and show the images to one of the cardiologists, a heart specialist. The cardiologist may choose to take more pictures at this time. This is a normal part of the test. During this time, your child will stay connected to the echo machine. The sonographer or nurse will let you know when your child can get dressed again. </p><p>An echocardiogram takes from 30 minutes to 90 minutes or more. Often the first echocardiogram that your child has will take longer. How long the test lasts will also depend on why your child's doctor asked for the test. </p><h2>Preparing before the echocardiogram</h2><p>Most children do not need to do anything special to get ready for an echocardiogram. However, if your child is under three years old or cannot lie still, they may need a sedative. A sedative is a medicine that will help your child sleep for the test. An echocardiogram works best when the child does not move. </p><h3>Without a sedative</h3><p>If your child does not need a sedative, they can eat and drink normally before and after the echo. If your child has a comforting toy or a security blanket, please bring that along. There is a television in each echo exam room that your child may watch to pass the time. </p><p>Very young babies cannot be given a sedative. This includes babies who are premature or very small. If this is the case for your child, ask the doctor or nurse what the options are. </p><h3>If your child needs a sedative for the echocardiogram</h3><p>Your child needs to lie still during the test so the test results will be accurate. If your child needs a sedative, the bedside nurse will give your child medicine to swallow. This is medicine that will help your child sleep for the test. The medicine lasts just long enough for the test to be done. The nurse will monitor your child throughout the sedation process. </p><p>For sedation, your child must stop eating and drinking several hours before the test. A nurse will call you in the week before the test to make sure you understand the process. The table below describes what and when your child can eat and drink. </p><table class="akh-table"><thead><tr><th>Time before test</th><th>What you need to know</th></tr></thead><tbody><tr><td>8 hours</td><td><p>No more solid food, milk or orange juice. This also means no gum or candy.</p><p>Your child can still drink clear liquids. Clear liquids are anything you can see through, such as apple juice, ginger ale or water.</p><p>Your child can also eat Jell-O or popsicles.</p></td></tr><tr><td>6 hours</td><td>No more milk or formula.</td></tr><tr><td>4 hours</td><td>Stop breastfeeding your baby.</td></tr><tr><td>2 hours</td><td>No more clear liquids. This means no more apple juice, ginger ale or water. Your child cannot eat any Jell-O or popsicles.</td></tr></tbody></table><p>For more information about sedatives, please visit the <a href="/article?contentid=1260&language=english">sedation page</a> or ask your doctor or nurse. </p><h2>General anaesthesia for echocardiograms</h2><p>If your child is older than three years but cannot lie still, they may need <a href="/Article?contentid=1261&language=English">general anaesthesia</a>. Your child will have an appointment in another area of the hospital and there will be an anesthesiologist (sleep doctor) who provides the medication and monitors your child during the procedure. The echo machine will be brought to your child. A nurse will call you the week before the test to make sure you understand how to get ready for the test and the sleep medicine. </p><h2>Role playing the test with your child</h2><p>You and your child can practice the test at home.</p><p>Have your child lie on their back on a bed with the lights dimmed. Tell them that it will be warm and very quiet because the sonographer must concentrate on the study. Tell them the sonographer will put three small stickers on their chest. Put some warm hand lotion on the middle and left side of your child's chest. With the bottom of a smooth drinking glass push the hand lotion around on the chest. Explain that the glass is like the camera that the sonographer uses to take the pictures. Bring along your child's special toy or security blanket. Tell your child they will have to remove their shirt or sweater and wear clothing provided at the echo lab. Tell your child that you may lie down beside them on the echo bed during the test if they wished. Make sure the child knows the test will take some time, but you will never leave them alone. </p><h2>Helping your child prepare for the echocardiogram</h2><p>Be honest and open with your child about what to expect. Explain what will happen during the echocardiogram. Use as much detail as you think is appropriate for your child's level of understanding. Tell them about the appointment in advance so they are not surprised to show up at the hospital. Let your child know that you will be with them during the test.</p><p>The video below can be used to help prepare your child for an echocardiogram, a vascular ultrasound or a bicycle stress echo. </p><div class="asset-video"> <iframe src="https://www.youtube.com/embed/N-Cdm86rwsE?rel=0" frameborder="0"></iframe> </div><h2>At SickKids</h2><p>This test is usually performed in the Echocardiography Laboratory (Echo Lab), part of the <a href="https://www.sickkids.ca/en/care-services/centres/labatt-family-heart-centre/">Labatt Family Heart Centre</a>, located on 4B in the Atrium of the hospital. Sedated echocardiograms are usually performed in the Cardiac Catheterization Lab in the Burton Wing. We also perform bedside echocardiograms for patients throughout the hospital. </p><p>Within the Echo Lab, we also operate the <a href="https://www.sickkids.ca/en/care-services/clinics/cardiology-fetal-echo/">Fetal Cardiac Program</a> as well as our research lab. For more information about our research or if you or someone you know would be interested to participate in cardiovascular research, please visit us at the <a href="https://lab.research.sickkids.ca/cvus/">Cardiovascular Ultrasound Research Lab website</a>. </p>https://assets.aboutkidshealth.ca/AKHAssets/Echocardiogram.png
Echocardiogram bubble studyEEchocardiogram bubble studyEchocardiogram bubble studyEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartHeartTestsCaregivers Adult (19+)NA2009-11-06T05:00:00Z6.2000000000000072.8000000000000790.000000000000Health (A-Z) - ProcedureHealth A-Z<p>A bubble study is an echocardiogram that uses a bubble solution to image the flow of blood through the heart. Learn more about bubble studies. </p><h2>What is an echocardiogram?</h2> <p>An echocardiogram is an ultrasound of the heart. It is also called an "echo." Ultrasound uses sound waves to take pictures of the inside of the body. An echocardiogram is done to get pictures of the heart and the areas around the heart. This information helps doctors understand what your child's heart is doing. </p> <p>For more information on echocardiograms, including why they are done, how to prepare for the test, and what to expect during an echocardiogram, please read <a href="/Article?contentid=1274&language=English">Echocardiogram</a>.</p> <h2>What is a bubble study?</h2> <p>Sometimes we inject a fluid called contrast medium into your child's bloodstream. This helps us get a better picture of your child's heart on the echocardiogram. </p> <p>One type of contrast medium is saline (sterile salt water) mixed with a gas. Usually, the gas is carbon dioxide, the same gas that makes soda fizzy. When this solution is used it is called a bubble study. </p> <p>A bubble study lets us follow the path that the bubbles take through the bloodstream. This helps us to find heart or lung problems.</p> <p>The bubble study is safe. The bubble solution is easily absorbed into your child's bloodstream.</p><h2>Key points</h2> <ul> <li>A bubble study is a heart ultrasound that uses a bubbly liquid to help doctors get a better view of the path of blood through the heart. </li> <li>The contrast material is usually sterile salt water and carbon dioxide. It is injected into the body through an IV. It is safe. </li> <li>Your child should prepare for a bubble study in the same way as an echocardiogram. You should also tell your child they will need an IV. </li> </ul><h2>What will happen during the bubble study</h2> <p>Before the test, the nurse will ask your child to change into a hospital gown.</p> <p>Three people will be in the room to do the test:</p> <ul> <li>a doctor </li> <li>a nurse </li> <li>a sonographer, who operates the echocardiogram machine </li> </ul> <p>The doctor will mix the bubble solution in a sterile syringe and inject it into your child's IV. The sonographer will take the pictures with the echocardiogram probe. </p><h2>Going home after the test</h2> <p>If your child was not given a sedative, they can drink as usual. The nurse or doctor will remove the IV and put a bandage on before you and your child go home. </p> <p>If your child was given a sedative for the test, your child's nurse will tell you what you need to do.</p> <p>For more information on caring for your child after sedation, please read the Sedation pamphlet. </p><h2>Preparing for a bubble study</h2> <p>To get your child ready for a bubble study, follow the same instructions you follow for a regular echocardiogram.</p> <p>You should also tell your child that they will need an intravenous line (IV) on the day of the test. An IV is a needle in your child's arm, attached to a tube. This lets us put fluids directly into your child's bloodstream. </p> <h3>Eating and drinking before a bubble study</h3> <p>Most children do not need to do anything special to get ready for an echocardiogram. However, if your child is under three years old, they may need a sedative. A sedative is a kind of medicine that will help your child sleep for the test. An echocardiogram works best when the child does not move. </p> <p>If your child is having a sedative for the test, they must stop eating and drinking several hours before the test. A nurse will call you in the week before the test to make sure you understand what and when your child can eat and drink. The table below also tells you when your child must stop eating and drinking. </p> <h3>What your child can eat and drink before the sleep medicine</h3> <table class="akh-table"> <thead> <tr><th>Time before test</th><th>What you need to know</th></tr> </thead> <tbody> <tr> <td>8 hours</td> <td><p>No more solid food, milk or orange juice. This also means no gum or candy.</p><p>Your child can still drink clear liquids. Clear liquids are anything you can see through, such as apple juice, ginger ale or water.</p><p>Your child can also eat Jell-O or popsicles.</p></td> </tr> <tr> <td>6 hours</td> <td>No more milk or formula.</td> </tr> <tr> <td>4 hours</td> <td>Stop breastfeeding your baby.</td> </tr> <tr> <td>2 hours</td> <td>No more clear liquids. This means no more apple juice, water or ginger ale. Your child cannot eat any popsicles or Jell-O.</td> </tr> </tbody> </table><h2>At SickKids</h2> <p>Take your child to register on 4B in the Atrium wing of the hospital, in the Echo Lab.</p>
Ectopic pregnancyEEctopic pregnancyEctopic pregnancyEnglishPregnancyAdult (19+)BodyReproductive systemHealthy living and preventionPrenatal Adult (19+)Abdominal pain;Bleeding2009-09-11T04:00:00Z10.700000000000048.9000000000000535.000000000000Flat ContentHealth A-Z<p>Learn about ectopic pregnancy. Risk factors and treatment are discussed. After an ectopic pregnancy time must be taken for physical and emotional healing.</p><p>One of the main concerns during the first few weeks of pregnancy is the risk of an ectopic pregnancy. If the fertilized egg cell implants itself outside the uterus, it may start to grow in the fallopian tube. If this happens and is allowed to continue, the growing set of cells will eventually rupture the tube, causing severe pain in the side of the abdomen, vaginal bleeding, and sometimes fainting. Ruptured ectopic pregnancy is the leading cause of death of the mother in the first trimester of pregnancy. </p><h2>Key points</h2> <ul><li>Ectopic pregnancy is when the fertilized egg cell implants itself outside the uterus and begins to grow in the fallopian tube.</li> <li>Anything that impairs the ability of the fallopian tube to transport the fertilized egg cell to the uterus can result in an ectopic pregnancy.</li> <li>Ectopic pregnancy can be stopped with a drug called methotrexate, however in some cases urgent surgery may be required to end the pregnancy.<br></li></ul>https://assets.aboutkidshealth.ca/AKHAssets/ectopic_pregnancy.jpg
Eczema (atopic dermatitis)EEczema (atopic dermatitis)Eczema (atopic dermatitis)EnglishDermatologyChild (0-12 years);Teen (13-18 years)SkinSkinConditions and diseasesCaregivers Adult (19+)NA2019-02-15T05:00:00Z6.9000000000000067.80000000000002342.00000000000Health (A-Z) - ConditionsHealth A-Z<p>​Learn what atopic dermatitis is and what you can do to help your child cope.</p><h2>What is atopic dermatitis (eczema)?</h2><p>Atopic dermatitis is a chronic (long-lasting) skin condition that comes in many forms. Some children may have very mild eczema, while others may have a severe form. Sometimes, as children with eczema grow older, their symptoms lessen or disappear altogether. Other children may have eczema for life.</p><p>With eczema, the skin becomes dry, very itchy and a rash may appear. There are times when the condition is worse and times when the condition is better. When the condition worsens, this is called a flare-up. Flare-ups often occur in the winter months when the air is drier, but they can happen any time throughout the year.</p><p>The causes of eczema are unclear. Both genetic and environmental factors likely play a part. Children who have eczema may also have asthma or allergies such as hay fever.</p><p>There is no cure for eczema, but your health-care team will work with you to develop a plan to control the symptoms. They will also work with you so that you recognize when your child needs to see a health care provider.</p><h2>Key points</h2><ul><li>Atopic dermatitis (eczema) is a chronic skin condition that comes in many forms. Skin becomes dry and very itchy and a rash may appear. There will be times when the skin is worse or better.</li><li>Scratching the skin causes redness, swelling, damage and discomfort. In more serious cases, weeping of clear fluid, crusting and scaling can occur.</li><li>There are many things you can do to control the itch and to protect your child's skin. </li></ul><h2>Signs and symptoms of eczema</h2><p>Signs and symptoms may vary depending on how severe your child’s eczema is.</p><p>Signs and symptoms of eczema include:</p><ul><li>itching (pruritus)</li><li> <a href="/Article?contentid=790&language=English">dry skin</a></li><li>redness</li><li>eczema patches (scaly rash)</li><li>sleep loss</li><li>thickening of skin, redness, swelling, scratches and discomfort from scratching</li><li>skin colour changes</li><li>in more serious cases, oozing of clear fluid, crusting and scaling</li></ul><div class="asset-3-up"> <figure> <img alt="Photo of mild atopic dermatitis" src="https://assets.aboutkidshealth.ca/akhassets/Atopic_dermatitis_mild_EN.jpg" /> </figure><figure><img alt="Photo of moderate atopic dermatitis" src="https://assets.aboutkidshealth.ca/akhassets/Atopic_dermatitis_moderate_EN.jpg" /> </figure><figure><img alt="Photo of severe atopic dermatitis" src="https://assets.aboutkidshealth.ca/akhassets/Atopic_dermatitis_severe_EN.jpg" />​ </figure> </div><h2>How to manage eczema</h2><p>Good skin care, including bathing and moisturizing, is a key part of managing your child's eczema.</p><p>It is also sometimes possible to figure out what factors cause eczema in your child. If you know the triggers of your child's eczema, help your child stay away from them. However, many flare-ups happen without an obvious trigger.</p><p>Your child’s health care provider may also prescribe one or more medicines to help your child. These medicines may be topical (applied to the skin) or oral (to be taken by mouth).</p><h2>Skin care</h2><h3>Bathing</h3><p>Taking frequent baths is an important step to help manage flare-ups and help prevent infection. Your child should bathe at least once a day, up to three times a day if they have the chance to do so.</p><ul><li>Bathing your child in lukewarm water for five to 10 minutes is ideal for hydrating the skin. Do not use hot water, which can irritate the skin and trigger itching. Being in the water any longer does not help and may even make the skin drier. If you need a reminder, try using a timer.</li><li>Fill up the tub to about hip level when your child is sitting in the tub.</li><li>Use soap-free cleansers or very mild soap products. If you use soap, use it only on the areas that need it. Do not rub or lather with a cloth, as this can irritate the skin. Rinse off all of the soap well to prevent further dryness.</li><li>Do not use wash cloths, sponges or loofahs, as these can cause irritation when rubbed along the skin.</li><li>When you have finished bathing your child, pat their skin dry, do not rub. Try to leave as much water on the skin as you can.</li><li>Apply a prescribed medicated ointment or cream to all the affected skin areas right away (the rough, red, bumpy spots).</li><li>After applying the prescribed active ointment or cream, use a product like petroleum jelly or moisturizer over the unaffected skin areas.</li><li>Use bath time as a chance to inspect your child's skin for redness, irritation or flare-ups. </li></ul><h3>If you want to use emulsifying oils</h3><p>Adding an emulsifying oil can also help keep the skin hydrated. Emulsifying oils work by mixing with the bath water and helping the skin absorb some of the water. Because the oil can make the bathtub slippery, your child could slip and be injured. Be extra-cautious when using emulsifying oils in your child's bath.</p><p>Add the emulsifying oil to the bath water before your child gets in the bathtub. Mix the oil into the bath water. When using emulsifying oil, use the same bathing routine as you normally would (as described above).</p><p>Ask your pharmacist for these special oils. Emulsifying oils are different from regular bath oil, vegetable oil or other types of oils. These types of oils will coat the skin and prevent water, topical medicated creams, or moisturizer from getting in.</p><h3>Moisturizing</h3><p>Dry skin is one of the most common features of eczema. When skin is dry, it can be itchy. It also starts to lose its function as a protective barrier. This means that more water is lost from the skin and irritants can get into the skin. Both can trigger an eczema flare-up.</p><p>Moisturizers help decrease the itch and soothe the skin. They do this by creating a protective layer over the skin. This helps keep the water in the skin and the irritants out. Moisturizers are a mixture of fats, oils and water. There are three kinds of moisturizers that are used: ointments, creams and lotions.</p><ul><li>Ointments are thicker, greasier products. Most of them do not contain water. They are the most effective method for hydrating very dry skin and large areas of skin. They are usually well tolerated.</li><li>Creams are a mixture of fats and water. They feel light and cool on the skin. Creams are used very often to prevent skin from drying out and when skin is cracked. These products often "burn" or sting the skin of patients with eczema.</li><li>Lotions contain the most water. They spread easily and can be cooling to the skin. They can be used on the scalp. They are not as effective for moisturizing dry skin as ointments or creams. Lotions can cause skin discomfort or stinging in very dry skin.</li></ul><p>Avoid any product that irritates the skin. No particular brand of moisturizer is better than another. Find one that works well and that your child likes.</p><h2>Medicines and other treatments</h2><p>Depending on how severe your child's eczema is, your child's health care provider may prescribe one or more medicines.</p><h3>Topical corticosteroids</h3><p>Topical corticosteroids are steroid ointments or creams that are put on the skin. Steroids are an effective way to help reduce inflammation in the skin. Inflammation causes swelling, redness, bumpiness and skin irritation. Less inflammation leads to less itching and therefore, less scratching.</p><p>These medicines are grouped by strength. Which corticosteroid you use depends on where the flare-up is on the body and how bad it is. For example, your child might need a milder corticosteroid for the face but a stronger one for the body. Your child's health care provider will explain which type is best for your child. By carefully following your health care provider’s instructions, you will use topical corticosteroids in the optimum way. This will allow for a better control of your child's flare-ups. When used correctly, topical steroids have almost no side effects. If you have concerns about these medications, talk to your health care provider about them.</p><h3>Topical calcineurin inhibitors</h3><p>Topical calcineurin inhibitors are medications that help regulate the immune system in the skin. They are applied directly to the affected area of skin. Their brand names are Protopic and Elidel. These medicines are used in:</p><ul><li>children who cannot tolerate topical steroids</li><li>children whose eczema does not get better with topical steroids</li></ul><h3>Antihistamines</h3><p>Antihistamines may be used in combination with topical ointments to help relieve the itch that happens with eczema. They may not work in all people. Oral antihistamines are preferred over topical antihistamines, as the topical forms can be irritating to the skin.</p><p>Some antihistamines can cause sleepiness or drowsiness. This can be helpful for children who have trouble sleeping at night because of itching. If your child needs to take antihistamines during the day, their health care provider will review the options with you.</p><h3>Anti-infective agents</h3><p>Having eczema increases a person's risk of infection. Scratching can disrupt the skin barrier, making it easier for bacteria on the skin to enter the body and cause infection. Viruses or fungi can also cross the skin barrier, although this is less common. Infection in the skin can make eczema worse.</p><p>Anti-infective agents are medicines used to fight infections caused by bacteria (antibiotics), viruses (antivirals), and fungi (antifungals). The use of anti-infective agents treats infections and prevents complications. If your child needs an anti-infective, your child's health care provider will prescribe one.</p><h3>Coal tar preparations</h3><p>Crude coal tar can be used to treat skin inflammation and itch. It creates a soothing effect. This treatment has many ingredients that have not all been identified but seem to have a therapeutic effect. Many people avoid using this treatment because it can be messy, it has some odour, it can take a lot of time and it is not very convenient.</p><h3>Herbal remedies and alternative therapy</h3><p>Herbal remedies and alternative therapy may include the use of:</p><ul><li>herbal and dietary supplements</li><li>vitamins</li><li>other over-the-counter products</li></ul><p>These products have not been proven to help with eczema. Tell your health care provider about any alternative therapies and supplements your child is using.</p><h2>When your child should see a health care provider</h2><p>Contact your child's health care provider in the following situations:</p><ul><li>When medicines are not working or your child's condition is worsening.</li><li>If you see any sign of infection, such as crusting, oozing, pus or blister.</li></ul><h2>Resources</h2><ul><li>The <a target="_blank" href="https://eczemahelp.ca/">Eczema Society of Canada</a></li><li> <a target="_blank" href="https://nationaleczema.org/">National Eczema Association</a></li><li> <a target="_blank" href="http://www.eczema.org/">National Eczema Society</a></li></ul>eczemahttps://assets.aboutkidshealth.ca/AKHAssets/eczema.jpg
Eczema: Coping with eczemaEEczema: Coping with eczemaEczema: Coping with eczemaEnglishDermatologyChild (0-12 years);Teen (13-18 years)SkinSkinNon-drug treatmentCaregivers Adult (19+)NA2014-01-10T05:00:00Z6.5000000000000072.1000000000000930.000000000000Flat ContentHealth A-Z<p>Learn how to help your child and your family cope with atopic dermatitis (eczema).</p><h2>​​​What is eczema (atopic dermatitis)?</h2><p> <a href="/Article?contentid=773&language=English">Atopic dermatitis</a> is a chronic (long-lasting) skin condition that comes in many forms. It is also called eczema.</p><p>With eczema, the skin becomes dry and very itchy, and a rash may appear. There are usually times when the condition is worse, and times when the condition is better. When the condition worsens, this is called a flare-up. Flare-ups often occur in the winter months when the air is drier, but it can happen any time throughout the year.<br></p><h2>Key points</h2> <ul> <li>Atopic dermatitis (eczema) is a chronic skin condition that comes in many forms. There will be times when the skin is worse or better. Skin becomes dry, very itchy and a rash may appear.</li> <li>Caring for a child with eczema can take a lot of time and can be very stressful. Use all the resources available to help you cope.</li> <li>Your child's health-care professionals are there to answer any questions and address any concerns that you may have.</li> <li>Never make changes to your child's treatment plan without consulting the doctor.</li> </ul>https://assets.aboutkidshealth.ca/AKHAssets/coping_with_eczema.jpg
Eczema: School and activitiesEEczema: School and activitiesEczema: School and activitiesEnglishDermatologyChild (0-12 years);Teen (13-18 years)SkinSkinNon-drug treatmentCaregivers Adult (19+)NA2014-01-10T05:00:00Z7.5000000000000067.50000000000001152.00000000000Flat ContentHealth A-Z<p>Learn how to help your child with atopic dermatitis (eczema) at school, with physical activities and swimming.<br></p><h2>What is eczema (atopic dermatitis)?</h2><p><a href="/Article?contentid=773&language=English">Atopic dermatitis</a> is a chronic (long-lasting) skin condition that comes in many forms. It is also called eczema.</p><p>With eczema, the skin becomes dry, very itchy and rash may appear. There are usually times when the condition is worse, and times when the condition is better. When the condition worsens, this is called a flare-up. Flare-ups often occur in the winter months when the air is drier, but it can happen any time throughout the year.<br></p><h2>Key points</h2><ul><li>Atopic dermatitis (eczema) is a chronic skin condition that comes in many forms. Skin becomes dry and very itchy and a rash may appear. There will be times when the skin is worse or better.</li><li>Talk to your child's teacher about eczema. Explain that it cannot spread to other children and that it may be hard for your child to sit still and not scratch.</li><li>Discuss options for decreasing the chance of an eczema flare-up with your child's school.</li><li>Your child can swim and do other physical activities. There are steps you can take to reduce the chance of eczema flare-ups.<br></li></ul>https://assets.aboutkidshealth.ca/AKHAssets/eczema_school_activities.jpg
Eczema: Seasonal changesEEczema: Seasonal changesEczema: Seasonal changesEnglishDermatologyChild (0-12 years);Teen (13-18 years)SkinSkinNon-drug treatmentCaregivers Adult (19+)NA2014-01-10T05:00:00Z6.1000000000000073.8000000000000612.000000000000Flat ContentHealth A-Z<p>Atopic dermatitis (eczema) can be worse in cold, dry weather or when your child is hot and sweaty. Find out how you can help your child.</p><p> <a href="/Article?contentid=773&language=English">Atopic dermatitis</a> is a chronic (long-lasting) skin condition that comes in many forms. It is also called eczema.</p><p>With eczema, the skin becomes dry, very itchy and rash may appear. There are usually times when the condition is worse, and times when the condition is better. When the condition worsens, this a called a flare-up. Flare-ups often occur in the winter months when the air is drier, but it can happen any time throughout the year.<br></p><h2>Key points</h2><ul><li>You may find that your child's eczema is worse in the colder, dryer months. Use a humidifier and keep moisturizing your child's skin.</li><li>In the warmer months, help your child stay cool to avoid sweating.</li><li>Protect your child's skin from the sun.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/eczema_seasonal_changes.jpg
Effective management of diabetes care at homeEEffective management of diabetes care at homeEffective management of diabetes care at homeEnglishEndocrinologyChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemHealthy living and preventionAdult (19+)NA2017-09-25T04:00:00Z8.3000000000000061.50000000000001534.00000000000Flat ContentHealth A-Z<p>Proper diabetes care at home includes sharing responsibility and creating and maintaining a routine. Find out how to do this in a way that works for your family.</p><p>​​Adjusting to a diagnosis of <a href="/Article?contentid=1717&language=English">diabetes</a> takes time and patience for all family members. Everyone will have to get used to the “new normal.” You will need to manage situations differently in many ways.</p> <p>Here are some ways to effectively manage diabetes care at home.</p><h2>Key points</h2> <ul><li>Diabetes management is easiest when everyone in the family gets involved.</li> <li>The diabetes team is available to support you and answer any questions you may have.</li> <li>To help establish proper diabetes management, create a routine, stay positive and consider the impact diabetes has on your entire family.</li></ul>https://assets.aboutkidshealth.ca/akhassets/effective_management_diabetes_home.jpg
Effects of prematurity on behaviour and intellectual abilityEEffects of prematurity on behaviour and intellectual abilityEffects of prematurity on behaviour and intellectual abilityEnglishDevelopmentalPremature;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+)NA2009-10-31T04:00:00Z13.700000000000033.30000000000001439.00000000000Flat ContentHealth A-Z<p>Learn about the effect of prematurity on behavior and intellect. Disability can take many forms, be they physical, intellectual, or behavioural.</p><p>Prematurity’s effect on a child’s intellectual abilities, thinking, memory, verbal skills, ability to learn, and so on, are reasonably well known. The bad news is that in general, some premature babies are negatively affected intellectually by the complications associated with their early birth. The good news is that, for many of those affected, this intellectual impairment is not profound and, with the proper intervention and attention, these intellectual impairments can be minimized to the point that they should not be a major hindrance to a reasonably “normal” life. </p><h2>Key points</h2> <ul><li>Brain injury and chronic lung disease are associated with a higher risk of intellectual and behavioural problems.</li> <li>Providing a nurturing environment is a great way for parents to maximize their premature baby's outcome.</li> <li>Prematurity will have generalized effects on intellectual disability and behaviour, as well as specific effects on behaviour.</li></ul>
Egg allergyEEgg allergyEgg allergyEnglishAllergyChild (0-12 years);Teen (13-18 years)BodyImmune systemConditions and diseasesCaregivers Adult (19+)NA2021-03-08T05:00:00Z7.4000000000000064.80000000000001548.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Find out how to help your child manage an egg allergy.</p><h2>What is an egg allergy?</h2><p>An egg allergy occurs when the body reacts to one or more of the proteins in eggs.</p><p>Most allergic reactions occur in response to ovalbumin and ovomucoid, the proteins in egg whites. Sometimes, the proteins in egg yolks can also cause an allergic reaction.</p><p>Eggs are one of the most common foods that cause an allergic reaction. For those with an egg allergy, any food made with eggs can be dangerous. People with an egg allergy can still enjoy a wide range of foods every day, but they must learn how to eat safely.</p> ​ <h2>How serious is an egg allergy?</h2><p>Egg allergy reactions are different for each child, but they usually happen soon after exposure to egg. In rare cases, an egg allergy can cause <a href="https://www.aboutkidshealth.ca/Article?contentid=781&language=English">anaphylaxis</a> , a severe and life-threatening allergic reaction.</p><h2>Key points</h2> <ul> <li>Many children with an egg allergy outgrow it as they grow older. Consult an allergist regularly to see if there is any change in your child's allergy.</li> <li>Eggs have a number of names, including albumen, lysozyme and ingredients starting with "ova". Many products contain eggs, including baby food, baked goods, sauces, fat substitutes and some pastas.</li> <li>To prevent an allergic reaction, always read food product labels, avoid foods if you are not sure of the ingredients and avoid using utensils or containers that might have come in contact with eggs.</li> <li>If your child's diet is limited because of an egg allergy, a registered dietitian can offer advice on getting a balanced diet.</li> </ul><h2>Possible sources of egg</h2><p>Eggs are used in a range of packaged foods and in some drinks. Below is a list of some of the many food products that contain eggs.</p><table class="akh-table"><tbody><tr><td>Baby food</td><td>Baked goods, baking mixes, candy, chocolate or nougat</td></tr><tr><td>Battered or fried foods</td><td>Creamy dressings, salad dressings or spreads such as mayonnaise</td></tr><tr><td>Desserts such as custard, dessert mixes, ice cream or pudding </td><td>Drinks such as eggnog, foam or milk topping on coffee</td></tr><tr><td>Egg substitutes, such as Egg Beaters</td><td>Fat substitutes, such as Simplesse</td></tr><tr><td>Icing, glazes (such as egg wash on baked goods)</td><td>Lecithin</td></tr><tr><td>Meat mixtures such as hamburger, hot dogs, meatballs, meatloaf or salami</td><td>Pancakes, waffles or French toast</td></tr><tr><td>Pasta, such as egg noodles</td><td>Quiche or souffle</td></tr><tr><td>Sauces such as béarnaise, hollandaise or newburg</td><td>Soups</td></tr></tbody></table><h2>What do I do if my child has an egg allergy?</h2><p>Your child should see an allergist (a doctor who specializes in diagnosing and treating allergies) who can discuss the egg allergy with you in more detail. Children who have an egg allergy should avoid all products that may contain egg. Some children who have an egg allergy are able to safely eat baked goods containing egg. If your child has an egg allergy, you should consult with an allergist before giving your child baked goods containing egg.</p><p>Some vaccines have small quantities of egg protein, including the seasonal flu vaccine; the measles, mumps, rubella (MMR) vaccine; and the yellow fever vaccine. Children with an egg allergy do not have an increased risk of allergic reaction to the flu or MMR vaccine and can receive these vaccines. If your child has previously had a reaction to the flu or MMR vaccine, you should consult with an allergist to evaluate the risk of getting these vaccines again. If your child has an egg allergy and needs the yellow fever vaccine, you should consult with an allergist.</p><p>Your child’s doctor may also prescribe a medication called an <a href="https://www.aboutkidshealth.ca/article?contentid=130&language=English">epinephrine autoinjector</a>, which can be used to treat allergic reactions, in case your child accidentally eats a food containing egg.</p><h2>Reducing the risk of cross-contamination</h2><p>Cross-contamination occurs when one substance unintentionally comes in contact with another substance, for example a potential allergen. If the substances mix together, one substance taints the other substance, making it unsafe to eat.</p><p>Food allergens can contaminate other foods when, for example, the same containers, utensils or frying pans hold a range of foods.</p><p>Bulk food containers pose a high risk of cross-contamination because they are often used for different products.</p><p>Be sure to avoid using utensils or containers that may have come in contact with allergy-causing foods and ask about possible cross-contamination when eating out.</p><h2>How can my child get the right mix of nutrients if they must avoid eggs?</h2><p>The main nutrients in eggs include <a href="https://www.aboutkidshealth.ca/Article?contentid=1444&language=English">protein</a>, <a href="https://akhpub.aboutkidshealth.ca/article?contentid=1449&language=English">folate</a>, <a href="https://akhpub.aboutkidshealth.ca/article?contentid=1446&language=English">vitamin B12</a>, <a href="https://akhpub.aboutkidshealth.ca/article?contentid=1452&language=English">zinc</a> and <a href="https://akhpub.aboutkidshealth.ca/article?contentid=1450&language=English">iron</a>. Your child can still get these nutrients even if they must avoid eggs and products that contain them.</p><h3>Nutrients in eggs that are found in other foods</h3><table class="akh-table"><thead><tr><th>Nutrient</th><th>​Where to find it</th></tr></thead><tbody><tr><td>Protein​</td><td>Meat, fish, poultry, cheese, milk, soy</td></tr><tr><td>​Folate</td><td>Leafy green vegetables, beans (navy, pinto, kidney, garbanzo), lentils</td></tr><tr><td>Vitamin B12</td><td>Meat, fish, poultry, shellfish, milk, cheese, fortified cereal, soy milk</td></tr><tr><td>​Zinc</td><td>Meat, fish, poultry, whole grains, vegetables</td></tr><tr><td>Iron​</td><td>Meat, shrimp, poultry, beans (navy, pinto, kidney, garbanzo), whole wheat products, leafy green vegetables</td></tr></tbody></table> <br><h2>When to go the emergency room</h2><p>If your child is having a severe allergic reaction to egg, call 911 or go to your nearest emergency department immediately. If your child’s doctor prescribed them an epinephrine autoinjector, administer this medication to your child right away. See <a href="https://www.aboutkidshealth.ca/Article?contentid=781&language=English">Anaphylaxis: How to recognize and respond to a severe allergic reaction</a> for more information.</p><h2>At SickKids</h2><p>Kingsmill Egg Replacer is a commercial product that you can use for baking and cooking. Each 350 g box replaces 100 eggs. You can buy this product at the Specialty Food Shop on the main floor of the hospital.</p><p>For more information on living with food allergies, visit the Specialty Food Shop: <a href="https://www.specialtyfoodshop.ca/">www.specialtyfoodshop.ca</a><br></p><h2>Further information</h2><p>Here is a list of reliable resources that can help you become aware of potential risks and how to deal with them.</p><ul><li>FARE. <a href="https://www.foodallergy.org/living-food-allergies/food-allergy-essentials/common-allergens/egg" target="_blank"> <em>Egg Allergy</em></a></li><li>Health Canada. <a href="https://www.canada.ca/en/health-canada/services/food-nutrition/reports-publications/food-safety/eggs-priority-food-allergen.html" target="_blank"> <em>Eggs – A priority food allergen</em></a></li><li>Health Canada. <a href="https://www.canada.ca/en/health-canada/services/food-nutrition/food-safety/food-allergies-intolerances.html" target="_blank"> <em>Food allergies​ and intolerances</em></a></li></ul>https://assets.aboutkidshealth.ca/AKHAssets/egg_allergy.jpg
Elastic compression garmentsEElastic compression garmentsElastic compression garmentsEnglishHaematologyChild (0-12 years);Teen (13-18 years)Arm;LegsCardiovascular systemNon-drug treatmentAdult (19+) CaregiversNA2017-09-25T04:00:00Z7.2000000000000068.90000000000001458.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Elastic compression garments improve symptoms of deep vein thrombosis and post-thrombotic syndrome. Find out what they are and how to properly use them.</p><p>​​Elastic compression garments are used to improve symptoms of <a href="/article?contentid=2534&language=English">deep vein thrombosis (DVT)</a> and <a href="/article?contentid=2884&language=English">post-thrombotic syndrome (PTS)​</a> by helping to transport blood back to the heart. They prevent fluid from pooling in the affected limb, as well as reduce swelling, pain and other symptoms.<br></p><h2>Key points</h2><ul><li>Elastic compression garments are used to improve symptoms of deep vein thrombosis (DVT) and post-thrombotic syndrome (PTS) by helping to transport blood back to the heart.</li><li>Compression garments are available in different degrees of pressure, depending on your child’s needs.</li><li>Wearing the compression garment is especially important when participating in physical activity, while travelling, or when your child’s symptoms of PTS worsen. </li><li>Compression garments should be worn daily for however long they continue to ease and improve symptoms of DVT and PTS, which can vary by weeks, months or years.</li><li>Compression garments should be replaced every six months, if worn daily.</li></ul><h2>When to see a doctor</h2><p>Stop using the compression garments and contact the thrombosis clinic or the thrombosis doctor in case of:</p> <ul><li>increase in pain with the use of compression garments</li><li>change in the color and temperature of the skin with the use of compression garments: toes turn pale and cold or purple.<br></li></ul><h2>What are elastic compression garments?</h2><p>Elastic compression garments are made of breathable elastic fabrics such as nylon, cotton, spandex or natural rubber. They are occasionally referred to as “graduated compression garments”. The stockings are tightest at the ankle (where the most pressure is put by the body) and become less tight as the garment moves up the leg. A compression sleeve is tightest at the wrist and becomes less tight as it moves up the arm.</p> <figure class="asset-c-80"> <span class="asset-image-title">Effect of elastic compression garments on damaged veins</span> <img src="https://assets.aboutkidshealth.ca/AKHAssets/compression_garments_damaged_veins_EN.jpg" alt="A damaged vein with backward blood flow and a damaged vein with compression garment allowing for better blood flow" /> <figcaption class="asset-image-caption">A deep vein thrombosis (DVT) can damage a vein. As a result, the vein wall does not function properly and the vein valves open wider than usual. This results in backward blood flow, away from the heart. Compression garments gently compress the muscle and expanded vein wall, allowing the valves to close once again, resulting in healthier blood flow towards the heart.</figcaption> </figure> <p>Compression garments are typically available in several different lengths and sizes. Stockings can come up to the knee, thigh, or waist, with an option of open or closed toe. Your doctor will prescribe the appropriate garment length, but knee-high stockings are the most commonly prescribed in children with PTS in the legs.</p><p>For the arms, sleeves are only made in a full-length style. The sleeve ends about two fingers below the underarm and begins either at the wrist (sleeve-style), the thumb (gauntlet-style) or midway through the fingers (glove-style).</p><p>Elastic compression garments gently compress the muscles in the affected limb as well as the expanded vein walls. With the vein walls being less stretched, the vein valves are able to close once again, resulting in healthier overall circulation.</p><h3>Class of compression</h3><p>Compression garments are available in various degrees of pressure, or classes of compression. Compression is measured in millimetres of mercury (mmHg), with the highest compression at the ankle or wrist joints. The higher the pressure is, the tighter the garment will fit. There are different compression levels (15-20 mmHg, 20-30 mmHg, 30-40 mmHg and +40 mmHg) depending on what your child needs. </p><h2>How to wear elastic compression garments</h2><p>Elastic compression garments are intended to be tight. This can make putting them on difficult, especially when putting them on your child. The following tips will make it easier to put on the garments:</p><ul><li>Wash the garment before the first use, to decrease its stiffness. </li><li>Ensure the limb is dry. It is important to apply moisturizing cream to the skin after each use because garments can cause dry skin. Applying creams at the end of the day, when the garment is removed, ensures that moisturizers are completely absorbed before putting on the garment the following day. This will increase the lifespan of the garment. </li><li>Do not pull the stocking by the top (as with a normal sock), since that will make application more difficult and will take more time. Instead, invert (turn inside out) the stocking halfway and insert the foot until the stocking is over the heel. Next, using your palm rather than fingers, gradually unfold the stocking moving up the leg. </li><li>For sleeves: Invert the sleeve halfway and put the hand through it until the bottom part of the sleeve is at the level of the wrist. Then, use the palm of your hand to glide the sleeve up toward the underarm.</li><li>Technique to remove garments: Holding the top of the garment, peel the sleeve or stocking down the limb. The garment should be inside out once removed.</li><li>After properly applying the knee-high stockings or sleeve, the top of the garment should be approximately one-inch below the bend of the knee or underarm.</li></ul><p>An expert garment fitter can show you some tricks and devices to help apply the stocking or sleeve, such as using a donning glove (or a rubber cleaning glove) to make putting on the garment easier.</p><p>The length or size of the garment may be wrong for your child if:</p><ul><li>They want to fold or roll the top of the garment down, away from the bend in the knee or underarm.</li><li>The stocking continuously slides or rolls down on its own.</li></ul><p>For more information on thrombosis, post-thrombotic syndrome and the management of these conditions, please visit the <a href="/thrombosis">Thrombosis Learning Hub</a>.</p>https://assets.aboutkidshealth.ca/AKHAssets/compression_garments_damaged_veins_EN.jpg
Elbow flexion contracture related to brachial plexus birth injuryEElbow flexion contracture related to brachial plexus birth injuryElbow flexion contracture related to brachial plexus birth injuryEnglishNeurology;Orthopaedics/MusculoskeletalChild (0-12 years);Teen (13-18 years)Arm;ElbowNervesNon-drug treatmentAdult (19+) CaregiversNA2020-12-17T05:00:00ZHealth (A-Z) - ProcedureHealth A-Z<p>An elbow flexion contracture can happen as a result of a brachial plexus injury at birth. Find out what causes this contracture and what the different treatment options are. </p><h2>What is an elbow flexion contracture? </h2><p>An elbow flexion contracture can result from a <a href="/article?contentid=849&language=english">brachial plexus injury</a>. </p><p>The brachial plexus is a group of five nerves located at the top of the spinal cord that send signals to the muscles in the arm. If the nerves are injured, the muscles in the arm are weakened. At the elbow, if the nerves have been injured, the muscles that bend the elbow can become short and tight, while the muscles that straighten the elbow may become weak. This makes it hard to straighten the elbow all the way. This results in a bent and stiff elbow called an elbow flexion contracture. </p><h2>Not everyone with a brachial plexus injury will get a stiff elbow </h2><p>About half of children with a brachial plexus birth injury will develop an elbow flexion contracture. One in three of these children will have a stiff elbow that is bent more than 30 degrees. When a contracture is greater than 30 degrees, it is more visible and may cause limitations in daily activities. Most often, a stiff elbow does not stop most children from doing everyday activities, but they may need to adjust how they do it. </p><h2>What your child wants to know</h2><p>Most children and teens with a brachial plexus birth injury usually want to know why the nerves make one of their arms smaller than the other.</p><div class="asset-animation">src="https://www.aboutkidshealth.ca/Style%20Library/akh/animation/Brachial%20plexus%20injury%20-%20Storyline%20output/story.html"</div><p>The nerve injury at birth affects how the muscles and bones in the arm and hand will grow. This is why their arm and hand on the injured side may be smaller in size.</p> <br><h2>Key points</h2><ul><li>An elbow flexion contracture can occur as a result of a brachial plexus birth injury. </li><li>There are three treatment options for an elbow flexion contracture: watch and wait, stretching program (cast and splint) or elbow release surgery. </li><li>The type of treatment your child receives will depend on how stiff and bent their elbow is and how comfortable they are with the look and movement in their elbow. </li><li>A stretching program is a big commitment for children and teens. It is important that your child be involved in the decision-making process for their treatment. </li><li>Your child must try a stretching program before their doctor will consider elbow release surgery. </li></ul><h2>How is an elbow flexion contracture treated? </h2><p>There are three treatment options available for children with an elbow flexion contracture: </p><ol><li>Watch and wait </li><li>Stretching program (cast and splint) </li><li>Elbow release surgery </li></ol><h3>Watch and wait </h3><p>It is important to ask your child how they feel about the look and movement in their elbow. If they are happy with how it looks and feels for day-to-day activities, think about watching and waiting. If they are not happy, a stretching program might help. </p><p>It is important to keep an eye on how bent the elbow is. For some children who do not receive treatment, the bend can slowly get worse as they grow. If this happens, it is important to think about doing a stretching program (cast and splint). </p><h3>Stretching program (cast and splint) </h3><p>A regular stretching program, including exercises, casting or splinting, may help straighten the elbow. Your child’s therapist can teach them some exercises to do every day. The therapist will let you know how long and often your child should stretch their elbow. Heat packs and massage may help relax and warm-up the arm muscles before stretching. </p><p> <strong>Stretching</strong> is a commitment. About half of children who start a stretching program stay committed to the stretches, casting or splinting prescribed by their therapist. Before agreeing to a regular stretching program, it is important that you and your child talk with the therapist about strategies to help your child keep committed to a stretching program every day. </p><p> <strong>Casting</strong> can help to stretch the arm straighter. Serial casting is repeating the steps of stretching and wearing a cast. A therapist will typically use massage and heat packs before stretching your child’s elbow to help it become straighter. After the stretching exercises, your child’s therapist and an orthopaedic technologist will apply a cast to your child’s arm. This cast is typically made out of fibreglass and is not removable; your child will wear the cast for one week. </p><p>After the cast is removed, the process of stretching and casting is repeated to help the elbow to become straighter week by week. Your therapist will let you know how many weeks of casting you will have. Some studies show that casting can help decrease the elbow contracture to an average 15 degrees. Casting will not likely make the elbow completely straight. </p><p>After casting, a custom <strong>splint</strong> is made to help keep your elbow in its straighter position. This splint is removable and typically worn at nighttime, while your child sleeps. Your child’s therapist will talk to you about the different splinting options. On occasion, serial splinting can be used as an option to stretch your elbow straight when wearing a cast, which is not removable, is not suitable. </p><p>Starting a stretching routine when children are young improves the success of getting the best movement in the elbow. When comparing the options to stretch the elbow, casting has been shown to be more effective in making the elbow straighter. Splinting and stretching can help, but may be less effective on their own. Most importantly, wearing a splint is important to keep the elbow straighter after stretching. Your child’s elbow will bend back up if they stop stretching and splinting. </p><h3>Risks of a stretching program (casting and splinting) </h3><p>A stretching program, with or without splinting or casting, does not have a lot of risks. </p><p>Your child’s muscles may ache from stretching or they may have trouble sleeping because the splint is uncomfortable. Wearing a cast may cause weakness in the muscles that bend and straighten the arm, but this goes away once they use their arm again. Sometimes a cast may be put on too tight and your child can have pain or a sore on their skin. Sometimes stretching the elbow can cause changes to the elbow joint. Your child’s therapist will watch for this and stop treatment if this happens. </p><h3>Elbow release surgery </h3><p> <strong>Your child must try stretching, casting or splinting before considering surgery.</strong> </p><p>Surgery is done to make the tight and short muscles in the elbow longer, which helps straighten the arm. It is only offered by your child’s doctor if their elbow is making everyday activities more difficult. This is because surgery makes the muscles that bend the elbow weak and risks taking away some of the bending movement in the elbow. </p><p>After surgery there are exercises that need to be done every day for three months to help the elbow move easily again. Wearing the splint is important to keep the elbow contracture from coming back again. Your child’s surgeon will let you know how long your child needs to wear the splint. </p><h3>What happens after elbow release surgery? </h3><p>The results of surgery are hard to predict. Successful recovery will depend on how strong the elbow muscles are, how much bend there is in the elbow and if there are any changes to the shape of the bones. Some studies show that surgery can help decrease the elbow contracture to 10 to 25 degrees. Surgery will not make the elbow completely straight. </p><p>The biggest concern when choosing to have surgery is the risk of losing strength in the muscles that bend the elbow. Loss of muscle strength makes it difficult to bend the elbow to move your hand to your mouth or face. This ability is important for every day self-care including washing your face and eating. </p><h2>Making a decision about treatment </h2><p> <strong>Important</strong>: Your child needs to be involved in any decision making about their treatment. Stretching, casting and splinting are more likely to be successful if your child is engaged in the process and wants to participate in the treatment program. </p> <a href="https://assets.aboutkidshealth.ca/AKHAssets/Elbow%20flexion%20contracture%20-%20What%20Matters%20Most%20Questionnaire.pdf"> <figure class="asset-small"> <img alt="Download heart failure symptoms poster PDF" src="https://assets.aboutkidshealth.ca/AKHAssets/Download_PDF_image_ElbowFexionContracture.png" /> </figure> </a> <p>You and your child should understand the benefits and risks of each option and feel confident about your decision. If your child needs help deciding what the best option is for them, have them fill out the "What matters most" questionnaire. </p><p>If there is any disagreement as to what the best treatment option is for your child, try to find things that you agree on. Have you, your child, and others involved in the decision fill out the Decision Support Tool below. Together, you and your child can speak to a neutral party or health-care professional to receive coaching on making a decision.</p><table class="akh-table"><thead><tr><th> <br> </th><th>Watch and wait</th><th>Stretching program</th><th>Stretching program with cast/splint</th><th>Surgety (if applicable)</th></tr></thead><tbody><tr><td>Reasons to choose this option (list the benefits/pros)<br></td><td></td><td> <br> </td><td> <br> </td><td></td></tr><tr><td colspan="5"> <strong>Think</strong>: How important are these benefits to you?</td></tr><tr><td>Reasons <strong>not</strong> to choose this option (list the risks/cons)</td><td> <br> </td><td> <br> </td><td> <br> </td><td> <br> </td></tr><tr><td colspan="5"> <strong>Think</strong>: How important are these benefits to you?</td></tr></tbody></table>
Elbow fractureEElbow fractureElbow fractureEnglishOrthopaedics/MusculoskeletalChild (0-12 years);Teen (13-18 years)ElbowBonesNon-drug treatmentCaregivers Adult (19+)NA2009-11-06T05:00:00Z5.5000000000000079.7000000000000437.000000000000Health (A-Z) - ProcedureHealth A-Z<p>A half cast is used to help heal an elbow fracture. Learn about taking the cast off, and how to care for your child's arm once the cast is removed. </p><figure> <span class="asset-image-title">Fractured </span> <span class="asset-image-title">elbow</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Fracture_elbow_MED_ILL_EN.jpg" alt="Fractured elbow affecting the humerus, radius and ulna" /> <figcaption class="asset-image-caption">Three</figcaption> <figcaption class="asset-image-caption"> different bones meet at the elbow joint. In an elbow fracture, either the radius, ulna or humerus can be broken in the joint.</figcaption> </figure> <h2>A cracked or minor fracture of the elbow</h2><p>Your child has a minor fracture of the elbow. This might also be called a cracked elbow.</p><h2>Key points</h2> <ul> <li>Your child needs a half cast to help heal a fractured elbow. </li> <li>You will take off the cast at home after three weeks. </li> <li>Your child will need to avoid high-impact activities after the cast is removed. </li> <li>Your child's elbow may need a year to fully recover strength and movement. </li> </ul><h2>Your child will need a cast</h2> <p>For the bone to heal, your child will need a partial cast and a sling. The cast will stay on for about three weeks.</p> <p>About one week after the cast has been on, your child will need to have a follow-up appointment with the fracture clinic at the hospital. At the clinic, staff will make sure your child's elbow is healing properly. They will also show you how to take off the cast at home. </p> <p>Depending on the size of the fracture, it may take six months to a year before your child's arm can fully straighten, bend and twist. However, most children do not need physiotherapy. </p><h2>Healing after the cast is removed</h2> <p>Your child should avoid high-impact, contact sports for four to six weeks after taking off the cast. Your child will gradually gain confidence in the arm and will return to regular activities. </p> <p>If you have any concerns, contact your family doctor or the advanced practice nurse (APN) at the fracture clinic.</p>elbowfracturehttps://assets.aboutkidshealth.ca/AKHAssets/elbow_fracture.jpg
Elbow injury: Supracondylar humerus fractureEElbow injury: Supracondylar humerus fractureElbow injury: Supracondylar humerus fractureEnglishOrthopaedics/MusculoskeletalChild (0-12 years);Teen (13-18 years)ElbowBonesNon-drug treatmentCaregivers Adult (19+)NA2016-01-29T05:00:00Z7.0000000000000071.9000000000000777.000000000000Health (A-Z) - ProcedureHealth A-Z<p>A supracondylar humerus fracture is a fracture just above the elbow. Learn how to help your child recover and when to see a doctor.</p><p>Your child has broken their arm just above the elbow. The medical name for this is a supracondylar humerus fracture.</p> <figure class="asset-c-80"> <span class="asset-image-title">Elbow fracture (supracondylar humerus fracture)</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_fracture_supracondylar_humerus_EN.jpg" alt="Arm with a fractured humerus" /><figcaption class="asset-image-caption">A supracondylar fracture is a fracture of the humerus bone, just above the elbow.</figcaption> </figure><h2>Key points</h2> <ul> <li>After an elbow fracture, your child will need to wear a backslab to help heal their broken arm and a sling for comfort.</li> <li>Pain and swelling are common in the first 24 to 48 hours after injury. Monitor any changes to the colour and temperature of your child’s skin and any stiffness or numbness in the hands and fingers.</li> <li>Remove the backslab at home after three weeks, as shown by your child’s doctor.</li> <li>Make sure your child avoids high-risk activities for 12 weeks after their injury.</li> <li>Your child's elbow may need a year to fully recover strength and movement.</li> </ul><h2>What to do if you notice a problem</h2> <p>If you child has any signs of severe pain, numbness or changes in colour or temperature, have them rest their arm on a pillow for 30 minutes while lying down. If the problem does not get better, call your doctor or go to your nearest hospital.</p><h2>Will my child need a sling?</h2><p>Yes, your child will need to wear a backslab (a cast that goes halfway around the arm) and a sling to allow their bones to heal properly. The backslab supports the bone as it heals. The sling helps your child keep their arm in a comfortable position until they can move it again.</p><p>Your child will be fitted with the backslab and sling before they leave hospital. Your child’s health-care team will show you <a href="/Article?contentid=1036&language=English">how to make a basic forearm sling</a> when you are at home. It is often easiest to have your child wear the backslab and sling under loose clothing instead of through a shirt or sleeve.</p><h2>What to expect in the first 24 to 48 hours after injury</h2><h3>Pain</h3><p>You child will have pain in their elbow at first. To reduce pain, give your child <a href="/article?contentid=153&language=English">ibuprofen</a> as needed, following the directions on the bottle.</p><h3>Swelling</h3><p>Your child’s arm, hand and fingers may swell in the first 24 to 48 hours after injury. To decrease this swelling, have your child rest their arm on a pillow when sitting or lying down.</p><h3>Possible changes in temperature, colour and movement</h3><p>If the backslab is too tight, it can limit blood flow to and from your child’s hand and fingers. Encourage your child to bend and straighten their fingers every hour while they are awake. Check the temperature, colour and movement of your child’s fingers about every four hours while they are awake.</p><p>In particular, check if:</p><ul><li>your child has severe pain when moving their fingers</li><li>your child’s fingers are blue or white</li><li>your child’s fingers are cold (compare them to the fingers on their other hand)</li><li>your child’s fingers cannot curl up or straighten out</li><li>your child has numbness or pins and needles in their fingers.</li></ul>https://assets.aboutkidshealth.ca/akhassets/IMD_fracture_supracondylar_humerus_EN.jpg
Electrocardiogram (ECG) testEElectrocardiogram (ECG) testElectrocardiogram (ECG) testEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartHeartTestsCaregivers Adult (19+)NA2009-11-06T05:00:00Z5.9000000000000071.4000000000000254.000000000000Health (A-Z) - ProcedureHealth A-Z<p>An electrocardiogram (ECG) is a test that measures the electrical activity of the heart. Find out when an ECG may be done and what is involved in the test. </p><figure><span class="asset-image-title">Electrocardiogram</span><img alt="Electrocardiogram pattern" src="https://assets.aboutkidshealth.ca/akhassets/ECG_MEDIMG_PHO_EN.jpg" /> </figure> <h2>What is an electrocardiogram?</h2><p>An electrocardiogram (ECG) is a test that records the electrical activity of your child's heart on a graph.</p><p>The test gives the doctor information about:</p><ul><li>your child's heart rate </li><li>any irregularity in the heart rhythm </li><li>the size of the heart muscle </li></ul><h2>Key points</h2> <ul> <li>An electrocardiogram (ECG) is a test that records the electrical activity of your child's heart. </li> <li>The test takes about 10 minutes. It does not hurt. </li> <li>Your child will need to lie completely still for about one minute while the recording is made. </li> </ul><h2>How is an ECG done?</h2><p>The test takes about 10 minutes. It does not hurt.</p><p>A technologist will give your child the test. Technologists are people who are trained to give tests on the machines in the hospital. The technologist will put 13 small stickers called electrodes on your child's arms, legs and chest. Each sticker has a wire attached to it. </p><p>Your child will lie down on a bed. Your child will need to lie completely still for about one minute while the recording is taken. </p><p>The technologist will remove the stickers when the test is finished.</p>https://assets.aboutkidshealth.ca/akhassets/ECG_MEDIMG_PHO_EN.jpg
Electrocardiogram (ECG), Holter monitor and telephone transmitterEElectrocardiogram (ECG), Holter monitor and telephone transmitterElectrocardiogram (ECG), Holter monitor and telephone transmitterEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartCardiovascular systemTestsAdult (19+)NA2009-12-11T05:00:00Z7.3000000000000065.9000000000000665.000000000000Flat ContentHealth A-Z<p>An electrocardiogram (ECG) is a test that measures the electrical activity of the heart. Find out when an ECG may be done and what is involved in the test.</p><p>An electrocardiogram (ECG) records the electrical activity of your child's heart.</p> <p>If the doctor needs more information, your child may need to use a Holter monitor or a telephone transmitter at home for a day or more. </p><h2> Key points </h2> <ul><li> Electrocardiograms, Holter monitors and telephone transmitters all help monitor the heart's electrical activity over a longer time or from a distance.</li></ul>https://assets.aboutkidshealth.ca/akhassets/ECG_MEDIMG_PHO_EN.jpg
Electroencephalogram (EEG)EElectroencephalogram (EEG)Electroencephalogram (EEG)EnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainBrainTestsCaregivers Adult (19+)NA2009-11-06T05:00:00Z7.0000000000000070.0000000000000780.000000000000Health (A-Z) - ProcedureHealth A-Z<p>An electroencephalogram (EEG) is a test that measures patterns of electricity in the brain. Learn about why an EEG may be performed and what to expect. </p><h2>What is an electroencephalogram (EEG)?</h2> <figure> <span class="asset-image-title">Electroencephalogram (EEG) patterns</span> <img src="https://assets.aboutkidshealth.ca/AKHAssets/electroencephalogram_EEG_recording.jpg" alt="Electroencephalogram patterns" /> <figcaption class="asset-image-caption">Electrodes are attached to your child's scalp that measure the pattern of electrical activity in different areas of the brain. These patterns are represented by wavy lines that help the doctor determine where the abnormal brain activity is occurring.</figcaption> </figure> <p>Cells in the brain use low levels of electricity to communicate with each other. An electroencephalogram (EEG) measures this electricity over time. The brain's electrical activity shows up as wavy lines on a computer monitor. Doctors read the wavy lines to find out how well the brain is working. </p><h2>Reasons to have an EEG</h2><p>Doctors use the EEG to locate problems in the brain. For example, an EEG can show where convulsions or seizures start. The electrical pattern changes when there is a problem. The change in pattern shows up as a change in the wavy lines on the computer screen. This shows where in the brain the problem is. The doctor can then decide on the best treatment. </p><h2>Key points</h2> <ul> <li>An EEG is a test that looks at patterns of electricity in the brain. </li> <li>Children have EEGs if doctors think there might be a problem with the brain. </li> <li>An EEG takes about an hour. </li> <li>Children might be sedated for the test if they cannot lie still. </li> </ul><h2>During an EEG</h2><p>An EEG takes about an hour. It does not hurt.</p><p>EEG tests are usually done at a hospital. They are done by an EEG technologist, a person who is specially trained. Usually, children lie on a bed during an EEG. Sometimes, children sit down during an EEG. Parents are usually allowed to stay with their child while the test is done. </p><p>Your child's head will be measured and marked with a wax pencil so that the EEG technologist knows where to put the small metal circles called electrodes. The marked areas on your child's head will be cleaned with a gel, which is a thick soap. Then electrodes will be put on your child's head with cream and gauze. The electrodes are hooked up to the computer. </p><p>The computer records the patterns of electricity of your child's brain. The EEG machine makes a continuous record of your child's brain activity which can be seen on a computer screen. </p> <h3>During the test, the technologist may ask your child to:</h3><ul><li>breathe deeply for three minutes </li><li>open and close their eyes </li><li>watch a flashing bright light for a few minutes </li></ul><p>These exercises are done to stimulate certain types of brain activity. As this brain activity changes, so do the electrical patterns. How these patterns change during the different activities can help doctors find out more about how the brain works. </p><h3>Asleep and awake</h3><p>Your child may have the test while they are asleep and again while they are awake. This may show the differences in the brain when your child is awake and asleep. </p><h2>Side effects from EEG</h2> <p>If your child did not have a sedative, they will have no side effects or problems, from the EEG.</p> <p>If your child had a sedative, they might be sleepy, grumpy and unsteady for four to six hours. Please check on your child carefully for about six hours after the test. Give your child only small sips of clear liquids such as water or apple juice. Your child can have a regular meal if they feel like eating. When your child is fully awake, they can return to their usual activities. </p> <p>Your child's hair may be a little sticky from the cream. You can easily wash out the cream with shampoo.</p><h2>How to get your child ready for an EEG</h2> <p>Wash your child's hair before you bring them to the hospital. You should check for lice when you wash your child's hair. If there are any signs of lice, please tell the nurse at the lab. Please do not use conditioner or gel on your child's hair. </p> <h3>Sedation</h3> <p>If your child cannot lie still for the test, they may need to take a mild sedative. A sedative is a medicine that will calm your child so they can lie still. The most common sedatives are chloral hydrate and pentobarbital sodium. </p> <p>If your child needs a sedative, they must stop eating solid food eight hours before the test; stop drinking milk, formula or liquids six hours before the test; and stop breastfeeding four hours before the test. If you are unsure about whether your child needs a sedative or if you are unsure when to stop your child from eating and drinking, ask the nurse at the lab the day before the test is scheduled. </p>https://assets.aboutkidshealth.ca/AKHAssets/electroencephalogram_EEG_recording.jpg
Electroencephalogram (EEG) before epilepsy surgeryEElectroencephalogram (EEG) before epilepsy surgeryElectroencephalogram (EEG) before epilepsy surgeryEnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemTestsCaregivers Adult (19+)NA2017-10-10T04:00:00Z7.7000000000000068.6000000000000870.000000000000Health (A-Z) - ProcedureHealth A-Z<p> Find out what happens during an electroencephalogram before epilepsy surgery.</p><p>​​The first step in preparing for epilepsy surgery is for your child to have a routine electroencephalogram (EEG) brain wave recording.</p><h2>Key points</h2> <ul><li>An EEG measures electrical activity in your child's brain to help your child's doctors see more clearly where seizures start.</li> <li>During the test, your child will lie still on a bed and do different activities while electrodes are attached to their scalp to record the activity in the brain.</li> <li>If your child needs to take a sedative before the test, follow any eating and drinking instructions from your child's team.</li> <li>You will be able to discuss the EEG results with your child's doctor about four to six weeks after the test.</li></ul><p>An EEG takes 60 to 90 minutes. However, if your child needs to take a sedative (see below), please allow up to three hours for your hospital visit. This allows enough time for the EEG and for any medicine to wear off before your child goes home.</p><h2>Why does my child need an EEG?</h2> <figure> <span class="asset-image-title">Example of an EEG recording</span><img src="https://assets.aboutkidshealth.ca/akhassets/electroencephalogram_EEG_recording.jpg" alt="EEG patterns" /> </figure> <p>Neurons (nerve cells in the brain) use electrical signals to communicate with each other. An EEG measures this electrical activity to help your child’s doctors see more clearly where seizures start.</p><p>Your child may have two EEGs: one while they are awake and another while asleep.​​​ During the test, electrodes are attached to your child’s scalp to record different patterns of activity in the brain while your child does simple tasks or has a short sleep.</p><p>The patterns of electrical activity show up as wavy lines on a computer monitor. Doctors are trained to read these wavy lines to identify what might cause a seizure.</p><h2>What happens when my child arrives for the EEG?</h2> <ol><li>A technologist will measure your child’s head and mark it with a wax pencil so they know where to place the electrodes.</li> <li>The technologist will clean the marked areas on your child's head with a gel and use a special paste to attach the electrodes to your child’s scalp. They will then cover the electrodes with gauze.</li> <li>The technologist will connect the electrodes to the EEG machine.</li></ol> <h2>What happens during an EEG?</h2> <p>The technologist will ask your child to sit or, usually, lie on a bed. They may then ask your child to do different activities, such as:</p> <ul><li>breathe deeply for three minutes</li> <li>open and close their eyes</li> <li>watch flashing bright lights for a few minutes.</li></ul> <p>While your child does these activities, the EEG machine will continuously record the patterns of electrical activity in their brain as wavy lines on a computer screen. </p> <h2>May I stay with my child during the EEG?</h2> <p>Yes, you will be able to stay with your child during the test.<br></p><h2>What should I expect after an EEG?</h2> <p>Once the test is done, the technologist will remove the electrodes from your child’s scalp. You are then free to go home.</p> <p>If your child took a sedative, they might be sleepy, grumpy and unsteady and will need to be watched carefully until the medicine wears off (usually about six hours after the test). They can return to their usual activities when they are fully alert again.</p> <p>Your child’s hair may be a little sticky from the paste that attaches the electrodes to their scalp. You can easily wash the paste away with shampoo and water.</p><h2>How do I prepare my child for an EEG?</h2> <ul><li>Explain what will happen during the EEG in words your child understands.</li> <li>Make sure your child’s hair is freshly washed. Check for any signs of <a href="/article?contentid=795&language=English">head lice</a> and tell the nurse at the hospital if you see anything.</li> <li>To help the electrodes stay in place during the test, do not use conditioner or styling products in your child's hair after you wash it.</li></ul> <h2>Will my child need to be sedated for an EEG?</h2> <p>An EEG does not hurt, but some children may need a mild sedative (medicine to keep them calm) to help them lie still for the test. The most common sedatives are <a href="/article?contentid=97&language=English">chloral hydrate</a> or melatonin, a natural substance that helps someone fall asleep.</p> <p>If your child needs to take a sedative, they must:</p> <ul><li>stop eating solid foods eight hours before the test</li> <li>stop drinking milk, formula or other liquids six hours before the test</li> <li>stop any breastfeeding four hours before the test</li> <li>stop drinking water three hours before the test.</li></ul><p>If your doctor has told you that your child needs a sedative for the EEG, a nurse from the neurophysiology department will contact you with instructions on when your child needs to stop eating and drinking before the EEG appointment.</p> <p>If the EEG is booked without a sedative but you think your child will need it, please contact the neurophysiology department a week before the appointment at 416-813-6297.</p> ​​​​​https://assets.aboutkidshealth.ca/akhassets/electroencephalogram_EEG_electrodes.jpg
Electroencephalogram (EEG) for brain tumoursEElectroencephalogram (EEG) for brain tumoursElectroencephalogram (EEG) for brain tumoursEnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemTestsAdult (19+)NA2009-07-10T04:00:00Z6.8000000000000072.6000000000000861.000000000000Flat ContentHealth A-Z<p>An in-depth description of what is involved in an EEG as part of brain tumor diagnosis, and a look at MEG.<br></p><p>Cells in the brain use low levels of electricity to communicate. An electroencephalogram (EEG) is a test that looks at the patterns and location of electrical activity in the brain. During the test, these patterns of electricity are recorded as wavy lines on a computer or on paper. The doctor uses these wavy lines to find out what your child’s problem is. This test usually takes about one hour and does not hurt. </p><h2>Key points</h2> <ul><li>Doctors use the EEG to see where your child has problems with the electricity made in the brain cells. </li> <li>Electrodes are used to record the patterns of electricity of your child's brain.</li> <li>If your child did not have a sedative, she will have no side effects, or problems, from the EEG.</li> <li>A magnetoencehalogram measures magnetic fields in the brain.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/EEG_output_EQUIP-PHO_EN.jpg
Electromyography (EMG)EElectromyography (EMG)Electromyography (EMG)EnglishNeurologyChild (0-12 years);Teen (13-18 years)BodySkeletal muscle;NervesTestsCaregivers Adult (19+)NA2009-11-06T05:00:00Z5.2000000000000079.5000000000000442.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Electromyography (EMG) tests how well muscles and nerves work together. Learn about what to expect during an EMG test and how to prepare your child. </p><h2>What is electromyography?</h2> <p>Electromyography (EMG) is a test that looks at how muscles and nerves work together. Nerves carry messages to and from the muscles. If the nerves or muscles are damaged, the muscles might not work properly. </p> <p>EMG can tell the doctor these things:</p> <ul> <li>if your child has a problem with the nerves or muscles </li> <li>why the muscles feel weak, stiff or painful </li> <li>where the problem is: The problem might be in the muscles, the nerves or the place where the muscles and nerves meet. </li> </ul> <p>This page explains what happens during an EMG test. Use this information to explain to your child what will happen, using words your child can understand. </p><h2>Key points</h2> <ul> <li>EMG is done to find out how well the nerves and muscles work together. The test can show if there is a problem with the muscles, the nerves or the place where the muscles and nerves meet. </li> <li>Small needles are put into one to four muscles during the test. The needles may hurt a little. </li> <li>The test takes about 30 minutes. </li> </ul><h2>EMG is done at the hospital</h2> <p>EMG is usually done in a hospital. It is done by specially trained doctors and nurses. Most hospitals will let you stay with your child during the test. </p> <h2>What happens during an EMG test</h2> <p>The test usually takes up to 30 minutes.</p> <p>Your child will lie on a comfortable bed. The doctor will put a very thin needle that looks like a wire into one to four different muscles. The needle will stay in each muscle for about 30 seconds. If your child can, the doctor or nurse will ask your child to relax the muscle and then tighten the muscle. The number of muscles the doctor will test depends on your child's problem. </p> <p>The needle is connected to a computer. The computer will record what each muscle does.</p> <p>The doctor and nurse will always tell you and your child when and where they will put the needle. Putting the needle in the muscles may hurt a little, just like it does when your child gets a regular needle. </p><h2>After an EMG test</h2> <p>Your child can go back to their usual activities right away. The muscles that were tested might hurt a little for a short time after the test. </p><h2>Getting ready for an EMG test</h2> <p>You and your child do not need to do anything special to get ready for the test. Your child can eat and drink as usual before this test. </p>
Emergency medicineEEmergency medicineEmergency MedicineEnglishNANANANANATeen (13-18 years) Adult (22+) CaregiversNALanding PageLearning Hub<p>There are many reasons a child may need to go to the Emergency Department. This page highlights common conditions such as cough and injuries such as bone fractures.</p><p>There are many reasons a child may need to go to the Emergency Department. These can range from coughs and fever, to injuries such as bone fractures and ankle sprains. This page highlights some common conditions and injuries that are often treated in the Emergency Department.</p>ed,erhttps://assets.aboutkidshealth.ca/AKHAssets/ED_Learning_hub.jpg
Emotional help for parents in the NICUEEmotional help for parents in the NICUEmotional help for parents in the NICUEnglishNeonatologyPremature;Newborn (0-28 days);Baby (1-12 months)NANASupport, services and resourcesPrenatal Adult (19+)NA2009-10-31T04:00:00Z8.9000000000000060.90000000000001111.00000000000Flat ContentHealth A-Z<p>Read about the challenge that parents face when coping with emotional ups and downs in the NICU. These often overshadow practical realities.</p><p>Although the practical realities of having a newborn baby in the Neonatal Intensive Care Unit (NICU) can be trying, the emotional ups and downs can be even more of a challenge. It is important for parents to seek help during this time.</p><h2>Key points</h2> <ul><li>Parents of babies in the NICU should seek help to cope with difficult emotions, including relationship and family stress.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/emotional_help.jpg
Encephalopathies and progressive epilepsy syndromesEEncephalopathies and progressive epilepsy syndromesEncephalopathies and progressive epilepsy syndromesEnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemConditions and diseasesCaregivers Adult (19+) EducatorsNA2010-02-04T05:00:00Z11.300000000000038.50000000000001078.00000000000Flat ContentHealth A-Z<p>Read about the causes, symptoms and treatments for encephalopathies and progressive syndromes.</p><p>Encephalopathy is a general term that means brain disease. The epileptic encephalopathies are a group of epilepsy syndromes in which seizures are associated with developmental delay or intellectual disability. In these conditions, the seizures are often frequent and difficult to control with medication. In some epileptic encephalopathies, there is a progressive decline in function. </p><h2>Key points</h2> <ul><li>Epileptic encephalopathies are a group of epilepsy syndromes in which seizures are linked with developmental delay or mental impairment.</li> <li>Many children with these seizures stop developing psychomotor skills.</li> <li>These types of seizures are often difficult to treat with medication.</li></ul>
Encouraging healthy coping behavioursEEncouraging healthy coping behavioursEncouraging healthy coping behavioursEnglishAdolescent;RheumatologyPre-teen (9-12 years);Teen (13-15 years);Late Teen (16-18 years)NANANAAdult (19+)NA2017-01-31T05:00:00Z9.2000000000000054.4000000000000462.000000000000Flat ContentHealth A-Z<p>Encourage healthy coping behaviours in your teen with these expert tips.</p><p>It's important for parents to encourage healthy coping behaviours in their teenager. Use positive reinforcement of good behaviour, model positive coping skills and avoid reinforcing negative behaviour.</p><h2>Key points</h2> <ul><li>Reinforce and strengthen positive behaviours, through the use of praise and attention.</li> <li>It may be difficult, but avoid reinforcing negative behaviour in your teenager.</li> <li>Set a positive example for your teenager by modeling positive coping skills.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/encouraging_healthy_coping_behaviour.jpg
Encouraging healthy habitsEEncouraging healthy habitsEncouraging healthy habitsEnglishAdolescent;OncologyPre-teen (9-12 years);Teen (13-15 years);Late Teen (16-18 years)NANANAAdult (19+) CaregiversNA2019-09-03T04:00:00Z9.7000000000000054.40000000000001089.00000000000Flat ContentHealth A-Z<p>Encourage healthy habits in your teen during cancer treatment and after with these expert tips.</p><p>Encouraging your teenager to adopt healthy habits now helps set your teenager up to live a healthy lifestyle in the future. A great way to teach your teenager healthy habits is to adopt them yourself. If you truly make physical activity and healthy eating a high priority in your life, your teen is much more likely to do the same. </p><h2>Key points</h2><ul><li>Regular exercise, eating properly and getting enough sleep are all important health habits to adopt during cancer treatment and after treatment ends.</li><li>Your teen should always check with their health-care team before starting a new activity program or changing their diet.</li><li>Use positive reinforcement to encourage good behaviour and healthy habits.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/Encouraging_healthy_habits_TTC_Cancer.jpg
Encouraging healthy lifestyle habitsEEncouraging healthy lifestyle habitsEncouraging healthy lifestyle habitsEnglishAdolescent;RheumatologyPre-teen (9-12 years);Teen (13-15 years);Late Teen (16-18 years)NANANAAdult (19+)NA2017-01-31T05:00:00Z8.7000000000000055.7000000000000472.000000000000Flat ContentHealth A-Z<p>Exercising regularly, eating well and sleeping well are all important parts of proper JIA management. Learn how to encourage your teen to be healthy.</p><p>Help your teenager to have a healthy lifestyle by encouraging them to exercise regularly, eat properly and maintain healthy sleep habits. Maintaining a healthy lifestyle is an important part of proper JIA management.</p><h2>Key points</h2><ul><li>Encourage physical activity that requires your teen to walk, move around or stand instead of sitting or lying down.</li><li>Eating well is important for everyone, including teenagers with JIA as their medications may cause them to gain or lose weight.</li><li>Help your teen get a good night's sleep by setting a regular sleep schedule.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/encouraging_healthy_lifestyle_habits.jpg
Endovascular laser treatment (EVLT): Caring for your child at home after the procedureEEndovascular laser treatment (EVLT): Caring for your child at home after the procedureEndovascular laser treatment (EVLT): Caring for your child at home after the procedureEnglishOtherChild (0-12 years);Teen (13-18 years)BodyVeinsNon-drug treatmentCaregivers Adult (19+)NA2021-02-23T05:00:00Z6.9000000000000066.1000000000000574.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn how to properly care for your child at home after endovascular laser treatment.</p><p>Your child has had <a href="/Article?contentid=2448&language=English">endovascular laser treatment (EVLT)</a>. The information on this page explains how to care for your child at home after the procedure, and when to call for help.</p><h2>Key points</h2><ul><li>Your child may have acetaminophen or ibuprofen for pain.</li><li>Your child may bathe 24 hours after the procedure.</li><li>If prescribed, your child must wear a high compression garment for six weeks.</li><li>Your child should avoid any major physical activity for six weeks.</li></ul><h2>When to see a doctor</h2><p>Phone your child’s specialist, the Image Guided Therapy (IGT) clinic or go to the nearest Emergency Department right away if your child has any of the following:</p><ul><li> <a href="https://www.aboutkidshealth.ca/Article?contentid=30&language=English">fever</a> greater than 38°C (100.4°F)</li><li>severe <a href="https://www.aboutkidshealth.ca/pain">pain</a> in treatment area that is not controlled with acetaminophen or ibuprofen</li><li>generalized swelling of the leg</li><li>skin blisters</li></ul><h2>What to expect after EVLT</h2><h3>Your child may experience the following symptoms:</h3><ul><li>Bruising along the treated vein.</li><li>Swelling in the area where the vein was treated.</li><li>Slight tenderness in the treated area.</li><li>A "pulling" sensation in the leg where EVLT was done. This may occur a couple of days after the procedure. If your child is in pain, give them <a href="https://www.aboutkidshealth.ca/Article?contentid=153&language=English">ibuprofen</a> for 48 hours.</li></ul><h3>Discharge from the hospital</h3><p>Most children who have EVLT go home the same day. This is usually four hours after the procedure.</p><h2>At SickKids</h2><p>If you have any concerns, call the <a href="http://www.sickkids.ca/IGT/index.html">Image Guided Therapy (IGT) clinic</a> at (416) 813-7654 ext. 201804. Speak to the IGT clinic nurse during working hours or leave a non-urgent message.</p><p>If you have concerns and it is after working hours, see your family doctor or go to the nearest Emergency Department. You can also call the Hospital for Sick Children switchboard at (416) 813-7500 and ask them to page a member of your child’s health-care team or the interventional radiology fellow on call.</p>https://assets.aboutkidshealth.ca/AKHAssets/endovascular_laser_caring_for_child_at_home.jpg
Endovenous laser therapy using image guidanceEEndovenous laser therapy using image guidanceEndovenous laser therapy using image guidanceEnglishOtherChild (0-12 years);Teen (13-18 years)NAVeinsProceduresCaregivers Adult (19+)NA2016-02-09T05:00:00Z9.0000000000000058.70000000000001306.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn what endovenous laser therapy is and how it is done using image guidance</p><h2>What is endovenous laser therapy?</h2> <p>Endovenous laser therapy (EVLT) (sometimes called endovenous laser ablation) uses a laser to close some abnormal veins. The laser burns the inner surface of the vein and stops blood flow in that area.</p> <p>EVLT is done using image guidance by an interventional radiologist.</p><h2>Key points</h2> <ul> <li>EVLT is used to close some abnormal veins.</li> <li>It is usually considered a low-risk procedure.</li> <li>You must bring your child’s high-pressure garment with you on the day of the procedure.</li> </ul><h2>On the day of the endovenous laser therapy</h2><p>Arrive at the hospital two hours before the planned time of your child’s procedure. Once you are checked in, your child will be dressed in a hospital gown, weighed and assessed by a nurse. You will also have a chance to speak to the interventional radiologist who will be doing the EVLT, and the anesthetist who will be giving your child medication to make them comfortable during the procedure.</p><p>You must bring your child’s high-pressure garment (30–40 mmHg) with you to the hospital on the day of their procedure. If you do not have these, your child may not have the EVLT done and they may need to be rebooked.</p><p>During the endovenous laser therapy, you will be asked to wait in the waiting area.</p><h2>Your child will have medicine for pain</h2><p>Children are given medicine for treatments that may be frightening, uncomfortable, or painful. This includes <a href="/Article?contentid=1260&language=English">sedation</a> or <a href="/Article?contentid=1261&language=English">general anaesthesia</a>. For EVLT, most children are given a general anaesthetic.</p><h2>How endovenous laser therapy is done</h2><p>The interventional radiologist will insert a special tiny tube, called a catheter, into the affected vein. The interventional radiologist may use an X-ray or ultrasound machine to make sure the catheter is in the correct position inside the vein. Through this catheter, a laser fibre is inserted into the vein. The interventional radiologist then uses the laser to burn the vein. The laser fibre is slowly pulled out, closing the vein and stopping the blood flow through the abnormal vein.</p><p>The procedure generally takes two hours.</p> <figure class="asset-c-80"> <span class="asset-image-title">Endovenous laser therapy</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_EVLT_EN.jpg" alt="Laser fibre inserted into abnormal vein in the leg and then turned on as it’s pulled back out to close the vein" /> <figcaption class="asset-image-caption">A: Laser fiber is inserted into the abnormal vein. B: Laser is turned on to burn the abnormal vein from the inside while the laser fibre is slowly pulled out. C: The laser closes the vein and stops the blood flow.</figcaption> </figure><h2>After the endovenous laser therapy</h2><p>Once the venous laser treatment is complete, your child will be moved to the recovery area. The interventional radiologist will come and talk to you about the details of the procedure. As soon as your child starts to wake up, a nurse will come and get you.</p><h2>Going home</h2><p>In most cases, children go home the same day as the procedure. If your child’s doctor has arranged this, your child will be ready to go home about four hours after the procedure. Your child’s nurse will let you know when they are well enough to go home.</p><h2>Visiting the clinic before the procedure</h2> <p>Your child will visit the Vascular Anomalies Clinic and be seen by an interventional radiologist before the procedure to decide on the best treatment options.</p> <p>During this clinic visit, your child may:</p> <ul> <li>see a physiotherapist and/or occupational therapist</li> <li>get information about pressure garments</li> <li>be sent to have photographs taken</li> <li>have blood work, if needed</li> </ul> <p>Your child may also need to have other tests such as ultrasound, magnetic resonance imaging (MRI) or venography done. This will help the doctor see what your child’s veins look like. After these tests, the doctor can determine if your child is a suitable candidate for EVLT.</p> <p>If your child is suitable for EVLT, you should expect:</p> <ul> <li>A health assessment to make sure your child is healthy and that it is safe to have <a href="/Article?contentid=1261&language=English">general anaesthesia</a> and to go ahead with the procedure.</li> <li>An overview of the procedure, and a review of the consent form with an interventional radiologist.</li> </ul> <h2>Giving consent before the procedure</h2> <p>Before the procedure, the interventional radiologist will go over how and why the procedure is done, as well as the potential benefits and risks. They will also discuss what will be done to reduce these risks, and will help you weigh any benefits against the risks. It is important that you understand all of these potential risks and benefits of the EVLT and that all of your questions are answered. If you agree to the procedure, you can give consent for treatment by signing the consent form. A parent or legal guardian must sign the consent form for young children. The procedure will not be done unless you give your consent.</p> <h2>Pressure garments/stockings</h2> <p>Parents must obtain their child’s high-pressure garment(s) (30–40 mmHg) prior to EVLT. They will be given a prescription for the garment at their visit to the Vascular Anomalies Clinic.</p> <p>If your child regularly wears a garment in addition to the high-pressure garment, please bring both of these with you on the day of your laser treatment.</p> <p>The interventional radiologist doing the treatment will decide which garment will be applied and when it should be used.</p> <p>If the garment is to be used, often it is required for the following period:</p> <ul> <li>day and night for the first 48 hours</li> <li>then in the daytime only for six weeks</li> </ul> <h2>How to prepare your child for the procedure</h2> <p>Before any treatment, it is important to talk to your child about what will happen. When talking to your child, use words they can understand. Let your child know that medicines will be given to make them feel comfortable during the procedure.</p> <p>Children feel less anxious and scared when they know what to expect. Children also feel less worried when they see their parents are calm and supportive.</p> <h2>If your child becomes ill within two days before the procedure</h2> <p>It is important that your child is healthy on the day of the procedure. If your child starts to feel unwell or has a fever within two days before the EVLT, let your doctor know. Your child may need to be rebooked.</p> <h2>Food, drink, and medicines before the procedure</h2> <ul> <li><a href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/Eating-guidelines/index.html" target="_blank">Your child’s stomach must be empty</a> before sedation or general anaesthetic.</li> <li>If your child has special needs during fasting, talk to your doctor to make a plan.</li> <li>Your child can take their regular morning medicine with a sip of water two hours before the procedure.</li> <li>Medicines such as <a href="/Article?contentid=77&language=English">acetylsalicylic acid (ASA)</a>, <a href="/Article?contentid=198&language=English">naproxen</a> or <a href="/Article?contentid=153&language=English">ibuprofen</a>, <a href="/Article?contentid=265&language=English">warfarin</a>, or <a href="/Article?contentid=129&language=English">enoxaparin</a> may increase the risk of bleeding. Do not give these to your child before the procedure unless they have been cleared first by their doctor and the interventional radiologist.</li> </ul><h2>At SickKids</h2><p>At SickKids, the interventional radiologists work in the <a href="http://www.sickkids.ca/IGT/index.html" target="_blank">Department of Diagnostic Imaging – Division of Image Guided Therapy (IGT)</a>. You can call the IGT clinic at (416) 813-6054 and speak to the clinic nurse during working hours (8:00 to 15:00) or leave a message with the IGT clinic nurse.</p><p>For more information on fasting see <a href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/Eating-guidelines/index.html" target="_blank">Eating and drinking before surgery</a>.</p><p>For more information on preparing your child for their procedure see <a href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/index.html" target="_blank">Coming for surgery</a>.</p>https://assets.aboutkidshealth.ca/akhassets/IMD_EVLT_EN.jpg
Enema: How to distract your child at homeEEnema: How to distract your child at homeEnema: How to distract your child at homeEnglishGastrointestinalChild (0-12 years);Teen (13-18 years)Large Intestine/ColonLarge intestine;RectumNon-drug treatmentCaregivers Adult (19+)NA2014-12-23T05:00:00Z7.5000000000000071.2000000000000525.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Find out how you can help your child feel more comfortable and pass the time during an enema.</p><p>Giving an <a href="/Article?contentid=983&language=English">antegrade continence enema</a> takes time and involves a lot of waiting for your child. They will need to:</p><ul><li>lie on their side for five to 10 minutes while they get an enema</li><li>stay still for another five to 10 minutes while the enema is working</li><li>sit on the toilet for up to 45 minutes to empty their bowel</li></ul><p>All this waiting and staying still can be difficult, especially for younger children and those who would rather do anything than have an enema. An enema can also be an uncomfortable experience for your child, so it is useful to make the experience as fun as possible. This is when distraction is important.</p><br><h2>Key points</h2> <ul> <li>An enema can be uncomfortable for your child. You can use a portable DVD player, games, books or simple arts and crafts to help your child pass the time.</li> <li>Other ways to help your child include using a reward chart, talking about the other things that they can do and reminding them of the benefits of an enema.</li> </ul><h2>How to distract your child during an enema</h2> <p>Your child can do a number of activities to pass the time and take their mind off what is happening.</p> <ul> <li>Let your child play games on a laptop, tablet, cell phone, games console or any other portable device.</li> <li>Have your child watch a movie on a portable DVD player.</li> <li>Play music for your child and have them sing along.</li> <li>Let your child read books.</li> <li>Encourage your child to do homework if they can — if they do it during toilet time there is more time for fun before bedtime.</li> <li>Have your child colour, draw or do arts and crafts if possible.<br></li> <li>Give a younger child search-and-find books, puzzles or other games (such as dot-to-dots, word search and so on).</li> <li>Let your child play cards or other travel-size games.</li> </ul> <h2>Other tips to help your child through an enema</h2> <ul> <li>Have patience and do not rush…take the time that is needed.</li> <li>For younger children, provide a foot stool and potty seat (if necessary) for comfort while they are seated.</li> <li>Try to talk positively about the enema. Putting a positive spin on something that can be seen as negative and unpleasant will help your child cope with the enema and see it as a normal part of their routine.</li> <li>Remind your child that there are still so many things that they can do and that these do not need to be put on hold. For instance, when your child wants to do anything rather than sit on the toilet, get them to focus on the things that they can do instead of what they are missing.</li> <li>Keep your child motivated with a reward chart. Use stickers or stamps to track their successes.</li> <li>To avoid your child focusing on toilet time, tell them about all the activities they will be doing during the day.</li> <li>Reinforce the benefits of enemas, such as keeping clean, being able to wear underwear and feeling comfortable changing at school.</li> </ul>
Enemas: How to give at homeEEnemas: How to give at homeEnemas: How to give at homeEnglishGastrointestinalPreschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)Large Intestine/ColonLarge intestineNon-drug treatmentCaregivers Adult (19+)NA2020-09-06T04:00:00Z7.3000000000000065.4000000000000456.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Discover the precautions to take when giving enemas to your child at home in order to relieve constipation.</p><p>If your child has severe <a href="/Article?contentid=6&language=English">constipation</a>, your child's doctor may prescribe an enema to be given at home.</p> <h2>What is an enema?</h2> <p>An enema is a liquid that is placed into the rectum. It flushes out stool (feces) that has built up (impacted) in the bowel.<br></p> <p>An enema may be uncomfortable for your child, but it usually relieves constipation.<br></p> <p>Enemas should only be used when a doctor has prescribed them, usually if nothing else has worked or if the child is very uncomfortable. Enemas should not be used regularly.</p> <h3>Other less invasive ways to relieve constipation include:</h3> <ul> <li>increasing fibre and fluids in your child's diet</li> <li>using stool softeners</li> </ul><h2>Key points</h2><ul><li>Enemas should be used only when necessary.</li><li>Encourage your child to drink lots of water after taking the enema.</li></ul><h2>Precautions when using enemas</h2> <p>Always follow the doctor or pharmacist's instructions. Enemas can lead to <a href="/Article?contentid=776&language=English">dehydration</a> or more severe conditions if they are not used correctly.</p> <p>If you give enemas too often, they may inflame or irritate your child's anus. This may cause your child to hold in bowel movements and get more constipated.<br></p><h2>When to see a doctor</h2><p>Make an appointment with your child's doctor right away or visit the nearest Emergency Department if:</p><ul><li>your child shows signs of severe dizziness or passes out</li><li>your child has severe nausea or <a href="/Article?contentid=746&language=English">vomiting</a></li><li>your child is feeling extremely tired or weak<br></li><li>your child has severe <a href="/Article?contentid=7&language=English">diarrhea</a> for an extended time</li><li>your child has severe abdominal pain</li><li>your child is unable to pass urine<br></li></ul><h2>How does an enema work?</h2> <ol> <li>Have your child lie down on their side or stomach with their legs bent and knees to their chest.</li> <li>Gently place the small tube inside your child's anus. You can rub some petroleum jelly around your child's anus to help the tube go in more easily.</li> <li>Flush the enema solution (liquid) through the tube into your child's rectum.</li> <li>After five to 10 minutes, your child can sit on the toilet and push out the enema solution and feces.</li> </ol> <p>You may need to repeat this process six to 12 hours later. This depends on the type of enema used. Ask your child's doctor or pharmacist for exact instructions.</p> <p>Your child may find the enema uncomfortable, but enemas do not usually hurt.</p><h2>Different types of enemas</h2> <h3>Doctors recommend two types of enemas for children: </h3> <ul> <li>sodium phosphate solution enema</li> <li>saline solution (salt water) enema</li> </ul> <p>Your child's doctor will usually tell you which type of enema solution is best for your child. Tell your child's doctor or pharmacist if your child has any allergies to medicines.<br></p>
Energy boosting during baby's first yearEEnergy boosting during baby's first yearEnergy boosting during baby's first yearEnglishNutritionNewborn (0-28 days);Baby (1-12 months)BodyDigestive systemNon-drug treatmentCaregivers Adult (19+)NA2009-11-06T05:00:00Z6.6000000000000072.4000000000000557.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Sometimes infants do not gain weight at the rate they are supposed to. Find out ways to increase your baby's caloric intake in a healthy manner. </p><h2>What is energy boosting?</h2> <p>Babies who are not eating well, or who need a lot of calories, may have problems such as the following:</p> <ul> <li>getting tired more easily </li> <li>having trouble gaining weight normally </li> <li>losing weight </li> </ul> <p>To gain weight and have more energy, these babies need to get more calories from what they eat and drink. It can be hard to get a baby to eat more. But you can increase the amount of calories in the food your baby does eat. This is called energy boosting. </p><h2>Key points</h2> <ul> <li>Energy boosting is when you increase the amount of calories in the food your baby eats so that they can gain weight and have more energy.</li> <li>Offer your baby foods that are highest in calories first and lowest in calories last. You can also add extra calories to your baby's foods.</li> <li>Do not give your baby low-calorie drinks such as water.</li> </ul><h2>Two ways to get your baby to eat more calories</h2><p>Dietitians have two general strategies to increase a baby's calories:</p><ul><li>Offer your baby foods that are highest in calories first. Offer the lowest in calories last.</li><li>Add extra calories to your baby's foods.</li></ul><h2>High-calorie foods first</h2><p>Your baby can only eat or drink a certain amount at any one feeding time. The best thing to do is to begin feeding times with foods that are the highest in calories. If your child is still hungry after that, then you can offer foods that are lower in calories.</p><p>Here are foods that babies typically eat in their first year of life, rated by calories:</p><h3>Highest calorie foods</h3><ul><li>breast milk or formula</li><li>infant cereals</li><li>strained meats</li></ul><p>Baby foods labelled "meat with vegetables" have fewer calories than meat alone.</p><p>Baby foods labelled "vegetables with meat" have fewer calories than "meat with vegetables."</p><h3>Lower calorie foods</h3><ul><li>custards</li><li>pureed or mashed fruits</li></ul><p>Strained desserts, yogurts and custards have more calories than strained fruits alone.</p><h3>Lowest calorie foods</h3><ul><li>pureed or mashed vegetables</li></ul><h2>Adding extra calories to your baby's foods</h2> <figure><img src="https://assets.aboutkidshealth.ca/akhassets/Baby_food_energy_boosting_EQUIP_ILL_EN.jpg" alt="Scale of lowest calorie foods to highest calorie foods from pureed or mashed vegetables to breast milk" /> </figure> <p>Here are some ways you can add extra calories to your baby's food:</p><h3>With cereal</h3><p>Mix infant cereal with expressed breast milk or formula instead of water.</p><h3>With meat and vegetables</h3><p>Add 1/2 teaspoon (2.5 ml) of margarine or oil to every 1/4 cup (60 ml or 2 oz) of meat and vegetable baby food.</p><h3>With fruit and desserts</h3><p>Add 1/2 teaspoon (2.5 ml) of table cream to each 1/4 cup (60 ml or 2 oz) of pureed or mashed fruit baby food. Table cream will have the words 18% m.f. on the carton.</p><h2>Do not give your baby low-calorie drinks</h2><p>Drinks such as water, tea and coffee do not have any calories, so do not give them to your baby.</p><p>Juice does have calories, but it does not have as many as the foods listed above. Juice may fill up your baby's tummy and make them less hungry. Try not to give your baby juice unless your baby is still hungry after eating high-calorie foods.</p>babyenergyboostinghttps://assets.aboutkidshealth.ca/akhassets/Baby_food_energy_boosting_EQUIP_ILL_EN.jpg
Energy boosting for teens and kids over one year oldEEnergy boosting for teens and kids over one year oldEnergy boosting for teens and kids over one year oldEnglishNutritionToddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)BodyDigestive systemNon-drug treatmentCaregivers Adult (19+)NA2009-11-06T05:00:00Z4.9000000000000080.70000000000001444.00000000000Health (A-Z) - ProcedureHealth A-Z<p>If your child does not gain weight at the rate they are supposed to, they may need to increase their caloric intake. Read how to increase calories in meals. </p><h2>What is energy boosting?</h2> <p>Children and teens who are not eating well, or who need a lot of calories, may have problems such as the following:</p> <ul> <li>losing weight </li> <li>failing to gain weight </li> <li>getting tired more easily </li> </ul> <p>To gain weight and have more energy, these children need to get more calories from food and drink. It can be hard to get a child to eat more. However, you can choose or serve foods that are higher in calories. </p> <p>This page is full of suggestions you can use to boost calories and gain weight and energy.</p><h2>Key points</h2> <ul> <li>Energy boosting is when you increase the amount of calories in the food your child eats so that they can gain weight and have more energy.</li> <li>To increase the amount of calories your child is getting only eat during regular meals and snacks, offer them foods that are highest in calories first and lowest in calories last, and add extra calories to their foods.</li> </ul><h2>How to get more calories in your diet</h2><p>Here are the three basic things you can do to help your child get more calories from food:</p><ul><li>Only eat during regular meals and snacks.</li><li>Choose foods that are highest in calories first and lowest in calories last.</li><li>Add extra calories to your foods.</li></ul><p>This page will give you the guidelines to help you with each of these recommendations. There are also other ideas and recipes to help add more calories to a daily diet.</p><h2>Only eat during regular meals and snacks</h2><p>Have your child eat three meals and no more than three snacks per day. Nibbling in between meals can reduce your child's appetite at meal times.</p><p>Drinks can do the same thing: they may fill your child up and lower appetite. Try to avoid giving drinks between meals as well.</p><h2>Choose foods that are high in calories first</h2><p>The more calories a food has, the higher in energy it is. See the image list of different types of foods. They are listed in order: the highest in calories are at the top and the lowest in calories are at the bottom.</p><p>You will find more information on how to use these foods to boost calories further on in this pamphlet.<br></p><h2>Add extra calories to your food</h2> <figure><img src="https://assets.aboutkidshealth.ca/akhassets/Food_groups_energy_boosting_EQUIP_ILL_EN.jpg" alt="Scale of lowest energy foods to highest energy foods from soups and broths to meat and alternatives" /> </figure> <h3>Adding fat</h3><p>An easy way to add calories to foods is to add or cook with fats. This will also make the food taste better. Here are a few examples of fats you can add to all kinds of foods:</p><h3>Oils, creams and sauces</h3><ul><li>Cheese sauce</li><li>Gravy</li><li>Oil such as corn, canola, olive or safflower oil</li><li>Salad dressings</li><li>Sour cream</li><li>Table cream or liquid whipping cream</li></ul><h3>Spreads</h3><ul><li>Non-hydrogenated margarine</li><li>Mayonnaise</li><li>Sour cream</li><li>Cream cheese</li><li>Peanut butter -- if age appropriate and your child has no allergies</li><li>Butter</li><li>Chocolate spread</li></ul><h3>Adding powdered carbohydrate</h3><p>Powdered carbohydrate can add extra calories to your food. Here are some ways you can use them in your foods:</p><ul><li>Sprinkle the powder on cereal, fruit or desserts.</li><li>Mix the powder with Jell-O and homemade popsicles.</li><li>Add the powder to drinks such as juice and fruit drinks.</li><li>Stir the powder into soups, mashed potatoes and casseroles.</li></ul><h3>Your dietitian may also suggest:</h3><p></p><p></p>energyboostinghttps://assets.aboutkidshealth.ca/akhassets/Food_groups_energy_boosting_EQUIP_ILL_EN.jpg
Enhancing movement skills in your childEEnhancing movement skills in your childEnhancing movement skills in your childEnglishPreventionChild (0-12 years);Teen (13-18 years)NANAHealthy living and preventionCaregivers Adult (19+)NA2020-04-02T04:00:00Z8.6000000000000060.6000000000000853.000000000000Flat ContentHealth A-Z<p>Discover some tips to help your child learn fundamental movement skills.</p><p>Fundamental movement and sports skills – also called "physical literacy" – help a child learn to move with confidence and control.</p><p>There are many benefits to learning movement skills. They help children improve their strength, posture and sleep, and enhance their confidence, social skills and sense of achievement.</p><p>Parents can do a lot to help foster their child’s movement skills. More than encouraging a range of physical activities, developing movement skills involves practising specific, fundamental moves to help your child improve their co-ordination, balance and speed.</p><p>Canadian Sport for Life's <a href="http://sportforlife.ca/physical-literacy/">Developing Physical Literacy </a>guidelines offer a number of suggestions for children of all ages, including children with a disability.<br></p><h2>Key points</h2> <ul> <li>Learning movement skills can help a child improve their strength, posture and sleep.</li> <li>You can help a toddler or school-age child practise tumbling, balancing, throwing and running.</li> <li>As your child grows, you can use more complicated techniques to practise throwing, catching and kicking.</li> <li>Older children can benefit from doing activities that improve co-ordination, flexibility, balance, agility and speed.</li> </ul>https://assets.aboutkidshealth.ca/AKHAssets/kids_in_motion_enhancing_movement_skills_in_your_child.jpg
Enlarged adenoidsEEnlarged adenoidsEnlarged adenoidsEnglishOtolaryngologyNewborn (0-28 days);Baby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years)NANasopharynxConditions and diseasesCaregivers Adult (19+)NA2010-08-18T04:00:00Z6.7000000000000064.6000000000000577.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Adenoids are located behind the nose on the back wall of the nasal cavity. Find out about the signs and symptoms of enlarged adenoids and what you and your child's doctor can do to help.</p><h2>What are enlarged adenoids?</h2><p>Adenoids are lumps of tissue on the back wall of the nasal cavity. They are found above the tonsils and behind the nose. Adenoids cannot be seen when looking in the mouth. </p><p>Adenoids are made of lymphatic tissue. This tissue helps fight infection. After a recurrent infection, the adenoids can become swollen. This is common and normal. They usually shrink to normal after an infection.</p><p>Swollen adenoids that don't shrink back down after a cold may lead to chronic symptoms. They may block the child's air passage. They may prevent the middle ears from draining normally. </p><p>Adenoids start to get smaller overall around the age of seven years. They are very small or non-existent by adolescence. </p> <figure class="asset-c-80"> <span class="asset-image-title">Adenoids</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Adenoids_MED_ILL_EN.jpg" alt="Location of adenoid" /> <figcaption class="asset-image-caption">The adenoids are located behind the nose.</figcaption> </figure><h2>Key points</h2><ul><li>Adenoids are lumps of lymphatic tissue. They are found on the back wall of the nasal cavity. They cannot be seen when looking in the mouth.</li><li>In some children, adenoids become more enlarged after repeated infections. This is common and normal.</li><li>Severely enlarged adenoids can lead to fluid in the ear. This can cause mild, temporary hearing loss if left untreated.</li><li>Surgery to remove the adenoids may be recommended if they are disrupting breathing or sleep.</li></ul><h2>Signs and symptoms of enlarged adenoids</h2> <p>The symptoms may include:</p> <ul> <li>severe snoring</li> <li>trouble sleeping</li> <li><a href="/Article?contentid=1210&language=English">sleep apnea</a>: when a child stops breathing for a few seconds while sleeping</li> <li>mouth breathing</li> <li>speech problems</li> <li>nasal voice</li> <li>problems swallowing</li> <li>frequent <a href="/Article?contentid=8&language=English">ear infections</a><br></li> </ul><h2>Causes</h2> <p>After the first year of life, the adenoids tend to grow as they are part of the body’s immune system. The adenoids filter and fight germs that enter the body through the mouth and nose. The adenoids may become so enlarged that they disturb the child’s quality of life. </p><h2>What your child's doctor can do to help </h2> <p>The doctor will physically examine your child. They will listen to your child's breathing. They will feel your child's neck near the jaw. </p> <p>Currently, adenoids and tonsils are no longer removed with surgery simply for recurrent infections. If a child has sleep apnea, certain medications may be given. These include decongestants and anti-inflammatories. Antibiotics are not given for this problem. Surgery may be an option if drugs do not work. </p> <p>The operation is called an adenoidectomy (say: ADD-uh-noy-DECK-toe-mee). Surgery usually helps the child breathe and sleep more easily. The tonsils are sometimes taken out at the same time.</p> <p>For more information on the surgery, please read the article <a href="/Article?contentid=1211&language=English">Adenoid surgery: Caring for your child after the operation</a>.</p><h2>Complications </h2><p>The eustachian tubes lead from the ears to the throat. If the adenoids block these tubes, your child may have many ear infections. These may cause middle ear problems and hearing loss. </p><p> <a href="/Article?contentid=1918&language=English">Sleep apnea</a> is a complication of enlarged adenoids. Some children snore so strongly that it disrupts their breathing. This can cause trouble sleeping. A poor night's sleep may need to poor attention at school, difficulty learning, hyperactivity, or impulsivity.</p>adenoidshttps://assets.aboutkidshealth.ca/akhassets/Adenoids_MED_ILL_EN.jpg
Enoxaparin: Injecting at homeEEnoxaparin: Injecting at homeEnoxaparin: Injecting at homeEnglishPharmacyToddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)NACardiovascular systemDrug treatmentCaregivers Adult (19+)NA2019-11-01T04:00:00Z7.1000000000000067.20000000000001619.00000000000Health (A-Z) - ProcedureHealth A-Z<p>A guide on how to give your child enoxaparin injections. Find out the injection sites and how to discard the needle.</p><div class="asset-video"> <iframe src="https://www.youtube.com/embed/iaHrD13O6ss" frameborder="0"></iframe> <br></div><h2>What is enoxaparin?</h2><p> <a href="/article?contentid=129&language=english">Enoxaparin​</a> is a blood thinner (anticoagulant). It works by changing the normal way the blood clots together. It helps prevent unwanted blood clots or existing blood clots from getting bigger.</p><p>Enoxaparin comes as a clear liquid for injection.</p><h2>Key points</h2><ul><li>Enoxaparin is an anticoagulant (blood thinner).</li><li>Enoxaparin helps prevent unwanted blood clots or existing clots from getting bigger.</li><li>It is given for as long as your child needs it.</li><li>Enoxaparin can be injected into the thigh or upper arm (for infants older than four to six months).</li><li>You will be given a prescription for the right size of syringes. They are called insulin syringes and come in sizes of 30 units (3/10 mL), 50 units (1/2 mL) and 100 units (1 mL). The size of the syringe depends on the prescribed dosage.</li><li>Enoxaparin does not require refrigeration, and can be kept at room temperature.</li><li>Once opened the bottle can be used for 28 days only.</li><li>1 unit on the insulin syringe = 1 mg of enoxaparin.</li></ul><h2>While your child is taking enoxaparin</h2> <p>Your child may bleed and bruise more easily.</p> <ul> <li>Please check with the medical team about what activities your child is allowed. Contact sports are not recommended. </li> <li>Your child may need to wear a Medic Alert bracelet if on this medication for a long time. You can discuss this with the medical team.<br></li> </ul><h2>When should you call your child’s medical or thrombosis team?</h2> <p>Call the medical or thrombosis team if your child:</p> <ul> <li>hits their head or has a fall</li> <li>has bruises that are large or cannot be explained</li> <li>has a nose bleed that is hard to stop</li> <li>has bowel movements that are black or red</li> <li>has new bleeding from gums when brushing the teeth</li> <li>will be having any medical or dental procedures or surgeries</li> </ul><h2>What to expect before going home</h2><ol><li>You will be given information that explains why your child is taking enoxaparin.</li><li>The nurse or pharmacist will teach you how to give your child the enoxaparin needles. They will help you learn to give your child’s enoxaparin needles by yourself before you go home. <strong>Please note that the syringes used at the hospital may look slightly different from the ones you will pick up from a pharmacy</strong>.</li><li>You will be given a prescription for enoxaparin. </li><li>You will be given a prescription for the recommended syringe size. They are called insulin syringes and come in sizes of 30 units (3/10 mL), 50 units (1/2 mL) and 100 units (1 mL). The size of syringe you will need depends on your child’s dosage.</li><li>The medical team will arrange follow-up clinic appointments. The dates and the times should be on your discharge paperwork or you will receive notification of the appointments by phone or through the mail.</li></ol><h2>How long will your child need to take enoxaparin?</h2><p>Your child’s thrombosis team will decide how long your child needs to take enoxaparin, depending on the reason for your child’s treatment.</p><p>To decide when to stop your child’s treatment, the doctor may do follow-up imaging tests, such as an ultrasound, MRI, echocardiogram or a CT scan.</p><h2>Keeping track of blood work results</h2><p>You will discuss where and when the blood work will be done with the medical team and thrombosis team. </p><h2>Storing enoxaparin</h2><p>Enoxaparin does not require refrigeration and can be kept at room temperature (less than 25°C). Once you open the bottle, it can be used for 28 days only. After 28 days, the bottle must be thrown away, even if there is still medicine in it.</p><h2>How much to give</h2><p>Doses can be administered no sooner than 10 hours apart, and no later than 14 hours between doses.</p><p>Enoxaparin is available in several different strengths. The dosing information below applies to the 100 mg/mL (3 mL) multidose vials only.</p><p>Enoxaparin is usually injected using insulin syringes that are specially designed for injections into the skin. It is important to note that the volume is measured in "units" on an insulin syringe, and that one unit on the insulin syringe is equal to 1 mg of enoxaparin.</p><p>Your child has been prescribed _______ mg of enoxaparin for each dose. This dose is equivalent to _______units on an insulin syringe.</p><h2>Drawing up enoxaparin</h2><p>Before giving your child enoxaparin, you first need to draw up the medicine from the bottle. Make sure to check the date on the medication bottle to make sure it has not expired.</p><p>You will need:</p><ul><li>Enoxaparin bottle (100 mg/mL)</li><li>Insulin 30 unit (3/10 mL), 50 unit (1/2 mL) or 100 unit (1 mL) syringe, depending on the dose. Use only insulin syringes. You must use a new needle and syringe each time.</li><li>Alcohol swab</li><li>Cotton ball</li><li>Sharps container </li></ul><div class="caution"><h3>Precaution</h3><p>Make sure that the concentration of the enoxaparin is 100 mg/mL and that you check that you are using the correct size of syringe for your child’s dosage. Take a look at the pictures below. If you are unsure if the size of the syringe is correct, contact your pharmacy or your child's thrombosis team.</p></div> <figure class="asset-c-100"> <span class="asset-image-title">Out-patient insulin syringes: Enoxaparin dosing</span> <img src="https://assets.aboutkidshealth.ca/akhassets/InsulinSyringes_OutPatient_EnoxaparinDosing.jpg" alt="Photos showing three different doses of enoxaparin in different-sized syringes" /> <figcaption class="asset-image-caption">The syringe your child is prescribed will depend on their dosage of enoxaparin. Because the syringes look very similar, it is important for you to double check the type of syringe you have before giving enoxaparin to your child.</figcaption> </figure> <p>To draw up enoxaparin:</p><ul><li>Wash your hands.</li><li>Clean the rubber stopper on the medicine bottle with an alcohol swab. Wait 30 seconds for the alcohol to dry.</li><li>Remove the cap from the needle and syringe. Put the needle through the rubber stopper on the medicine bottle at 90 degrees.</li><li>Turn the bottle upside down with the syringe in it. Ensure the tip of the needle is in the solution.</li><li>Slowly pull down on the plunger of the syringe until you have a bit more than the required number of units. If you have trouble pulling out the medicine, inject a bit of air into the bottle, and try again.</li><li>Check the syringe for any air bubbles. Tap the syringe to make any air bubbles float to the top.</li><li>Slowly push up on the plunger to the desired amount. If you have pushed out too much, pull back again on the syringe to the correct volume. Recheck for air bubbles.</li><li>Lift off the medicine bottle from the syringe. Be sure not to touch the exposed needle to any surfaces. It is now ready to be given to your child.</li></ul><h2 class="pdf-page-break">Where to inject enoxaparin</h2><ul class="akh-steps"><li> <figure><span class="asset-image-title">Subcutaneous injection with insulin syringe</span><img src="https://assets.aboutkidshealth.ca/akhassets/Injection_subcutaneous_insulinsyringe_layers_EQUIP_ILL_EN.jpg" alt="Cross-section of skin, subcutaneous tissue and muscle with needle injected at a ninety-degree angle" /></figure> <p>Enoxaparin is injected into the fatty layer just below the skin. This is called the subcutaneous (SC) layer. Safe areas of injection are: thighs and upper arms. Do not use the buttocks.</p></li><li> <figure><span class="asset-image-title">Thigh injection site</span><img src="https://assets.aboutkidshealth.ca/akhassets/Injection_site_baby_thigh_EQUIP_ILL_EN.jpg" alt="Lower body of baby with marking on thigh for injection" /></figure> <p>Thighs: Top front side and outer parts of thigh only. Do not use the inner thigh or back of the thigh. Divide the thigh into thirds; the injection site is in the middle third section.</p></li><li class="pdf-page-break"> <figure><span class="asset-image-title">Upper arms injection site</span><img src="https://assets.aboutkidshealth.ca/akhassets/Injection_subcutaneous_triceps_sideback_EQUIP_ILL_EN.jpg" alt="Upper body of child with marking on upper arm for injection" /> </figure> <p>Upper Arms: Fatty area on the side and back of the arm. This site is only for infants older than four to six months. Divide the upper arm into thirds; the injection site is in the middle third section.</p></li></ul> <br><h2>At SickKids</h2> <h3>The Thrombosis Team </h3> <p>The Thrombosis Team at The Hospital for Sick Children operates 24 hours a day, seven days of the week to respond to urgent calls from families of children and teens. If you need immediate attention, please call <strong>(416) 813-7500</strong> and ask the switchboard operator to page the Thrombosis team member on call.</p> <p>The Thrombosis Nurse Coordinator will arrange Thrombosis clinic appointments and call you with the dates and times. Families may call <strong>(416) 813-5859</strong> (Thrombosis Clinic) if they have not heard from the coordinator within two to three weeks after leaving the hospital with an appointment time.</p> <h3>Keeping track of blood work results</h3> <ul> <li>Blood tests can be done at SickKids. You will discuss where and when the blood work will be done with the Thrombosis Nurse. Please call the Thrombosis Nurse in one week after discharge to arrange next blood work.</li> <li>Notify the Thrombosis Team on the day your child has had blood work done by calling the Thrombosis Nurse at <strong>(416) 813-8514</strong> on Monday to Friday. The Thrombosis team will call you when they have received the results and will let you know if anything needs to be changed. You should receive a call from the Thrombosis Team whether or not changes are required.</li> </ul><h2>Personal stories about the use of low molecular weight heparins</h2><p>Two families share their experiences with using low molecular weight heparins. This video will help to answer any questions you may have if you or someone you know will be taking this medication.</p><div class="asset-video"> <iframe src="https://www.youtube.com/embed/iMp8r3hKmGU?rel=0" frameborder="0"></iframe>  </div><p>If you are using a printout of this page you can watch two videos at <a href="/article?contentid=993&language=english">www.aboutkidshealth.ca/injectenoxaparin</a>.</p> <h2>Thrombosis Learning Hub</h2><p>For more information on thrombosis, post-thrombotic syndrome and the management of these conditions, please visit the <a href="/thrombosis">Thrombosis Learning Hub</a>.<br></p>injectenoxaparinhttps://assets.aboutkidshealth.ca/akhassets/Injection_subcutaneous_insulinsyringe_layers_EQUIP_ILL_EN.jpg
Enteral feedingEEnteral feedingEnteral feedingEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartCardiovascular systemConditions and diseasesAdult (19+)NA2010-01-15T05:00:00Z6.0000000000000076.2000000000000798.000000000000Flat ContentHealth A-Z<p>Getting food and liquids through a tube going into the digestive tract is known as enteral feeding. Learn about feeding tubes and how to help your child adjust.<br></p><p>Your child may need to be fed through a feeding tube. Getting food and liquids through a tube going into the digestive tract is known as enteral feeding. </p> <p>Children tend to adjust very quickly to feeding tubes. Tube feeding is a temporary measure to help a child gain weight while good eating skills are reinforced. </p><h2> Key points </h2><ul><li>Enteral feedings can help children having problems with chewing and swallowing, gaining weight, malabsorption, reflux, or if they need breathing relief.</li> <li> NG tubes are put in through the nose and run down through the throat into the stomach.</li><li> G tubes are inserted directly into the stomach in a surgical procedure.</li><li> Children can receive formula through the tube in single doses several times a day, or opt for a continuous feeding.</li></ul>https://assets.aboutkidshealth.ca/akhassets/GTubes_EQUIP_ILL_EN.jpg
Enthesitis-related arthritis (ERA): A guide for teenagersEEnthesitis-related arthritis (ERA): A guide for teenagersEnthesitis-Related Arthritis (ERA): A Guide for TeenagersEnglishRheumatologyChild (0-12 years);Teen (13-18 years)Back;Knee;Ankle;Foot;HipImmune system;Ligaments;TendonsConditions and diseasesTeen (13-18 years)NA2016-08-12T04:00:00Z7.3000000000000065.60000000000001376.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Enthesitis-related arthritis is a type of childhood arthritis. Learn about how it is treated, how exercise helps, and how to maintain a normal lifestyle.</p><p>You have been told you have enthesitis-related arthritis. You may wonder what it is and what it means for you.</p> <p>You may be scared or worried about how this will change what you like to do, what your friends might think, or your future plans for school or a career. Here is a quick guide to help you learn about your type of arthritis and what it means for you.</p> <h2>Key points</h2> <ul> <li>Enthesitis-related arthritis (ERA) is an autoimmune disease that causes pain and swelling in the joints and the points where tendons and ligaments attach to bone (entheses).</li> <li>ERA is treated with medicine. Depending on your situation, you may need to take medicine for a short time or for a longer time.</li> <li>Exercise is important to help you manage your symptoms and stay healthy.</li> <li>ERA may make some activities harder, but you can still do the same things you did before you were diagnosed with ERA.</li> </ul><h2>Treatment for ERA</h2> <p>You will meet your rheumatology team made up of doctors, nurses, physical therapists, social workers, dieticians and child-life specialists. They have a lot of experience treating people with ERA. You will see the team three to five times a year. How often depends on how you are doing.</p> <p>You may need to take different kinds of medicine for ERA. Medication is used to:</p> <ul> <li>reduce inflammation of the joints and entheses</li> <li>take away pain and decrease swelling</li> <li>maintain function and movement of joints</li> <li>prevent damage to bone, cartilage, ligaments and tendons within the joints</li> </ul> <p>You may need to take these medicines for a short time, on and off for a number of years, or for many years. The amount of time you need to take the medicine depends on:</p> <ul> <li>how you are feeling</li> <li>if the doctor can see inflammation in your joints and entheses, by noticing swelling and warmth</li> <li>if the doctor can see evidence of inflammation in your blood</li> </ul> <p>When taking medicines, ask yourself these questions:</p> <ul> <li>Do I know which medications I am taking?</li> <li>Do I know how much or the dose I am taking?</li> <li>Do I know why I am taking each of the medications?</li> <li>Do I know what will happen if I do not take the medications?</li> </ul> <p>If you cannot answer these questions, please speak to your doctor. Make sure you understand what your medicines are and why you need to take them.</p> <p>Taking medications can be irritating. It can be hard to remember to take them and some medicines can have side effects. Side effects are the unwanted effects of a medicine (such as stomach aches or nausea). Tell your doctor if you have side effects. Please do not stop taking your medicines, as stopping certain medicines suddenly can hurt your body and can be dangerous.</p> <p>Talk to your doctor, nurse, pharmacist, or social worker about ways to make taking medicine easier and less painful.</p> <p>​To learn more about treatment and medicines, please read <a href="/Article?contentid=1003&language=English">Juvenile enthesitis-related arthritis: Treatment</a>.​</p>https://assets.aboutkidshealth.ca/AKHAssets/Enthesitis-Related-Arthritis_A_Guide_for_Teenagers.jpg
Enucleation: Caring for your child's custom-fitted (artificial) eyeEEnucleation: Caring for your child's custom-fitted (artificial) eyeEnucleation: Caring for your child's custom-fitted (artificial) eyeEnglishOphthalmologyChild (0-12 years);Teen (13-18 years)EyesNervous systemProceduresCaregivers Adult (19+)NA2014-07-17T04:00:00Z6.7000000000000072.70000000000001147.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn what to expect when a child receives a custom-fitted eye after an enucleation.</p><p>Your child has had an <a href="/Article?contentid=56&language=English">enucleation</a>, an operation to remove an eye. After the enucleation, your child will have a temporary, prosthetic (fake) eye. After about six weeks, they will have a long-term, custom-fitted eye.</p><h2>Key points</h2> <ul> <li>A prosthetic eye is a big contact lens. It is used right after enucleation for about six weeks.</li> <li>A custom-fitted eye is a long-term eye that your child receives when their eye socket heals. Your child should wear it all the time.</li> <li>The ocularist will check the eye regularly to make sure it is in good condition and continues to fit your child.</li> <li>If your child has any problems with the custom-fitted eye, contact the ocularist or your ophthalmologist.</li> </ul><h2>How is the custom-fitted eye made?</h2> <figure><span class="asset-image-title">Long-term custom-fitted eye</span> <img src="https://assets.aboutkidshealth.ca/akhassets/PMD_eye_custom_fitted_EN.jpg" alt="Close-up of an older boy’s eyes" /> <figcaption class="asset-image-caption">The eye on the right (or the boy's left eye) is custom-fitted.</figcaption> </figure> <p>Your child's custom-fitted eye is made by a person called an ocularist. Your child's doctor will send your child to see the ocularist when your child's eye socket has healed.</p><p>The ocularist will take a mould of your child's eye socket and use it to create the custom-fitted eye so that it matches your child's working eye. Both eyes will be the same shape and colour. The pupil of your child's custom-fitted eye will be a normal size, but, unlike in the working eye, it will not dilate (get bigger) or contract (get smaller) when the light gets brighter or darker.</p><h2>When will my child get their custom-fitted eye?</h2> <p>Your child will get their custom-fitted eye when their eye socket finishes healing after surgery. Your child's doctor will wait until all the swelling has gone down so that the eye will fit properly. This usually happens at least six to eight weeks after surgery.</p><h2>How do I pay for the custom-fitted eye?</h2><p>In Ontario, the <a href="https://www.ontario.ca/page/assistive-devices-program/" target="_blank">Assistive Devices Program (ADP)</a> will cover 75 percent of the cost of the custom-fitted eye. The eye doctor will fill in the ADP form that you will need to give to the ocularist.</p><p>If your family has difficulty covering the rest of the cost, you can ask a social worker in the hospital for advice about other sources of funding.</p>https://assets.aboutkidshealth.ca/akhassets/Enucleation_step3_MED_ILL_EN.jpg

Thank you to our sponsors

AboutKidsHealth is proud to partner with the following sponsors as they support our mission to improve the health and wellbeing of children in Canada and around the world by making accessible health care information available via the internet.

Our Sponsors