IV-line careIIV-line careIV-line careEnglishOtherChild (0-12 years);Teen (13-18 years)NAVeinsNon-drug treatmentCaregivers Adult (19+)NA2015-10-12T04:00:00Z7.1000000000000072.80000000000001115.00000000000Health (A-Z) - ProcedureHealth A-Z<p>IV lines can be an important part of your child's care. Learn about the importance of IV-line care and keeping your child safe.</p><p>Intravenous (IV) catheters, also known as "IV lines," can be an important part of your child's care. Keeping your child safe when they require an IV line is important to your child's healthcare providers. A child's safety is reinforced when parents and caregivers are informed and involved in their care.</p> <figure><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_IV_line_EN.jpg" alt="Child in bed with IV in back of hand" /> </figure> <h2>What is an IV line?</h2><p>IV lines are used to deliver different types of fluids, medications, and blood products to patients of all ages. The catheter or the "line" is a thin, flexible plastic tube. A trained health care provider inserts the line into a vein in the hand, arm, foot, leg, or scalp. Fluid flows through the line directly into the child's bloodstream.</p><h3>Inserting an IV line</h3><p>An IV line has a small needle inside the tube that helps get the tube into the vein. When the nurse or doctor inserts the needle and the surrounding tube into the vein, the needle is pulled out and the plastic tube stays in place. This area of the body where the IV line is inserted is known as the "IV site." Your child may feel a small pinch when the needle is inserted, but the pain will go away once the needle is removed. The IV line is held in place at the insertion site with clear tape.</p><h2>Key points</h2> <ul> <li>It is a nurse's responsibility to ensure the safe monitoring and management of your child's IV line.</li> <li>Nurses will be checking the IV at least once every hour, including throughout the night.</li> <li>Parents and caregivers can help with IV monitoring by ensuring their child does not pull the line, watching for pain or numbness, keeping the IV site dry, keeping the IV site visible and alerting the nurse when concerns or problems arise.</li> <li>Be aware of the signs of an IV line not working properly and the symptoms your child may experience.</li> </ul><h2>Complications</h2><p>If an IV line is not working properly, your child may experience any of the following symptoms:</p> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_IV_line_signs_of_complications_EN.jpg" alt="Hand with redness and leakage at IV site" /> </figure> <ul><li>General pain or pain to the touch at the IV site</li><li>Swelling of the area where the IV line is inserted</li><li>Numbness at the area</li><li>Redness</li><li>Bruising</li><li>Wetness at the area, suggesting that the IV line is leaking</li><li>Firmness at the area, which may be related to swelling</li><li>Warmth or coolness at the IV site</li></ul><p>The hourly assessments done by the nursing staff will ensure the IV line is working properly or let them know if there are problems.</p><h3>What happens if an IV line is pulled out?</h3><p>If your child's IV line is accidentally pulled out, call the nurse for help. While you are waiting, apply pressure to the area (where the IV line used to be) using gauze or tissue to stop any bleeding. Hold on to the IV line until the nurse arrives.</p><h3>What happens if the IV line stops working?</h3><p>If the IV line is not working properly, the fluid in the IV may leak into the surrounding tissues. Your child may experience some of the symptoms described above (e.g., pain, swelling). The IV line may need to be restarted, reinserted or switched if it is not working or if it has been accidentally removed. In this situation, your child's nurse or doctor will talk to you about the next course of action.</p><p>Parents and caregivers can speak to their nurse at any time if they have questions or concerns about the IV line.</p><h2>Caring for an IV line</h2><p>Intravenous lines must be properly checked and cared for to ensure the line is working properly and that there are no complications. It is the nurse's responsibility to ensure IV line safety, but parents and caregivers can assist in IV care by monitoring the line when the nurse is not present and alerting the nurse to any problems or concerns.</p><h3>What your nurse will do to care for the IV line</h3><p>It is the nurse's responsibility to check the IV site at least once every hour, including throughout the night.</p><p>Nurses will treat your child's IV line with <strong>TLC+<sup>1</sup></strong>, meaning they will do the following:</p><div class="akh-series"><div class="row"><div class="col-md-12"> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_IV_line_care_touch_EN.jpg" alt="Feeling hand for temperature change or leakage at IV site" /> </figure> <p> <strong>TOUCH</strong> for signs of temperature change (heat or warmth) or leakage at the IV site.</p></div></div><div class="row"><div class="col-md-12"> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_IV_line_care_look_EN.jpg" alt="Nurse examining IV site with a flashlight" /> </figure> <p> <strong>LOOK</strong> to make sure the IV site is dry and visible at all times.</p></div></div><div class="row"><div class="col-md-12"> <figure><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_IV_line_care_compare_EN.jpg" alt="Comparing hand with IV to opposing hand" /> </figure> <p> <strong>COMPARE</strong> the IV site (such as the hand or leg) with the opposite limb to look for signs of swelling.</p></div></div><div class="row"><div class="col-md-12"> <figure><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_IV_line_care_communicate_EN.jpg" alt="Nurse speaking with child and mother" /> </figure> <p> <strong>+ENGAGE</strong> with patients, parents, and caregivers to ensure the best possible care. This means encouraging patients and families to:</p><ul><li>notify the nurse if they notice any symptoms of complications (outlined below)</li><li>ask questions or share concerns</li><li>assist and support nurses caring for the IV line.</li></ul></div></div></div><p>Nurses will try to minimize disruptions when checking the IV line (such as using a flashlight at night), but for safety reasons they must check the site, even when your child is asleep.</p><h3>What YOU can do to care for the IV line</h3><p>Parents and caregivers can help care for the IV line when the nurse is not around by doing the following:</p><ul><li> <strong>Help protect the IV line</strong>. Sometimes an IV line can accidentally come out if it is bumped. Make sure the IV line does not get pulled when your child is walking, playing, using the bathroom, or getting up from a bed or chair. Ask a nurse if you need help managing the IV line during these activities.</li><li> <strong>Speak with your child</strong>. Ask your child to tell you if the IV line hurts, or if the IV site feels tingly or numb. Remind them not to pull or tug on the IV line and to ask the nurses for help if they want to move.</li><li> <strong>Keep IV site visible (especially when your child is sleeping)</strong>. This will make it easier for the nurse to check the IV without waking your child.</li><li> <strong>Keep the IV site dry</strong>. The IV site should be kept dry at all times. This helps prevent infection and accidental IV line removal.</li><li> <strong>Call the nurse if you notice any signs of complications</strong>. These are outlined below.</li></ul><p><sup>1</sup>TLC+ adapted with permission from Cincinnati Children's TLC (Touch, Look, Compare) policy for peripheral intravenous catheter care.</p>https://assets.aboutkidshealth.ca/akhassets/IMD_IV_line_care_compare_EN.jpgMain
Identifying your valuesIIdentifying your valuesIdentifying your valuesEnglishAdolescent;PsychiatryTeen (13-18 years)NANAHealthy living and preventionTeen (13-18 years)NA2020-02-05T05:00:00ZFlat ContentHealth A-Z<p>Everyone experiences points of uncertainty in their lives. Children and teens who live with a chronic physical or mental illness, may find themselves in unwanted situations. These situations can be scary or difficult, but you can use them to learn more about yourself and to grow as a person. One way to do this is to determine what your values are.</p><p>Click through the interactive below to learn about how to identify your values and how you can use your values to guide you through both every day decisions, as well as more difficult or unwanted situations.</p>Teens
Idiopathic thrombocytopenia purpura (ITP)IIdiopathic thrombocytopenia purpura (ITP)Idiopathic thrombocytopenia purpura (ITP)EnglishHaematologyChild (0-12 years);Teen (13-18 years)BodyCardiovascular systemConditions and diseasesCaregivers Adult (19+)NA2011-06-02T04:00:00Z9.1000000000000052.80000000000001613.00000000000Health (A-Z) - ConditionsHealth A-Z<p>A general overview or idiopathic thrombocytopenia purpura or ITP, an acquired blood disorder.</p><h2>What is ITP?</h2> <p>Idiopathic thrombocytopenia purpura (ITP) is an acquired disorder, resulting from an increase in the breakdown of platelets. ITP is not a cancer or malignancy. Platelets are small blood cells needed for normal blood clotting. In healthy people, old platelets are destroyed in the spleen by a type of white cell called a macrophage. With ITP, this process is much more rapid. Acute ITP occurs more frequently in children between the ages of two and nine, although it can occur in children of any age. ITP is found equally in boys and girls.</p><h2>Key points</h2> <ul> <li>Idiopathic thrombocytopenia purpura (ITP) is an acquired disorder. ITP is not a cancer or malignancy.</li> <li>Platelets, or thrombocytes, are blood cells produced in the bone marrow. Platelets circulate in the blood for approximately eight to 10 days.</li> <li>The most common sign of ITP is the appearance of numerous pinpoint haemorrhages, or petechiae, which look like tiny red spots under the skin.</li> <li>About 80% to 90% of patients recover spontaneously, usually within three months from the beginning of the illness.</li> <li>ITP can be treated in several ways: prednisone, intravenous immunoglobulin, intravenous Anti-D and splenectomy (removal of the spleen).</li> <li>Always check with your child's doctor before giving them any medication. Acetylsalicylic acid (ASA) or any medication that contains ASA should be avoided.</li> </ul><h2>Signs and symptoms of ITP</h2> <p>The most common sign of ITP is the appearance of numerous pinpoint haemorrhages, or petechiae, which look like tiny red spots under the skin. The presence of petechiae along with bruising is referred to as purpura. Both are caused by spontaneous bleeding in the skin and mucous membranes (surfaces in the skin and mouth). Except for signs of bleeding, your child may appear well.</p><h2>Causes of ITP</h2> <p>The onset of ITP is generally sudden. Most cases occur a few days or even weeks after a viral infection, such as chicken pox or a respiratory infection. Sometimes ITP can be caused by an unusual response in the body to a drug. Researchers think that antibodies formed naturally by the body's immune system attach themselves to the platelets. The platelets are then rapidly destroyed. If the body is unable to produce enough new platelets to replace those destroyed by the antibodies, the number of platelets in the blood will decrease.</p><h2>Diagnosing ITP</h2> <p>The doctor will take a careful history of your child's past health and current illness. If your child's doctor suspects ITP, a physical examination will be performed and a blood test will be ordered. Blood will be taken either by a finger prick or from a vein in the arm. The results of the physical examination and blood test will help confirm the diagnosis of ITP. In most cases, a sample of bone marrow will also be taken to rule out other causes of a low platelet count.</p> <p>Once ITP has been diagnosed, a daily blood test is usually ordered to assess the number of platelets in the blood.</p><h2>Treatment of ITP</h2><p>ITP can be treated in several ways. Your child's doctor will advise you on whether treatment is necessary. Treatment is the same for both acute and chronic ITP. The following treatments are most common:</p><h3>Prednisone</h3><p>Prednisone is a steroid. It is given in pill form and taken by mouth.</p><h3>Intravenous immunoglobulin</h3><p>This is a protein solution prepared from the plasma of many blood donors. This solution is given by infusion into a vein over several hours. It works by temporarily preventing platelet destruction in the spleen. The spleen is the body organ responsible for the rapid destruction of the platelets.</p><h3>Intravenous Anti-D</h3><p>Like <a href="/Article?contentid=161&language=English">intravenous immunoglobulin</a>, Anti-D is a protein solution prepared from blood plasma. The solution is given by infusion into a vein over a 20- to 30-minute period. It also works by temporarily preventing platelet destruction in the spleen.</p><h3>Splenectomy</h3><p>If ITP does not respond to medical treatment, or the side effects of the treatment are too severe, a splenectomy may be required. A splenectomy is the removal of the spleen by a surgical procedure. </p><p>Following treatment, the platelet count should rise. The petechiae and bruising will begin to disappear. Your child's doctor will probably want a few blood tests done, at regular intervals, to assess the platelet counts.</p><p>Medical treatment does not actually cure ITP. Instead, it raises the platelet count for a period ranging anywhere from a few weeks to even months. If your child's ITP does not clear up spontaneously during this time, the platelet count will fall again. More therapy will be required until the ITP disappears spontaneously.</p><h2>Side effects of medication</h2><h3>Prednisone</h3><p>The most common side effect is weight gain due to increased appetite. It is characterized by a "moon face," "pot belly" and fat deposits on the back of the shoulders. These symptoms are temporary and will disappear when the drug is stopped.</p><p>Other side effects associated with prednisone include:</p><ul><li>acne</li><li>increased blood pressure</li><li>a change in the level of blood sugar</li><li>mood swings ranging from euphoria to temper tantrums</li></ul><p>If your child is taking prednisone and comes into contact with chicken pox, seek medical attention right away. Your child's doctor may want to change the type of treatment.</p><h3>Intravenous immunoglobulin</h3><p>The most common side effects are headaches, fever, and nausea. In most cases, these side effects occur when two treatments are given back-to-back (12 hours apart). Give your child <a href="/Article?contentid=62&language=English">acetaminophen</a> to relieve their headache and/or fever. Similarly, give your child dimenhydrinate to treat nausea and vomiting. Within 24 hours after the second dose of <a href="/Article?contentid=161&language=English">intravenous immunoglobulin</a>, the symptoms should disappear. If only a single dose of intravenous immunoglobulin is given, the chance of these side effects occurring is small.</p><h3>Intravenous Anti-D</h3><p>The most serious side effect is a drop in the level of haemoglobin (red cells) in the blood. The biggest drop will occur seven to 10 days after the Anti-D has been given. Your child may appear tired and pale. In most cases, the haemoglobin does not drop low enough to require a transfusion.</p><h2>Medications to avoid</h2><p>If your child has ITP, always check with their doctor before giving them any medication. <a href="/Article?contentid=77&language=English">Acetylsalicylic acid</a> (ASA) or any medication that contains ASA should be avoided. This is because ASA interferes with platelet function for a period of seven to 10 days. If your child has a low platelet count, this may increase their risk of bleeding. All over-the-counter cough and cold medications should be carefully checked before being bought. If you are unsure if a medicine contains ASA or not, check with your pharmacist.</p><p>The following is a short list of medicines that should not be given to your child with ITP:</p><ul><li>ASA and all compounds that contain it</li><li>antihistamines</li><li>non-steroidal anti-inflammatory drugs (NSAIDs)</li><li>vitamin E</li><li>cod liver oil</li></ul>Main
Ileostomy: Dietary guidelines to help with stool consistencyIIleostomy: Dietary guidelines to help with stool consistencyIleostomy: Dietary guidelines to help with stool consistencyEnglishGastrointestinalChild (0-12 years);Teen (13-18 years)Small Intestine;Large Intestine/ColonSmall intestine;Large intestineNon-drug treatmentCaregivers Adult (19+)NA2015-10-27T04:00:00Z7.7000000000000067.10000000000001405.00000000000Health (A-Z) - ProcedureHealth A-Z<p>If your child has an ileostomy, learn what they should eat and drink to produce the proper texture of stool.</p><p>An ileostomy is one type of <a href="/Article?contentid=1027&language=English">ostomy</a>, which is an opening that connects the intestine to the abdomen (tummy). Stool passes through this opening into a pouch outside the body that is emptied and changed regularly.</p> ​ <h2>What is the goal of a special diet for a child with an ileostomy?</h2><p>The foods your child eats can change the consistency (texture) of their stool. The goal of a special diet is for your child to produce stool that is pasty but not too watery.</p><p>If stool is watery, your child may not absorb as many nutrients from their food. Watery stool also increases the risk of leaks and potential soiling from the pouch that is placed over their ileostomy.</p><p>There is no specific diet for children with ileostomies. However, some foods may be better tolerated than others.</p><ul><li>Some foods travel through the digestive tract quickly, which can make the stool output loose and more watery.</li><li>Some foods travel through the digestive tract slowly, which can make the stool output more like a thick paste.</li></ul><p>Eating foods that both increase and decrease stool output will help control the texture of your child’s stool. It will also make sure that your child is eating a varied, nutrient-rich diet.</p><p>Not all people react the same way to foods, so it may take time to learn what works best.<br></p><h2>Key points</h2> <ul> <li>A diet rich in soluble fibre and low in sugar can help your child’s stool achieve a paste-like texture. This texture helps the stool pass through your child’s ileostomy with a reduced risk of soiling.</li> <li>Have your child drink plenty of water and eat regularly to help them digest their food and replace any fluids lost through watery stool. </li> <li>Always talk to your child’s healthcare team before starting your child on any special diet and seek their advice about any sodium supplements.</li> <li>Keep a record of your child’s symptoms as you try different foods so you can learn what works best.</li> </ul><h2>Dietary guidelines for proper stool texture </h2><p>Important: Please tell your child’s healthcare team if your child is already on a special diet before you follow any of the guidelines below. </p><h3>Chew food well</h3><ul><li>Encourage your child to chew tough and fibrous foods well to reduce the risk of these foods blocking the stoma (opening).</li><li>If your child does not chew well, consider serving food that is softer or has been cooked for longer.</li></ul><h3>Eat regularly</h3><ul><li>Have three meals and one or two snacks each day.</li><li>Aim to eat every three hours. This will make your child’s bowel work throughout the day and may also help reduce the amount of <a href="/Article?contentid=822&language=English">gas</a> your child experiences.</li></ul><div class="akh-series"><div class="row"><div class="col-md-12"> <figure><img src="https://assets.aboutkidshealth.ca/akhassets/INM_ileostomy_diet_avoid_sugar_EN.png" alt="Limit sugars" /> </figure> <h3>Limit simple sugars and sugar alternatives</h3><p>Sugars and sugar alternatives can increase gas and bloating. They can also cause very watery stool.</p><ul><li>Avoid sweets and sugary foods such as candies, cookies, soda, juice and syrup.<br></li><li>Avoid sugar alternatives such as sucrose (Splenda), sorbitol, xylitol and manitol.</li><li>Read the <a href="/Article?contentid=1442&language=English">labels of processed food</a> and chose foods and drinks with less than 10 g of sugar per serving.</li></ul></div></div><div class="row"><div class="col-md-12"> <figure><img src="https://assets.aboutkidshealth.ca/akhassets/INM_ileostomy_diet_allowed_fibre_EN.png" alt="More soluble fibre" /> </figure> <h3>Eat a diet high in soluble fibre and limit insoluble fibre</h3><p>Soluble <a href="/Article?contentid=964&language=English">fibre</a> dissolves in water and helps to make stool more gel-like. Insoluble fibre (roughage) bulks up stool but can sometimes block the stoma. </p><ul><li>Introduce soluble fibre slowly. Introducing it too quickly may cause gas and bloating.</li><li>To increase soluble fibre, include foods such as oatmeal, pears and most cooked vegetables.</li><li>To reduce insoluble fibre:</li><ul><li>offer breads and cereals made from refined wheat, rye, corn and rice</li><li>remove skins from fruits and vegetables</li><li>use ripe, canned or cooked fruits without skin or seeds</li><li>avoid foods with dried fruit and visible seeds or nuts.</li></ul></ul></div></div><div class="row"><div class="col-md-12"> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/INM_ileostomy_diet_allowed_water_EN.png" alt="More water" /> </figure> <h3>Drink lots of water</h3><p>If a child has a lot of watery stool, they should drink enough water all day to stay hydrated. Drinking plenty of water can also help soluble fibre make stool output thicker. </p><ul><li>It is especially important for your child to drink water throughout the day during the hot summer months.</li><li>Your child’s healthcare team might sometimes recommend low-sugar drinks that contain electrolytes (mineral salts) if your child is losing a lot of water through their stool.</li></ul></div></div><div class="row"><div class="col-md-12"> <figure><img src="https://assets.aboutkidshealth.ca/akhassets/INM_ileostomy_diet_avoid_lactose_EN.png" alt="Reduce lactose" /> </figure> <h3>Watch your child’s response to dairy products</h3><p>Milk and milk products contain a sugar called lactose. Reducing lactose intake can sometimes help to improve your child’s stool output.</p><ul><li>Try lactose-free milk or low sugar fortified dairy-alternative drinks such as soy or hemp milk.</li><li>Offer your child yogurt and firmer cheese such as parmesan, cheddar or mozzarella. They might find these easier to tolerate than other dairy products.</li></ul></div></div><div class="row"><div class="col-md-12"> <figure><img src="https://assets.aboutkidshealth.ca/akhassets/INM_ileostomy_diet_allowed_salt_EN.png" alt="If allowed, add sodium" /> </figure> <h3>Add sodium to your child’s diet, if instructed</h3><p>Some children, especially babies, need extra sodium to help them replace the sodium they lose in their stool.<br></p><ul><li>Only add sodium to your child’s diet if instructed by your child’s healthcare team. They will check if your child needs more sodium by monitoring their electrolytes.<br></li><li>If your child needs extra sodium, the healthcare team will suggest which form is best. Options include table salt, salt tablets or a special sodium solution made in a pharmacy.</li></ul></div></div></div><p>You can find more guidelines in the table below.</p><table class="akh-table"><thead><tr><th>Food group</th><th>Foods to choose</th><th>Foods to avoid</th></tr></thead><tbody><tr><td>Vegetables and fruit</td><td><ul><li>Most tender cooked and canned vegetables</li><li>Leafy green vegetables – chew well</li><li>Fresh or frozen fruit, except for fruit with lots of seeds – limit to 1/2 to 1 cup per sitting</li><li>Lower-sugar fruits such as apples and pears (can be better tolerated)</li><li>Prunes<br></li></ul></td><td><ul><li>Stringy or tough vegetables (such as celery or corn)</li><li>Seeds in vegetables and fruit</li><li>Peels of vegetables and fruit</li><li>Berries</li><li>Citrus fruits with membranes</li><li>Dried fruit</li><li>Canned fruit in syrup, fruit cups, canned pie fillings</li><li>All fruit and vegetable juices</li></ul></td></tr><tr><td>Grain products</td><td><ul><li>Bread, toast, rolls, biscuits, muffins, crackers, pancakes and waffles</li><li>Crackers without obvious nuts, seeds</li><li>Refined cold cereals made from corn, rice or oats</li><li>Oatmeal, grits and farina</li><li>Enriched noodles and rice</li></ul></td><td><ul><li>Sweetened cereals</li><li>Donuts, cakes, cookies</li><li>Sweet rolls, pastries</li><li>Any baked goods with visible seeds, nuts or dried fruit</li><li>Wild rice</li></ul></td></tr><tr><td>Milk and alternatives</td><td><ul><li>Yogurt and hard cheeses</li><li>Lactose-free milk or soy milk (preferably unsweetened)</li></ul><p>Everyone tolerates dairy differently - please watch your child’s symptoms.</p></td><td><ul><li>Flavoured dairy milk or sweetened, flavoured alternatives such as vanilla or chocolate flavoured almond, rice or soy milk</li><li>Dairy with added seeds</li><li>Ice-cream, pudding, custard, sweetened yogurt</li></ul></td></tr><tr><td>Meat alternatives</td><td><ul><li>Tender, ground or well-cooked beef, lamb, ham, veal, pork, poultry, fish, shellfish and organ meats</li><li>Well-cooked legumes (such as beans, peas and lentils)</li><li>Eggs<br></li><li>Smooth nut butters (for example peanut, almond, hazelnut)</li></ul></td><td><ul><li>Tough fibrous meats or gristle</li><li>Clams, oysters and shellfish with tough connective tissue</li><li>Meat prepared with seeds or nuts</li><li>Uncooked legumes</li><li>Chunky peanut butter</li></ul></td></tr></tbody><thead><tr><th colspan="3">Other foods</th></tr></thead><tbody><tr><td>Fats and snacks</td><td><ul><li>Margarine, butter, vegetable oils, lard, mayonnaise, cream substitutes, crisp bacon, plain gravies and salad dressing</li><li>Potato chips, nacho chips, tortilla shells</li></ul></td><td><ul><li>Any snack made with seeds, nuts, coconut or dried fruit</li><li>Popcorn</li><li>Pastries or pies with seeds, nuts or dried fruit</li><li>Snacks or desserts made with a lot of sugar</li><li>Candy, chocolate bars</li></ul></td></tr><tr><td>Drinks</td><td><ul><li>Water</li></ul></td><td><ul><li>Carbonated (fizzy) drinks</li><li>Drinks containing sugar, sorbitol, manitol, xylitol or sucralose (Splenda), such as soda, chocolate milk or ice tea</li><li>Drinks containing caffeine</li><li>Fruit and vegetable juice</li></ul></td></tr><tr><td>Other</td><td><ul><li>Bouillon, broth or strained cream soups made with allowed ingredients</li><li>Salt, soy sauce, lemon juice, vinegar</li><li>Ketchup, sweet and sour sauce, teriyaki sauce, plum sauce (smooth, with no fibrous pieces of fruit) in small amounts – most condiments and dipping sauces contain sugar</li><li>Spices, in moderation</li><li>Vanilla and other flavouring extracts</li></ul></td><td><ul><li>Corn soup</li><li>Sorbitol, manitol, xylitol, sucralose (Splenda)</li><li>Sugar added to cereal or decaffeinated coffee and tea</li><li>Syrup, jam, honey<br><br></li></ul></td></tr></tbody></table>https://assets.aboutkidshealth.ca/AKHAssets/ileostomy_dietary_guidelines.jpgMain
ImageryIImageryImageryEnglishOncologyPre-teen (9-12 years);Teen (13-15 years);Late Teen (16-18 years)NANANon-drug treatmentPre-teen (9-12 years) Teen (13-15 years) Late Teen (16-18 years)NA2019-09-03T04:00:00Z000Flat ContentHealth A-Z<p>Imagery involves using your imagination. You use your imagination when you think of things such as the taste of a lemon, the colours of the sunset, or the sound of a drum.</p> <p>There are two main ways to use imagery to help with how you’re feeling, whether physically or emotionally: changing a sensation or changing your thoughts. </p>Teens
Imaging tests (X-rays) and JIAIImaging tests (X-rays) and JIAImaging tests (X-rays) and JIAEnglishRheumatologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemTestsAdult (19+)NA2017-01-31T05:00:00Z5.9000000000000074.9000000000000392.000000000000Flat ContentHealth A-Z<p>Discover how X-rays are used to rule out conditions that may be similar to arthritis. X-rays are also used to monitor bone damage in arthritis.</p><p>An X-ray is a type of radiation that passes through the body. The amount of radiation that passes through the body in an X-ray is very small. An X-ray leaves a shadow of one's bones on a photograph. It gives the doctor information on the size, shape, and location of the bones and certain organs. This information can help diagnose a condition. It is also called radiography.</p><h2>Key points</h2> <ul><li>X-rays allow doctors to see the size, shape and location of the bones and certain organs.</li> <li>X-rays are not used to diagnose JIA but to exclude other conditions.</li> <li>X-rays will not cause damage to your child's body.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/imaging_tests_x-rays_and_JIA.jpgMain
Imaging tests and JIAIImaging tests and JIAImaging tests and JIA-CANEnglishRheumatology;AdolescentPre-teen (9-12 years);Teen (13-15 years);Late Teen (16-18 years)BodySkeletal systemTestsPre-teen (9-12 years) Teen (13-15 years) Late Teen (16-18 years)NA2017-01-31T05:00:00Z000Flat ContentHealth A-Z<p>Discover how imaging tests, such as X-rays, MRIs and ultrasounds, are used to rule out conditions that may be similar to arthritis and diagnose JIA.</p><p>In addition to blood tests, you may need to have several imaging tests to help the doctors see your bones and joints and make a better diagnosis. These imaging tests include X-rays, an MRI, ultrasound, bone scan, and bone density test.</p><h2>Key points</h2><ul><li>X-rays allow doctors to see the size, shape and location of the bones and certain organs, which can help diagnose a condition.</li><li>The MRI machine uses a magnet, radio signals and a computer to scan and produce images of the body. It can show if there is inflammation in the joint.</li><li>The ultrasound machine uses high-frequency sound waves to produce pictures of internal organs and other structures in your body. Ultrasounds can be used to look for fluid in hip joints or tendons and can also be used by your doctor to determine where to insert the needle for a joint injection if you are having one done. <br></li></ul>Teens
Imaging tests: X-ray, MRI and CT scanIImaging tests: X-ray, MRI and CT scanImaging tests: X-ray, MRI and CT scanEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartCardiovascular systemTestsAdult (19+)NA2009-12-11T05:00:00Z6.1000000000000075.90000000000002067.00000000000Flat ContentHealth A-Z<p>Learn about imaging tests such as X-rays, MRI and CT. These tests give pictures of the inside of your child's body.</p><p>Imaging tests are ways of taking pictures of the inside of the body. Different types of imaging are useful in different situations.</p><h2> Key points </h2> <ul> <li>X-rays are a kind of radiation. X-rays passing through the body give a two-dimensional picture of the inside of the body.</li> <li>Magnetic resonance imaging (MRI) uses a strong magnet and radio signals to take pictures.</li> <li>Computed tomography (CT) scans use X-rays and a computer to take cross-sectional pictures.</li> <li>Sometimes a liquid called contrast medium is used to give more information or more detailed pictures of certain parts of the body.</li></ul>https://assets.aboutkidshealth.ca/akhassets/NEURO_MRI1_EQUIP-PHO_EN.jpgMain
Immediate risks of scoliosis surgeryIImmediate risks of scoliosis surgeryImmediate risks of scoliosis surgeryEnglishOrthopaedics/MusculoskeletalChild (0-12 years);Teen (13-18 years)Vertebrae;SpineMuscular system;Skeletal systemProceduresAdult (19+)NA2008-06-01T04:00:00Z7.4000000000000064.3000000000000976.000000000000Flat ContentHealth A-Z<p>Read about some of the complications that can arise after having scoliosis surgery. Trusted answers from The Hospital for Sick Children.</p><p>Immediate risks of surgery are those risks that can occur within the few weeks after surgery. </p><h2>Key points</h2><ul><li>Possible complications after scoliosis surgery include complications from blood transfusions, neurologic complications, infection, lung complications, intestinal blockage, blood clots in the thighs or leg, pain where the bone chips are removed.</li><li>The risk of most of these complications is between 1 % to 2%.</li></ul>Main
Immune thrombocytopenia (ITP): What happens after diagnosisIImmune thrombocytopenia (ITP): What happens after diagnosisImmune thrombocytopenia (ITP): What happens after diagnosisEnglishHaematologyChild (0-12 years);Teen (13-18 years)BodyCardiovascular systemConditions and diseasesCaregivers Adult (19+)NA2012-12-20T05:00:00Z7.8000000000000062.50000000000001376.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Find out about living with ITP and the treatment options you can discuss with your child's health care team. </p><p>Your child has been diagnosed with the condition <a href="/Article?contentid=842&language=English">immune thrombocytopenia </a>(ITP).</p><p>In ITP, the small cells needed for normal blood clotting (called platelets) are too low. When platelets are low, the body has trouble healing wounds and cuts.<br></p><p>You will meet with your child's health care team to decide what treatment option is best. This brochure outlines the information you need to help prepare for that meeting. It will help you and your child's doctor make an informed decision together.</p> <figure class="asset-c-80"> <span class="asset-image-title">Blood cells and components</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Blood_cells_MED_ILL_EN.jpg" alt="White blood cells, red blood cells, plasma and platelets" /> </figure> <h2>Key points:</h2> <ul> <li>ITP happens when the body's immune system attacks a person's platelets (cells needed for blood to clot), causing them to be low.</li> <li>In most children, ITP will get better by itself over a few months.</li> <li>Until ITP gets better, there is a small but important risk of bleeding.<br></li> <li>There are three options for treatment: observation, IVIG or prednisone.</li> <li>Talk to your doctor about the treatment choices and which one is best for your child and family.</li> <li>While your child's platelets are low, avoid contact sports and rough play.</li> <li>While your child's platelets are low, avoid acetylsalicylic acid, ibuprofen and other anti-inflammatory medicines.</li> <li>Talk to your doctor or nurse about other everyday advice for your child's care.</li> </ul><h2>Signs of ITP</h2> <figure> <span class="asset-image-title">Petechiae and bruises</span> <img alt="Bruising and small red spots on an arm" src="https://assets.aboutkidshealth.ca/akhassets/PMD_ITP_petechiae_EN.jpg" /> </figure> <p>Your child may bruise easily or develop tiny red spots on the skin (called petechiae). Less often, children may bleed from the nose or gums or have blood in their stool.<br></p><p>Most bleeding is mild and only involves the skin (bruising or petechiae). Mild bleeding at the skin does not put your child at serious risk.</p><p>The most serious type of bleeding is in the brain. This is extremely rare: less than two out of every 1,000 children diagnosed with ITP develop bleeding in the brain. </p><p>Apart from these physical signs of ITP, your child looks well and acts normally.</p><h2>What causes ITP?</h2> <p>Usually, a child develops ITP after a viral infection such as a cold. The virus triggers a normal immune response, meaning that the immune system starts destroying the virus. But the immune system also starts destroying healthy platelets. It is not clear why this happens.</p><h2>Treatment for ITP</h2><p>There are three options to consider. Each option is a reasonable choice and has its own advantages and disadvantages. Your child's health care team will discuss these options to help you decide which is best.</p><p>All children with ITP will need to be monitored after they leave hospital and all children whose platelet counts are low are at risk for bleeding from falls and injuries. As long as your child's bleeding is limited to the skin (for example bruising, petechiae or mild bleeding that stops on its own), there is no rush to make a decision.</p><p>Different families have different preferences when it comes to making medical decisions. We want to include your values in the decision-making process. A team of paediatricians and haematologists (blood specialists) will meet you to discuss your child's case and the available options and answer any questions. Together, it is possible to make a decision that best suits your child and your family.</p><h2>Option 1: Observation</h2><p>During observation, your child is not given any medicines. Instead, the doctors will book follow-up appointments to closely monitor your child.</p><p>Observation is an acceptable choice for managing ITP when bleeding only happens on the skin (for example bruising, petechiae, or mild bleeding that stops on its own).</p><p>If your child has persistent bleeding from the nose or gums, they will likely need to start a different treatment option.</p><h3>What are the advantages of observation?</h3><p>Observation avoids the risks and side effects of medicines. Your child also gets to go home earlier.</p><h3>What are the disadvantages of observation?</h3><p>During observation, the number of platelets remains low for longer. As long as the platelet count is low, your child's doctors will recommend avoiding activities that can cause serious falls and injuries.</p><p>If your child is especially prone to injuries, observation may not be a good option.</p><h2>Option 2: Treat with intravenous immunoglobulin (IVIG)</h2><p>Your child is treated with a <a href="/Article?contentid=1107&language=English">blood product</a> called <a href="/Article?contentid=161&language=English">immunoglobulin (IVIG)</a>.</p><p>In ITP, the immune system releases antibodies that destroy the platelets. Immunoglobulin blocks these antibodies and protects the platelets. It is part of our immune system and is extracted from donated blood.</p><p>While your child is in the hospital, IVIG is given intravenously (into the vein) over a few hours.</p><h3>What are the advantages of IVIG?</h3><p>Platelets usually start to increase as early as 12 to 24 hours after receiving IVIG, but it may take as long as three days.</p><h3>What are the disadvantages of IVIG?</h3><p>IVIG requires an intravenous tube (IV) and must be given inside a hospital. Most children are monitored for at least 24 hours after it is given.</p><p>There is a small chance that this treatment may cause your child's red blood cells to break down (haemolysis). The doctor monitors your child to check for this. Usually it gets better on its own. Only in rare cases, your child may need a blood transfusion.</p><p>Some children may develop side effects, which include:</p><ul><li>headaches (some children can get bad headaches the next day)</li><li>nausea</li><li>vomiting</li><li>rash, fever, and chills (rarely).</li></ul><p>Antihistamines or <a href="/Article?contentid=62&language=English">acetaminophen</a> can be used to treat most of these symptoms. These side effects all go away eventually.</p><p>IVIG is safe and always cleaned. Since it is a blood product, its risks are similar to other blood transfusions. Talk to your child's doctor if you have any questions or concerns.</p><h2>Option 3: Treat with prednisone</h2><p> <a href="/Article?contentid=221&language=English">Prednisone</a> is a steroid medicine. It is not the same steroid as the one taken by some athletes. Instead, prednisone is similar to a steroid that occurs naturally inside the human body.</p><p>Doctors have been using prednisone for decades to treat different conditions. For ITP, prednisone helps the immune system stop destroying platelets.</p><p>Your child takes two to three doses of prednisone by mouth each day for four days.</p><h3>What are the advantages of prednisone?</h3><p>Your child does not need an IV and can take prednisone at home.</p><p>Platelets can start to increase as early as 24 to 48 hours after starting prednisone, but it may take as long as one week.</p><h3>What are the disadvantages of prednisone?</h3><p>Some children do not like the taste of liquid prednisone. You can try mixing it with food to make it easier for your child.</p><p>Some children may experience side effects, which include:</p><ul><li>mood swings</li><li>increased appetite.</li></ul><p>These side effects usually happen when prednisone is taken for a long time (longer than a week). Your child will probably not experience any of these side effects during the short time (four days) they are taking prednisone.</p><h2>At SickKids</h2> <p>Before your child leaves the hospital, your health care provider will arrange a follow-up appointment with the Haematology Clinic within five to seven days.</p> <p>You will also get contact information for a Haematology Clinic nurse. You can contact the nurse with any questions or concerns (Monday to Friday from 9 a.m. to 5 p.m.).</p> <p>You will also get a contact number to call in case of emergencies in the evenings or weekends.</p>https://assets.aboutkidshealth.ca/akhassets/Blood_cells_MED_ILL_EN.jpgMain
Immunization "catch-up" for children who have not been fully immunizedIImmunization "catch-up" for children who have not been fully immunizedImmunization "catch-up" for children who have not been fully immunizedEnglishPreventionChild (0-12 years);Teen (13-18 years)NANADrug treatmentCaregivers Adult (19+)NA2020-07-27T04:00:00Z9.5000000000000054.5000000000000544.000000000000Health (A-Z) - ProcedureHealth A-Z<p>An overview of immunization for children who have not been fully immunized according to the standard schedule.</p><p>Immunization (vaccines) protects your child against several serious, life-threatening infectious diseases. Your child should have "shots" according to the schedule recommended for your province, state or country. Your child should also have a written record of which immunizations they have had and when.</p><p>Children who are new to Canada — immigrant, refugee or adopted children — may not be vaccinated according to Canada's schedule.</p><h2>Key points</h2> <ul> <li>Immunization protects your child against disease.</li> <li>In Canada, children normally receive vaccines according to a schedule. </li> <li>There are several reasons why a child may not be fully immunized, including illness or being new to Canada.</li> <li>If your child has not been immunized according to the normal schedule, speak to your child’s doctor.</li> <li>Your child should have a written immunization record.</li> </ul><h2>The immunization schedule</h2><p>The following chart is the recommended schedule of immunizations during childhood for the <a href="http://www.health.gov.on.ca/en/pro/programs/immunization/docs/immunization_schedule.pdf" target="_blank">province of Ontario</a> as of December 2016. For the most current recommendations according to the National Advisory Committee on Immunization and for each province and territory, go to the <a href="https://www.canada.ca/en/public-health/services/provincial-territorial-immunization-information/provincial-territorial-routine-vaccination-programs-infants-children.html" target="_blank">Government of Canada</a> website.</p> <figure class="asset-c-100"><img src="https://assets.aboutkidshealth.ca/AKHAssets/immunization_table_EN.png" alt="Immunization schedule chart" /> </figure> <h2>If your child has not been fully immunized</h2><p>There are several reasons why children may not have received all their vaccines, such as:</p><ul><li>missing one or more appointments with their primary care provider<br></li><li>illness during the time they should have had a vaccine<br></li><li>being new to Canada: immigrant, refugee and internationally adopted children may not have been immunized according to Canada’s schedule or some vaccines may not be available where they come from</li></ul><p>These children could be at risk of catching a vaccine-preventable disease. If your child has not been fully immunized for any reason, talk to your primary care provider about how to make up the missing vaccines. </p><p>If your child has not been in your care since birth, it may be hard to determine their vaccine history. If your child has a written immunization record, show it to your doctor.<br></p><p>All children who have not been fully immunized, or who do not have a written immunization record, should start receiving vaccines on a routine schedule. This schedule depends on your child’s age. Speak to your doctor about what is right for your child.</p><p>If you are unsure of your child's immunization history, it is always preferable to give a vaccine. There is no harm to repeating any immunization, unless the child has had an allergic reaction to the vaccine in the past or has an underlying disease that could affect the response to the vaccine. </p><h2>References</h2> <p>Government of Canada. Contraindications, precautions and concerns. Canadian Immunization Guide. Last updated: January 2020. Retrieved from: <a href="https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-2-vaccine-safety/page-3-contraindications-precautions-concerns.html">https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-2-vaccine-safety/page-3-contraindications-precautions-concerns.html"</a></p><p>Government of Canada. Immunization of persons with inadequate immunization records. Canadian Immunization Guide. Last updated: September 2016. Retrieved from: <a href="https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-3-vaccination-specific-populations/page-3-immunization-persons-inadequate-immunization-records.html">https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-3-vaccination-specific-populations/page-3-immunization-persons-inadequate-immunization-records.html</a></p>https://assets.aboutkidshealth.ca/AKHAssets/immunization_catch_up.jpgMain
Immunization scheduleIImmunization scheduleImmunization scheduleEnglishPreventionChild (0-12 years);Teen (13-18 years)NANADrug treatmentCaregivers Adult (19+)NA2018-07-26T04:00:00Z10.500000000000043.70000000000001116.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Read about types of immunizations that are recommended during a child's first year of life and onward.</p><p>Immunizations protect your child against several serious, life-threatening infectious diseases. Your child should receive their immunizations according to the schedule recommended for your province, state, or country. For more specific information, contact your child's health care provider, or the local public health unit for your community.</p><h2>Key points</h2> <ul> <li>Immunizations protect against serious, life-threatening infectious diseases.</li> <li>Children should be immunized according to the schedule recommended by their province, state or country.</li> </ul><p>The following chart is the recommended schedule of immunizations during childhood for the <a href="http://www.health.gov.on.ca/en/pro/programs/immunization/docs/immunization_schedule.pdf" target="_blank">province of Ontario</a> as of December 2016. For the most current recommendations according to the National Advisory Committee on Immunization and for each province and territory go to the <a href="https://www.canada.ca/en/public-health/services/provincial-territorial-immunization-information/provincial-territorial-routine-vaccination-programs-infants-children.html" target="_blank">Government of Canada</a> website.</p> <figure class="asset-c-100"> <img src="https://assets.aboutkidshealth.ca/AKHAssets/immunization_table_EN.png" alt="Immunization schedule chart" /> </figure> <h2>Descriptions of immunizations</h2><h3>DTap-IPV-Hib: Diphtheria, tetanus, acellular pertussis, inactivated polio virus, haemophilus influenzae type B vaccine</h3><p>Immunization against diphtheria, tetanus, and pertussis (whooping cough) is important, since all of these diseases can be deadly. Pertussis is a serious disease, especially for young babies. Children who get pertussis can have spells of violent coughing. The cough can cause children to stop breathing for brief periods of time. The cough can last for weeks and makes it difficult for children to eat, drink and breathe. The risk of children getting pertussis increases if fewer children are immunized.</p><p>The polio vaccine protects children from this now rare but crippling disease. Polio can cause nerve damage and can paralyze a person for the rest of their life. The inactivated polio vaccine is now recommended for all polio doses.</p><p>Haemophilus influenzae is a type of bacteria that causes several life-threatening diseases in young children such as meningitis, epiglottitis, and pneumonia. Before the vaccine was available, a large number of children developed H. influenzae meningitis each year. Some died and others developed learning or developmental problems such as blindness, deafness, or cerebral palsy. Because of the vaccine, H. influenzae type B infection is now uncommon. The Hib vaccine does not protect against pneumonia and meningitis caused by viruses.</p><p>For more information, see "<a href="/article?contentid=759&language=english">Tetanus</a>," "<a href="/article?contentid=754&language=english">Pertussis</a>," and "<a href="/article?contentid=149&language=english">Haemophilus Influenzae Type B Vaccine</a>."</p><h3>Pneu-C-13: Pneumococcal conjugate (13-valent) vaccine</h3><p>Pneumococcal infections are serious bacterial infections that may cause pneumonia, bloodstream infections, and meningitis. The pneumococcal vaccine protects against the thirteen types of pneumococcal bacteria that cause most of these serious diseases. The vaccine also prevents a small percentage of ear infections caused by pneumococci.</p><p>Routine use of pneumococcal vaccine is now recommended for babies and toddlers. Some older children with serious illnesses, such as sickle cell anemia, may also benefit from the vaccine.</p><h3>Rota: Rotavirus oral vaccine</h3><p>Rotavirus is a condition that causes vomiting and diarrhea. Sometimes the diarrhea is so severe, children need to be hospitalized. It is very contagious and spreads easily between children. Vaccines active against rotavirus became available at the beginning of 2006. The rotavirus vaccine is given by mouth.</p><h3>Men-C-C: Meningococcal conjugate C vaccine</h3><p>Meningococcal infections are serious bacterial infections that cause bloodstream infections or meningitis. </p><h3>MMR: Measles, mumps, and rubella vaccine</h3><p>This is a three-in-one immunization that protects against measles, mumps and rubella. It is given in infancy and then again at pre-school age.</p><p>For more information, see "<a href="/article?contentid=752&language=english">Measles</a>," "<a href="/article?contentid=753&language=english">Mumps</a>," and "<a href="/article?contentid=758&language=english">Rubella</a>."</p><h3>Var: Varicella (chickenpox) vaccine</h3><p>This vaccine is 70% to 90% effective in preventing chickenpox. If vaccinated children get chickenpox, they have a much milder form of the disease.</p><p>For more information, see "<a href="/article?contentid=760&language=english">Chickenpox (Varicella)</a>."</p><h3>Men-C-ACYW-135: Meningococcal conjugate ACYW-135 vaccine</h3><p>Students in Grade 7 are eligible to receive a single dose of this vaccine. Students who were eligible in Grade 7 and have not yet received the vaccine are eligible for a single dose of Men-C-ACYW.</p><h3>HB: Hepatitis B vaccine</h3><p>Vaccination against hepatitis B prevents this type of hepatitis and the severe liver damage that can occur 20 or 30 years after a person is first infected. A significant number of adults die each year from hepatitis-related liver cancer or cirrhosis. The younger the person is when the infection occurs, the greater the risk of serious problems. Students in Grade 7 are eligible to receive this vaccine.</p><h3>HPV: Human papillomavirus vaccine</h3><p>HPV is a virus that can lead to different types of cancers in females and males. Both males and females are eligible to receive this vaccine starting in Grade 7.</p><p>For more information, see "<a href="/article?contentid=25&language=english">Human Papilloma Virus (HPV) and Genital Warts</a>" and "<a href="/article?contentid=151&language=english">Human Papilloma Virus (HPV): What You Need to Know</a>"</p><h3>Inf: Seasonal influenza vaccine</h3><p>Influenza is a common respiratory virus in the fall and winter. It can lead to pneumonia and hospitalization, especially in young children and children with underlying medical conditions. All children and youth are encouraged to get the seasonal influenza vaccine.</p><p>For more information, see "<a href="/article?contentid=763&language=english">Influenza (Flu)</a>."</p><h2>Other vaccines</h2><h3>Hepatitis A vaccine</h3><p>The hepatitis A vaccine is recommended for children and teenagers in selected geographic regions, and for certain people at high risk. Talk to your health care provider or local public health unit for more information.</p><p>For more information, see "<a href="/article?contentid=819&language=english">Hepatitis A</a>."</p>immunizationhttps://assets.aboutkidshealth.ca/AKHAssets/immunization_schedule.jpgMain
Immunizations for children and teens with suppressed immune systemsIImmunizations for children and teens with suppressed immune systemsImmunizations for children and teens with suppressed immune systemsEnglishPreventionChild (0-12 years);Teen (13-18 years)NANADrug treatmentCaregivers Adult (19+)NA2011-04-18T04:00:00Z9.6000000000000053.70000000000001045.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Treatment to suppress the immune system affects how your child’s body responds to routine immunizations. This guide discusses how to keep your child healthy while taking immune-suppressing treatment.</p><p>Your child is starting treatment that will suppress the immune system. This will affect how your child’s body responds to routine immunizations that protect your child against disease.</p><p>This guide explains how different vaccines interact with immune-suppressing treatment. It also discusses special situations like travel to other countries. You will need to work with your child’s regular health-care provider to make sure that your child is up-to-date on all necessary immunizations and to help keep your child healthy while taking immune-suppressing treatment.</p><p>If you have any questions, speak to your child’s doctor or the treatment team.</p><h2>Key points </h2> <ul> <li>Immune-suppressing treatment can make inactivated vaccines work less well and can make live vaccines cause disease. </li> <li>Your child should be up-to-date on all inactivated vaccines at least two weeks before starting immune-suppressing treatment. </li> <li>Your child should be up-to-date on all live vaccines at least four to six weeks before starting immune-suppressing treatment. </li> <li>Family members should be up-to-date on most vaccines, to help keep your child healthy.</li> <li>Work with your child’s doctor and the treatment team to make sure your child’s immunizations and immune-suppressing treatment work well together.</li> </ul><h2>Inactivated vaccines </h2> <p>Inactivated or "killed" vaccines do not contain any live viruses or bacteria that can cause disease. This means they are safe for patients whose immune system is suppressed. </p> <p>The main concern with these vaccines is that a suppressed immune system may not respond to them, so they may not work as well. Therefore, the goal with inactivated vaccines is to make sure that your child has had all of the necessary vaccines at least two weeks before starting immune-suppressing treatment.</p> <p>Inactivated vaccines include: </p> <ul> <li>tetanus and diphtheria (Td) or tetanus, diphtheria and acellular pertussis (Tdap) </li> <li>inactivated polio virus vaccine (IPV) </li> <li><a href="/Article?contentid=149&language=English">haemophilus influenzae type B</a> (Hib) </li> <li><a href="/Article?contentid=151&language=English">human papillomavirus</a> (HPV) </li> <li>pneumococcus </li> <li>meningococcus </li> <li>hepatitis A and/or B </li> <li>influenza</li> </ul> <p>For hepatitis B vaccine, your child’s doctor may need to take a blood test to find out if your child has responded to the vaccine.</p> <p>If your child is already taking immune suppression treatment and there are no plans to stop the treatment, your doctor can give inactivated vaccines according to the regular schedule. In some circumstances, changes to the routine schedule may be needed.</p> <h2>Live vaccines</h2> <p>Live vaccines contain live viruses or bacteria that can cause disease. Patients whose immune system is suppressed should not take live vaccines.</p> <p>Your child should have any necessary live vaccines four to six weeks before starting immune-suppressing treatment.</p> <p>Live vaccines include: </p> <ul> <li>measles, mumps and rubella (MMR) </li> <li>varicella (chickenpox) </li> <li>live influenza vaccine given as a nasal spray (FluMist) </li> <li>rotavirus</li> </ul><p>This patient information pamphlet was developed through the collaborative efforts of the Inflammatory Bowel Disease Program and the Infectious Diseases Program, and sponsored by an unrestricted educational grant from Abbott Canada.</p>https://assets.aboutkidshealth.ca/AKHAssets/immunizations_for_children_with_supressed_immune_systems.jpgMain
ImmunophenotypingIImmunophenotypingImmunophenotypingEnglishOncologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemTestsAdult (19+)NA2018-03-06T05:00:00Z10.500000000000043.3000000000000287.000000000000Flat ContentHealth A-Z<p> Learn how immunophenotyping is performed and how it can determine your child's particular leukemia.</p><p> Immunophenotyping is a technique that helps distinguish between different types of leukemia. For this reason, it can be used to determine whether your child has acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML). It also distinguishes between each leukemia subtype. </p><h2> Key points </h2><ul><li>Immunophenotyping can determine whether your child has acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML) and distinguish leukemia subtypes. </li><li> This technique can detect the different antigens on bone marrow cells.</li></ul>Main
ImmunosuppressantsIImmunosuppressantsImmunosuppressants for transplantEnglishTransplant;NephrologyTeen (13-18 years)KidneysRenal system/Urinary systemProcedures;Conditions and diseasesTeen (13-18 years)NA2017-11-30T05:00:00Z000Flat ContentHealth A-Z<p>Immunosuppressants work by suppressing, or weakening, your immune system so that it will not reject your transplant organ.<br></p><div class="asset-video"> <iframe src="https://www.youtube.com/embed/jvVHJy019Q0"> </iframe>  </div>Teens
Immunosuppression: Protecting your child from infection when the immune system is loweredIImmunosuppression: Protecting your child from infection when the immune system is loweredImmunosuppression: Protecting your child from infection when the immune system is loweredEnglishImmunologyChild (0-12 years);Teen (13-18 years)BodyImmune systemNon-drug treatmentCaregivers Adult (19+)NA2012-01-23T05:00:00Z7.6000000000000063.40000000000001463.00000000000Health (A-Z) - ProcedureHealth A-Z<p>If your child has a low immune system learn how to protect them against infection.</p><h2>What is immunosuppression?</h2><p>Infections in children are common. They can contract infections both inside and outside the home. When a child gets an infection, the immune system usually works to fight it off. Some medicines or diseases can weaken the immune system (immunosuppression). When the immune system is weak, a child is more vulnerable to infection. They will also have a difficult time recovering. </p><p>If your child is on a medicine that lowers her immune system, it is important to protect against infection as much as possible. You may not be able to prevent your child from getting an infection. However, following these steps may reduce the risk.</p><h2>Key points </h2> <ul> <li>Be aware of possible sources of infection and protect your child against infection as much as possible.</li> <li>Hand washing is the most important step in preventing the spread of infections.</li> <li>Keep your house clean and prepare and store food safely. </li> <li>Limit your child's exposure to people with infection, pets, and second-hand smoke.</li> <li>Ensure all family members are immunized.</li> <li>Know what to do if your child gets an infection.</li> </ul><h2>What do I do if my child gets an infection?</h2> <p>If your child has any of the following, contact your paediatrician or family doctor within 24 hours. Go to the local emergency department or walk-in clinic if your doctor is unavailable.</p> <ul> <li><a href="/Article?contentid=30&language=English">Fever</a>. An oral temperature of 38.3°C or a temperature of 38°C that lasts for one hour or more. It also includes temperature under the arm of 37.8°C or a temperature of 37.5°C that last for one hour or more. It is not recommended to use a thermometer that is placed in the ear.</li> <li>Cough, runny nose, breathing problems</li> <li>Nausea, <a href="/article?contentid=746&language=English">vomiting</a> or loss of appetite</li> <li><a href="/article?contentid=7&language=English">Diarrhea</a> (loose, watery, foul smelling bowel movements)</li> <li>Foul smelling urine, pain when voiding (peeing), frequent voiding</li> <li>Thrush (white specks in the mouth or on the diaper area)</li> <li>Rash</li> <li>Increased sleepiness</li> </ul> <h2>What do I do if my child comes into contact with someone who has chickenpox?</h2> <p>Your child may need to take the treatment called Varicella Zoster Immune Globulin (VZIG). VZIG has a large number of antibodies to help prevent chickenpox. It is given by injection (a needle). A health care professional must give your child VZIG within 96 hours (four days) of the exposure to chickenpox. If your child comes into contact with chickenpox, call your health care team to discuss whether your child needs VZIG. This is particularly important if your child has been in contact with the infected person (family member, classmate or playmate) for 1 hour or more indoors. Very close contact outdoors (e.g., playing with another child in a sandbox) can also place your child at risk. If your child gets chickenpox, they may need to take a medicine that makes it less serious. </p><h2>Practice and promote good hand washing<br></h2> <figure><img src="https://assets.aboutkidshealth.ca/akhassets/Suppository_wash_hands_EQUIP_ILL_EN.jpg" alt="Handwashing" /> </figure> <p>Recent studies have found that <a href="/Article?contentid=1981&language=English">hand washing</a> is the most important step in preventing the spread of infections. Hand washing is especially important after:<br></p><ul><li>using the toilet</li><li>changing diapers</li><li>handling garbage<br></li><li>using a cleaning cloth or soiled dishcloth</li><li>handling raw food (meat, eggs)</li><li>touching a pet</li><li>blowing or touching the nose</li><li>contact with other body fluids such as vomit or blood</li></ul><p>As soon as someone enters your home, ask them to immediately wash their hands or use a hand sanitizer. Anyone who has <a href="/Article?contentid=7&language=English">diarrhea</a> should thoroughly wash their hands with soap and water. Always wash your hands before:</p><ul><li>touching your child</li><li>preparing food</li><li>eating</li></ul><h2>Keep your home clean</h2><ul><li>Dust and vacuum your house weekly.</li><li>Wash your child's bed linens, bathroom towels, and pajamas at least once a week.</li><li>Wash all dishes and utensils in hot water or in the dishwasher.</li><li>Wash surfaces in common areas such as the bathroom, kitchen, and living room with a disinfectant. Pay particular attention to surfaces that are touched frequently such as handles on doors, the refrigerator, the oven, cupboards, sink taps, toilet handles and seat, telephones, and computers. Clean these surfaces regularly.</li><li>Clean toys before your child touches them.</li><li>Do not use humidifiers unless you clean them daily.</li></ul><h2>Limit contact with those who have an infection</h2><p>The following suggestions are for children with severe immunosuppression. These are not required for all children receiving immunosuppressive treatment. Talk to your child's health care team and ask if you need to take these precautions:</p><ul><li>Keep your child away from crowds. Try to avoid stores, markets, parties, etc.</li><li>Keep your child out of daycare and group play activities during the treatment period.</li><li>Avoid communal play areas such as play parks, sandboxes, and public swimming pools.</li><li>Limit sharing of household items such as toys, towels, drinking glasses, and eating utensils.</li><li>All visitors should be screened for illness. They should not visit if they are sick or have recently been directly exposed to someone who is sick. In the event that this cannot be avoided, the sick family member should wash their hands thoroughly before coming in direct contact with your child.</li><li>If you must be in a public place, use a plastic cover on the stroller and choose times when there is less likely to be crowds. An older child may wear a mask.</li><li>When at a clinic, doctor's office or medical lab, advise them of your child's lowered immune system and request to be put in a room right away or ask for an appointment at the beginning or end of the day. Avoid waiting rooms as much as possible.</li></ul><h2>Ensure family members are immunized</h2><p>Immunizations reduce the risk of many serious infections. Family members you live with should update their immunizations. This includes having annual flu vaccines. Immunizations make it less likely they will get sick and expose your child to one of these serious infections.<br></p><p>In general, it is safe for family members to be vaccinated during your child's treatment period. However, be cautious with two vaccines:</p><ul><li> <a href="/Article?contentid=760&language=English">Chickenpox (varicella)</a>: About 5% of people who receive this vaccine develop a rash. If this happens, your child should avoid contact with this person. Also contact your child's doctor because your child may need treatment to prevent infection.</li><li>Rotavirus: It is possible that people who receive this vaccine may have live virus in their feces. If a family member receives the rotavirus vaccine, wash hands thoroughly and often.</li></ul><p>Try to have your child's vaccinations updated four to six weeks before starting treatment. It is safe for your child to have 'inactivated' vaccines while immunosuppressed. However, they may not work well. The vaccine may need to be repeated at a later date. Talk to your child's health care team before your child has any vaccinations.</p><p>For more information, see <a href="/Article?contentid=1987&language=English">Immunizations for Children and Teens with Suppressed Immune Systems</a>.</p>https://assets.aboutkidshealth.ca/akhassets/Suppository_wash_hands_EQUIP_ILL_EN.jpgMain
Impact of cancer on sexualityIImpact of cancer on sexualityImpact of cancer on sexualityEnglishAdolescent;OncologyPre-teen (9-12 years);Teen (13-15 years);Late Teen (16-18 years)NANANAAdult (19+) CaregiversNA2019-09-03T04:00:00Z12.000000000000039.0000000000000339.000000000000Flat ContentHealth A-Z<p>Learn how to start a conversation with your teenager about sexuality, and how having cancer and going through treatment can impact their sexuality.</p><p>Part of normal teenage development is the development of sexuality. Sexuality means having sexual feelings and experiences. Having cancer can have a major effect on a teenager’s developing sexuality by:</p><ul><li>changing how a teenager sees themselves and altering their body image and self-esteem</li><li>causing them to feel different from their peers</li><li>affecting sexual development (treatments may affect hormones or how sexual organs function, either temporarily or permanently) </li><li>changing interest in, or desire for, sexual experiences</li><li>causing them to feel a sense of isolation</li><li>affecting a relationship with their partner<br></li></ul><h2>Key points</h2><ul><li>Sexuality means having sexual feelings and experiences.</li><li>Cancer can impact a teen's sexuality by changing how they see themselves and altering their self-esteem, affecting sexual development, and causing a sense of isolation.</li><li>The health-care team will discuss issues related to sexuality with your teenager, but it is important for parents and caregivers to encourage open dialogue.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/The_impact_of_cancer_on_sexuality.jpgMain
Impact of painIImpact of painImpact of painEnglishPain/AnaesthesiaChild (0-12 years);Teen (13-18 years)BodyCentral nervous system;Peripheral nervous system;Autonomic nervous systemSymptomsCaregivers Adult (19+)Pain2009-09-18T04:00:00Z9.2000000000000060.40000000000001966.00000000000Flat ContentHealth A-Z<p>Impacts of chronic pain on children are discussed, including impact on mood, school, socializing, hobbies, sleep, and family.</p><p>Pain can have a huge impact on a child’s life and all their family members. How much impact will depend on a number of factors, including the type and duration of the pain, the treatments required, and the disease or injury that is causing it. How well your child and family learn to cope with the changes demanded of them will also be important.</p> <p>Chronic pain may require permanent lifestyle adjustments, and may make your child susceptible to depression. Shorter bouts of acute pain can cause social disruption for both the child and family. But, because it is by definition temporary, things will generally resolve themselves in the short term. </p> <p>Most of this section is focused on how to deal with the impact of chronic or recurrent non-cancer pain. However, many of the principles outlined are relevant to those parents whose children are suffering from acute pain. </p>Main
ImpetigoIImpetigoImpetigoEnglishDermatologyBaby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years)SkinSkinConditions and diseasesCaregivers Adult (19+)NA2010-03-05T05:00:00Z6.7000000000000062.9000000000000616.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Impetigo is a common skin infection that is caused by bacteria. Learn what to look for, and what you and your doctor can do to care for your child.</p><h2>What is impetigo?</h2> <p>Impetigo is a bacterial skin infection. It spreads easily. It is very common in young children, especially babies. Without treatment, impetigo can last for several months. It can develop into something more severe. </p><h2>Key points</h2> <ul> <li>Impetigo is a skin infection. It is caused by a bacteria.</li> <li>Symptoms of impetigo include small or large blisters. The blisters appear on a red background. They are filled with pus. They occur around the mouth or nose area. They may also occur in the diaper area.</li> <li>Impetigo is caused by bacteria. The bacteria enters the body through a cut or cracked skin.</li> <li>An antibiotic ointment is usually enough to treat the infection.</li> <li>Impetigo spreads easily by touch. Keep your child away from other children until the infection clears. </li> </ul><h2>Signs and symptoms of impetigo</h2> <p>The symptoms of impetigo change over time:</p> <ul> <li>At first, the child develops small or large blisters on a red background. The blisters contain pus. They appear around the mouth or nose. They may also appear in the diaper area.</li> <li>The blisters then split open. They form irregular sores. The sores may grow larger.</li> <li>The surface of the sore dries. Honey-coloured crusts form on the sore.</li> <li>The sores become itchy after the blisters burst.</li> </ul><h2>Causes of impetigo</h2> <p>Impetigo is caused by bacteria. The bacteria enter the body through a cut, open sore, insect bite or cracked skin. Impetigo is usually caused by <em>Staphylococcus aureus</em>. This is called a staph infection. Impetigo may also be caused by <em>Streptococcus pyogenes</em>. This is called a strep infection.</p> <p>Your child is more likely to get this infection if they have:</p> <ul> <li>dry or flaky skin</li> <li><a href="/Article?contentid=773&language=English">eczema</a></li> <li>burns, scratches, splinters, cuts or scrapes</li> <li>other skin infections </li> <li>spider or insect bites</li> </ul><h2>What your child's doctor can do</h2> <h3>Physical examination</h3> <p>Usually the doctor can see if your child has impetigo just by looking at the skin. The doctor may also suggest blood or other tests. However, these tests are usually not needed. </p> <h3>Antibiotics</h3> <p>Your child's doctor will likely prescribe an antibiotic ointment. The ointment will be effective against the bacteria. You will need to spread the ointment on the sores a few times a day. </p> <p>The impetigo should improve after a few days. However, even if your child feels better, do NOT stop giving the antibiotics before finishing the full amount prescribed. This infection can come back, especially if the complete treatment is not given. </p> <p>If your child's impetigo is more severe or getting worse, your child may need an oral antibiotic (taken by mouth).</p><h2>When to see a doctor</h2> <p>Book an appointment immediately with your child's doctor if your child is showing symptoms of impetigo.</p> <p>See your doctor again if:</p> <ul> <li>your child cannot take the prescribed oral antibiotic medication because they are throwing up often</li> <li>your child does not seem to be improving with antibiotic ointment or oral medication</li> </ul>impetigoMain
Importance of skin-to-skin contactIImportance of skin-to-skin contactImportance of skin-to-skin contactEnglishNeonatologyNewborn (0-28 days)SkinNANAAdult (19+)NA2009-10-18T04:00:00Z11.100000000000053.7000000000000376.000000000000Flat ContentHealth A-Z<p>Learn about the benefits of skin-to-skin contact between you and your newborn baby directly after birth. Answers from Canadian Paediatric Hospitals.</p><p>Skin-to-skin contact with your baby is important for developing connections, soothing your baby and allowing them to move freely.</p><h2>Key points</h2> <ul><li>Babies who are placed in skin-to-skin contact with their mother cry very rarely in the first hour or two of life, have less of a chance of their temperature dropping and maneuver towards their mother's nipple and start to suck.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/importance_of_skin_to_skin_contact.jpgMain
In the hospital: AMLIIn the hospital: AMLIn the Hospital: AMLEnglishOncologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemConditions and diseasesAdult (19+)NA2018-03-06T05:00:00Z8.0000000000000067.7000000000000377.000000000000Flat ContentHealth A-Z<p> Learn how to help your child get used to staying in the hospital.</p><p>After being diagnosed with acute myeloid leukemia (AML), your child will spend most of the time in hospital during their treatment. Getting used to the hospital setting can be challenging for many children and teens. </p> <p>Children with ALL may require intermittent hospitalizations throughout their treatment.</p> <p>It is important to keep as much of your child’s home routine as possible. Maintaining a daily routine will help your child get used to the hospital room being their temporary home. If you can, try to create some "safe" time for your child in the day, where they have no tests, medications, or dealings with the health care team. </p><h2> Key points </h2> <ul><li>Having a routine for your child during their leukemia treatment can help them feel like their hospital room is their home for the time being.</li> <li> Arranging activities and maintaining contact with friends and other people your child is comfortable with can help improve their time in hospital.</li></ul>Main
In-hospital hemodialysisIIn-hospital hemodialysisIn-hospital hemodialysisEnglishNephrologyChild (0-12 years);Teen (13-18 years)KidneysCardiovascular systemNon-drug treatmentCaregivers Adult (19+)NA2014-07-30T04:00:00Z9.9000000000000051.0000000000000548.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Find out what is involved in in-hospital hemodialysis and its benefits.</p><p>In-hospital <a href="/Article?contentid=44&language=English">hemodialysis</a> is a dialysis option offered in a hospital setting. It is a rapid type of dialysis that removes any toxins and fluid that have built up in your child's body over the previous day or two.</p><h2>Key points</h2> <ul> <li>In-hospital hemodialysis is a type of dialysis that is done over three to four hours in a hospital setting.</li> <li>Your child will usually receive in-hospital dialysis as an outpatient three or four times a week. </li> <li>In-hospital hemodialysis means you do not need to store any equipment at home and lets your child meet other patients and have immediate access to medical care.</li> <li>Your child must take time away from school for in-hospital appointments, follow a strict diet and take more medications than with other types of dialysis.</li> </ul><h2>How often does my child need in-hospital hemodialysis?</h2> <p>Your child receives this dialysis as an outpatient in a hospital (they do not stay overnight). The dialysis is usually done three or four times a week, including holidays. Each treatment lasts three or four hours. You may stay with your child during the treatment.</p><h2>Things to consider when deciding on in-hospital hemodialysis</h2> <p>Coming to the hospital for dialysis may mean less responsibility, but it may affect other areas of your child's life. To help you decide if in-hospital dialysis is suitable for your child, please consider the following points.</p> <h3>Impact of in-hospital hemodialysis on your child's routine</h3> <ul> <li>Your child will need dialysis on a fixed schedule every week.</li> <li>Your child will miss a lot of school to attend the treatments.</li> <li>Your child will need to follow a strict diet, including fluids.</li> <li>Your child will need to take more medications than if they had <a href="/Article?contentid=42&language=English">peritoneal dialysis</a> or <a href="/Article?contentid=41&language=English">home hemodialysis</a>.</li> </ul> <h3>Impact of in-hospital hemodialysis on your family's routine</h3> <ul> <li>You or another family member must take time off work to be with your child for the dialysis treatments.</li> <li>You will need travel to and from the hospital and cover any related transportation expenses such as gas, parking or transit.</li> </ul> <h3>How your child feels during and after in-hospital hemodialysis</h3> <ul> <li>Your child might feel unwell during dialysis (light headed, cramps, headache and nausea).</li> <li>Your child will have less energy and need more time to recover after each treatment.</li> </ul><h2>At SickKids</h2> <p>The Dialysis Unit at SickKids is open Monday through Saturday and can offer dialysis in the morning or afternoon.</p> <p>Your child can eat one meal during the dialysis treatment. If you wish, they can also be taught by a teacher from the Toronto District School Board to help them keep up with their school work. We can also arrange physiotherapy for your child on request.</p> <p>For more information or a tour of the Dialysis Unit, please contact 416-813-7563.</p>Main
Incentive spirometry or bubbles: Encouraging deep breathing to clear the lungsIIncentive spirometry or bubbles: Encouraging deep breathing to clear the lungsIncentive spirometry or bubbles: Encouraging deep breathing to clear the lungsEnglishRespiratoryPreschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)LungsLungsNon-drug treatmentCaregivers Adult (19+)NA2014-06-25T04:00:00Z8.0000000000000068.3000000000000703.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn how your child can exercise their lungs to reduce the risk of breathing problems.</p><p>An incentive spirometer is a device that provides exercise to the <a href="https://pie.med.utoronto.ca/htbw/module.html?module=lung-child">lungs</a>. It does this by encouraging deep breaths with the movement of the diaphragm, the muscle between the lungs and abdomen (tummy).</p><p>Deep breathing exercises help open the air sacs in the lungs and may reduce the risk of:</p><ul><li>breathing problems such as <a href="/Article?contentid=784&language=English">pneumonia</a> after surgery</li><li>acute chest syndrome in patients with <a href="/Article?contentid=745&language=English">sickle cell disease</a>.</li></ul> ​<h2>Key points</h2> <ul> <li>An incentive spirometer is a device that helps your child exercise their lungs.</li> <li>Deep breaths with an incentive spirometer reduce the risk of breathing problems such as pneumonia after surgery or, in patients with sickle cell disease, acute chest syndrome.</li> <li>If your child can use an incentive spirometer, they should take 10 deep breaths every hour.</li> <li>Your child may need to avoid using an incentive spirometer if they are in too much pain or need more oxygen after using the device. A physiotherapist may need to assess your child before using an incentive spirometer if they have a history of asthma or they are wheezing.</li> <li>If your child is under age five or cannot use an incentive spirometer for another reason, they should blow bubbles for two to three minutes every hour.</li> </ul><h2>How to use an incentive spirometer</h2> <ol> <li>Have your child sit up straight.</li> <li>Hold the incentive spirometer in an upright position. The incentive spirometer has different levels and contains a ball that rises when your child takes a deep breath in.</li> <li>Have your child place the mouthpiece in their mouth and hold it there with their lips closed tightly.</li> <li>Starting at level 0, have your child take 10 slow, deep belly breaths while they keep their head and shoulders still. For each breath, your child should raise the ball in the incentive spirometer to the top and hold it there for two seconds before breathing out.</li> <li>After your child takes the 10 deep breaths in and out, have them cough to help clear any mucus. If it hurts your child to cough, you can hold a pillow firmly against their chest to help ease any pain.</li> </ol> <p>Your child should take 10 breaths every hour that they are awake.</p> <h2>When it may not be appropriate to use an incentive spirometer</h2> <p>Your child may need to avoid using an incentive spirometer if:</p> <ul> <li>their breathing is more difficult when they use the device</li> <li>they need more oxygen after using the device</li> <li>they are in too much pain</li> <li>they do not know how to use the device.</li> </ul><h2>When a physiotherapist should assess your child before using an incentive spirometer</h2> <p>Sometimes a physiotherapist will first need to check that an incentive spirometer is the right option for your child. Your child will be assessed if:</p> <ul> <li>they are wheezing</li> <li>they have a history of asthma</li> <li>they have pneumothorax (air around the lungs) when they are due to use the device</li> <li>there is not enough oxygen in their lungs (the oxygen level is 90 per cent or less when they are breathing room air, without receiving extra oxygen).</li> </ul> <p>If your child is under age five or cannot use the spirometer for one of the reasons listed above, bubbles might be more appropriate for them.</p>https://assets.aboutkidshealth.ca/AKHAssets/incentive_spirometry.jpgMain
Infantile hemangiomasIInfantile hemangiomasInfantile hemangiomasEnglishDermatologyNewborn (0-28 days);Baby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years)SkinSkinConditions and diseasesCaregivers Adult (19+)NA2019-11-07T05:00:00Z8.6000000000000059.00000000000001001.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Learn about common growths, called infantile hemangiomas. Also, learn when they are tested and treated by doctors.</p><h2>What is an infantile hemangioma?</h2> <figure><span class="asset-image-title">Hemangiomas</span><img src="https://assets.aboutkidshealth.ca/akhassets/Hemangioma_MEDIMG_PHO_EN.jpg" alt="Raised red spots on a person's back" /> </figure> <p>Infantile hemangiomas are the most common, non-cancerous growths in babies. They are caused by extra growth of cells lining the small blood vessels in the skin. These cells are called endothelial (say: en-doh-THEE-lee-ull) cells. </p><p>Infantile hemangiomas present with red-purple skin changes, which are flat or raised. They are soft to touch and do not cause pain unless the skin above is broken (ulceration). About 60% of hemangiomas occur on the head and neck, but they can occur anywhere on the body. Rarely, they can occur inside the body as well.</p><p>Infantile hemangiomas normally appear in the first two weeks of life. Deeper hemangiomas may not appear until two to three months of age. About 30% to 40% of hemangiomas appear at birth as a barely visible spot, either slightly dusky or coloured differently than the skin around them.<br></p><h2>Key points</h2> <ul> <li>Infantile hemangiomas are common growths in babies. </li> <li>They are not cancerous. </li> <li>Hemangiomas usually get smaller as the child gets older. </li> <li>Doctors will run tests and treat the hemangioma if it affects breathing, vision or other organs. </li> </ul><h2>Who is at risk of having an infantile hemangioma?</h2><p>Infantile hemangiomas are more common in girls, twins, premature babies and babies who are born with a low birth weight.</p><h2>Testing for hemangiomas</h2> <p>Usually, your child's doctor can diagnose an infantile hemangioma by looking at it. Tests are not needed in most cases. The doctor may run tests or ask for a consultation from other specialists to make sure the hemangioma does not affect breathing and eyesight and to assess the depth of the hemangioma. </p> <p>The doctor may order some tests like ultrasound or magnetic resonance imaging (MRI). They help the doctor see how much the hemangioma affects other parts of your child's body. </p><h2>Treatment for hemangiomas</h2><p>Most infantile hemangiomas require no treatment or workup as most go away on their own and are not associated with other problems. Your child's doctor may suggest a "wait and see" approach. This means waiting to see what happens on its own before treating the hemangioma.</p><p>If your child's hemangioma requires treatment, they may be referred to a dermatologist. Your child's doctor will decide if the hemangioma needs to be treated by considering:</p><ul><li>location of the hemangioma on the body </li><li>size of the hemangioma </li><li>age of your child </li><li>risk and benefits of treatment </li></ul><p>Medicine, surgery and laser treatments are options at different stages of hemangiomas, if needed. They can be discussed with your child's primary care provider or dermatologist. </p><p>Treatment options for hemangiomas that are growing may include the following medicines:</p><ul><li>topical gel known as timolol (an eye drop that can help to shrink small hemangiomas)<br></li><li>beta-blockers (propranolol, nadolol) taken by mouth</li><li>laser treatment may be helpful to stop bleeding hemangiomas or to help heal ulcerated hemangiomas. It may also help to improve redness or fine blood vessels if they persist after the hemangioma has gone away or involuted</li></ul><h2>Complications of infantile hemangiomas</h2><p>If your child has an infantile hemangioma on or near the eyes, nose, ears, lips or neck, it might affect their ability to see or breathe. </p><p>Infantile hemangiomas may cause bleeding or become infected and cause pain, especially if they are near diaper areas, skin folds and the lips. </p><p>Infantile hemangiomas may leave a change in skin colour or a change in the skin texture, which can be a cosmetic concern for some people.</p><p>Talk to your doctor if your child has any of these problems.</p><h3>Treating bleeding</h3><p>If your child's hemangioma starts to bleed, follow these steps:</p><ul><li>Apply pressure to the site for 15 minutes. </li><li>If the bleeding does not stop after 15 minutes, take your child to the closest emergency department. </li></ul>https://assets.aboutkidshealth.ca/AKHAssets/hemangiomas.jpgMain
Infantile osteopetrosisIInfantile osteopetrosisInfantile osteopetrosisEnglishGeneticsChild (0-12 years);Teen (13-18 years)BodyBonesConditions and diseasesCaregivers Adult (19+)NA2011-09-01T04:00:00Z10.300000000000044.90000000000001627.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Information for parents about infantile osteopetrosis, a rare genetic condition that may cause fractures, short stature (height), recurrent infections, hearing loss and vision problems.</p><h2>What is infantile osteopetrosis?</h2> <p>Infantile osteopetrosis (say: oss-tee-oh-peh-TRO-siss) is a genetic condition that may result in: </p> <ul> <li>fractures</li> <li>short stature (height)</li> <li>recurrent infections</li> <li>hearing loss</li> <li>vision problems</li> </ul> <p>Other names you may hear for this condition are early onset osteopetrosis and malignant infantile osteopetrosis. </p> <p>This condition is quite rare and is believed to affect about one in 200,000 people. </p> <p>There are several different forms of osteopetrosis: infantile, juvenile and adult onset. In general, infantile osteopetrosis is the most severe form, while adult-onset osteopetrosis is the mildest form.<br></p><h2>Key points</h2> <ul> <li>Infantile osteopetrosis is a genetic condition that may result in fractures, short stature, recurrent infections, hearing loss and vision problems.</li> <li>Children with infantile osteopetrosis need to be followed carefully by a health care team made up of different specialists because they may develop health problems.</li> <li>Genetic counselling can help families understand infantile osteopetrosis, the options for managing it, and the chances that other children will also be affected.</li> </ul><h2>Osteopetrosis is a genetic condition</h2><p>Genetic means related to genes. Each of us inherits our genes from our parents. They provide our bodies with instructions that influence our health, looks and behaviour. In general, each person has two copies of every gene. </p><p>Infantile osteopetrosis is caused by a mutation (change) in each copy of a gene. One mutation is inherited from the mother and the other from the father. To date, there are several genes known to cause infantile osteopetrosis, including CLCN7, OSTM1, TCIRG1, TNFSF11, PLEKHM1 and TNFRSF11A. </p><p>Infantile osteopetrosis is inherited in an autosomal recessive pattern. This means that:</p><ul><li>A person with infantile osteopetrosis has a mutation in each copy of the gene.</li><li>Each parent carries a mutation in one copy of the gene. The other copy of the gene works normally and because of this, the parent does not show signs and symptoms of infantile osteopetrosis. This person is called a carrier of infantile osteopetrosis.</li></ul> <figure class="asset-c-100"> <span class="asset-image-title">Inheritance of infantile osteopetrosis</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Infantile_osteopetrosis_Inheritance_MED_ILL_EN.jpg" alt="Chromosome distribution from parents each carrying a gene with a mutation" /> <figcaption class="asset-image-caption">Infantile osteopetrosis is caused by mutations in both copies of one of the genes known to cause this condition. In this example, both healthy parents are carriers of the gene with a mutation. Their baby can inherit one of the following gene combinations: one, two or no copies of the gene with a mutation. If a baby inherits no copies or just one copy of the gene with a mutation, the baby will not have infantile osteopetrosis. It is only when a baby inherits two copies of the gene with a mutation that the baby will have infantile osteopetrosis.</figcaption> </figure> <p>To learn more about genetics, visit: <a href="/Article?contentid=343&language=English">Genetic counselling</a>.</p><h2>Diagnosing infantile osteopetrosis</h2><p>A diagnosis of infantile osteopetrosis is made on the basis of physical examination and X-ray findings. X-rays shows thickening and increased density of bones and bone-within-bone appearance. The diagnosis may be confirmed by DNA testing (blood test).</p><h3>Infantile osteopetrosis can be diagnosed before birth</h3><p>Before birth, infantile osteopetrosis can be diagnosed by testing DNA taken from the fetus. This can be obtained in one of the following ways:</p><ul><li>by amniocentesis after the 15th week of pregnancy </li><li>by chorionic villus sampling (CVS) between the 11th and 14th week of pregnancy</li></ul><p>These methods are used for high-risk pregnancies, for instance if the parents have another child diagnosed with infantile osteopetrosis. </p><p>To be eligible for this testing, the mutations in the gene responsible for causing infantile osteopetrosis must be known. This means that the child with the condition must have genetic testing.<br></p><p>Infantile osteopetrosis may also be diagnosed before birth using ultrasound as early as 14 weeks' gestation. However, it is possible to have a normal ultrasound and still have a baby with infantile osteopetrosis. </p> <figure class="asset-c-100"> <span class="asset-image-title">X-ray of healthy vs. infantile osteopetrotic thigh bones</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Infantile_osteopetrosis_Xray_MED_ILL_EN.png" alt="X-ray of thighs with healthy bone thickness and density and x-ray of thighs with increased bone thickness and density" /> <figcaption class="asset-image-caption">The thigh bones in the right X-ray show the effects of infantile osteopetrosis. The bones are thicker and have a higher bone density making them appear whiter on the X-ray. </figcaption> </figure><h2>Treatment of infantile osteopetrosis</h2><p>Children with infantile osteopetrosis need attentive, informed care from their parents and health-care providers. </p><p>The goals of treatment are:</p><ul><li>to help children with infantile osteopetrosis adapt socially and physically</li><li>to treat the symptoms</li></ul><h3>Transplantation of hematopoietic stem cells</h3> <p>The most effective treatment option available for infantile osteopetrosis is the transplantation of hematopoietic stem cells. These are the blood stem cells that come from the bone marrow or blood. It is a life-saving procedure with some risks. When successful, it prevents the progression of symptoms and improves bone health. Other problems like vision loss and dental and orthopaedic problems can still happen. </p><p>For more information, please see the <a href="/Article?contentid=2477&language=English">Blood and Marrow Transplant Resource Centre</a> on AboutKidsHealth.ca.</p><h3>Calcium supplements</h3><p>People with infantile osteopetrosis need to have the calcium levels in their blood and urine monitored. If your child's calcium levels are low, your child will need supplements. </p><h3>Transfusions</h3><p>Your child should have a complete blood count at least once every year. Depending on the levels, your child may need transfusions of red blood cells and platelets. </p><p>For more information, please see the <a href="/Article?contentid=1107&language=English">blood transfusion</a> and <a href="/Article?contentid=32&language=English">blood donation</a> articles on AboutKidsHealth.ca.</p> <h3>Treatment of infections</h3><p>If your child often has infections, your child may need antibiotics. </p><h3>Treatment of vision problems</h3><p>Your child should have an eye examination at least once a year. Children with vision problems may need surgery to release the compression of the optic nerve. </p><h3>Treatment of fractures</h3><p>Recurrent fractures need management by an orthopaedic surgeon. Special attention is needed because the fracture may take a long time to heal. Patients may need medication for joint pains. </p><h3>Treatment of dental problems</h3><p>Children with osteopetrosis are more likely to have dental problems like abscesses, cysts and teeth that take longer to come in. Your child should see a dentist regularly.</p><h2>How infantile osteopetrosis affects the body</h2><h3>Bone and dental problems</h3><p>Osteopetrosis is a disorder of bone development in which the bones become thickened. Normally, small areas of bone are constantly being broken down by special cells called osteoclasts, then made again by cells called osteoblasts. This is called bone remodeling, and it helps keep the bones healthy.</p> <figure class="asset-c-100"> <span class="asset-image-title">Bone remodeling cells</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Infantile_osteopetrosis_bone_cells_MED_ILL_EN.jpg" alt="Osteoclast and osteoblast on bone" /> <figcaption class="asset-image-caption">Within our bones are special cells that constantly break down bone and build new bone. Osteoclasts break down bone and osteoblasts make new bone.</figcaption> </figure> <p>In osteopetrosis, the cells that break down bone (osteoclasts) do not work properly, so there is an imbalance between these two functions. This leads to the bones becoming thicker and not as healthy. This can lead to: </p><ul><li>bone fractures </li><li>less overall bone growth, causing short stature</li><li>a thicker skull bone, which may cause teeth to come out later than expected</li><li>larger head size</li></ul> <figure class="asset-c-100"> <span class="asset-image-title">Osteopetrotic bone</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Infantile_osteopetrosis_bone_cycle_MED_ILL_EN.jpg" alt="Osteopetrotic bone with abnormal osteoclasts compared to a healthy bone" /> <figcaption class="asset-image-caption">Normally, our bones are constantly being broken down by osteoclasts and made again by osteoblasts. In osteopetrosis, the osteoclasts are abnormal and cannot break down bone but osteoblasts continue to make new bone. This imbalance results in thicker bones that are not as healthy.</figcaption> </figure> <h3>Problems with bone marrow and blood cells </h3><p>Bone marrow makes new blood cells. It is found inside the bones. In people with infantile osteopetrosis, because the cells that break down bone do not work properly, the space where the bone marrow is found is smaller or even missing. This means there is less bone marrow, so fewer blood cells are made. This can lead to:</p><ul><li>Anemia because of low red blood cells. Symptoms of anemia include pale skin and lack of energy.</li><li>Bleeding problems because of low platelets. Platelets are blood cells needed for clotting to help stop bleeding.</li><li>Many infections due to low white blood cells. White blood cells are needed to fight infections. </li></ul><h3>Problems due to thickening of skull bones</h3><p>The skull bone of people with infantile osteopetrosis is thickened, which can lead to: </p><ul><li>compression of some nerves, causing vision problems and weakness of facial muscles </li><li>narrow nasal sinus, causing chronic nasal congestion</li></ul><p>Thickening of the bones of the ear can cause compression of the nerves, resulting in hearing loss.</p><h3>Calcium and parathyroid levels</h3><p>Children with infantile osteopetrosis have lower levels of calcium and parathyroid hormone in their blood than normal. This may sometimes lead to increased irritability and seizures if it is not managed. These seizures are often the first sign of infantile osteopetrosis. </p><h3>Life expectancy</h3><p>With bone marrow failure and recurrent infections, some babies with infantile osteopetrosis may die before two years of age. Without treatment, most die by the age of ten. Transplantation of hematopoietic stem cells (see below) is the most promising treatment for long-term survival. <br></p><h2>Resources and support</h2><p>The following organizations and sites can offer more information, support and contact with other affected individuals and their families.</p><h3>The OsteoPETrosis Society (OPETS)</h3><p> <a href="http://www.osteopetrosis.org/">www.osteopetrosis.org</a>.</p><h3>Osteopetrosis Support Trust</h3><p> <a href="https://www.osteopetrosis-support-trust.org.uk/">www.osteopetrosis-support-trust.org.uk</a>.</p><h3>National Institute of Arthritis and Musculoskeletal and Skin Diseases</h3><p> <a href="https://www.niams.nih.gov/">www.niams.nih.gov</a>.</p><h3>The Paget Foundation</h3><p> <a href="https://www.iofbonehealth.org/national-societies/1284">www.iofbonehealth.org/national-societies/1284</a>.</p>https://assets.aboutkidshealth.ca/akhassets/Infantile_osteopetrosis_Xray_MED_ILL_EN.pngMain
Infantile spasmsIInfantile spasmsInfantile spasmsEnglishNeurologyNewborn (0-28 days);Baby (1-12 months)BodyNervous systemConditions and diseasesCaregivers Adult (19+)NA2013-11-19T05:00:00Z7.3000000000000069.60000000000003240.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Learn about infantile spasms, a type of epilepsy. Learn how infantile spasms are diagnosed and treated, and who can help you and your baby.</p><p>Infantile spasms are a type of epilepsy. You may also hear infantile spasms called West syndrome after Dr. William West, who described infantile spasms in his own son in the 1840s. </p><h2>What are infantile spasms?</h2><p>Infantile spasms usually begin in the first year of life. Spasms are a type of seizure. When your baby has a spasm, any of the following things may happen:</p><ul><li>arms and legs jerk up quickly </li><li>head drops forward </li><li>arms fly out </li><li>legs go up to the chest </li><li>muscles become stiff and then relax </li><li>eyes look to the side or up </li><li>breathing changes </li></ul><p>Babies experiencing infantile spasms will sometimes look as though they have severe stomach pain or <a href="/Article?contentid=295&language=English">colic</a>, but they are not in pain. Spasms usually happen when the baby is waking up, but they can happen at other times. The baby may have one spasm at a time, or many spasms in a row. Many spasms in a row are called a cluster. Each spasm usually lasts less than 10 seconds. A cluster or severe spasms can last for minutes. </p> <figure class="asset-c-100"> <span class="asset-anim-title">Infantile spasms</span> <div class="asset-animation asset-cv-animation"> <iframe src="https://www.aboutkidshealth.ca/Style%20Library/akh/animation/Infantile%20Spasms/Infantile_spasm_CANVAS_EN.html"></iframe>  </div> <p class="sr-only">A step-by-step animation of infantile spasms. Infantile spasms usually start when a child is between 4 and 8 months old. They will most likely occur when a child is sleepy, such as when they are waking up from a nap. They will suddenly flex their head or body at the waist, and their arms may come up in a startling way. Their knees may be drawn up to their chest, and they may let out a short cry. This will last a second or two, they will relax, and then the same spasm will quickly happen again. This can happen in a series of 4-5 spasms. They may have many series of spasms per day. This type of seizure is usually only seen in young children.</p> </figure> <p>After a spasm, the baby may cry or laugh. The spasms do not cause pain, but the baby may cry because the quick jerking movement surprises them.</p><h3>After infantile spasms start, the baby may stop developing</h3><p>Once the spasms start, parents often notice that their babies stop developing. They stop doing the things they did before, such as smiling, rolling over or sitting. They may also stop following things with their eyes (tracking) and looking at people in the eyes. They do not learn to do new things. </p><h2>Key points</h2> <ul> <li>Infantile spasms are a type of epilepsy that usually begins in the first year of life. </li> <li>Infantile spasms do not cause your baby pain, but they must be treated as soon as possible, or your baby will stop developing and learning new things.</li> <li>After being diagnosed with infantile spasms, your baby may need tests to help find the cause of the infantile spasms. Your baby may need to have an MRI of the brain or have blood and urine tested for chemical changes or changes in the genes. </li> <li>Your baby’s infantile spasms will be treated with medicine. Your baby will be treated with vigabatrin first. If vigabatrin does not work then your baby will be treated with ACTH or prednisolone or another anti-seizure medicine.</li> <li>Many babies who have infantile spasms will develop other seizures later in life. </li> </ul><h2>Signs and symptoms of infantile spasms</h2> <p>Your doctor will diagnose your baby with infantile spasms if they experience all of the symptoms below:</p> <ul> <li>Your baby has the type of seizures usually seen in infantile spasms that are described above. </li> <li>Your baby's EEG (electroencephalogram) test shows a pattern of brain waves called hypsarrhythmia.</li> <li>Your baby has stopped developing or has stopped learning to do new things since the seizures started.</li> </ul><h2>What causes infantile spasms?</h2><p>Infantile spasms can happen because of many different problems. Sometimes they happen in babies who experience delayed development. These babies may already have a known problem with their brains. These problems can start:</p><ul><li>Before they are born. </li><ul><li>If the brain does not form properly during fetal development</li><li>If there is a chromosomal abnormality that causes a disorder that affects the brain, such as <a href="/Article?contentid=9&language=English">Down Syndrome</a> or Tuberous Sclerosis, and increases the risk of getting infantile spasms </li><li>If there is a problem with the body's metabolism, causing too much or too little of necessary body chemicals</li><li>If there is damage to the brain from a clot or bleeding in the brain or an infection<br></li></ul><li>Around the time they are born. </li><ul><li>If they do not receive enough oxygen at birth</li><li>If they experience trauma during birth</li></ul><li>In the first few months of life. </li><ul><li>Due to brain infection</li><li>Due to brain injury </li></ul></ul><p>Sometimes babies are developing normally when they start having infantile spasms and the cause is unknown.</p><p>Infantile spasms are divided into three groups:</p><ul><li>Symptomatic: When we know what has caused the spasms. </li><li>Cryptogenic: When a baby had problems with development before the spasms started, but we cannot find a cause. </li><li>Idiopathic: When a baby's development was normal before the spasms started and we cannot find a cause. </li></ul><h2>Tests to diagnose infantile spasms</h2><p>Your baby will need various tests before and after being diagnosed with infantile spasms.</p><h3>Electroencephalogram</h3><p>Your baby will have an (EEG). This test looks at the patterns of electricity that the brain cells make. It does not hurt. </p><p>A technologist will put small gold discs called electrodes on your baby's scalp. Sometimes your baby will need medicine to sleep during the EEG. </p><p>The EEG helps the doctor decide if your baby has infantile spasms. The EEG will also be used to check how well the treatment is working. </p><h3>CT scan and MRI of the brain</h3><p>Most babies with infantile spasms will have a CT scan or MRI of the brain.</p><ul><li> A CT scan is a special X-ray that uses a computer to take pictures of the brain. </li><li> An MRI uses a magnet, radio signals and a computer to make pictures of the brain.</li></ul><p>These pictures help the doctors see if your baby's brain looks normal or not. This may help the doctor find the cause of your baby's infantile spasms. </p><h3>Other tests</h3><p>The doctors may also do other tests to look for the cause of the infantile spasms:</p><ul><li> The doctors may test your baby's blood and urine to look for infections and chemical changes. </li><li>If the doctors cannot find the cause of the infantile spasms using these tests, they may do a blood test to look at your baby's genes to see if there are any abnormalities.</li><li>The doctors may look at your baby's skin using a Woods lamp. Some conditions that cause infantile spasms also cause changes in the skin. This lamp uses a special light to show these changes. </li></ul><p>Because there are so many causes of infantile spasms, the tests will be different for each baby. The doctors and nurses will explain any other tests your child may need. </p><h2>Infantile spasms are treated with medicine</h2><p>Two medicines are the best at stopping infantile spasms. One is called <a href="/Article?contentid=260&language=English">vigabatrin</a> (Sabril) and the other is called ACTH (Synacthen).</p><p>At SickKids, the doctor will probably put your baby on vigabatrin first. Usually, after two to three weeks of treatment, your baby will have an EEG and be seen by the neurologist. If the spasms have not stopped or the hypsarrhythmia pattern on the EEG does not go away, the neurologist may decide to start your baby on ACTH or sometimes another medicine called prednisolone or another anti-seizure medicine.</p><p>Treatment will stop the infantile spasms in most children, but in some children the spasms will not stop.</p><h2>Vigabatrin</h2><p>Vigabatrin (Sabril) is medicine that is given by mouth. It comes as a pill that can be crushed and mixed with small amounts of liquid such as a spoonful of water, milk or juice, or a spoonful of food such as apple sauce or baby cereal. It also comes as a powder called a sachet that can be dissolved in a liquid. Make sure that your baby takes all of the liquid or food so that they get all of the medicine. For suggestions on how to give the medicine to your baby see the AboutKidsHealth <a href="https://www.youtube.com/watch?v=Q0ewm7bgtTA">Medicines Video: How to Give Your Child Liquid Medicines at Home</a>. </p><p>Keep the medicine at room temperature in a dry place.</p><p>The amount of medicine you give is increased each day over a few days to a very high dose. If the vigabatrin stops the spasms, your baby will stay on it for at least six months. Your doctor will tell you when your baby is ready to stop taking the medicine. </p><p>Here is what to do if your baby throws up the medicine or if you forget a dose:</p><ul><li>If your baby throws up the medicine within 30 minutes after taking it, give the dose again. </li><li>If your baby throws up more than 30 minutes after taking the medicine, do not give any more until the next time it is supposed to be given. </li><li>If the medicine is not given on time, give it as soon as you remember or can, unless the next dose is scheduled within four hours. </li><li>If the next dose of the medicine needs to be given in less than 4 hours, do not give the dose you forgot. Give the next dose a little earlier and then return to giving the medicine at the usual times after that. Do not give 2 doses at the same time.</li></ul><h3>Side effects of vigabatrin</h3><p>Your baby may have some of the following side effects:</p><ul><li>changes in how well the baby can see, in particular loss of peripheral or side vision, which is sometimes called tunnel vision </li><li>wanting to sleep more than usual, especially in the first few days to 3 weeks of treatment </li><li>upset stomach</li><li> <a href="/Article?contentid=6&language=English">constipation</a> </li><li>hyperactivity, restlessness, always wanting to move </li><li>being awake a lot in the middle of the night </li><li>irritability, fussiness, hard to make happy </li><li>weight gain </li><li>arms and legs become floppy, also called decreased muscle tone or hypotonia </li></ul><p>Not all babies get these side effects. Your baby may get some of these side effects and not others.<br></p><h3>A note on tunnel vision</h3><p>Doctors at The Hospital for Sick Children have monitored many children taking vigabatrin to see how vigabatrin affects their eyesight. They have found that: </p><ul><li>Changes in eyesight because of vigabatrin happen in fewer than 10% of children who are younger than 2 years old. </li><li>It is very rare to see eye changes in children who have been taking vigabatrin for less than six months. </li><li>Serious changes to the eyes are more likely to happen after one to two years of treatment, but they are still uncommon. </li><li>Most children will not have their eyesight changed by vigabatrin. </li></ul><h3>How to deal with side effects of vigabatrin</h3><ul><li>Changes in eyesight: Your baby will have an eye test called an electroretinogram (ERG) within a short time after starting on vigabatrin. Vigabatrin can sometimes cause narrowing of the peripheral vision, which means that a child cannot see as well to the side. The ERG will help the doctor know if this is a problem for your child. An ERG will be done every three to six months while your child is taking vigabatrin to see if there are any changes. One more ERG will be done after your child stops taking vigabatrin.</li><li>Sleepiness: Your baby will become less sleepy over time as he or she gets used to the medicine. Make sure your baby gets enough to eat and drink. Wake your baby up if it is time to feed them. If your baby is very sleepy and will not eat or drink, call the doctor who gave you the prescription for vigabatrin. </li></ul><h2>ACTH</h2><p>ACTH (Synacthen) is given by needle into the leg. We will arrange for a nurse to come to your home to give this medicine to your baby. </p><p>ACTH is started at a high dose. At SickKids the dose is lowered slowly over six weeks and then the treatment is stopped. </p><p>The side effects are usually worse at first when the dose is higher. The side effects will go away after the ACTH is stopped.</p><p>The nurse must check your baby's blood pressure before giving the medicine. Your baby's blood needs to be tested every one to two weeks and the urine tested two times a week. </p><p>Sometime doctors will suggest using prednisolone instead of ACTH. It is a similar type of drug as ACTH and causes the same side effects, but the dose is not as high and it is given by mouth. </p><h3>Side effects of ACTH</h3><p>Your baby may have some of the following side effects:</p><ul><li>increased chance of getting a serious infection </li><li>not sleeping well, although some babies are more sleepy and lethargic </li><li>irritability: your baby may be very fussy and hard to calm down </li><li>hunger or wanting to eat more </li><li>weight gain </li><li>puffy-looking face </li><li>upset stomach, such as vomiting (throwing up) or stomach pain </li><li>high blood pressure </li><li>changes in the chemicals of the body, such as high sugar or high salt </li><li>acne: red, raised bumps on the face</li><li>tremor (mild shaking) </li><li>rarely, thinning of the bones that makes them easy to break </li><li>very rarely, thickening of the heart muscle </li></ul><p>Not all babies get these side effects. Your baby may get some of these side effects and not others. These side effects will go away after the ACTH or <a href="/Article?contentid=221&language=English">prednisolone</a> is stopped.</p><h3>How to deal with the side effects of ACTH and prednisolone </h3><ul><li>Chance of a serious infection: Wash your hands well with soap before touching or holding your baby. You may want to buy soap that has 'anti-bacterial' written on the label. Ask everyone who comes into your home to wash his or her hands. Anyone with an infection such as a cold or flu should not touch or hold your baby. We suggest that your baby not be in a day care while taking ACTH. It is very important that you take your baby to see your paediatrician or family doctor right away if he or she shows any signs of an infection. Some signs of infection are fever, runny nose, cough, diarrhea (watery bowel movements), bad smelling urine, and change in alertness. For more information, please see "Immunosuppression: Protecting Your Child from Infection." </li> <li>Severe irritability or fussiness: If it is really hard for your baby to sleep, the doctor may suggest you give your baby a medicine to help him or her sleep at night. You will be given a prescription for this. Ask for help from family or friends to take turns caring for your baby so that you can get some rest. Hold, rock, swing, give warm baths, play music, or do anything that seems to make your baby feel better. Sometimes, no matter what you do, your baby will not stop crying or being fussy. </li><li>Increased appetite: Feed your baby the type and amount of food that is usually fed to a baby your child's age. Ask your baby's nurse for the information on 'What to Feed Your Baby in the First Year of Life' or speak to your paediatrician for information about the type and amount of food that is best for your baby. We can also arrange for you to speak with a dietitian. </li><li>Upset stomach: The doctor will give you a prescription for a medicine that will help settle your baby's stomach. </li><li>High blood pressure: The nurse will check your baby's blood pressure before giving ACTH. If your baby is taking prednisolone then their blood pressure should be checked at least once a week by your paediatrician. Blood pressure is a measurement of how strongly and how often the heart pushes blood around the body. If the blood pressure is above a certain level, the doctor may have you give a medicine to your baby that lowers the blood pressure. </li><li>Changes in chemicals of the body: Your baby's blood will be tested every 1 to 2 weeks. Your baby's urine will be tested 2 times a week. The blood can be tested through your paediatrician or family doctor. The nurse who comes into your home will test the urine. The doctor will give you a prescription for medicine to treat any problems. </li></ul><h2>When should I call a doctor or nurse?</h2><p>Call your baby’s neurologist or neurology clinic nurse if:</p><ul><li>your child has side effects to the medicine that are hard to deal with </li><li>your child is not eating or drinking enough </li><li>your child is sleeping most of the day and is hard to wake up </li><li>your child shows any signs of an allergic reaction, such as hives, rash or wheezing<br></li><li>your child has more spasms than usual </li></ul><p>Call your baby’s paediatrician or family doctor if your baby has any signs of infection or you have any other worries about your baby’s health. </p><h2>Resources to help you cope</h2><p>There are many people who can help you.</p><ul><li>Social workers can support you and your family to help you adjust to your child’s condition. They can also help with getting community supports and finding money to help pay for your child’s medicine.</li><li>Occupational therapists help with the development of your baby. They will check how your baby is developing, give treatment as needed and teach you how to help your baby learn new things. We often call this infant stimulation. </li><li>Family, friends and your religious community may help support you in different ways. </li><li>Being in touch with other parents who also have a child with infantile spasms may help. </li></ul>Main
Infants, toddlers, and preschoolers with diabetesIInfants, toddlers, and preschoolers with diabetesInfants, toddlers, and preschoolers with diabetesEnglishEndocrinologyNewborn (0-28 days);Baby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years)PancreasEndocrine systemHealthy living and preventionAdult (19+)NA2017-09-25T04:00:00Z8.9000000000000061.30000000000001064.00000000000Flat ContentHealth A-Z<p>Find out what to expect when your infant, toddler or preschooler has diabetes, and what you need to know to manage it.</p><p>​​Babies and toddlers — whether they have <a href="/Article?contentid=1717&language=English">diabetes</a> or not — generally:</p> <ul><li>determine thoughts by what they see and hear</li> <li>begin to develop a sense of themselves, first by gaining a trust in their environment as infants, and then by testing this environment in the next few years</li> <li>enhance their knowledge of the world around them by constantly exploring, asking questions, and developing language</li> <li>become more curious and independent, choosing some activities and rejecting others.</li></ul><h2>Key points</h2> <ul><li>The target blood glucose range for infants and toddlers is a pre-meal level between 6 and 10 mmol/L.</li> <li>Challenges in diabetes care at this age include changing eating habits and keeping a child still during insulin injections and finger pricks.</li> <li>Signs of a healthy infant or toddler include normal growth, good energy and no symptoms of high blood sugar levels.</li> <li>The routines and tasks needed for good diabetes care may influence and sometimes interfere with normal child development.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/infants_toddlers_preschool_diabetes.jpgMain
Infection after a kidney transplant IInfection after a kidney transplant Infection after a kidney transplantEnglishTransplant;NephrologyTeen (13-18 years)KidneysRenal system/Urinary systemProcedures;Conditions and diseasesTeen (13-18 years)NA2017-11-30T05:00:00Z000Flat ContentHealth A-ZTeens
Infection after a liver transplantIInfection after a liver transplantInfection after a liver transplantEnglishTransplant;GastrointestinalTeen (13-18 years)LiverDigestive systemProcedures;Conditions and diseasesTeen (13-18 years)NA2017-11-30T05:00:00Z000Flat ContentHealth A-ZTeens
Infection and the immune system of a premature babyIInfection and the immune system of a premature babyInfection and the immune system of a premature babyEnglishNeonatology;ImmunologyPremature;Newborn (0-28 days);Baby (1-12 months)BodyImmune systemNAPrenatal Adult (19+)NA2009-10-31T04:00:00Z13.700000000000035.0000000000000695.000000000000Flat ContentHealth A-Z<p>Read about infections and the immune system of premature babies. A premature baby is susceptible to infection because their immune system is immature.</p><p>Premature babies are typically more vulnerable to infections because their immune systems are immature. The lack of antibodies and immunity in a premature baby's immune system means they can't fight off bacteria, viruses or fungi in the same way that full-term babies may be able to.</p><h2>Key points</h2> <ul><li>Over time, the immune system is exposed to different bacteria, viruses, and fungi, and develop antibodies to respond to these invading organisms and develop immunities to their effects.</li> <li>Usually, a mother's antibodies cross through the placenta during the third trimester of pregnancy, which gives a newborn some immunity to diseases it has not yet been exposed to.</li> <li>Premature babies may not have received enough antibodies from the mother, and may also have difficulty producing white blood cells and antibodies to fight off infection.</li> <li>Infection in a premature baby can come from many sources including the womb, the birth canal, or the Neonatal Intensive Care Unit (NICU) environment.</li></ul>https://assets.aboutkidshealth.ca/akhassets/mom_looking_in_isolette_BRA_EN.jpgMain
Infection in newborn babiesIInfection in newborn babiesInfection in newborn babiesEnglishNeonatologyNewborn (0-28 days)BodyNAConditions and diseasesAdult (19+)Pain;Fatigue;Fever2009-10-18T04:00:00Z10.100000000000052.70000000000001285.00000000000Flat ContentHealth A-Z<p>Learn about the symptoms, causes, diagnosis and treatment of infections in newborn babies. Trusted Answers provided by Canadian Paediatric Hospitals.</p><p>Newborn babies have weak immune systems. This is one reason why breastfeeding is so important: it provides the newborn baby with antibodies to help fight infection. As a result, breastfed infants have fewer infections than babies who are bottle fed. </p><h2>Key points</h2> <ul><li>Most infections in newborns are caused by bacteria, while some are caused by viruses.</li> <li>Symptoms of infection include temperature above 38.0 degrees C, poor feeding, irritability, excessive sleepiness, rapid breathing and change in behaviour.</li> <li>Your newborn's infection may be treated with antibiotics, or they may need to go to the hospital for special care including IV fluids or a feeding tube.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/infection_in_newborn_babies.jpgMain
Infections after a blood and marrow transplantIInfections after a blood and marrow transplantInfections after a blood and marrow transplantEnglishHaematology;Immunology;OncologyChild (0-12 years);Teen (13-18 years)BodyImmune systemConditions and diseasesAdult (19+)NA2010-01-06T05:00:00Z8.5000000000000057.6000000000000926.000000000000Flat ContentHealth A-Z<p>Information for parents about infections that may occur after a child's blood and marrow transplant (BMT).</p><p>Everything we contact in daily life potentially contains organisms which can cause infection. These include:</p><ul><li>bacteria, which are microscopic organisms that invade tissues and grow very quickly. They cause infections anywhere in the body.</li><li>fungi, which are primitive organisms that we encounter everywhere, such as bread mold. Some harmless forms reside inside our bodies.</li><li>viruses, which are parasites that are smaller than bacteria. They need another host, such as human cells, to survive and grow. </li></ul><p>These daily sources of infection are not a major issue for a healthy person. Our immune system protects us from becoming infected.</p><h2>Key points</h2><ul><li>High-dose chemotherapy or radiation destroys both weak and healthy cells, weakening the immune system.</li><li>It is common for BMT patients to have fevers while in hospital, caused by infection, chemotherapy, radiation, or blood transfusions.</li><li>Your child will be given some medicines before the transplant to decrease their risk of infection; other medicines will be given to treat the infection.</li></ul>Main
Infective endocarditis (IE)IInfective endocarditis (IE)Infective endocarditis (IE)EnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartHeartConditions and diseasesCaregivers Adult (19+)NA2010-10-25T04:00:00Z7.0000000000000069.30000000000001216.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Some children with heart problems are at risk for developing a serious infection called infective endocarditis. Learn about the prevention and treatment of infective endocarditis. </p><p>Some children with heart problems are at risk for developing a serious infection called infective endocarditis (IE). This condition was previously known as subacute bacterial endocarditis or bacterial endocarditis. </p> <h2>What is infective endocarditis?</h2> <p>IE is a serious infection of the heart. It is caused by germs such as bacteria and fungi. These germs may get into child's blood in different ways, such as: </p> <ul> <li>from an operation</li> <li>through invasive medical procedures</li> <li>through very deep cuts from an accident</li> <li>from having work done on the teeth</li> </ul> <p>Usually, a child's body fights the bacteria and they do not get sick. However, if the blood does not flow through your child's heart or valves smoothly, your child may get IE. The chance of your child getting IE is low. However, because IE can be serious, it is important that you and your child know how to prevent it. </p><h2>Key points</h2> <ul> <li>Infective endocarditis (IE) is a serious infection of the heart that can affect some children with heart problems.</li> <li>The signs of infective endocarditis are similar to those of the flu.</li> <li>It is better and easier to prevent infective endocarditis than to treat it.</li> <li>Take good care of your child's teeth, including proper brushing and flossing and regular visits to the dentist.</li> <li>Make sure your child gets antibiotics for certain dental procedures, ONLY if recommended by your child's cardiologist.</li> <li>Get your child a Medic Alert bracelet if needed.</li> </ul><h2>The signs of infective endocarditis are similar to the flu</h2> <p>The signs of IE are like the signs of flu. This can make it hard to know if your child has IE. Take your child to the doctor if they have some of these signs and they do not go away. </p> <ul> <li>a slight fever of 37.5°C to 38.5°C that you cannot explain and that lasts for five to seven days</li> <li>sweating</li> <li>loss of appetite</li> <li>pain in the muscles and joints, such as the knees, shoulders or knuckles</li> <li>loss of weight</li> <li>a skin rash</li> <li>headaches</li> <li>a general feeling of weakness</li> </ul><h2>A doctor will test your child for infective endocarditis</h2> <p>There are several tests that can help the doctors find out if your child has IE. These tests are:</p> <ul> <li>blood tests to check for bacteria; your child may need to have several blood samples taken at different times</li> <li>a urine test, which tests your child's urine (pee) for bacteria</li> <li>an echocardiogram, which is a recording of the positions and movement of the walls of the heart or the parts inside the heart, such as the valves</li> </ul><h2>Treating infective endocarditis with antibiotics</h2> <p>If your child has IE, the doctor will give them antibiotics, which are medicines that kill germs. These antibiotics will be given to your child through an intravenous tube (IV). An IV is a small tube that is put in a vein in an arm or leg.</p> <p>Your child may need antibiotics for six weeks or longer. If your child needs antibiotics for a long time, they will have to stay in the hospital for the first few days or weeks. Your child may be able to finish receiving the antibiotics at home with the support of nurses from a service called Community Care Access.</p><h2>At SickKids</h2> <p>Our dentists at SickKids like children to visit the dentist first when they are six months old. The dental clinic at SickKids is available for the dental care of some children with special needs up until the age of 18 years.</p>https://assets.aboutkidshealth.ca/AKHAssets/infective_endocarditis.jpgMain
Inflammation and auto-inflammationIInflammation and auto-inflammationInflammation and auto-inflammationEnglishImmunologyChild (0-12 years);Teen (13-18 years)BodyImmune systemConditions and diseasesCaregivers Adult (19+)NA2021-06-03T04:00:00Z11.900000000000038.90000000000001354.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Inflammation is the body's protective response against infections and injuries. Auto-inflammation occurs when the body produces an inflammatory response against its own healthy tissues. Learn about the signs and symptoms of inflammation and auto-inflammation.</p><h2>What is inflammation?</h2><p>Inflammation is the body's normal, protective response to injuries or infections. It is triggered by the immune system, which is a cellular system within the body. The immune system monitors for injuries to the body and detects “intruders” such as bacteria and viruses. If the immune system detects an injury or intruder, it mounts a response called an inflammatory response and signals cells to the site of injury or infection.</p><p>You may hear the words infection and inflammation together, but they mean very different things. Infection refers to the invasion and multiplication of bacteria or viruses within the body, while inflammation is the body's protective response against infection.</p><p>Inflammation is a complex cellular process involving various types of immune cells, clotting proteins and signaling molecules. It can occur after an injury, such as a burn or a cut, and also when there is an infection present in the body. But, inflammation can sometimes also occur without an injury or infection.</p> <figure class="asset-c-100"><span class="asset-image-title">Inflammation</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_inflammation_EN.jpg" alt="Splinter in the skin causing pain, warmth, redness and swelling" /><figcaption class="asset-image-caption">Inflammation is the normal response of your body’s immune system to injuries and harmful things that enter your body. Immune cells, triggered by the inflammatory response, quickly react after an injury to protect and heal the injury. A wood splinter enters the skin and the inflammatory response is triggered.</figcaption></figure> <h2>What is auto-inflammation?</h2><p>Sometimes, the immune system can over-react and can cause inflammation by attacking healthy tissues within the body. This process is called ‘auto-inflammation’. When auto-inflammation occurs, there is a dysfunction within the immune system that triggers the body to mount an inflammatory response against itself. It is not known why this occurs, but it is thought that a virus or another trigger in the environment may be the initial cause.</p><h2>Key points</h2><ul><li>Inflammation is the body's normal response to injuries or infections. Cells of the immune system travel to the site of injury or infection and cause inflammation to protect and heal the area.</li><li>Different types of white blood cells are involved in the immune system response.</li><li>Auto-inflammation occurs when the cells of the immune system produce an inflammatory response against its own healthy tissues.</li></ul><h2>Signs of inflammation after injury or infection</h2><p>When an injury occurs, the cells of our immune system immediately travel to the site of injury or irritation and the inflammatory response begins. This includes widening of local blood vessels to allow fluid and immune cells into surrounding injured tissue, which causes swelling, redness, warmth and pain at the site. This process protects the injured area and signals other cells to the site to begin repairing and healing the injury. Normally, inflammation slowly goes away after the irritation has been removed and the body is adequately protected, as can be seen with the example of the splinter in the skin.</p><h2>Signs of inflammation during auto-inflammation</h2><p>During auto-inflammation, cells of the immune system also travel to certain sites in the body. However, there are no injuries or infections at these sites. Instead of repairing and healing, the auto-inflammatory response often ends up harming healthy tissues.</p><p>Auto-inflammation can cause damage and destruction to the body tissues or organs that it affects. This can be seen with central nervous system (CNS) inflammatory diseases, where auto-inflammation causes dysfunction in the brain, spine and/or optic (eye) nerves. An auto-inflammatory event can be a one-time occurrence or it may develop into a chronic (long-term) issue.</p><h2>What causes auto-inflammation?</h2><p>The exact cause of auto-inflammatory conditions is not known. A dysfunction of the immune system causes auto-inflammation, but it is unknown why this dysfunction occurs. Various theories include exposure to a virus, possible environmental triggers, and genetics.</p><h2>How is an auto-inflammatory condition diagnosed?</h2><p>If your child has symptoms of auto-inflammation or a suspected auto-inflammatory disease, several tests may be completed including a physical exam, imaging tests such as <a href="https://akhpub.aboutkidshealth.ca/article?contentid=1270&language=English">magnetic resonance imaging (MRI)</a>, a biopsy, a <a href="https://www.aboutkidshealth.ca/Article?contentid=3380&language=English">lumbar puncture</a> and other tests including blood, urine or stool tests. Your child’s health-care team will review the results of the testing with you.</p><h2>Treatment of auto-inflammatory conditions</h2><p>Children with auto-inflammatory diseases are typically treated with immune-modifying therapies or immunosuppressant treatments. These are medications that are given to suppress (turn off) the abnormal immune response. Immunosuppressant medications may be given in pill form, injection or by intravenous (IV) infusion. Your child’s health-care team will recommend specific medication(s) and/or treatments for your child.</p><ul><li>It is important that you child follow the treatment regime recommended to treat their auto-inflammatory condition. If your child develops side effects of the treatments, their health-care team should be contacted.</li><li>Your child may be more at risk for infections when they are treated with immunosuppressant medications. If your child develops a fever or symptoms of an infection, their health-care team should be contacted.</li><li>The effectiveness of vaccines can also be influenced by immune-modifying medications. It is important to talk to your child’s health-care team if your child requires any immunizations.</li></ul><h2>When to seek medical attention</h2><p>Contact your child's health-care team, call 911 or go to the nearest Emergency Department right away if your child experiences any of the following:</p><ul><li>A <a href="https://www.aboutkidshealth.ca/Article?contentid=30&language=English">fever</a></li><li>A seizure</li><li>Changes in their level of consciousness</li></ul><p>If your child develops sudden symptoms of their auto-inflammatory illness, please contact their health-care team.</p>https://assets.aboutkidshealth.ca/akhassets/IMD_inflammation_EN.jpgMain
Inflammatory bowel disease (IBD)IInflammatory bowel disease (IBD)Inflammatory bowel disease (IBD)EnglishGastrointestinalPre-teen (9-12 years);Teen (13-18 years)Small Intestine;Large Intestine/ColonSmall intestine;Large intestineConditions and diseasesCaregivers Adult (19+)NA2010-02-18T05:00:00Z6.5000000000000067.8000000000000401.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Learn about the signs and symptoms of inflammatory bowel disease (IBD) and the two different types.</p><h2>What is inflammatory bowel disease?</h2> <p>Inflammatory bowel disease (IBD) is a condition where the small or large intestine becomes inflamed. </p><h2>Key points</h2> <ul> <li>IBD is an inflammation of part of the digestive system. Crohn's disease and ulcerative colitis are two types of IBD.</li> <li>IBD comes and goes.</li> <li>Your child may need anti-inflammatory drugs. In severe cases, children with IBD may need to have a liquid diet or surgery.<br></li></ul><h2>Sign and symptoms</h2><p>The main symptoms of IBD are <a href="/Article?contentid=7&language=English">diarrhea</a>, bloating, stomach pain, cramping and weight loss. IBD comes and goes. It can "flare up" and your child will have symptoms. At other times, your child will not have symptoms. This is called remission. Flare-ups and remission will occur at different times for different people. </p><h3>There are two types of IBD: Crohn's disease and ulcerative colitis.</h3><ul><li> <a href="/Article?contentid=923&language=English">Crohn's disease</a> is inflammation in any part of the digestive system from the mouth to the anus. </li><li> <a href="/Article?contentid=924&language=English">Ulcerative colitis </a>is inflammation in the large intestine only. </li></ul><p>Inflammatory bowel disease is not the same as <a href="/Article?contentid=823&language=English">irritable bowel syndrome</a>.</p><h2>Causes<br></h2><p>The cause of IBD is unknown. Family history of this disease and other immune-related factors may increase risk. IBD is not caused by eating certain foods. IBD is not caused by food poisoning. </p> <figure class="asset-c-80"> <span class="asset-image-title">Digestive system</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Digestive_system_MED_ILL_EN.jpg" alt="Salivary and parotid glands, esophagus, stomach, pancreas, small and large intestines, rectum, appendix, gallbladder, liver" /> </figure><h2>What a doctor can do to help your child</h2> <p>Take your child to the doctor if symptoms persist for more than a few days. The doctor will conduct tests of the intestines if IBD is suspected. Your child may have to swallow a white chalky liquid called barium for an X-ray. </p><h2>Treatment</h2> <p>Anti-inflammatory drugs may be prescribed depending on your child's diagnosis. In severe cases of Crohn's disease, your child may have to have a liquid diet or drugs or food may be given intravenously. Most children can live a healthy life by eating a well balanced diet. In severe cases of ulcerative colitis, surgery may be needed to remove the damaged colon. </p> <p>Claims have been made that some diets help control IBD. But none of these diets has been proven to help. If your child is on a special diet or avoids certain foods, speak to their doctor or dietitian. They will help make sure your child is still getting the nutrients they need for good health. Your child's diet will depend on their needs. </p>https://assets.aboutkidshealth.ca/AKHAssets/inflamatory_bowel_disease.jpgMain
Influenza (flu): An overviewIInfluenza (flu): An overviewInfluenza (flu): An overviewEnglishInfectious DiseasesChild (0-12 years);Teen (13-18 years)BodyImmune systemConditions and diseasesCaregivers Adult (19+)Cough;Fever;Headache;Sore throat2020-09-30T04:00:00Z7.1000000000000070.10000000000001335.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Although the flu is very common, it can be dangerous for some people including young children, the elderly, and those with compromised immune systems or other underlying diseases. Learn more about the flu and how to protect against it.</p><h2>What is influenza?</h2><p>Influenza (flu) is a lung infection caused by specific influenza viruses. People can get the flu at any time of year, but it is more common in the fall and winter. <br></p><h2>Key points</h2><ul><li>Influenza (flu) is not the same as the common cold. </li><li>Flu is caused by the influenza virus. </li><li>Most people who get the flu do not get seriously ill and will have symptoms for two to seven days. </li><li>You can reduce your risk of getting the flu by getting a flu shot each year and washing your hands frequently. </li><li>If your child has the flu they should stay home and rest. If they do not start to feel better after a few days or if symptoms get worse, call your child’s primary care provider. </li></ul><h2>Common symptoms of the flu</h2><p>People who get the flu usually have some or all of the following symptoms:</p><ul><li> <a href="/article?contentid=30&language=english">fever</a></li><li>muscle aches</li><li> <a href="/article?contentid=29&language=english">headache</a></li><li> <a href="/article?contentid=748&language=english">sore throat</a></li><li> <a href="/article?contentid=774&language=english">cough</a></li><li>fatigue and weakness</li></ul><p>Most of these symptoms usually last for two to seven days. Rare but serious complications of the flu include bacterial pneumonia and influenza infection of the brain. </p><h2>The flu can be serious for some people</h2><p>Most people who have the flu will not become seriously ill. But the flu can be more serious for some people. Typically, those most at risk are in one of the following groups:</p><ul><li>Children under two years of age</li><li>People 65 years of age or older</li><li>People living in long-term care facilities such as a nursing home, a home for the aged or a chronic care hospital </li><li>People with chronic heart, lung or kidney disease</li><li>People with diabetes, cancer, immune system problems or sickle cell anaemia</li><li>Children and teenagers aged six months to 18 years who have been treated with <a href="/article?contentid=77&language=english">acetylsalicylic acid (ASA)</a> for long periods </li><li>People who have trouble clearing mucus from their nose and throat because of weakness or underlying illness</li></ul><p>These groups, and anyone who lives or works with people from these groups, should generally be immunized each year with the flu vaccine (flu shot). That way, people from these high-risk groups are less likely to be infected with the flu. </p><h2>Treating the flu</h2><p>If you or your child have the flu, stay home and rest. Usually, treatment is focused on the symptoms the person is feeling. For example, if your child has a fever, you can give them acetaminophen or ibuprofen to reduce fever. </p><p>Do not give <a href="/article?contentid=77&language=english">acetylsalicylic acid (ASA)</a> to a child under 16 years of age. Do not give cough medicines to children under six years of age. Always read the label before giving any medicine.</p><p>In addition to fluids and pain medicine, other ways to treat flu symptoms include:</p><ul><li>applying heat on painful areas for short periods of time using a hot water bottle or heating pad to reduce muscle pain</li><li>taking a warm bath</li><li>gargling with a glass of warm water</li><li>using saline drops or spray and suction to clear a stuffy nose</li><li>keeping your home smoke free</li></ul><p>Call your child’s primary care provider if the above measures do not relieve your child's flu symptoms and your child feels worse or if you are worried.</p><h2>If your child has the flu in the hospital </h2><p>Your child will be placed in a single room and will not be able to visit the playroom until they are feeling better. Ask the child life specialist to bring toys and supplies to your child’s room.</p><p>Hospital staff will be wearing a mask, eye protection, gloves and gowns when they visit.</p><p>Wash your hands often, either with alcohol-based hand rubs or soap and water, before and after touching your child and before leaving your child's room. Hospital staff should wash their hands as well.</p><p>If you or anyone else who has visited becomes ill with symptoms of the flu, let your child's doctor or nurse know. </p><h2>When to seek medical attention</h2><p>Go see a doctor or to hospital if your baby is less than three months old and:</p><ul><li>has a fever</li><li>has fast or difficult breathing</li><li>is vomiting or not feeding</li></ul><p>Go see a doctor if your child:</p><ul><li>is more sleepy than usual</li><li>is more fussy than usual</li><li>is not drinking enough fluids or has not peed at least every six hours when awake</li><li>is vomiting</li><li>is having chest or stomach pain</li><li>is not feeling better after five days or gets better but then suddenly gets worse</li></ul><p>Call 911 or go to the nearest emergency department immediately if your child:</p><ul><li>is breathing quickly, or seems to be working hard to breathe</li><li>is very weak, dizzy, hard to wake up or does not respond well</li><li>is very fussy or cannot be comforted</li><li>is limping or refusing to walk</li><li>has bluish or dark-coloured lips or skin</li><li>has a stiff neck, severe headache or a seizure</li><li>has a very fast heart rate, even when the fever is down</li></ul><p>If you have any concerns, call your doctor or your local public health agency. In Ontario, you can also call TeleHealth Ontario at 1-866-797-0000.</p><p>If you or your child is in a high-risk group, call your doctor right away when you get flu symptoms. There are specific anti-viral medicines available to help treat flu. These medicines must be started early in the illness to be effective. Contact your child's doctor for more information. </p>fluhttps://assets.aboutkidshealth.ca/AKHAssets/influenza_overview.jpgMain
Information about cannabis for recreational useIInformation about cannabis for recreational useInformation about cannabis for recreational useEnglishAdolescentTeen (13-18 years)NANAHealthy living and preventionTeen (13-18 years)NA2022-05-25T04:00:00Z11.400000000000042.9000000000000974.000000000000Flat ContentHealth A-Z<p>Learn about cannabis and find out about the short- and long-term effects of using it recreationally.</p><h2>What is cannabis?</h2><p>Cannabis (also known as marijuana, weed and pot) refers to a group of plants that are grown around the world, including Canada. The cannabis plant contains many chemical substances, including over 100 "cannabinoids".</p><h2>What is a cannabinoid?</h2><p>Cannabinoids affect cells in the brain and the body. They can change how those cells behave and communicate with each other.</p><h2>What are examples of cannabinoids?</h2><ul><li>THC (delta-9-tetrahydrocannabinol) is a cannabinoid you may hear about the most. It is a "psychoactive" component, meaning that it is responsible for the way your brain and body respond to cannabis, including the "high" or intoxicating effect.</li><li>CBD (cannabidiol) is also a cannabinoid. While it is also psychoactive, it does not produce a high or intoxication and is often used for medicinal purposes.</li></ul><p>Each cannabinoid works on different cannabinoid receptors located in the brain or other parts of the body. Different formulations of cannabis contain varying amounts of THC and CBD, so the effects of cannabis on your body will depend on this, as well as how the cannabis is used (e.g., smoked, ingested, applied to the skin).</p><h2>Key points</h2><ul><li>Cannabis refers to a group of plants that contain chemical substances, including cannabinoids such as THC and CBD.</li><li>Cannabis can be consumed by smoking or vaping, eating cannabis products such as baked goods and candies, or applying it to the skin in the form of lotions or ointments.</li><li>You must be 19 and older to legally buy, use, possess and grow recreational cannabis in Ontario.</li><li>Short-term effects of cannabis use can include feeling relaxed, being sociable, increased heart rate, difficulty concentrating, delayed reaction time, feeling anxious or panicky, and distorted thoughts and/or paranoia.</li><li>Long-term effects of cannabis use can include: long-term impaired working memory, emotional dysregulation, poor attention and impulse control; increased risk of changes in thoughts, feelings and behaviours; cannabis hyperemesis (severe and repeated bouts of vomiting); and cannabis dependence.</li></ul><h2>Resources</h2><p><a href="https://www.canada.ca/en/health-canada/services/canadian-student-tobacco-alcohol-drugs-survey/2018-2019-summary.html">Summary of results for the Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS) 2018-19</a></p><p><a href="https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/research-data/canadian-cannabis-survey-2021-summary.html">Canadian Cannabis Survey 2021: Summary</a></p>https://assets.aboutkidshealth.ca/AKHAssets/Info_about_cannabis_rec_use.jpgTeens
Informed choice and informed consentIInformed choice and informed consentInformed choice and informed consentEnglishPregnancyAdult (19+)BodyReproductive systemNAPrenatal Adult (19+)NA2009-09-11T04:00:00Z10.100000000000057.10000000000001251.00000000000Flat ContentHealth A-Z<p>Learn about informed choice and informed consent, as they pertain to pregnancy. The mother's rights and responsibilities are discussed.</p><p>If you are pregnant, you have a responsibility to yourself and your unborn baby to make informed decisions about your pregnancy, childbirth, and the time after birth. The decisions you make influence the type of care you receive. Informed choice leaves you, not your caregiver, as the primary decision maker, in contrast to the traditional medical model of informed consent that leaves the choice of possible treatment in the hands of the health-care providers. </p><h2>Key points</h2> <ul><li>Informed choice is when a person is given options to choose from several diagnostic tests or treatments, knowing the details, benefits, risks and expected outcome of each.</li> <li>Informed consent is when a person agrees to the test or treatment they have been offered, knowing the details, benefits, risks and expected outcome.</li> <li>Your caregiver has the right to agree or disagree to provide the care that you request.</li> <li>In the case of an emergency when there is no time to obtain informed consent, a doctor can decide whether to go ahead without consent.</li></ul>Main
Informed consentIInformed consentInformed consentEnglishNeonatologyPremature;Newborn (0-28 days);Baby (1-12 months)NANANAPrenatal Adult (19+)NA2009-10-31T04:00:00Z10.700000000000049.7000000000000712.000000000000Flat ContentHealth A-Z<p>Read about informed choice, which is the option a person has to allow or not allow a procedure to happen once the procedure has been completely explained.</p><p>Informed choice is the option a person has to allow or not allow a procedure to happen once the procedure has been completely explained. In most cases except in emergencies, informed choice and informed consent will be obtained from parents or caregivers before treatment begins.</p><h2>Key points</h2> <ul><li>Informed choice is the option a person has to allow or not allow a test or procedure to happen after they have been informed of the benefits and risks of the options involved.</li> <li>Informed consent is when a person voluntarily agrees to a procedure after they know what the benefits and risks are.</li> <li>If treatment cannot wait for informed consent, the doctor can decide whether to go ahead without consent. This may vary depending on the hospital.</li></ul>Main
Informed consent for brain tumoursIInformed consent for brain tumoursInformed consent for brain tumoursEnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemNAAdult (19+)NA2009-07-10T04:00:00Z10.900000000000051.8000000000000938.000000000000Flat ContentHealth A-Z<p>An in-depth discussion of the issue of informed consent for children who are undergoing medical procedures.</p><p>Informed choice is the option a person has to allow or not allow something to happen, like diagnostic procedures or treatment, after they have been informed of the benefits and risks of the options involved. If the person agrees, they give informed consent. </p><h2>Key points</h2> <ul><li>Informed choice is the option to allow or not allow something to happen after being informed of all the benefits and risks of all options involved.</li> <li>Agreeing to a specific procedure or treatment is giving informed consent.</li> <li>A parent or guardian usually gives informed consent, unless it is an emergency and the guardian cannot be contacted.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/informed_consent_for_brain_tumours.jpgMain
Informed consent for treatment and researchIInformed consent for treatment and researchInformed consent for treatment and researchEnglishNAChild (0-12 years);Teen (13-18 years)NANANon-drug treatmentCaregivers Adult (19+)NA2009-12-04T05:00:00Z10.300000000000055.3000000000000969.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn about informed consent, or the option a person has to allow or not allow something like treatment, after she has been informed of the situation.</p><h2>What is informed choice or informed consent?</h2><p>Informed choice is the option a person has to allow or not allow something to happen, like treatment, after they have been informed of the benefits and risks of the options involved. If the person agrees, they give informed consent.</p> <br><h2>Key points</h2> <ul> <li>Informed choice is the option a person has to allow or not allow something to happen, after they have been informed of the benefits and risks of the options. If the person agrees, they give informed consent. </li> <li>Different provinces have different rules about who gives informed consent.</li> <li>In Ontario, children who are fully capable of understanding their care have the right to make decisions about their treatment. Children who are partly capable of understanding decisions about their care have the right to participate in those decisions.</li> <li>You have the right to ask questions and express your concerns about treatment.</li> </ul><h2>What is assent?</h2> <p>Children who are partially able to understand treatment or research issues have a right to participate in decisions about their care or participation in research. After having the treatment or research explained in a way they can understand, they will be asked for their assent, or agreement, which can involve signing an assent form. </p> <p>If a child refuses to assent to treatment, and the doctor and guardian believe treatment is necessary, treatment will usually be provided. If a child refuses to assent to participate in research, they should not be included in the research. </p> <h2>What does informed consent to undergo treatment such as surgery involve?</h2> <p>Consent before surgery or other treatment is an example of the informed consent process. Before your child is scheduled for a procedure or surgery, you, as the parent or guardian, need to decide whether or not the doctor can go ahead, unless your child is capable of deciding themselves. The doctor will discuss with you the risks involved with the surgery, treatment or procedure under anaesthetic before you sign a consent form. The doctor is required to tell you about any potential problems that could occur and to ensure that you understand the general nature of the procedure. They should also explain why they think the surgery is required, and the problems that might occur if the surgery does not go ahead.</p> <p>This discussion provides an opportunity to ask any questions you may have about the procedure or express any concerns you have. Brace yourself to hear about the potential negative outcomes. This is usually very difficult to hear, but you should try to stop yourself from thinking the worst. </p> <p>In the case of surgery and some other procedures, by signing the form you will also be consenting to the use of anaesthetic if necessary. At some hospitals, you may be asked to give a separate consent for the use of anaesthetic. Usually you are also agreeing to any additional investigation or treatment that the doctor may decide is immediately necessary during the surgery. This would only happen if the doctor finds something they were not expecting to find, and needs to do something about it right away. The consent forms will be kept in your child's medical record. </p> <h2>What does informed consent to take part in research or a clinical trial involve?</h2> <p>A clinical trial is a type of research study that involves treatment. In Ontario, a child that is able to understand fully or partially may decide whether or not to take part in a research study or a clinical trial. The health care team member must make certain you and your child have a full understanding of the purpose of study, the results expected, how the study works, any risks or benefits, and in the case of a clinical trial, the other treatments available. You may ask questions about the study and receive information about the results when the study is finished. </p> <p>After explaining this, they will ask you or your child to make a decision about taking part in the study. To give consent to take part, you or your child will sign a document called a consent form describing the research and the risks and benefits to your child. </p> <p>If you decide not to take part in a research study or clinical trial, your child will continue to receive the same quality of care from your child's health care team and the hospital. If you do decide to take part in the study or trial, signing a consent form is not a contract. You can change your mind and withdraw at any time. </p> <p>For more information, please read <a href="/Article?contentid=1264&language=English">Clinical trials and your child</a>.</p>https://assets.aboutkidshealth.ca/AKHAssets/consent_giving_informed_consent.jpgMain
Ingrown toenailIIngrown toenailIngrown toenailEnglishDermatologyChild (0-12 years);Teen (13-18 years)SkinSkinConditions and diseasesCaregivers Adult (19+)NA2020-05-13T04:00:00Z7.2000000000000068.60000000000001281.00000000000Health (A-Z) - ConditionsHealth A-Z<p>An ingrown toenail occurs when the side of the nail grows into the surrounding skin. Learn what causes this condition and how it can be treated.</p><h2>What is an ingrown toenail?</h2><p>An ingrown toenail occurs when the side of the nail grows into the surrounding skin instead of straight outward. Since the nail cuts into the skin, it is common for the area to become infected or inflamed.</p><p>Ingrown toenails can cause discomfort and pain. They are a common problem, especially in teenagers and young adults.</p> <figure class="asset-c-80"> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_ingrown_toenail_EN.png" alt="Illustration of a healthy toenail and an ingrown toenail" /> </figure><h2>Key points</h2> <ul> <li>An ingrown toenail occurs when the toenail grows into the surrounding skin, causing pain and discomfort.</li> <li>The causes of ingrown toenails include tight footwear, improperly trimmed nails and repeated bumps to the toes.</li> <li>The early signs and symptoms of an ingrown toenail include swelling, redness and pain.</li> <li>Early on, an ingrown toenail can be treated by improving footwear, trimming nails straight across and applying a topical antibiotic ointment, if needed.</li> <li>Later signs of ingrown toenail include pus, a bad smell or a fever. If your child has these signs and symptoms, they should see a doctor because they may need antibiotics.</li> </ul><h2>How does an ingrown toenail affect the body?</h2><p>An ingrown toenail is most likely to occur on the big toe, but any toe can be affected.</p><p>At first, the skin around the ingrowing nail may become red and feel slightly sore. With time, there can be more pain and swelling. Small openings in the skin can then allow bacteria to enter, which can cause the area to become infected.<br></p><h2>What causes an ingrown toenail?</h2><p>An ingrown toenail can have a number of causes, including:</p><ul><li>poorly fitting shoes</li><li>over-trimming of the nails</li><li>tearing or picking at the nail</li><li>repeated pressure or trauma to the nail</li><li>certain nail or toe shapes<br></li></ul><h3>Shoes</h3><p>Shoes that are too narrow or those that put pressure over the nails are more likely to cause ingrown toenails.</p><h3>Nail trimming</h3><p>Trimming the nails too much or rounding the edges instead of cutting straight across can lead to ingrown toenails.</p> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_toenail_trimming_EN.png" alt="Illustration of correct toenail trimming and incorrect toenail trimming" /> </figure> <h3>Picking at nails</h3><p>Ingrown toenails are more likely in children who pick at their toenails.</p><h3>Pressure or impact on the nail</h3><p>An ingrown toenail is more likely to occur following a bump or other injury to the toe. For example, people who participate in sports may be more likely to develop ingrown toenails because their feet might be more prone to pressure and injury. The increased sweating that results from physical activity also makes it easier for bacteria to grow and cause an infection.</p><h3>Nail and toe shapes<br></h3><p>Sometimes, deformities of the foot or toes can place extra pressure on the nails. In addition, some people are born with curved nails that grow downward. Others have toenails that are too big for their toes. All of these factors can make ingrown toenails more likely. Some of these conditions may improve on their own over time.</p><h2>How is an ingrown toenail diagnosed?</h2> <p>A doctor can diagnose an ingrown toenail by examining your child and asking questions about how they feel when they walk.</p> <p>Inspect your child’s feet often to look for any signs of an ingrown toenail. One early sign is redness and swelling of the skin near the edge of the nail. If the ingrown nail is infected, your child may develop a fluid-filled blister or redness that extends around the toe or towards the foot. Your child may also complain that their foot hurts or may limp or wince when they walk.</p><h2>How is an ingrown toenail treated?</h2> <figure> <span class="asset-image-title">Ingrown toenail: Treatment with tape</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_ingrown_toenail_tape_treatmetreatment.png" alt="Attaching tape to skin beside toenail, pulling to move skin away from toenail, then wrapping tape around to attach the ends" /> <figcaption class="asset-image-caption">1) Attach one end of a piece of tape to the skin beside the ingrown toenail. 2) Move skin out of the way by gently pulling the tape as you start to wrap it around the toe. 3) Stick the two ends of the tape together at the front of the toe, near the cuticle.</figcaption> </figure> <p>Several options are available to treat an ingrown toenail.</p><p>The early signs can be resolved by:</p><ul><li>wearing wider or open-toed footwear</li><li>trimming nails straight across<br></li><li>finding ways to allow the nail to grow out of the skin, for example by using tape to pull the skin beside the nail out of the way (see image to the right).</li></ul><p>Other treatments for ingrown toenails include:</p><ul><li>Soaking the foot in a mix of lukewarm water and mild soap or one to two teaspoons of Epsom salt. After soaking the foot, apply a topical antibiotic ointment around the ingrown toenail. During the day, while your child is wearing shoes, the toenail can be covered with a bandage. At night, the bandage can be removed to allow the toenail to "air out" in bed.</li><li>Using a short piece of unflavoured, unwaxed dental floss to gently separate the skin of the toe.<br></li></ul><p>If an infection develops, your child will need to take antibiotics to treat it and prevent complications. In rare cases, your child might need surgery to resolve the problem.</p><div class="akh-series"><div class="row"><div class="col-md-12"> <figure> <span class="asset-image-title">Ingrown toenail surgery</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_ingrown_toenail_surgery_EN.png" alt="Illustration of incision line over an ingrown toenail and of toenail with ingrown nail section removed" /> </figure> <h3>How to treat repeated episodes of ingrown toenail</h3><p>If your child experiences ingrown toenail repeatedly, they may need surgery (an operation) to remove part of their nail. This involves a number of steps.</p><ol><li>Your child is injected with a local anaesthetic into the base of their toe to numb it.</li><li>A surgeon cuts their toenail the long way (towards the cuticle), just a few millimetres from the problem edge.</li><li>If the nail bed has been exposed a number of times, the surgeon may apply some medication to help stop the edge of the nail from re-growing and causing another ingrown toenail.<br></li><li>The surgeon dresses the nail with a bandage.<br></li></ol><p>The surgeon will tell you how to care for the area around the nail as it heals.</p></div></div></div><h2>Infection</h2><p>If an infection occurs, the skin may become more swollen, red and painful. Some yellow or green pus (fluid) may start oozing from around the nail. The area may also produce a bad smell. Over time, the skin around the nail can overgrow, causing more pain.</p><p>If left untreated, an ingrown toenail can lead to <a href="/article?contentid=801&language=English">cellulitis</a>, a type of skin infection. In extremely rare cases, it can lead to <a href="/article?contentid=2311&language=English">osteomyelitis</a>, an infection of the bone.</p><h2>When to see a doctor for ingrown toenail</h2> <p>See your child’s doctor if:</p> <ul> <li>you have checked your child and noticed early signs of an ingrown toenail but would like a clear diagnosis</li> <li>your child’s symptoms continue after you have treated the early signs of an ingrown toenail</li> <li>your child complains of pain across the toe</li> <li>your child shows signs of infection beside the nail, such as redness, pus or a bad smell</li> <li>your child has a fever</li> </ul><h2>References</h2><p>Schmitt, B. <a href="https://patiented.solutions.aap.org/handout.aspx?gbosid=494554">Toenail - Ingrown</a>. American Academy of Pediatrics, Pediatric Patient Education. Retrieved from <a href="https://patiented.solutions.aap.org/handout.aspx?gbosid=494554">https://patiented.solutions.aap.org/handout.aspx?gbosid=494554</a>.</p>https://assets.aboutkidshealth.ca/akhassets/IMD_ingrown_toenail_surgery_EN.pngMain
Insect bitesIInsect bitesInsect bitesEnglishDermatologyChild (0-12 years);Teen (13-18 years)SkinSkinConditions and diseasesCaregivers Adult (19+)NA2021-03-23T04:00:00Z8.0000000000000060.9000000000000818.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Discover how to recognize, treat and prevent insect bites and bee stings, and when to seek medical attention. </p><p>Insect bites and stings occur when an insect feeds off a person's skin or tries to defend itself.</p><p>Different insects bite and sting in different ways. Common biting or stinging insects include mosquitoes, blackflies, bed bugs, fleas, ticks, fire ants, bees and wasps. Bees often leave stingers in the wound.</p><p>Insect bites usually cause mild swelling, redness and itchiness limited to the small area around the bite or sting. </p><p>Some children, however, can experience potentially life-threatening allergic reactions. This is called an anaphylactic reaction and requires immediate medical attention. In children who are at risk, <a href="/Article?contentid=781&language=English">anaphylaxis</a> is most commonly caused by bees, wasps and hornets.</p><p>Other insects can transmit disease. For example, some mosquitoes can transmit malaria or West Nile virus and some ticks can cause Lyme disease.</p><h2>Key points</h2><ul><li>Insect bites often cause swelling and redness.</li><li>Some children experience severe and potentially life-threatening reactions to stings from certain insects like bees and wasps.</li><li>Common biting or stinging insects include mosquitoes, blackflies, bees and wasps.</li><li>Some children respond well to antihistamine medication; others may just need some ice.</li><li>Prevent insect bites and stings by covering the body with light-coloured clothing and applying insect repellent to exposed skin.</li><li>DEET is a very effective repellent for insects that bite, but use it carefully according to your child's age. If using sunscreen and insect repellent, apply sunscreen first.</li></ul><h2>Signs and symptoms of an insect bite or sting</h2><p>Signs and symptoms of insect bites and stings vary according to the type of insect and your child's reaction.</p><p>Normally, an insect bite or sting causes:</p><ul><li>a small, red, raised bump, pimple or blisters</li><li>itchiness and irritation around the bump<br></li></ul><p>The symptoms can last from a few hours up to two days.<br></p><p>Some children develop a big firm swollen area around the bite. This is not an allergic reaction. It is known as a large local reaction and rarely leads to a skin infection.</p><p>If your child has an anaphylactic reaction, they may develop <a href="/article?contentid=789&language=English">hives</a>, facial or mouth swelling, or breathing problems or they may collapse. Use an epinephrine auto-injector, if your child has one, and call for emergency assistance.</p><h2>How to treat insect bites and stings</h2><ul><li>Cold, damp compresses or ice can relieve some of the swelling.</li><li>Over-the-counter topical medications (medications you put on the skin) may also help to relieve the itch.</li></ul><p>Some children may respond well to oral (taken by mouth) antihistamine medication for itching. Your child’s doctor or pharmacist can suggest a product.</p><h2>When to see a doctor after an insect bite or sting</h2><p>If your child has been bitten or stung, see a doctor right away if:</p><ul><li>you are in an area where the insects are known to transmit diseases</li><li>your child develops an unusual rash, a <a href="/Article?contentid=30&language=English">fever</a> or other symptoms of anaphylaxis</li></ul>insectbiteshttps://assets.aboutkidshealth.ca/AKHAssets/insect_bites.jpgMain
Insulin dose adjustment on a multiple daily routineIInsulin dose adjustment on a multiple daily routineInsulin dose adjustment on a multiple daily routineEnglishEndocrinologyChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemDrug treatmentAdult (19+)NA2016-10-17T04:00:00Z11.300000000000051.0000000000000858.000000000000Flat ContentHealth A-Z<p>Find out how to adjust insulin doses at home using the sliding scale when your child is on a multiple daily injections (MDI) routine</p><p>The following guidelines will help you adjust <a href="https://akhpub.aboutkidshealth.ca/Article?contentid=1728&language=English">insulin</a> dosages at home. With practice and experience, this will soon become second nature. If you have any questions, or if adjusting the insulin dosage does not seem to help achieve <a href="https://akhpub.aboutkidshealth.ca/Article?contentid=1724&language=English">target blood glucose (sugar) levels</a>, contact your primary diabetes care team.</p><h2>Key points</h2><ul><li>An MDI regimen allows for insulin changes based on the sliding scale, which adjusts the dose of rapid-acting insulin before meals and snacks based on blood sugar levels.</li></ul>https://assets.aboutkidshealth.ca/akhassets/IMN_blood_glucose_target_range_EN.pngMain
Insulin in diabetes managementIInsulin in diabetes managementInsulin in diabetes managementEnglishEndocrinologyChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemDrug treatmentAdult (19+)NA2016-10-17T04:00:00Z8.2000000000000064.2000000000000650.000000000000Flat ContentHealth A-Z<p>Insulin allows sugar to be stored as energy. Learn what role insulin plays in diabetes management.</p><p>Our bodies require insulin to allow cells to have energy and to allow extra sugar to be stored as energy. This section will cover the important role insulin plays in diabetes management.</p><h2>Key points</h2> <ul><li>Insulin is a hormone produced by the beta cells of the pancreas that allows cells to use sugar for energy and allows the extra sugar to be stored as energy for future use.</li> <li>Without enough insulin, sugar cannot be taken up and used by most of the body cells.</li> <li>Patients with diabetes must administer their own insulin.</li><ul></ul></ul>Main
Insulin injection management during illnessIInsulin injection management during illnessInsulin injection management during illnessEnglishEndocrinologyChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemDrug treatmentAdult (19+)NA2016-10-17T04:00:00Z7.9000000000000062.5000000000000654.000000000000Flat ContentHealth A-Z<p>Find out how to manage insulin injections while your child is sick.</p><p>​When children are sick, they still need their long-acting insulin at their usual times. In fact, they may need extra injections of <a href="/Article?contentid=1729&language=English">rapid-acting insulin</a> as often as every four hours if they have <a href="/Article?contentid=1723&language=English">high blood glucose (sugar) levels</a> or if <a href="/Article?contentid=1727&language=English">ketones</a> show up in their urine.</p><h2>Key points</h2><ul><li>To decide how much insulin to give, check blood sugar and urinary ketone levels every four hours.</li><li>To determine the total daily dose (TDD) of insulin, you must add all amounts of insulin from the past 24 hours including both long/intermediate and rapid-acting insulin.<br></li></ul>Main
Insulin injectionsIInsulin injectionsInsulin injectionsEnglishEndocrinologyChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemDrug treatmentAdult (19+)NA2016-10-17T04:00:00Z8.5000000000000059.20000000000001452.00000000000Flat ContentHealth A-Z<p>Giving insulin injections can be stressful. Find out how to safely prepare and inject insulin into your child.<br></p><p></p><p>​Injecting a child with <a href="https://akhpub.aboutkidshealth.ca/Article?contentid=1728&language=English">insulin​</a> is probably one of the biggest challenges parents face. Many are nervous about needles, so it can be hard to think of giving one to their own child. Some children are also frightened of needles, which makes the adjustment difficult. With practice, however, children and parents quickly grow comfortable with administering insulin. And increasingly, children prefer to receive their insulin using pre-loaded injectable pens.<br></p><h2>Key points</h2><ul><li>Insulin is injected using a syringe, available in various sizes.</li><li>Some children require single-type insulin, while most will require two different types in one injection.</li><li>Carefully follow the instructions on how to inject insulin.<br></li></ul>https://assets.aboutkidshealth.ca/akhassets/IMD_syringe_insulin_EN.pngMain
Insulin pumpsIInsulin pumpsInsulin pumpsEnglishEndocrinologyChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemDrug treatmentAdult (19+)NA2016-10-17T04:00:00Z8.6000000000000059.80000000000001714.00000000000Flat ContentHealth A-Z<p>Learn how insulin pumps work, if they're right for your child and what the potential concerns are.</p><p> <a href="/Article?contentid=1728&language=English">Insulin​</a> pumps continuously deliver insulin. Their formal name is continuous subcutaneous insulin infusion pump. The pump is about the size of a phone pager, and is worn on the belt or kept in a pocket. An insulin pump allows your child to get as much insulin as needed without having to get a new needle each time.<br></p><h2>Key points</h2><ul><li>Insulin pumps continuously deliver insulin, allowing your child to get as much as needed without having to get a new needle each time.</li><li>Users can change the amount of insulin released based on their needs.</li><li>Insulin pumps have several advantages and disadvantages that will need to be considered.</li><li>Always carry back up supplies in case there is a problem with the insulin pump.<br></li></ul>https://assets.aboutkidshealth.ca/akhassets/IMD_insulin_pump_EN.jpgMain
Intellectual development and children with heart diseaseIIntellectual development and children with heart diseaseIntellectual development and children with heart diseaseEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartCardiovascular systemConditions and diseasesAdult (19+)NA2009-12-14T05:00:00Z13.700000000000028.7000000000000427.000000000000Flat ContentHealth A-Z<p>Read about how the development of a child's intellect may be affected by a congenital heart condition.</p><p> This page explains how severe heart conditions may affect a child's mental development.</p><h2> Key points </h2> <ul><li> The majority of children with mild congenital heart defects will not experience negative effects on their intellectual development.</li> <li>Some aspects of the condition may influence the child's mental development and affect their attention, language development, or executive function memory. </li> <li>Most children with CHD have similar psychological and emotional development to children without CHD.</li> <li>Psychological or emotional problems surface more often during adolescence. </li></ul>https://assets.aboutkidshealth.ca/AKHAssets/intellect_of_children_with_heart_disease.jpgMain
Interrupted aortic archIInterrupted aortic archInterrupted aortic archEnglishCardiologyChild (0-12 years)HeartCardiovascular systemConditions and diseasesAdult (19+)NA2009-12-04T05:00:00Z10.200000000000049.0000000000000366.000000000000Flat ContentHealth A-Z<p>Learn about interrupted aortic arch in children. This is a defect of the aorta not developing properly, and causes congestive heart failure.</p><p>Interrupted aortic arch is a defect that results when the aorta does not develop properly. With this condition, oxygen-rich blood from the left side of the heart cannot reach all areas of the body because of the defective aorta. The heart manages to get enough blood to the body by way of the ductus arteriosus, which has stayed open after birth. It usually occurs with a large atrial or ventricular septal defect. </p> <figure class="asset-c-80"><span class="asset-image-title">Normal heart</span><img src="https://assets.aboutkidshealth.ca/akhassets/Hearts_CHD/Normal_Heart_CHD.jpg" alt="Normal heart showing placement of the atria, ventricles, aorta, superior vena cava, inferior vena cava, pulmonary artery and pulmonary veins" /><figcaption class="asset-image-caption">The heart has two upper (receiving) and two lower (pumping) chambers. Blood flows into the upper chambers (the right atrium and the left atrium). The lower chambers (the right and left ventricles) pump blood out of the heart. The heart valves open and close to keep blood flowing in the correct direction. </figcaption> </figure> <figure class="asset-c-80"><span class="asset-image-title">Interrupted aortic arch</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/Hearts_CHD/Interrupted_aortic_arch.jpg" alt="Heart with divided aorta and patent ductus arteriosus that allows blood to get to the lower body" /><figcaption class="asset-image-caption">Interrupted aortic arch is a malformation of the aorta, resulting in the aortic arch being divided. This results in the body not receiving enough blood high in oxygen. A patent ductus arteriosus provides a bypass, allowing blood low in oxygen to reach the body.</figcaption> </figure><h2> Key points </h2><ul><li> A child with an interrupted aortic arch will have symptoms as the ductus arteriosus begins to close.</li><li>An interrupted aortic arch will be treated with drugs and open heart surgery during the first few days of life.</li> <li>Complete repair of the defect results in a very high survival rate.</li></ul>Main

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