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Safe food handling and preparation after a blood and marrow transplantSSafe food handling and preparation after a blood and marrow transplantSafe food handling and preparation after a blood and marrow transplantEnglishHaematology;Immunology;Oncology;NutritionChild (0-12 years);Teen (13-18 years)BodyImmune systemHealthy living and preventionAdult (19+)NA2017-06-05T04:00:00ZJohn Doyle, MD, FRCPC, FAAPChristine Armstrong, RN, MScN, NP Peds000Flat ContentHealth A-Z<p>Learn how to safely handle and prepare food for your child after a blood and marrow transplant.</p><p>After a <a href="/Article?contentid=1512&language=English">blood and marrow transplant</a>, your child’s immune system will be weak. Children with weak immune systems are more likely to get sick from harmful bacteria in food. Because of this, your child will need to avoid foods that may contain harmful bacteria. The diet that they follow is called a <a href="/Article?contentid=1546&language=English">low-bacteria diet</a>.</p><h2>Key points</h2> <ul><li>After a blood and marrow transplant, your child will need to use safe food handling guidelines and follow a low-bacteria diet.</li> <li>A low-bacteria diet involves avoiding foods that contain harmful bacteria.</li> <li>To minimize harmful bacteria, wash your hands before and after handling food, keep hot and cold food outside the temperature danger zone and store cooked and raw food separately in the fridge.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/safe_food_handling_and_preparation_after_blood_marrow_transplant.jpg
Safe outdoor mealsSSafe outdoor mealsSafe outdoor mealsEnglishPreventionChild (0-12 years);Teen (13-18 years)NANAHealthy living and preventionCaregivers Adult (19+)NA2014-06-11T04:00:00ZKellie Welch, RD7.5000000000000067.9000000000000731.000000000000Flat ContentHealth A-Z<p>Follow these tips for safe and tasty outdoor meals during the summer months.</p><p>On a hot summer day, there are few things nicer than a picnic or barbecue. Both offer a great opportunity to get outside, enjoy healthy foods in season and spend time with family and friends.<br></p><p>To make sure your dining experience is remembered for fun rather than food poisoning, follow these tips for tasty and safe summertime meals.</p><h2>Key points</h2><ul><li>Wash hands carefully before and after handling food.</li><li>Keep raw meat, seafood and poultry separate from other food.</li><li>Use a food thermometer to check the internal temperature of barbecued meat.</li> <li>For picnics, bring plenty of water and balance treats with whole grains, vegetables and fruit, and lean protein choices.</li><li>Wash vegetables and fruit before packing them and use cold packs or coolers to keep food and drinks cool.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/safe_outdoor_meals.jpg
Safety & the environmentSSafety & the environmentSafety & the environmentEnglishNANANANANACaregivers Adult (19+) Teen (13-18 years)NALanding PageLearning Hub<p>Information for parents about indoor and outdoor safety, car and travel safety, and poison prevention. Also find first aid resources including information about animal bites, insect bites and sunburns.</p><p>Information for parents about indoor and outdoor safety such as scald prevention and how to prevent head injuries in children. There are also resources discussing car and travel safety, and poison prevention. Also find first aid resources including information about animal bites, insect bites and sunburns.<br></p>safetyhttps://assets.aboutkidshealth.ca/AKHAssets/safety_and_the_environment_landing_page.jpg
ScabiesSScabiesScabiesEnglishDermatologyChild (0-12 years);Teen (13-18 years)SkinSkinConditions and diseasesCaregivers Adult (19+)NA2010-03-05T05:00:00ZSheila Jacobson, MBBCh, FRCPC6.2000000000000071.2000000000000620.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Scabies is a skin condition caused by mites. Learn what to look for and how it is treated.</p><figure> <span class="asset-image-title">Scabies</span> <img alt="Infant with scabies on arm, shoulder and armpit" src="https://assets.aboutkidshealth.ca/akhassets/Scabies2_MEDIMG_PHO_EN.jpg" /> <figcaption class="asset-image-caption">Scabies can lead to a secondary infection. It should be treated as soon as possible by a doctor.</figcaption> </figure> <h2>What is scabies?</h2><p>Scabies is an itchy skin condition caused by mites. The female mites dig into the skin to lay eggs. This causes intense itching. Scabies spreads very easily. The more mites on a person, the more likely they will spread to another person. Scabies spreads more easily in crowded places. Scabies can be confused with eczema or impetigo in children.</p><h2>Key points</h2> <ul> <li>Scabies is a common, highly infectious skin disease caused by a small mite.</li> <li>Signs and symptoms of the skin disease start about three to six weeks after contact.</li> <li>Scabies spread rapidly through direct physical contact. </li> <li>Untreated scabies can lead to bacterial infection </li> <li>All close contacts should be treated for scabies to prevent reinfection.</li> </ul><h2>Signs and symptoms of scabies</h2> <p>After the mites burrow into your child's skin, it may take three to six weeks before any symptoms show. Signs and symptoms may include:</p> <ul> <li>intense itching that gets worse at night</li> <li>thin, grey, raised lines on the skin, often found in the skin between the fingers or around the wrists, the elbows, armpits or the genitals</li> <li>in babies, sores may appear on the palms, the soles of the feet, neck, face and the scalp</li> <li>sores, blisters, or scabs from scratching</li> <li>inflamed lumps on the body</li> </ul><h2>Causes of scabies</h2> <p>Scabies is caused by mites. The female mites dig into the skin to lay eggs. Scabies usually spread through direct skin-to-skin contact, like holding hands or hugging. It can also spread by sharing towels or linens. Scabies spread from person to person during the incubation period, when there are no symptoms. The mites can only reproduce on human beings. Pets are unlikely to spread scabies.</p> <h2>Risk factors</h2> <p>The presence of scabies does not mean your child has poor personal hygiene. Children who live in crowded housing, share beds or spend time in crowded day cares are at higher risk. </p><h2>Treatment of scabies</h2> <p>Scabies will not clear without treatment. Your child's doctor will likely prescribe a cream or lotion that will kill the scabies mites. The cream will likely contain 5% permethrin. In general, your doctor will advise you to treat the scabies with one application of cream to your child's body for about eight hours. Apply the cream all over your child's body, with particular attention to the spaces between fingers, wrists, armpits and around the genitals. Do not put the cream inside your child's genitals. If mites reappear, it may be necessary to reapply the cream one or two weeks later. </p> <p>Your doctor may also prescribe an antihistamine or anti-itch cream to help ease your child's skin irritation. The irritation can go on for two to four weeks after the mites are killed.</p> <p>Your child can go back to day care or school once the treatment regime is complete. You must be certain the mites have been killed. </p><h2>Complications </h2> <p>Scratching can further damage the skin resulting in additional infection. If these infections are not treated, it can lead to impetigo, a bacterial infection of the skin. Children who do not have scabies diagnosed early are more likely to develop a secondary infection. </p><h2>When to seek medical assistance</h2> <p>Make an appointment with your child's doctor as soon as you notice your child scratching regularly. See a doctor right away if you see other signs or symptoms of scabies.</p>scabieshttps://assets.aboutkidshealth.ca/akhassets/Scabies2_MEDIMG_PHO_EN.jpg
Scald preventionSScald preventionScald preventionEnglishPreventionChild (0-12 years);Teen (13-18 years)NANAHealthy living and preventionCaregivers Adult (19+)NA2013-09-19T04:00:00ZCharis Kelly, RN(EC), MN5.0000000000000077.0000000000000133.000000000000Flat ContentHealth A-Z<p>Hot liquids are the major cause of burn injuries in young children. Learn how to keep your children safe from scalds and how to treat a burn.</p><p>Hot liquids are the major cause of burn injuries in young children. Burns that are caused by contact with a hot liquid are called scalds. They are preventable.</p><h2>Key points</h2> <ul> <li>Hot liquids are the major cause of burn injuries in young children. Burns that are caused by contact with a hot liquid are called scalds.</li> <li>Scalds are preventable. Do not leave children alone around hot beverages or food preparation areas including the stove. Turn handles of pots on the stove inwards.</li> <li>If your child has a scald injury remove any clothes that are covering the injury. Then using either room temperature or a bit cooler than room temperature water cool the burn over a period of 20 minutes.</li> </ul>https://assets.aboutkidshealth.ca/AKHAssets/scald_prevention.jpg
Scarlet feverSScarlet feverScarlet feverEnglishInfectious DiseasesPreschooler (2-4 years);School age child (5-8 years)SkinImmune systemConditions and diseasesCaregivers Adult (19+)Fever;Headache;Nausea;Rash;Sore throat;Vomiting2014-07-28T04:00:00ZShawna Silver, MD, FRCPC, FAAP, PEng7.8000000000000064.6000000000000995.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Easy-to-understand overview covers signs, causes, treatment and advice on when to seek medical assistance for this serious strep throat infection with a rash.</p><figure> <span class="asset-image-title">Scarlet </span> <span class="asset-image-title">fever</span> <img alt="Scarlet fever rash on body" src="https://assets.aboutkidshealth.ca/akhassets/Scarlet_fever_MEDIMG_PHO_EN.jpg" /> <figcaption class="asset-image-caption">The</figcaption> <figcaption class="asset-image-caption"> scarlet fever rash looks like red, sunburned skin. It is made up of tiny pink spots.</figcaption> </figure> <h2>What is scarlet fever</h2><p>Scarlet fever is an infection caused by a strain of the bacteria called Group A Beta-haemolytic Streptococcus (GABS), or strep for short. This strain of bacteria produces a toxin (a harmful substance) that causes the scarlet rash. However, not all strains of bacteria produce this toxin.</p><p>Scarlet fever occurs most often in children aged four to eight. It is rare in children younger than two years.</p><h2>Key points</h2> <ul> <li>The main symptoms of scarlet fever are fever and a rough red rash. Your child may also have a sore throat.</li> <li>If you suspect that your child might have scarlet fever, go to see your child's health-care provider.</li> <li>Scarlet fever is treated with antibiotics. It is very important to finish the antibiotics to prevent repeat infections and complications.</li> <li>Use soft foods and cold drinks as well as pain medications to reduce the pain.</li> <li>Make sure that any other family members or close contacts with similar symptoms see their health-care provider.</li> </ul><h2>Signs and symptoms of scarlet fever</h2> <figure> <span class="asset-image-title">Scarlet fever on the </span> <span class="asset-image-title">elbow</span> <img alt="Scarlet fever rash on arm, in elbow crease" src="https://assets.aboutkidshealth.ca/akhassets/Scarlet_fever_arm_MEDIMG_PHO_EN.jpg" /> <figcaption class="asset-image-caption">Scarlet</figcaption> <figcaption class="asset-image-caption"> fever can cause the elbow creases and other skin folds to become very red.</figcaption> </figure> <h3>Rash</h3><p>The main symptom of a scarlet fever infection is a scarlet (red-to-orange) rash that spreads along your child's skin.</p><ul><li>The rash often appears first on the neck and face.</li><li>It begins by looking like a sunburn. It can feel rough, like sandpaper and may itch.<br></li><li>After it appears on the neck and face, the rash spreads to the chest and back, and then the rest of the body.</li><li>It tends to form red streaks in body creases, especially around the underarms and elbows.</li><li>It usually fades after four to six days.</li></ul><h3>Skin peeling</h3><p>The affected skin may start to peel seven to 10 days after the rash disappears and may continue to peel for up to six weeks.</p><h3>Fever</h3><p>Often, a <a href="/Article?contentid=30&language=English">fever</a> appears one to four days before the rash.</p><h3>Sore throat</h3><p>If you look into your child's mouth, you may see enlarged red tonsils, sometimes covered with a white-yellow coating. The tongue may be white-red with small red dots and look like a strawberry.</p><h3>Other symptoms</h3><p>Some children may have other symptoms like <a href="/Article?contentid=29&language=English"> headache</a>, <a href="/Article?contentid=347&language=English">nausea</a>, <a href="/Article?contentid=746&language=English">vomiting</a>, stomach-area pain and muscle pain.</p><p>Other infectious conditions (such as measles or staphylococcal skin infection) or inflammatory conditions (such as Kawasaki disease) can cause similar symptoms to scarlet fever.</p><h2>How scarlet fever is diagnosed</h2> <p>To find out the cause of your child's pain and rash, the doctor may take a throat swab. A throat swab is a cotton-tipped stick that the doctor wipes along the side and back of your child's throat. The swab is then tested for the GABS or strep bacteria.</p><h2>How scarlet fever is treated</h2> <p>If the throat swab is positive for GABS, the doctor will prescribe oral antibiotics (taken by mouth) for your child.</p><h2>Complications from scarlet fever</h2> <p>Although rare, one complication of scarlet fever is rheumatic fever, a condition that can involve the skin, joints, heart and brain. Treating the initial strep infection with antibiotics almost always prevents rheumatic fever.</p> <p>Other complications can include joint inflammation (arthritis) and kidney inflammation.</p><h2>When to see a doctor</h2> <p>Call your child's doctor if:</p> <ul> <li>the fever does not go away three days after starting antibiotics</li> <li>the rash develops blisters or open sores or becomes quite painful</li> <li>your child is unable to drink or eat and is becoming dehydrated</li> <li>your child has difficulty breathing</li> </ul>scarletfeverhttps://assets.aboutkidshealth.ca/akhassets/Scarlet_fever_arm_MEDIMG_PHO_EN.jpg
School & career planning for children with heart diseaseSSchool & career planning for children with heart diseaseSchool & career planning for children with heart diseaseEnglishCardiologyTeen (13-18 years)HeartCardiovascular systemConditions and diseasesAdult (19+)NA2009-12-14T05:00:00ZRoss Hetherington, PhD, C.Psych12.700000000000043.1000000000000515.000000000000Flat ContentHealth A-Z<p>Read about preparing a teenager with congenital heart disease for high school. Guidance counselors and managing work, time and treatment are discussed.<br></p><p> This page outlines how you can support your teenager with a heart condition while they are in school and help them start thinking about prospective careers.</p><h2> Key points </h2> <ul><li> Teenagers with a heart condition may require extra support from their school administration, a tutor, or guidance counsellor as they navigate high school and start planning a career path.<br></li></ul>https://assets.aboutkidshealth.ca/AKHAssets/school_and_career_planning_for_children_with_heart_disease.jpg
School Age ChildSSchool Age ChildSchool Age ChildYourSchoolagechildEnglishNASchool age child (5-8 years)NANANACaregivers Adult (19+)NALanding PageLearning Hub<p>Starting school is a landmark in a young child's life. Learn about the typical physical, emotional and communication milestones for school-age children and how to handle issues such as bullying, bladder control and sleep problems.</p><p>Starting school is a landmark in a young child's life. Learn about the typical physical, emotional and communication milestones for school-age children and how to handle issues such as bullying, bladder control and sleep problems.</p>YourSchoolagechildhttps://assets.aboutkidshealth.ca/AKHAssets/Ages_stages_school-age.jpg
School and children with heart diseaseSSchool and children with heart diseaseSchool children with heart diseaseEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartCardiovascular systemConditions and diseasesAdult (19+)NA2009-12-14T05:00:00ZRoss Hetherington, PhD, C.Psych10.000000000000053.10000000000002143.00000000000Flat ContentHealth A-Z<p>Learn how congenital heart disease can affect a child’s experience in school.</p><p> This page explains how congenital heart disease can affect your child's academic performance, and outlines ways you can prepare your child for their return to school.</p><h2> Key points </h2> <ul><li> A heart condition will often have some impact on a student’s performance at school, both in and out of the classroom.</li> <li> Teachers should be aware of any restrictions on physical activity a student has because of a heart condition.</li> <li> Teachers should understand that heart surgery will be disruptive to the student's school work and may also have other physical and behavioural effects.</li> <li> By co-ordinating with the student's parents and staff at the child’s cardiac clinic, teachers can help children with heart conditions succeed.</li> </ul>https://assets.aboutkidshealth.ca/AKHAssets/school_and_children_with_heart_disease.jpg
School and leukemiaSSchool and leukemiaSchool and LeukemiaEnglishOncologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemConditions and diseasesAdult (19+)NA2018-03-06T05:00:00ZOussama Abla, MDDanielle Weidman, MDKarin Landenberg, MD000Flat ContentHealth A-Z<p> Learn about education options for your child during their leukemia treatment and how to handle their transition back into school.</p><p>Education should remain an active part of your child’s life during their leukemia treatment so they will not fall too far behind. You can work with your child’s doctors and teachers to create a unique program that can accommodate your child.</p> <p> The hospital can provide school teachers to your child, especially if their length of admission is long.</p><h2> Key points </h2><ul><li>You can work with your child's school and the hospital to keep education as part of their life during their leukemia treatment.</li><li> Your child's teachers may not be familiar with leukemia, so it is important to advocate for your child's abilities upon their return to school.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/School_and_leukemia.jpg
School services for autism spectrum disorder (ASD)SSchool services for autism spectrum disorder (ASD)School services for autism spectrum disorder (ASD)EnglishNeurologyChild (0-12 years)NANervous systemConditions and diseasesAdult (19+)NA2009-03-09T04:00:00ZJanice Mulligan MSW, RSWRadha MacCulloch, MSWWendy Roberts MD. FRCPCLee Steel00687.000000000000Flat ContentHealth A-Z<p>Provides information about the various services that are available in schools for children with autism spectrum disorder. Also provides information about other programs that can be used to help pre-school and school-age children.<br></p>
School-aged child, tween and teen meal ideasSSchool-aged child, tween and teen meal ideasSchool-aged child, tween and teen meal ideasEnglishNutritionChild (0-12 years);Teen (13-18 years)NANAHealthy living and preventionCaregivers Adult (19+) Educators Hospital healthcare providers Community healthcare providers Remote populations First nationsNA2013-09-27T04:00:00ZStephanie Gladman, RD, MHSc.;Mahsa Esmaeili, RD, MHSc.;Elly Berger, BA, MD, FRCPC, FAAP, MHPE6.4000000000000073.2000000000000638.000000000000Flat ContentHealth A-Z<p>Learn how to support your child's changing nutrition needs with nutritious snacks and meal ideas.</p><p>Starting school is a big occasion for you and your child. During this time, and until your child reaches the teen years, your child's diet will depend on their activity levels and growth spurts as well as influences from friends, family and the media. </p> <br><h2>Key points</h2><ul><li>Continue offering your child, or encouraging your child to eat, a range of foods from all four food groups.</li><li>Make breakfast an essential start to your child's day so that they have enough fuel to help them concentrate at school.</li><li>Work with your child to prepare breakfasts and lunches the night before so they can more easily choose nutritious food when they are hungry or in a hurry.</li><li>Continue establishing good eating habits at dinner time by encouraging the family to eat and talk together.</li><li>Work with your child on different meal and snack options over time.</li></ul> <br>https://assets.aboutkidshealth.ca/AKHAssets/school-aged_child_tween_teen_meal_ideas.jpg
School-aged children with diabetesSSchool-aged children with diabetesSchool-aged children with diabetesEnglishEndocrinologySchool age child (5-8 years);Pre-teen (9-12 years)PancreasEndocrine systemHealthy living and preventionAdult (19+)NA2017-09-25T04:00:00ZCatherine Pastor, RN, MN, HonBScVanita Pais, RD, CDESanjukta Basak, MSc, MD CM, FRCPCRuth Slater, PhD, C. PsychJennifer Harrington, MBBS, PhD​9.3000000000000057.8000000000000776.000000000000Flat ContentHealth A-Z<p>Learn about sharing responsibility for diabetes care with your school-aged child, and the impact diabetes management will have on them.</p><p>​​Starting school is an exciting time for both children and parents. Children will spend most of their day away from home and their parents’ watchful eyes. Because children cannot be expected to understand their <a href="/Article?contentid=1717&language=English">diabetes</a> treatment fully until late childhood and early adolescence, some planning is needed to support them at school.</p> <p>Normal developmental patterns in the early school years include:</p> <ul><li>Learning to solve concrete problems logically</li> <li>Further development of social skills (friends begin to take on more importance)</li> <li>Learning to play by the rules and thrive in a structured and supportive environment (when children know the rules and can gain appropriate skills in a fun way, they develop a positive self-image)</li></ul><h2>Key points</h2> <ul><li>The target range for blood sugar levels in school-aged children is between 4 and 10 mmol/L, to allow for good blood sugar control while reducing the risk of hypoglycemia.</li> <li>School-aged children with diabetes may feel different from their peers, which may cause stress for your child.</li> <li>At this age, your child may be able to help with their finger pricks or giving their own injections, but parents and caregivers should still take most of the responsibility.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/school_aged_children_diabetes.jpg
Sclerotherapy using image guidanceSSclerotherapy using image guidanceSclerotherapy using image guidanceEnglishOtherChild (0-12 years);Teen (13-18 years)BodyArteries;VeinsNon-drug treatmentCaregivers Adult (19+)NA2017-08-04T04:00:00ZMichelle Cote BScN RN;Dalia Bozic MN, RN(EC), NP-PHC;Joao Amaral, MD9.9000000000000050.30000000000001386.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn about sclerotherapy and how it is used to treat vascular malformations. Also find information about what will happen to your child before, during and after the procedure.<br></p><h2>What are vascular malformations?</h2><p> <a href="http://www.sickkids.ca/PlasticSurgery/What-we-do/Vascular-Anomalies-Clinic/index.html">Vascular malformations</a> are abnormal clusters of blood vessels that develop before birth. Some may not be noticed until many years later. Some vascular malformations cause no problems, but others interfere with blood flow and can be dangerous. Vascular malformations can cause disfigurement, pain, troublesome swelling, bleeding and infection. Some are associated with growth abnormalities in the affected body part. Vascular malformations can be treated with minimally invasive procedures such as embolization, laser and sclerotherapy. The type of treatment your child will receive will depend on the location, size and type of vascular malformation.</p><h2>What is sclerotherapy?</h2><p>Sclerotherapy is sometimes called “sclero”. A doctor inserts a needle into the skin and injects a special liquid (sclerosant) into the abnormal blood vessel. This makes the blood vessel shrink. Sometimes the malformations can enlarge again and sclerotherapy may be done in stages.</p><p>Sclerotherapy is done using image guidance by an interventional radiologist. Most often sclerotherapy is done alone or in combination with <a href="/Article?contentid=2448&language=English">laser</a> or embolization.</p> <figure class="asset-c-80"> <span class="asset-image-title">Sclerotherapy</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Sclerotherapy_EN.jpg" alt="Needle injecting sclerosant into abnormal blood vessel" /> <figcaption class="asset-image-caption">A) Abnormal blood vessels are injected directly with a needle filled with a liquid called sclerosant. B) Sclerosant works by clotting and shrinking the blood vessel.</figcaption> </figure> <h2>Key points</h2><ul><li>Sclerotherapy is a procedure used to treat vascular malformations. An interventional radiologist injects a sclerosant into the malformation to shrink the blood vessel.</li><li>Sclerotherapy is usually considered a low risk procedure.</li><li>Your child will need to stay at the hospital for the whole day.</li><li>The areas injected are normally swollen for one week and bruised for two to three weeks following the procedure.</li></ul> <h2>On the day of the procedure</h2><p>Arrive at the hospital two hours before the planned time of your child’s procedure. Once you are checked in, your child will be dressed in a hospital gown, weighed and assessed by a nurse. You will also be able to speak to the interventional radiologist who will be doing the sclerotherapy and the anaesthetist who will be giving your child medication to make them comfortable for the procedure.</p><p>During sclerotherapy, you will be asked to wait in the surgical waiting area.</p><h2>Your child will have medicine for pain</h2><p>It is important that your child is as comfortable as possible for the procedure. They may be given <a href="/Article?contentid=3001&language=English">local anaesthesia</a>, <a href="/Article?contentid=1260&language=English">sedation</a> or <a href="/Article?contentid=1261&language=English">general anaesthesia</a>. The type of medicine that your child will have for the procedure will depend on your child’s condition and the treatment option the interventional radiologist uses for sclerotherapy. Most children receive general anaesthetic for sclerotherapy.</p><h2>How sclerotherapy is done</h2><p>The interventional radiologist inserts a needle through your child's skin into the abnormal blood vessel and injects a special dye called contrast. The dye is a clear, colourless liquid that helps to outline the blood vessel so it will show up on an X-ray (fluoroscopy). The interventional radiologist can use fluoroscopy as a guide for the sclerotherapy injection. Ultrasound is often used in combination with fluoroscopy prior to the injection of the sclerosant to identify the abnormal blood vessels.</p><p>Next, the interventional radiologist injects a special liquid called sclerosant directly into the abnormal blood vessel. Sclerosant causes clotting and shrinking of the blood vessel. The interventional radiologist gives injections of the sclerosant into different areas of the vascular malformation if needed.</p><p>Each treatment will take about one to two hours and sometimes longer depending on the complexity of the malformation.</p><h2>After sclerotherapy</h2><p>Once sclerotherapy is complete, your child will be moved to the recovery area. The interventional radiologist will come and talk to you about the details of the procedure. As soon as your child starts to wake up, a nurse will come and get you.</p><p>In the recovery area, your child will receive fluids through an intravenous. Your child should drink plenty of fluids when they wake up.</p><p>If a foley catheter has been placed to monitor your child’s urine output, it will remain in, for four hours and will be removed before you go home.</p><p>It is important that your child passes urine at least once before going home.</p><h2>Going home</h2><p>After sclerotherapy, most children go home the same day. Your child will be ready to go home when they are wide awake, have started to eat and drink, and are making urine. Usually, this happens four hours after the procedure.</p><p>The areas that were injected are normally swollen for one week and bruised for two to three weeks following the procedure. The skin close to the abnormal blood vessel may blister or be sore.</p><p>Your child may have some discomfort after the procedure which may last one to two days.</p><p>At home, you can give your child <a href="/Article?contentid=62&language=English">acetaminophen</a> if needed or medications as prescribed by your doctor.</p><p>For more details on how to care for your child after sclerotherapy, please see: <a href="/Article?contentid=1223&language=English">Sclerotherapy: Caring for your child at home after the procedure</a>.</p><h2>Visiting the clinic before the procedure</h2><p>Your child will need to have a clinic visit with the interventional radiologist before the procedure to decide on the best treatment options.</p><p>During the visit, your child may:</p><ul><li>see physiotherapy and/or occupational therapy</li><li>obtain information about pressure garments</li><li>have a health assessment to make sure they are healthy and it is safe to have <a href="/Article?contentid=1260&language=English">sedation</a> or <a href="/Article?contentid=1261&language=English">general anaesthesia</a></li><li>be sent for photography</li><li>review the consent forms</li><li>have blood work done if needed</li></ul><h2>Giving consent before the procedure</h2><p>Before the procedure, the interventional radiologist will go over how and why the procedure is done, as well as the potential benefits and risks. They will also discuss what will be done to reduce these risks and will help you weigh any benefits against the risks. It is important that you understand all of these potential risks and benefits of sclerotherapy and that all of your questions are answered. If you agree to the procedure, you can give consent for treatment by signing the consent form. A parent or legal guardian must sign the consent form for young children. The procedure will not be done unless you give your consent.</p><h2>How to prepare your child for the procedure</h2><p>Before any treatment, it is important to talk to your child about what will happen. When talking to your child, use words they can understand. Let your child know that medicines will be given to make them feel comfortable during the procedure.</p><p>Children feel less anxious and scared when they know what to expect. Children also feel less worried when they see their parents are calm and supportive.</p><h2>If your child becomes ill within two days before the procedure</h2><p>It is important that your child is healthy on the day of their procedure. If your child starts to feel unwell or has a fever within two days before sclerotherapy, let your doctor know. Your child may need to be rebooked.</p><h2>Food, drink, and medicines before the procedure</h2><ul><li>Your child’s stomach must be empty before sedation or general anaesthetic.</li><li>If your child has special needs during fasting, talk to your doctor to make a plan.</li><li>Your child can take their regular morning medicine with a sip of water two hours before the procedure.</li><li>Medicines such as <a href="/Article?contentid=77&language=English">acetylsalicylic acid (ASA)</a>, <a href="/Article?contentid=198&language=English">naproxen</a> or <a href="/Article?contentid=153&language=English">ibuprofen</a>, <a href="/Article?contentid=265&language=English">warfarin</a> or <a href="/Article?contentid=129&language=English">enoxaparin</a> may increase the risk of bleeding. Do not give these to your child before the procedure unless they have been cleared first by their doctor and the interventional radiologist.</li></ul><h2>At SickKids</h2><p>At SickKids, the interventional radiologists work in the <a href="http://www.sickkids.ca/IGT/index.html">Department of Diagnostic Imaging — Division of Image Guided Therapy (IGT)</a>. You can call the IGT clinic at (416) 813-6054 and speak to the clinic nurse during working hours (8:00 to 15:00) or leave a message with the IGT clinic nurse.</p><p>For more information on fasting see <a href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/Eating-guidelines/index.html">Eating and drinking before surgery</a>.</p><p>For more information on preparing your child for their procedure see <a href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/index.html">Coming for surgery</a>.</p>https://assets.aboutkidshealth.ca/akhassets/Sclerotherapy_EN.jpg
Sclerotherapy with bleomycin using image guidanceSSclerotherapy with bleomycin using image guidanceSclerotherapy with bleomycin using image guidanceEnglishOtherChild (0-12 years);Teen (13-18 years)BodyArteries;VeinsNon-drug treatmentAdult (19+) CaregiversNA2017-08-04T04:00:00ZMichelle Cote BScN RN;Dalia Bozic MN, RN(EC), NP-PHC;Joao Amaral, MD;Philip John, MD11.400000000000037.1000000000000837.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn how bleomycin is used in sclerotherapy to treat vascular malformations. Find information about the advantages of using bleomycin as well as any risks involved and precautions to be considered.</p><h2>What are vascular malformations?</h2><p> <a href="http://www.sickkids.ca/PlasticSurgery/What-we-do/Vascular-Anomalies-Clinic/index.html">Vascular malformations</a> are abnormal clusters of blood vessels that develop before birth. Some may not be noticed until many years later. Some vascular malformations cause no problems, but others interfere with blood flow and can be dangerous. Vascular malformations can cause disfigurement, pain, troublesome swelling, bleeding and infection. Some are associated with growth abnormalities in the affected body part.</p><h2>What is sclerotherapy?</h2><p>Sclerotherapy (sometimes called “sclero”) is a procedure used to treat vascular malformations. A doctor inserts a needle into the skin and injects a special liquid (sclerosant) into the abnormal blood vessel. This makes the blood vessel shrink. Sometimes the malformations can enlarge again and sclerotherapy may be done in stages. Bleomycin is a type of sclerosant.</p><p>Sclerotherapy is done using image guidance by an interventional radiologist.</p><p>For more information on sclerotherapy, please see <a href="/Article?contentid=3206&amp%3blanguage=English">Sclerotherapy using image guidance</a> and <a href="/Article?contentid=1223&amp%3blanguage=English">Sclerotherapy: Caring for your child at home after the procedure</a>.</p> <figure class="asset-c-80"> <span class="asset-image-title">Sclerotherapy using bleomycin</span> <img src="https://assets.aboutkidshealth.ca/akhassets/sclerotherapy_bleomycin_EN.jpg" alt="Needle injecting bleomycin into abnormal blood vessel" /> <figcaption class="asset-image-caption">A) Abnormal blood vessel is injected directly with a needle filled with a liquid called bleomycin. B) Bleomycin works by clotting and shrinking the blood vessel.</figcaption> </figure> <h2>What is bleomycin?</h2><p>Bleomycin is a medicine that is used as a chemotherapy to kill cancer cells but it also has other uses. For example, it has been used as a sclerosant to shrink blood vessels since 1977. Many medical centres around the world use bleomycin for treatment of vascular malformations that involve veins and lymph vessels.</p><h2>Key points</h2><ul><li>Sclerotherapy is used to treat vascular malformations. The sclerosant is injected into the vascular malformation by an interventional radiologist to shrink the malformed blood vessels.</li><li>Bleomycin is a sclerosant that can be used for sclerotherapy for lymphatic and venous malformations.</li><li>Bleomycin is associated with less swelling than other sclerosants.</li><li>Using bleomycin for sclerotherapy is usually considered a low risk procedure.</li><li>Patients who have had bleomycin treatment need to get a yearly health assessment by their primary care physician.</li><li>A chest X-ray will need to be done one to two years following the completion of bleomycin treatment.</li></ul> <h2>How will it be determined if my child can receive bleomycin?</h2><p>Your child will have a clinic visit with the interventional radiologist a few weeks before the procedure to decide on the best treatment options.</p><p>During the visit, your child may:</p><ul><li>see physiotherapy and/or occupational therapy</li><li>obtain information about pressure garments</li><li>have a health assessment to make sure they are healthy and it is safe to have <a href="/Article?contentid=1260&amp%3blanguage=English">sedation</a> or <a href="/Article?contentid=1261&amp%3blanguage=English">general anaesthesia</a></li><li>be sent for photography</li><li>review the consent forms</li><li>have blood work done</li></ul> <h2>At SickKids</h2><p>At SickKids, the interventional radiologists work in the <a href="http://www.sickkids.ca/IGT/index.html">Department of Diagnostic Imaging — Division of Image Guided Therapy (IGT)</a>. You can call the IGT clinic at (416) 813-6054 and speak to the clinic nurse during working hours (8:00 to 15:00) or leave a message with the IGT clinic nurse.</p><p>For more information on fasting see <a href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/Eating-guidelines/index.html">Eating and drinking before surgery</a>.</p><p>For more information on preparing your child for their procedure see <a href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/index.html">Coming for surgery</a>.</p>https://assets.aboutkidshealth.ca/akhassets/sclerotherapy_bleomycin_EN.jpg
Sclerotherapy: Caring for your child at home after the procedureSSclerotherapy: Caring for your child at home after the procedureSclerotherapy: Caring for your child at home after the procedureEnglishOtherChild (0-12 years);Teen (13-18 years)BodyArteries;VeinsNon-drug treatmentCaregivers Adult (19+)NA2013-03-27T04:00:00ZJoao Amaral, MD;Candice Sockett, RN(EC), MN:APN8.0000000000000066.0000000000000606.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Your child just had sclerotherapy. The following information explains how to properly care for your child at home after the procedure.</p><p>Your child has had sclerotherapy. This brochure explains how to look after your child at home after the procedure, and when to call for help.</p><h2>Key points</h2> <ul> <li>If your child has a fever, severe pain around the treated area, or blackened skin, go to the nearest Emergency Department right away.</li> <li>If your child has a change in the colour or temperature of the limb where sclerotherapy was done, call your doctor or go to the nearest Emergency Department.</li> <li>If a blister forms, gently wash your child's skin with unscented soap and water. Apply Polysporin three times a day and cover with a clean bandage.</li> <li>For pain relief, give your child acetaminophen or ibuprofen.</li> </ul><h2>When to see a doctor</h2> <p>Call your specialist or go to the nearest Emergency Department right away if your child has any of the following:</p> <ul> <li><a href="/Article?contentid=30&language=English">fever</a> greater than 38°C (100.4°F)</li> <li>Severe <a href="/pain">pain</a> in the treatment area</li> <li>blackening of the skin in the treated area</li> <li>change in colour or temperature of the limb on the side of the body where the sclerotherapy was done; for example, the foot turns a pale blue/white or is cool to touch</li> </ul><h2>At SickKids</h2> <p>If you have any concerns in the first week, call the IGT clinic during working hours at (416) 813-6054 and ask to speak to an IGT nurse. After seven days, please call your referring doctor or the Vascular Anomalies Clinic at (416) 813- 4970. If you have any emergent concerns after working hours, see your child's doctor/paediatrician, call the hospital switchboard at (416) 813-1500 and ask to speak to the interventional radiologist on call, or go to the nearest Emergency Department. </p>
ScoliosisSScoliosisScoliosisEnglishOrthopaedics/MusculoskeletalPre-teen (9-12 years);Teen (13-18 years)Vertebrae;SpineMuscular system;Skeletal systemConditions and diseasesCaregivers Adult (19+)NA2018-01-19T05:00:00Z000Landing PageLearning Hub<p>Scoliosis is a sideways curvature in the spine. This curve can lead to changes in your child's shoulders, ribcage, pelvis, waist and the overall shape of their back. Find information about the diagnosis and treatment of scoliosis.</p><p>Scoliosis is a sideways curvature in the spine. This curve can lead to changes in your child's shoulders, ribcage, pelvis, waist and the overall shape of their back. Find information about the diagnosis and treatment of scoliosis and what to expect at home after surgery, and for the long-term.</p>scoliosishttps://assets.aboutkidshealth.ca/AKHAssets/scoliosis_landing_page.jpg
Scoliosis and emotional issuesSScoliosis and emotional issuesScoliosis and emotional issuesEnglishOrthopaedics/MusculoskeletalChild (0-12 years);Teen (13-18 years)Vertebrae;SpineMuscular system;Skeletal systemConditions and diseasesAdult (19+)NA2008-06-01T04:00:00ZSandra Donaldson, BA;Reinhard Zeller, MD, ScD, FRCSC8.6000000000000061.0000000000000722.000000000000Flat ContentHealth A-Z<p>Having scoliosis can be emotionally upsetting for teenagers. Find out about some common issues they face, such as negative self-image and increased stress.</p><p>While scoliosis can cause a teen stress and negatively affect their body image, there are a number of ways they can cope with feelings brought on by the diagnosis.</p><h2> Key points</h2> <ul><li> Surgery for scoliosis can prevent future problems and improve the appearance of your teen's back, rib cage, shoulders and hips. </li> <li> Scoliosis can affect your teen's body image, but feelings of anxiety, fear, and withdrawal often improve with time.</li> <li> While some studies show that teens with scoliosis are unhappy with their appearance or feel isolated or depressed, others found that many teens were not bothered by scoliosis.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/scoliosis_and_emotional_issues.jpg
Scoliosis resourcesSScoliosis resourcesScoliosis resourcesEnglishOrthopaedics/MusculoskeletalChild (0-12 years);Teen (13-18 years)Vertebrae;SpineMuscular system;Skeletal systemSupport, services and resourcesAdult (19+)NA2008-06-01T04:00:00ZNA10.000000000000051.300000000000079.0000000000000Flat ContentHealth A-Z<p>This page gives some useful websites that can help you learn more about scoliosis.</p><p>There are lots of resources that can allow you to better help your teenager learn to manage scoliosis.</p><h2>Key points</h2><p>There are many different resources to help you and your teenager manage scoliosis including several websites.</p>
Scoliosis surgery in boysSScoliosis surgery in boysScoliosis surgery in boysEnglishOrthopaedics/MusculoskeletalChild (0-12 years);Teen (13-18 years)Vertebrae;SpineMuscular system;Skeletal systemProceduresAdult (19+)NA2008-06-01T04:00:00ZSandra Donaldson, BA;Andrew Howard, MD, MSc, FRCSC;James G. Wright, MD, MPH, FRCSC7.0000000000000056.0000000000000180.000000000000Flat ContentHealth A-Z<p>Most scoliosis research focuses on girls. Read about the similarities and differences between boys and girls in their experiences with scoliosis.</p><p>Scoliosis is more common in girls than boys. As a result, most research studies tend to focus on girls. There have been a couple of studies comparing the outcome of scoliosis surgery between boys and girls.</p><h2> Key points </h2><ul><li> Studies have shown that boys and girls generally respond to surgery in similar ways, but boys had more rigid spines before surgery, experienced greater blood loss during surgery and higher pain scores on the day after surgery.</li></ul>
Scoliosis: At homeSScoliosis: At homeScoliosis: At homeEnglishOrthopaedics/MusculoskeletalChild (0-12 years);Teen (13-18 years)Vertebrae;SpineMuscular system;Skeletal systemHealthy living and preventionAdult (19+)NA2008-06-01T04:00:00ZJanet Ahier, RN, BScN, MN, ONC;Sandra Donaldson, BA;James Wright, MD, MPH, FRCSC7.7000000000000067.9000000000000213.000000000000Flat ContentHealth A-Z<p>This page is an introduction to the At Home section of the scoliosis resource centre. It touches on building back your teen's food intake after scoliosis surgery, going back to school, and getting back to normal.</p><p>This section describes what you and your teen can expect during their recovery, including care at home, pain management, clinic visits, and complications to watch for.</p>
Scoliosis: Cons of having or not having surgerySScoliosis: Cons of having or not having surgeryScoliosis: Cons of having or not having surgeryEnglishOrthopaedics/MusculoskeletalChild (0-12 years);Teen (13-18 years)Vertebrae;SpineMuscular system;Skeletal systemProceduresAdult (19+)NA2008-06-01T04:00:00ZSandra Donaldson, BA;Andrew Howard, MD, MSc, FRCSC;James G. Wright, MD, MPH, FRCSC14.900000000000038.80000000000001454.00000000000Flat ContentHealth A-Z<p>Read about some of the disadvantages of having surgery to correct scoliosis, as well as some of the disadvantages of not having surgery.</p><p>The information in this section is based on the results of many different research studies. Sometimes the results of these studies are in conflict with each other. One study may say one thing while another says the opposite. As a result, some of the information in this section may also be conflicting. In these situations, it’s important to understand that there may not be one specific result for all situations and all patients.</p><h2> Key points </h2> <ul><li>When considering whether or not to have surgery, there may or may not be cons with neurologic complications, infection, failure of spinal fusion (pseudoarthrosis), lung function, life span, self-image or appearance, pain, osteoarthritis in the lower (lumbar) spine, everyday activities, need for surgery in the future, quality of life, sexuality and childbirth, and curve changes. </li></ul>https://assets.aboutkidshealth.ca/AKHAssets/scoliosis_cons_of_having_not_having_surgery.jpg
Scoliosis: Looking aheadSScoliosis: Looking aheadScoliosis: Looking aheadEnglishOrthopaedics/MusculoskeletalChild (0-12 years);Teen (13-18 years)Vertebrae;SpineMuscular system;Skeletal systemHealthy living and preventionAdult (19+)NA2008-06-01T04:00:00ZSandra Donaldson, BA;Reinhard Zeller, MD, ScD, FRCSC8.0000000000000061.0000000000000230.000000000000Flat ContentHealth A-Z<p>This page gives a few statistics on how many teens may need additional surgery in the future. It describes why additional surgery may be required. It gives an idea of what to expect in terms of medical follow-up as the teen gets older.</p><p> If your teen has had scoliosis surgery, it is possible they will need more surgery in the future or need to continue seeing an adult spine surgeon.</p><h2> Key points </h2> <ul><li>While it is not common, teens who have had scoliosis surgery may need more surgery for reasons including infection, painful or prominent rods, or their spine not fusing properly.</li> <li>Your teen's paediatric spine surgeon will advise as to whether they need to see an adult spine surgeon after they turn 18.</li></ul>
Scoliosis: Pros of having or not having surgerySScoliosis: Pros of having or not having surgeryScoliosis: Pros of having or not having surgeryEnglishOrthopaedics/MusculoskeletalChild (0-12 years);Teen (13-18 years)Vertebrae;SpineMuscular system;Skeletal systemProceduresAdult (19+)NA2008-06-01T04:00:00ZSandra Donaldson, BA;Andrew Howard, MD, MSc, FRCSC;James G. Wright, MD, MPH, FRCSC14.000000000000041.90000000000001146.00000000000Flat ContentHealth A-Z<p>Read about some of the advantages of having surgery to correct scoliosis, as well as some of the advantages of not having surgery.</p><p>The information in this section is based on the results of many different research studies. Sometimes the results of these studies are in conflict with each other. One study may say one thing while another says the opposite. As a result, some of the information in this section may also be conflicting. In these situations, it’s important to understand that there may not be one specific result for all situations and all patients. </p><h2> Key points </h2> <ul><li>When considering whether or not to have surgery, there may or may not be pros in a teen's lung function, life span, self-image and physical appearance, pain, osteoarthritis in the lower (lumbar) spine, everyday activities, need for surgery in the future, quality of life, marriage and childbirth, and curve changes.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/scoliosis_pros_of_having_not_having_surgery.jpg
Scoliosis: Spinal orthosis after thoracoplasty surgerySScoliosis: Spinal orthosis after thoracoplasty surgeryScoliosis: Spinal orthosis after thoracoplasty surgeryEnglishOrthopaedics/MusculoskeletalPre-teen (9-12 years);Teen (13-18 years)SpineSkeletal systemNon-drug treatmentCaregivers Adult (19+)NA2009-12-29T05:00:00ZThe Certified Orthotists at the Centre for Orthotics and Medical Devices9.1000000000000056.3000000000000591.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Some scoliosis patients will have surgery called thoracoplasty. Learn about the post-operative spinal orthosis that patients wear after the surgery.</p><h2>What is a spinal orthosis?</h2> <p>An orthosis (say: or-THOH-sis) is a medical device that is designed to support or treat people who have problems with their muscles, bones or joints. </p> <p>Some scoliosis patients will have spinal surgery called thoracoplasty. After thoracoplasty, some surgeons will prescribe a <a href="/Article?contentid=974&language=English">spinal orthosis</a> to help support your spine and ribs as you are healing. The pressure of this spinal orthosis will also provide some pain relief. This spinal orthosis is called a sansplint spinal orthosis.</p><h2>Key points</h2> <ul> <li>Some scoliosis patients will have surgery called thoracoplasty. </li> <li>After surgery, you will wear a sansplint spinal orthosis to help you heal. </li> <li>A certified orthotist will measure your body to make the orthosis. </li> <li>You will need to wear the spinal orthosis for two to four months after the surgery.</li> </ul><h2>What a post-operative spinal orthosis looks like</h2><p>This spinal orthosis is made of plastic with a cotton corset. This is the most commonly prescribed post-surgical spinal orthosis and is likely what you will be wearing. </p><p>You will need to wear this spinal orthosis for about two to four months after the surgery to help reshape your ribs.<br></p> <figure><img alt="spinal brace for scoliosis" src="https://assets.aboutkidshealth.ca/akhassets/SpinalBrace_EN.jpg" /> </figure> <br> <br><h2>What happens at the first visit</h2> <p>About five days after your surgery, you will be seen by a certified orthotist to have the spinal orthosis made. You will be given a long cotton body stockinette to wear during the procedure. Several measurements will be taken of your body and you will be asked to lie on your stomach on a casting bed. A warm piece of plastic will be draped on your back. The plastic cools and hardens in about five minutes. A cotton corset is then attached to the plastic and the spinal orthosis is ready for the final fitting. </p> <p>The entire process takes about three hours.</p> <p>At the end of the appointment, you will start wearing the orthosis, slowly building up your wear time over the course of a week until you are wearing the orthosis 22 to 23 hours per day. </p><h2>At SickKids</h2><h3>Costs for a post-operative spinal orthosis</h3><p>In Ontario, OHIP does not cover any of the cost of the post-operative spinal orthosis; however, most extended health insurance plans may cover all or a portion depending on your coverage. Ask your orthotist for an insurance letter to submit to your insurance company for coverage. If you need help to pay for the orthosis, visit our reception desk for a listing of charitable organizations that may assist you.</p><p>A minimum of 50% of the payment for this device is expected at the time of the casting. The remaining 50% of the cost is expected when you receive the orthosis. We are unable to bill your insurance company directly.</p><p>Please visit or contact The Centre for Orthotics for further information on pricing.</p>https://assets.aboutkidshealth.ca/akhassets/SpinalBrace_EN.jpg
Scoliosis: The physical examSScoliosis: The physical examScoliosis: The physical examEnglishOrthopaedics/MusculoskeletalChild (0-12 years);Teen (13-18 years)Vertebrae;SpineMuscular system;Skeletal systemTestsAdult (19+)NA2008-06-01T04:00:00ZSandra Donaldson, BA;James G. Wright, MD, MPH, FRCSC6.0000000000000074.0000000000000354.000000000000Flat ContentHealth A-Z<p>When assessing a child's scoliosis, several measurements may be taken. Learn about how Adam's test, balance, leg length and height are used in assessment.</p><p>If your teen’s curve is moderate or large, they will be referred to an orthopaedic surgeon. In that case, your teen’s surgeon, or a member of the surgical team, may do some or all of these physical tests. </p><h2>Key points </h2><ul><li>Teens with a moderate or large curve will be referred to an orthopaedic surgeon.</li><li>Height, reflexes, senses, strength, legs, shoulder and hip and spinal balance may all be measured. Your teen will also be asked to bend and touch their toes in the Adam's test to show if there is rib prominence.</li><li>Your teen's surgeon may request before and after medical photographs to document changes in the back.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/scoliosis_the_physical_exam.jpg
Scoliosis: Treatment with a spinal orthosis (spinal brace)SScoliosis: Treatment with a spinal orthosis (spinal brace)Scoliosis: Treatment with a spinal orthosis (spinal brace)EnglishOrthopaedics/MusculoskeletalPre-teen (9-12 years);Teen (13-18 years)SpineSkeletal systemNon-drug treatmentCaregivers Adult (19+)NA2009-12-29T05:00:00ZThe Certified Orthotists at the Centre for Orthotics and Medical Devices7.8000000000000066.10000000000001477.00000000000Health (A-Z) - ProcedureHealth A-Z<p>A spinal brace holds your spine in place, decreasing the chance that your spinal curve will get worse as you grow. Learn about the different types.</p><h2>What is scoliosis?</h2><p>Scoliosis (say: skoh-lee-OH-sis) is a sideways curvature in the spine.</p> <figure> <span class="asset-image-title">Scoliosis</span> <img src="https://assets.aboutkidshealth.ca/akhassets/scoliosis_03_MED_ILL_EN.jpg" alt="Person’s back with a curve in the spine" /> <figcaption class="asset-image-caption">With scoliosis, the spine curves to one side, usually to the right, resulting in one shoulder being higher than the other. </figcaption> </figure> <h2>What is a spinal orthosis?</h2><p>An orthosis (say: or-THOH-sis) is a medical device that is designed to support or treat people who have problems with their muscles, bones or joints.</p><p>At this time in your life, your body is growing quickly. This rapid growth increases the risk that the curves in your spine will get larger too. A <a href="/Article?contentid=973&language=English">spinal orthosis</a> is a back brace that is designed to hold your spine in place and decrease the chance that the curve in your spine will become worse as you grow.</p><p>By wearing a spinal orthosis, 80% (8 out of 10) of curves will stay the same size. Some curves may get smaller. That is a nice bonus, but it is not to be expected.</p><p>Your orthosis will be custom-made to fit you.<br></p><h2>Key points</h2> <ul> <li>A spinal orthosis holds your spine in place and decreases the chance that the curve in your spine will get worse as you grow. </li> <li>You need to wear a spinal orthosis until your skeleton stops growing so quickly. </li> <li>There are three main types of spinal orthoses used to treat scoliosis. </li> <li>Patients who need a surgery called thoracoplasty will wear a brace for two to four months to help their ribs heal. <br><br></li> </ul><h2>How long will you need to wear a spinal orthosis?</h2> <p>In order for the orthosis to work properly, it must be worn full-time, which is 22 to 23 hours per day.</p> <p>You will need to wear a spinal orthosis until your skeleton stops growing so quickly. This will be when you have almost reached your full height. For girls, this occurs about two years after their period starts. Boys usually stop growing so quickly by age 16. </p> <p>Your orthopaedic doctor will monitor you closely and will determine through X-rays and height measurements when you have finished growing. </p> <h2>Getting a spinal orthosis</h2> <p>Your family doctor or paediatrician has referred you to the Orthopaedic Clinic. You will need to make several visits to the clinic. </p> <ul> <li>At your first visit, you will be seen by a nurse, a physiotherapist and an orthopaedic doctor to assess your spine. An X-ray may be taken at this time. </li> <li>If a spinal orthosis is needed, you will be seen by a certified orthotist. An orthotist is a person who has been trained in making, fitting and assessing spinal and other orthoses. Your first visit with your orthotist may be on the same day as your clinic appointment, or it may be scheduled many weeks later. At this first visit, the orthotist will take many measurements and will take a cast of your body in order to make your custom spinal orthosis.</li> <li>A month later, you will see your orthotist again to fit the spinal orthosis. </li> <li>A month after the orthosis is fitted, you will see your orthotist again to have an X-ray taken while you wear your spinal orthosis. Any final adjustments will be made. The X-ray should show that the curve in your spine is straighter while wearing the orthosis. </li> <li>After that, you will be seen by your scoliosis care team every four to six months, or sooner if needed. Your scoliosis care team will include the doctor, the physiotherapist and the certified orthotist. </li> </ul><h2>What happens at the first visit</h2> <p>Your first appointment with your orthotist takes about an hour. Your orthotist will spend some time giving you information about spinal orthoses and answering your questions. You will then be given two long body stockings to wear for the assessment and casting part of the visit. </p> <p>Your orthotist will examine you, ask you some questions, and then measure your body with a cloth measuring tape and calipers, which is a type of ruler. After that, you will be asked to lie on a casting bed while wet plaster of paris bandage is applied to the front of your body. The plaster takes about 10 minutes to set and harden. After that, you lie on your stomach while plaster is applied to your back. After the plaster hardens, the cast is removed by simply lifting it off your body. </p> <p>This process is not painful. You will feel a little cold and some discomfort as the wet plaster is applied to your body. As the plaster hardens, the cast will become quite warm.</p> <p>We recommend that you bring extra undergarments to change into after the casting.</p> <h2>What happens at the fitting appointment</h2> <p>After putting on a body stocking, you will try on your spinal orthosis. Your orthotist will mark the plastic to trim some away. This will happen a few times until the trim lines of your orthosis are right. At this point, the spinal orthosis is finished and is ready for the final fitting, about an hour later. </p> <p>Your orthotist will speak with you and give you written instructions to make sure you know how to use the orthosis, and how to take care of your body and the spinal orthosis.</p> <p>A fitting appointment may take up to three hours. A lot of time is spent waiting while your orthotist is completing work, so please bring something to keep yourself busy during these down times. </p><h2>At SickKids</h2><p>As well as the basic colours of the orthosis, there are other optional designs, cartoon characters and sports logos that are available for a small extra fee. </p>https://assets.aboutkidshealth.ca/akhassets/scoliosis_03_MED_ILL_EN.jpg
Scoliosis: Understanding diagnosisSScoliosis: Understanding diagnosisScoliosis: Understanding diagnosisEnglishOrthopaedics/MusculoskeletalChild (0-12 years);Teen (13-18 years)Vertebrae;SpineMuscular system;Skeletal systemConditions and diseasesAdult (19+)NA2008-06-01T04:00:00ZSandra Donaldson, BA;James G. Wright, MD, MPH, FRCSC6.5000000000000071.5000000000000538.000000000000Flat ContentHealth A-Z<p>This page gives a brief introduction to the diagnosis of scoliosis. Usually a health-care professional doing a routine scoliosis check at the school will pick up on the problem, although sometimes a parent notices it first.</p><p>Parents and health-care professionals may notice a curve in a teen's back, but scoliosis is diagnosed after they have had an X-ray. Treatment depends on the type of curve they have.</p><h2> Key points </h2> <ul><li>In order to diagnose scoliosis, your teen requires an X-ray to view their vertebrae, which usually curve in the shape of an S or C with scoliosis.</li> <li>Small curves can be followed by their paediatrician or family doctor; moderate curves may require a brace or be followed for observation; and large curves may require surgery.</li></ul>https://assets.aboutkidshealth.ca/akhassets/ScoliosisDiagnosis_EN.jpg
Scoliosis: What to expect in adulthoodSScoliosis: What to expect in adulthoodScoliosis: What to expect in adulthoodEnglishOrthopaedics/MusculoskeletalChild (0-12 years);Teen (13-18 years)Vertebrae;SpineMuscular system;Skeletal systemHealthy living and preventionAdult (19+)NA2008-06-01T04:00:00ZSandra Donaldson, BA;Reinhard Zeller, MD, ScD, FRCSC8.0000000000000059.0000000000000558.000000000000Flat ContentHealth A-Z<p>Learn what to expect regarding physical and social activities, body image, sexual activity and pregnancy when a teen with scoliosis reaches adulthood.</p><p>A few studies have been done on adults who went through scoliosis surgery as teens. Most of these studies followed patients from five to 20 years after surgery. Here are some of the results.</p><h2>Key points</h2> <ul><li> Studies have shown that certain men and women who had scoliosis surgery in childhood experienced some difficulties with physical activity, social activities, body image and sexual activity.</li</li></ul>https://assets.aboutkidshealth.ca/akhassets/ChantalDriving_EN.jpg
Scoping procedures: Bronchoscopy, laryngoscopy, esophagoscopy and laser surgerySScoping procedures: Bronchoscopy, laryngoscopy, esophagoscopy and laser surgeryScoping procedures: Bronchoscopy, laryngoscopy, esophagoscopy and laser surgeryEnglishOtolaryngologyChild (0-12 years);Teen (13-18 years)Trachea;EsophagusEsophagus;TracheaTestsCaregivers Adult (19+)NA2009-11-10T05:00:00ZJen Subica, RN, BSc;Pauline Lackey, RN;Tomka George, RN;Vito Forte, MD, FRCSC7.1000000000000067.30000000000001275.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Scoping procedures are used to look inside the throat. Learn why your child may have to have a scoping procedure, how to prepare and what to expect.</p><h2>What are scoping procedures?</h2> <p>Your child is having trouble breathing or swallowing. To find out what is causing this problem, the doctor needs to look inside your child's air or food passageway. To do this, the doctor will use a thin tube with a light and a tiny camera on the end. This device is called a scope. </p> <p>During the scoping procedure, your child will be given a special sleep medicine called a <a href="/Article?contentid=1261&language=English">general anesthetic</a>. This means your child will sleep through the procedure and feel no pain. </p> <p>If the problem is caused by tissue that is not normal, the doctor may remove it using laser surgery.</p> <p>The doctor who will do the scoping procedure is called an otolaryngologist/head and neck surgeon (say: OH-toe-lar-ing-GOL-oh-jist). This is a doctor who specializes in problems with the ears, nose and throat. </p> <h3>To look inside your child's air passageway, we use bronchoscopy and laryngoscopy</h3> <p>Your child's air passageway is called the trachea (say: TRAY-key-ah). To look inside, the doctor will use scoping procedures called a bronchoscopy (say: bron-KOSS-co-pee) and a laryngoscopy (say: lar-ing-GOSS-co-pee). During each of these procedures, the doctor will put a scope in your child's mouth and down into the trachea. The doctor can look through the scope to see what is causing your child's breathing problem. The procedure takes about one hour. </p> <h3>To look inside your child's food passageway, we use esophagoscopy</h3> <p>Your child's food passageway is called the esophagus (say: ee-SOFF-ah-gus). To look inside it, the doctor will use a scoping procedure called an esophagoscopy (say: ee-SOFF-ah-GOSS-co-pee). During this procedure, the doctor will put a scope in your child's mouth and down into the esophagus. The doctor can look through the scope to see what is causing your child's swallowing problem. The procedure takes about one hour. </p> <h2>Laser surgery</h2> <p>Laser surgery uses a concentrated beam of light instead of a scalpel or knife to remove unwanted tissue or blockages. Laser surgery can be performed during a bronchoscopy, laryngoscopy and esophagoscopy.</p><h2>Key points</h2> <ul> <li>Scoping procedures let doctors look into your child's throat. They take about one hour. </li> <li>Your child will have sleep medicine during the procedure. </li> <li>Your child will likely stay for one day and one night in the hospital. </li> </ul><h2>Possible problems after the procedure</h2> <p>Please call your child's otolaryngologist or the otolaryngology clinic right away if your child has any of the following signs after going home: </p> <ul> <li>trouble swallowing </li> <li>trouble breathing </li> <li>fever of 38.5°C (101°F) or higher </li> <li>chest pain or throat pain that gets worse </li> <li>coughing that gets worse </li> <li>drooling that does not stop </li> <li>vomiting (throwing up) that does not stop </li> <li>bleeding from mouth or nose </li> </ul> <p>If it is an emergency or if you are worried, do not wait. Take your child to the closest emergency department right away.</p> <p>Write down the name of your child's otolaryngologist here:</p> <p>Write down the doctor's phone number here:</p> <p>Write down the otolaryngology clinic phone number here:</p> <p>Write down your family doctor's name and number here:</p><h2>Your child will not feel any pain during the procedure</h2> <p>Before the procedure starts, your child will be given a special sleep medicine called <a href="/Article?contentid=1261&language=English">general anesthetic</a>. This makes sure your child will sleep through the procedure and will not feel pain. After the procedure, your child's throat may be sore and feel dry. If your child feels pain after the procedure, they will be given pain medicine as needed. </p><h2>After the procedure</h2> <p>After the procedure, we will take your child to the recovery room, also called the <a href="/Article?contentid=1262&language=English">Post-Anesthetic Care Unit</a>. This is where your child will wake up. Your child will stay in the recovery room for one to two hours, depending on their age and symptoms. </p> <p>After your child has stayed in the recovery room, we will move them to a special room on the otolaryngology unit. This room has a nurse in it at all times. It is called the constant observation room. Your child will probably stay in this room overnight. </p> <h3>You will be able to see your child as soon as they are fully awake</h3> <p>A volunteer from the Surgical Waiting Room will bring you to see your child.</p> <p>Your child may have a mild cough or hoarse voice when they wake up. This usually will go away on its own.</p> <h2>Eating and drinking after the procedure</h2> <p>Your child will not be allowed to eat or drink for two to four hours after the procedure. Check with your child's nurse to see when your child can start eating and drinking. Your child will then start drinking clear liquids such as water or apple juice. Then your child may have soft foods such as Jell-O. After your child is able to drink, your child can start eating their usual food again. </p> <h2>One day and one night in the hospital</h2> <p>Your child will be in the hospital for the entire day of the procedure and probably overnight. This will depend on how quickly your child recovers after the procedure. One parent may stay with your child overnight in the constant observation room. </p><h2>Before the operation</h2> <p>Several hours before the operation, your child will need to stop eating and drinking. The nurse or doctor will tell you when your child must stop eating and drinking. Write this information here: </p> <p>The date and time of the operation: _____________________</p> <p>Time when your child must stop eating: __________________</p> <p>Time when your child must stop drinking clear fluids: ________________</p> <p>Other things to remember: _________________</p>
Screen time: OverviewSScreen time: OverviewScreen time: OverviewEnglishPreventionBaby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)NANAHealthy living and preventionCaregivers Adult (19+)NA2016-07-18T04:00:00ZSamantha Metler, MA;Suneeta Monga, MD, FRCPC10.000000000000056.80000000000001097.00000000000Flat ContentHealth A-Z<p>Learn how screen time affects children and how much screen time they should have each day.</p><h2>What is screen time?</h2><p>Screen time is the amount of time your child spends using a device that has a screen. It includes time spent watching television, browsing the internet, using a cell phone and playing video games. But regardless of the device, most screen time limits a child’s opportunities to get active outside the home. Over time, this low level of <a href="/Article?contentid=642&language=English">physical activity</a> can threaten their health.</p><h2>Key points</h2> <ul> <li>Screen time is the amount of time your child spends using a device that has a screen such as a TV, computer, games console, tablet or smartphone.</li> <li>The recommended amount of screen time depends on a child’s age. Children under two should not have any screen time and those under aged five and under should have less than two hours a day.</li> <li>Spending too much time in front of a screen can negatively impact your child’s mental health. Signs include feeling sad, overly tired, withdrawn or uninterested in other activities.</li> </ul>https://assets.aboutkidshealth.ca/AKHAssets/screen_time_overview.jpg
Screening for complications of diabetesSScreening for complications of diabetesScreening for complications of diabetesEnglishEndocrinologyChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemTestsAdult (19+)NA2017-11-20T05:00:00ZCatherine Pastor, RN, MN, HonBScVanita Pais, RD, CDEAndrea Ens, MD, FRCPCJennifer Harrington, MBBS, PhD8.6000000000000054.4000000000000562.000000000000Flat ContentHealth A-Z<p>Learn how often your child needs to be screened for diabetes complications and what you can expect from each test and screening.</p><p>Screening for risk factors and complications starts at diagnosis of <a href="/Article?contentid=1717&language=English">diabetes</a>. Even though complications rarely occur in children and in teenagers, screening is important because detecting complications at an early stage allows for actions to help slow their progression. </p><h2>Key points</h2> <ul><li>Your child will have regular screening tests for complications of diabetes.</li> <li>Your child will need different tests depending on how long they've had diabetes, and whether they have type 1 or type 2.</li></ul>
Screening for related conditions to diabetes (comorbidity)SScreening for related conditions to diabetes (comorbidity)Screening for related conditions to diabetes (comorbidity)EnglishEndocrinologyChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemTestsAdult (19+)NA2017-11-20T05:00:00ZCatherine Pastor, RN, MN, HonBScVanita Pais, RD, CDEAndrea Ens, MD, FRCPCJennifer Harrington, MBBS, PhD000Flat ContentHealth A-Z<p>An overview of conditions related to diabetes and how how often your child will need to be screened for each condition.</p><p>​​Related conditions are conditions that may occur in addition to diabetes. Comorbid conditions may affect the diabetes however they neither cause diabetes nor are caused by diabetes. Type 1 diabetes is more often associated with autoimmune conditions. Polycystic ovary syndrome (PCOS) and non-alcoholic fatty liver disease (NAFLD) are more common in people with type 2 diabetes.</p><h2>Key points</h2> <ul><li>Your child will be screened for conditions that occur in addition to either type 1 or type 2 diabetes. These conditions are not caused by diabetes but are more common in people who have it.</li></ul>
Seafood allergySSeafood allergySeafood allergyEnglishAllergyChild (0-12 years);Teen (13-18 years)BodyImmune systemConditions and diseasesCaregivers Adult (19+)NA2014-12-18T05:00:00ZVy Kim, MD, FRCPC;Anna Kasprzak, RN​8.8000000000000061.10000000000001003.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Learn which foods your child should avoid if they have a seafood allergy and how you can help your child manage their allergy.</p><h2>What is a seafood allergy?</h2><p>A seafood allergy is a reaction to one or more of the proteins in crustaceans, shellfish or fish. Crustaceans include crab, lobster and shrimp. Shellfish include clams, oysters and mussels.</p><h2>If my child has a seafood allergy, must they avoid all types of seafood?</h2><p>If your child has a specific seafood allergy, speak to an allergist (a doctor who specializes in diagnosing and treating allergies) before letting them try other types of seafood.</p><p>Some people may be allergic to one group of seafood, such as shellfish, but may be able to eat other groups of seafood, such as crustaceans, as long as they have not come in contact with each other in any way. Other times, a person might be able to eat crustaceans and shellfish but still have a fish allergy.</p><p>In addition, a person might not be allergic to complete families of seafood. For example, they might be allergic to clams but not allergic to other types of shellfish.</p><p>Your child may need to avoid all seafood due to the high chance of cross-contamination (see below), as seafood products are often processed in the same facility.</p><h2>Will my child always have a seafood allergy?</h2><p>Most children with a seafood allergy will continue to have it as they get older.</p><p>An allergist can help you find out when to test your child and see whether they have outgrown their allergy.</p><h2>Key points</h2> <ul> <li>A seafood allergy can be different for each person: some people can eat one complete type of seafood but cannot eat another. Other people can tolerate some crustaceans, for example, but not others. </li> <li>Most children with a seafood allergy do not outgrow it. Consult an allergist regularly to see if there is any change in your child's allergy.</li> <li>Sources of seafood include coffee, fried rice, salad dressing and gelatin.</li> <li>To prevent an allergic reaction, always read food product labels, avoid foods if you are not sure of the ingredients and avoid using utensils or containers that might have come in contact with seafood. </li> <li>If your child's diet is limited because of a seafood allergy, a registered dietitian can offer advice on getting a balanced diet.</li> </ul><h2>Possible sources of seafood</h2><p>Seafood is used in a wide range of packaged foods. Below is a list of some of the many food products that can contain seafood.</p> <table class="akh-table"><tbody><tr><td>Coffee</td><td>Deli meats (bologna, ham)</td></tr><tr><td>Fried rice<br></td><td>Gelatin</td></tr><tr><td>Hot dogs</td><td>Marshmallows</td></tr><tr><td>Salad dressing (for example Caesar dressing)</td><td>Soups and sauces</td></tr><tr><td>Spring rolls</td><td>Sushi</td></tr><tr><td>Worcestershire sauce</td><td></td></tr></tbody></table><h2>Reducing the risk of cross-contamination</h2><p>Cross-contamination occurs when a harmless substance comes in contact with a harmful substance, for example a potential allergen or harmful bacteria. If the substances mix together, the harmful substance taints the other substance, making it unsafe to eat.</p><p>Food allergens can contaminate other foods when, for example, the same containers, utensils or frying pans hold a range of foods.</p><p>Bulk food containers pose a high risk of cross-contamination because they are often used for different products.</p><p>Be sure to avoid using utensils or containers that may have come in contact with allergy-causing foods and ask about possible cross-contamination when eating out.</p><h2>How can my child get the right mix of nutrients if they must avoid seafood?</h2><p>Key nutrients in fish can include protein, omega-3 fats, vitamin A, vitamin B 12, vitamin D, vitamin E, calcium, iron and zinc. Your child can still get these nutrients even if they must avoid seafood and products that contain them. </p><h3>Nutrients in seafood that are also in other foods</h3><table class="akh-table"><thead><tr><th>Nutrient</th><th>Where to find it</th></tr></thead><tbody><tr><td>Protein</td><td>Milk, red meat, chicken, egg, beans, soy</td></tr><tr><td>Omega 3</td><td>Flaxseed oil, edamame (soybeans), radish seeds, omega-3 eggs fortified with DHA</td></tr><tr><td>Vitamin A</td><td>Sweet potato, pumpkin, liver, goat cheese, carrots, squash, spinach</td></tr><tr><td>Vitamin B12</td><td>Milk, cheese, liver, beef</td></tr><tr><td>Vitamin D</td><td>Milk, soy beverage fortified with vitamin D</td></tr><tr><td>Vitamin E</td><td>Spinach, red pepper, Swiss chard, wheat germ cereal, egg, almonds, sunflower seeds</td></tr><tr><td>Calcium</td><td>Milk, soy beverage fortified with calcium, buttermilk, cheese, yogurt, spinach, collards, beans</td></tr><tr><td>Iron</td><td>Spinach, tomato puree, edamame, lima beans, snow peas, instant oatmeal, cereal</td></tr><tr><td>Zinc</td><td>Bran cereal, wheat germ, cheese, milk, beef, pumpkin seeds, baked beans</td></tr></tbody></table> <h2>Can my child with a seafood allergy enjoy sushi?</h2><p>Many kinds of delicious sushi rolls do not contain any seafood. If you eat out at a sushi restaurant, contact the staff ahead of time to let them know about your child’s allergy. Ask if the restaurant can provide seafood-free sushi that is uncontaminated by seafood.</p><h2>When to see a dietitian for a seafood allergy</h2> <p>If you have removed many foods from your child's diet because of a seafood allergy, it may be a good idea to speak to a registered dietitian. The dietitian can review the foods your child still eats to decide if they are getting enough nutrients. If necessary, they can also recommend alternative foods that your child can eat safely.</p><h2>​Further information</h2> <p>Health Canada. <a href="http://www.hc-sc.gc.ca/fn-an/alt_formats/pdf/pubs/securit/fish-poisson-eng.pdf" target="_blank">Seafood (fish, crustaceans and shellfish) - One of the ten priority food allergens​</a></p>https://assets.aboutkidshealth.ca/AKHAssets/seafood_allergy.jpg
Second-hand smokeSSecond-hand smokeSecond-hand smokeEnglishPreventionChild (0-12 years);Teen (13-18 years)NANAHealthy living and preventionCaregivers Adult (19+)NA2011-11-10T05:00:00ZNA7.0000000000000063.0000000000000568.000000000000Flat ContentHealth A-Z<p>Second-hand smoke is harmful for babies and children. Learn tips on keeping your home 100% smoke-free.</p><p>Second-hand smoke is smoke that comes from:</p><ul> <li>a smoker’s exhale</li><li>a burning cigarette, cigar or pipe</li></ul><p>There are 4,000 chemicals in cigarette smoke. Fifty of these chemicals cause cancer (carcinogens). These chemicals are also linked to diseases like <a href="/Article?contentid=2474&language=English">asthma</a>, heart disease and emphysema.</p><h2>Key points</h2> <ul> <li>Second-hand smoke comes from a smoker's exhale and from a burning cigarette, cigar or pipe.</li> <li>Children frequently exposed to second-hand smoke may develop asthma, pneumonia, bronchitis and ear infections.</li> <li>Children who commonly breathe second-hand smoke may also develop asthma-like symptoms like cough, wheezing and shortness of breath.</li> <li>The best way to reduce your family's risk is to keep your home 100% smoke-free.</li> <li>If a family member smokes, create a "smokers' corner" outside for them to use. </li> </ul>https://assets.aboutkidshealth.ca/AKHAssets/second_hand_smoke.jpg
Secondary cancer after a brain tumourSSecondary cancer after a brain tumourSecondary cancer after a brain tumourEnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemConditions and diseasesAdult (19+)NA2009-08-14T04:00:00ZEric Bouffet, MD, FRCPC9.2000000000000050.5000000000000604.000000000000Flat ContentHealth A-Z<p>Important information concerning the occurrence of secondary cancer in your child. Trusted Answers provided by Canadian Paediatric Hospitals.</p><p>Some treatments carry a small risk that a new tumour or cancer will develop. This risk is higher than the general population, but it is still quite low. The risk of a new cancer depends on the type of treatment, the age at treatment, the child’s sex, and also the presence of genetic conditions that increases a person’s chance of getting cancer. </p> <p>Not all secondary brain tumours are malignant. The most common type of secondary brain tumour is called a meningioma, which is benign. </p><h2>Key points</h2> <ul><li>Radiation therapy and chemotherapy can cause changes in normal cells which may increase the risk of malignant cells developing over time.</li> <li>In some cases, certain genetic conditions can be connected to brain tumours increasing the chance of a second tumour developing.</li> <li>Children will need regular check-ups and screenings for their entire lives to detect any problems early.</li> <li>A healthy lifestyle is important for preventing adult cancers.</li></ul>
Secondary cancersSSecondary cancersSecondary CancersEnglishOncologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemConditions and diseasesAdult (19+)NA2018-03-06T05:00:00ZOussama Abla, MDDanielle Weidman, MDKarin Landenberg, MD10.700000000000044.1000000000000297.000000000000Flat ContentHealth A-Z<p> Learn why your child is at risk of developing secondary cancers after they are treated for acute lymphoblastic leukemia (ALL).</p><p>Children treated for acute lymphoblastic leukemia (ALL) are at risk of developing secondary cancers. Regular follow-up after treatment is important so that your child's doctor can check for any early signs of these cancers. </p><h2> Key points </h2> <ul><li>After your child is treated for acute lymphoblastic leukemia (ALL), they are at risk of developing secondary leukemias or other secondary cancers, brain tumours, skin cancer or thyroid cancer.</li></ul>
SedationSSedationSedationEnglishPain/AnaesthesiaChild (0-12 years);Teen (13-18 years)BodyNervous systemDrug treatmentCaregivers Adult (19+)NA2011-03-03T05:00:00ZSheelagh Kemp, MD, FRCPC;Melanie Hill, RN, MN(c)6.0000000000000079.0000000000000889.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn about sedation. Sedation is medicine to make your child sleepy or more comfortable during a hospital test or treatment.</p><h2>What is sedation?</h2> <p>Sedation is medicine to make your child sleepy or more comfortable during a hospital test or treatment.</p> <p>This information will help you prepare your child for their test or treatment. It describes what sedation is, what happens when your child gets sedation, and how to care for your child after the test or treatment. </p><h2>Key points</h2> <ul> <li>Your child's stomach must be empty during and after sedation. If your child's stomach is not empty, your child could vomit while asleep and damage their lungs. </li><li>Eight hours before your child's test or treatment, your child should only have clear liquids such as water, ginger ale or clear apple juice. Your child should not eat or drink any solid food, gum, candy, milk or orange juice. </li><li>Two hours before the operation, test or treatment, stop giving your child anything to drink. </li><li>If possible, bring another adult with you when you take your child home from the hospital.</li> </ul><h2>Sedation is used to help your child relax</h2><p>Your child may find the test or treatment frightening or uncomfortable. Your child may need sedation to help them relax and stay still during the test or treatment. The sedation may make your child fall asleep or just feel sleepy. The sedation may also help make your child forget what happened during the treatment. </p><p>For treatments that are painful, your child will also be given medicine for pain.</p><h2>The nurse or doctor will watch your child closely during sedation</h2> <p>Before your child gets the sedation, the nurse or doctor will ask you and your child some important questions. They will do a physical exam to make sure that it is okay for your child to get the sedation. </p> <p>While your child is sedated, the nurse or doctor will monitor your child's blood pressure, heartbeat and breathing often. The nurse may use several different machines, called monitors, to check on your child. </p> <p>After the sedation, the nurse or doctor will watch your child closely until they are ready to go home.</p><h2>Sedation may cause minor side effects</h2> <p>Your child may have side effects (problems) after the sedation is given. Usually these side efects are minor. They may include:</p> <ul> <li>throwing up </li><li>upset mood, feeling grumpy or tearful </li><li>feeling sleepy</li> <li>dizziness or instability</li> </ul> <p>Sometimes, instead of making your child sleepy, the sedation may make your child overly active and upset. If this happens, the nurse or doctor will stay with your child until they calm down, but the test or treatment may have to be arranged for another day. </p> <p>There is also a very small chance that your child may have an allergic reaction to the sedation. There is an even smaller chance that your child may need help with their breathing because of the sedation. This is why we watch your child very closely during and after the sedation. </p> <h2>The nurse will let you know when you can be with your child</h2> <p>For most tests or treatments, you will be allowed to be with your child. In some cases, you may have to wait in the waiting area during your child's test or treatment. Your child's nurse will let you know more about this. </p> <p>When the test or treatment is over, you can be with your child while they recover from the sedation.</p> <h2>Your child will be asleep for a short time after sedation</h2> <p>The amount of time that your child is asleep after sedation depends on the type of sedation, the drug and the dose. In most cases, your child will be asleep for one to two hours. Your child's nurse will let you know how long to expect. </p> <p>We will try to keep the amount of time your child is asleep as short as possible. This will allow them to recover quickly when the test or treatment is over. </p> <h2>Going home</h2> <h3>Your child will be ready to go home when they are awake</h3> <p>Your child will be ready to go home when they are awake and able to drink clear fluids. This may take one or two hours. </p> <h3>Taking your child home from the hospital</h3> <p>Bring another adult with you when you take your child home from the hospital.</p> <p>If you are driving home, it is strongly recommended that the second adult is available to sit beside and watch your child in the car. Please make sure your child wears their seat belt. </p> <p>If your child uses a stroller, bring it with you to the hospital. Your child may be dizzy and unable to walk on their own.</p> <p>You will get written instructions from your nurse before leaving the hospital. These notes will tell you what you need to know once you are at home. </p> <p>For more information, please read <a href="/Article?contentid=1251&language=English">Sedation: Caring for your child at home</a>.</p><h2>Before sedation</h2><h3>A nurse or doctor will decide if your child needs sedation</h3><p>After you come to the hospital for your child's test or treatment, a nurse or doctor will check your child. Then, you and the nurse or doctor will decide if your child should have sedation. </p><h3>A nurse or doctor will give your child sedation</h3><p>A nurse or doctor at the hospital will give your child sedation. This person will also watch your child closely while they are sedated. </p><p>Do not give your child any other medicine that may calm, relax or make them sleepy before coming to the hospital.</p><h2>There are different ways your child can get sedation</h2><p>Sedation can be given in the following ways:</p><ul><li>as a drink </li><li>as a pill to swallow </li><li>through a mask </li><li>through an intravenous line (IV), a small tube that is placed in a vein in an arm or leg using a small needle</li></ul><p>The doctor or nurse will decide and discuss with you which type of sedation is best for your child for the procedure. If your child is having sedation through an IV, ask for cream to numb the area where the <a href="/Article?contentid=990&language=English">needle goes in so it does not hurt your child</a>. You should ask for the cream as soon as you arrive on the day of your appointment. </p><h2>What to feed your child before sedation</h2><p>Your child's stomach must be empty before sedation. If your child has even a small amount of food or drink in the stomach, your child could <a href="/Article?contentid=746&language=English">throw up</a> (vomit) and damage their lungs. An empty stomach lowers the chance that your child will vomit. </p><p>Follow these instructions to make sure your child's stomach is empty. If you do not follow these instructions, your child's procedure will be delayed or cancelled. </p><ul><li>Eight hours before the sedation, your child must stop eating solid food, gum, candy, milk or orange juice. Your child can still drink clear liquids, which means liquids you can see through like a window. Clear liquids include water, ginger ale and clear apple juice. </li><li>Two hours before the sedation, your child must stop drinking clear liquids. Your child should not take anything by mouth until after they wake up. </li><li>If your child needs to take prescription medicine, talk to the doctor who prescribed the medicine before giving it.</li></ul><p>Your child is having the sedation at this time: ___________________________________</p><p>Your child should stop drinking clear fluids at this time: ____________________________</p><h3>For babies</h3><p>If your baby is breastfeeding, stop breastfeeding your baby four hours before the sedation.</p><p>If your baby drinks formula, stop giving formula six hours before the sedation.</p><h3>Summary: Eating and drinking before the sedation</h3><table class="akh-table"><thead><tr><th>Time</th><th>What your child can eat and drink</th></tr></thead><tbody><tr><td>8 hours before the sedation</td><td><p>No more solid food, gum, candy, milk or orange juice.</p><p>Your child can only drink clear liquids, including water, ginger ale and clear apple juice.</p></td></tr><tr><td>6 hours before the sedation</td><td>Stop giving your baby formula.</td></tr><tr><td>4 hours before the sedation</td><td>Stop breastfeeding your baby.</td></tr><tr><td>2 hours before the sedation</td><td>No more clear liquids. Your child should not eat or drink anything until they wake up.</td></tr><tr><td colspan="2">If your child takes prescription medicine, ask your child's doctor when and how to give the medicine.</td></tr></tbody></table><h2 class="pdf-page-break">Tell your child what will happen</h2><p>It is important to tell your child what will happen during the test or treatment. Tell your child who will be staying with them, what kinds of things will happen, and how they may feel during and after the test or treatment. </p><p>Your nurse can help you explain the test or treatment to your child. It is important to be honest. Children feel less anxious and scared when they know what to expect. </p>https://assets.aboutkidshealth.ca/AKHAssets/sedation.jpg
Sedation: Caring for your child at homeSSedation: Caring for your child at homeSedation: Caring for your child at homeEnglishPain/AnaesthesiaChild (0-12 years);Teen (13-18 years)BodyNervous systemNon-drug treatmentCaregivers Adult (19+)NA2015-06-04T04:00:00ZGuila BenDavid, MRTR​6.0000000000000083.0000000000000571.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Sedation is a medicine that helps your child relax, stay calm or sleep. Learn how to take care of your child at home after sedation. </p><p>Your child was given <a href="/Article?contentid=1260&language=English">sedation</a> during their visit to the hospital. Sedation is a medicine that helps your child relax, stay calm or sleep.</p><p>Your child will be ready to go home when they are wide awake, or back to how they were before being given sedation. </p><div class="pdf-page-break"> <h2>Important information about your child's sedation</h2><table class="akh-table"><tbody><tr><td width="70%">Name of the sedation medicine:</td><td width="30%"></td></tr><tr><td>Time and date your child received the sedation medicine:</td><td></td></tr><tr><td>Amount of sedative and method of sedation:</td><td></td></tr><tr><td>Your child's weight today:</td><td></td></tr><tr><td>Name of your child's sedation nurse or doctor:</td><td></td></tr><tr><td>Telephone:<br></td><td></td></tr></tbody></table></div><h2>Key points</h2> <ul> <li>Your child might feel different for up to one day after receiving sedation. Watch your child closely, especially if they are doing things that need balance or concentration.</li> <li>Feed your child clear fluids at first. When your child can drink without throwing up, start giving them what they normally eat.</li> <li>If your baby is able to drink from a bottle, try to give them one or two feedings of clear fluid before giving formula or breastfeeding.</li> <li>If your baby cannot drink from a bottle, make sure your baby is wide awake and start with a short feed.</li> <li>If you are driving with your child, have another adult sit next to your child to watch them.</li> <li>Check your child for the first three or four hours that they sleep. Make sure that you can wake them, they are breathing regularly and their skin is its usual colour. If there are any breathing problems, call 911 for help.</li> </ul><h2>When to seek medical assistance</h2> <p>If your child throws up more than twice, call your family doctor or take your child to the nearest Emergency Department. Bring this information with you so the doctor or nurse will know the name, time and amount of sedation your child received.</p> <p>If you have other questions or concerns that are not urgent, call the department where your child received the sedation.</p> <h3>When to call 911</h3> <p>The following problems are rare. However, if you notice any of these, call 911 for help:</p> <ul> <li>Your child is having problems breathing.</li> <li>Your child’s breathing is shallow, slow or different than usual.</li> <li>Your child’s skin colour is very blue or grey.</li> <li>You are not able to wake your child.</li> </ul><h2>Your child may feel unsteady or groggy after sedation</h2> <p>Your child may be unsteady on their feet. If your child feels this way, do not let them run, walk or crawl on their own.</p> <p>Your child may feel the effects of the sedation for up to one day; they may feel dizzy and groggy, and may be less active. Watch them closely. They may also become cranky, grumpy or hyper.</p>https://assets.aboutkidshealth.ca/AKHAssets/sedation_caring_for_child_at_home.jpg
SeizuresSSeizuresSeizuresEnglishNeonatology;NeurologyPremature;Newborn (0-28 days);Baby (1-12 months)BrainNervous systemConditions and diseasesPrenatal Adult (19+)NA2009-10-31T04:00:00ZHilary Whyte, MSc, MB, BCh, BAO, MRCPI, FRCPC11.000000000000048.3000000000000725.000000000000Flat ContentHealth A-Z<p>Learn about seizures occurring in premature babies, and treatment. During a seizure, the brain sends conflicting signals through the brain all at once.</p><p>One of the prime functions of the brain is to receive, interpret, and send information. From the outside of the body, this information comes in the form of sight, sounds, smells, and so on. Within the brain, this information is passed along in the form of electrical signals relayed back and forth by specialized cells called neurons. During a seizure, the brain misfires, sending overwhelming amounts of conflicting signals through the brain at the same time. </p><h2>Key points</h2> <ul><li>Risk factors for seizures in babies include asphyxia in the womb or during birth, infections such as meningitis, metabolic imbalances, or bleeding into the ventricles of the brain.</li> <li>Signs of seizures in premature babies include apnea, twitching of arms or legs, fluttering of eyelids, arching of the back and rhythmic arm or leg movement.</li> <li>Premature babies who have seizures do not necessarily have epilepsy; they may have one or two seizures in the days following birth and never have another seizure for the rest of their lives.</li> <li>Seizures are usually treated with medications depending on the severity and duration of the seizures.</li></ul>
Seizures during brain tumour treatmentSSeizures during brain tumour treatmentSeizures and brain tumoursEnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemConditions and diseasesAdult (19+)NA2009-07-10T04:00:00ZEric Bouffet, MD, FRCPCUte Bartels, MD6.1000000000000074.5000000000000552.000000000000Flat ContentHealth A-Z<p>An in-depth guide to dealing with your child experiencing seizures as a result of a brain tumour, or as a reaction to brain tumour surgery.</p><p>Your child may have had seizures, which could have led to their diagnosis. They may also have seizures for the first time after surgery. Seeing this can be a frightening experience for you and your family. </p><h2>Key points</h2> <ul><li>A seizure occurs when the electrical signals between nerve cells in the brain are disrupted or become too strong.</li> <li>In most cases, the best thing to do is watch closely if your child is having a seizure.</li> <li>Most seizures associated with brain tumours can be controlled by anti-seizure drugs.</li></ul>
Selecting the injection siteSSelecting the injection siteSelecting the injection siteEnglishEndocrinologyChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemDrug treatmentAdult (19+)NA2016-10-17T04:00:00ZCatherine Pastor, RN, MN, HonBSc;Vanita Pais, RD, CDE;Jennifer Harrington​, MBBS, PhD​000Flat ContentHealth A-Z<p>Learn about the safest areas of the body for insulin injection and the importance of rotating insulin injection sites.<br></p><p>There are four safe areas for <a href="/Article?contentid=1731&language=English">insulin injections</a>: the side of the thighs, the back of the upper arms, the abdomen (belly) and the upper outer buttocks. It is important to rotate insulin injection sites.</p><h2>Key points</h2><ul><li>The four safe areas for insulin injections are the side of the thighs, the back of the upper arms, the abdomen and the upper outer buttocks.</li><li>To avoid bumps and scar tissue on the skin, alternate a few different sites for insulin injection.<br></li><li>Create a systematic approach to injection site rotation.<br></li></ul>https://assets.aboutkidshealth.ca/akhassets/IMD_insulin_injection_site_rotation_EN.png
Self-care after leukemia treatmentSSelf-care after leukemia treatmentSelf-care after leukemia treatmentEnglishOncologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemConditions and diseases;Healthy living and preventionAdult (19+)NA2018-03-06T05:00:00ZOussama Abla, MDDanielle Weidman, MDKarin Landenberg, MD000Flat ContentHealth A-Z<p> Learn why it is important for a child who has had leukemia to be aware of their medical history and ways you can encourage them to be an active participant in their own health.</p><p>As your child gets older, they become more independent. As they mature, they need to be aware of their own medical history and the potential late effects caused by their leukemia treatment. This will be important, as they will need to continue follow-up care for the rest of their life. Becoming literate about their medical history is essential for their long-term health, as is learning the important steps needed to manage their health care. Your child can use ‘My Health Passport,’ a customized, wallet-size card that describes all of their medical information. For more information, visit the <a href="http://www.sickkids.ca/good2go/">Good 2 Go</a> website. </p><h2> Key points </h2> <ul><li>As your child grows up, they will need to know their medical history as they will require follow-up care for the rest of their life.</li> <li>Encourage your teen to make healthy lifestyle choices and meet with their doctor on their own.</li></ul>
Self-efficacy in childrenSSelf-efficacy in childrenSelf-efficacy in childrenEnglishNASchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)NANAHealthy living and preventionCaregivers Adult (19+)NA2012-08-30T04:00:00Z10.600000000000045.2000000000000942.000000000000Flat ContentHealth A-Z<p>​​Learn why self-efficacy is important for academic success and well-being in children.</p><h2>What is self-efficacy?</h2><p>Self-efficacy is the belief that you are capable of performing a task or managing a situation. As a quote often attributed to Henry Ford says, "Whether you think that you can or that you can’t, you are usually right." A child with high self-efficacy believes they have the skills to help them steer through life and reach their goals. Perhaps most importantly, self-efficacy is about learning how to persevere when one does not succeed.</p><p>Canadian psychologist Dr. Albert Bandura is most noted for his research in self-efficacy. Now a professor in social psychology at Stanford University, Bandura contends that self-efficacy touches nearly every aspect of our lives.</p> ​<h2>Key points </h2> <ul> <li>Self-efficacy is the belief that you are capable of performing a task or managing a situation. It is about learning how to persevere when one does not succeed at first. </li> <li>When a child equates success to internal factors, they develop a sense of mastery, which reinforces stronger self-efficacy beliefs. </li> <li>A child with high self-efficacy works harder, is more optimistic and less anxious, and perseveres more.</li> </ul><p>​​</p>https://assets.aboutkidshealth.ca/AKHAssets/self-efficacy_in_children.jpg
Self-efficacy: How to foster in childrenSSelf-efficacy: How to foster in childrenSelf-efficacy: How to foster in childrenEnglishDevelopmentalChild (0-12 years);Teen (13-18 years)NANAHealthy living and preventionCaregivers Adult (19+)NA2012-08-30T04:00:00ZNA8.0000000000000060.0000000000000876.000000000000Flat ContentHealth A-Z<p>These practical tips for parents help foster self-efficacy, so a child learns to persist when facing a setback.</p><p> <a href="/Article?contentid=630&language=English">Self-efficacy</a> is the belief that you are capable of performing a task or managing a situation. A child with high self-efficacy believes they have the skills to help them steer through life and reach their goals. Perhaps most importantly, self-efficacy is about learning how to persevere during a challenge or setback. </p><p>There are many ways parents can help nurture self-efficacy in a child.<br></p><h2>Key points </h2> <ul> <li>A child with high self-efficacy believes they have the skills to help them steer through life and reach their goals. </li> <li>Self-efficacy is about learning how to persevere during a challenge or setback. </li> <li>Experiencing setbacks and failure helps foster strong self-efficacy in children. Make sure your child is being challenged enough to experience setbacks and teach them how to learn from the obstacles. </li> <li>Help your child set realistic, short-term goals. These goals are more manageable, require frequent feedback and help foster strong self-efficacy. </li> <li>Praise effort and praise honestly. Praising ability rather than effort undermines motivation and performance. </li> <li>Help your child see their strengths during a setback so they learn to rely on their abilities and persist. </li> <li>Model self-efficacy to your child by sharing your own obstacles and efforts to work towards goals. </li> </ul>https://assets.aboutkidshealth.ca/AKHAssets/self_efficacy_how_to_foster_in_children.jpg
Self-harm in children and teens: OverviewSSelf-harm in children and teens: OverviewSelf-harm in children and teens: OverviewEnglishPsychiatrySchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)BodyNAConditions and diseasesCaregivers Adult (19+)NA2016-02-10T05:00:00ZMarijana Jovanovic, MD, FRCPC;Daphne Korczak, MD, MSc, FRCPC (Paediatrics), FRCPC (Psychiatry)9.1000000000000056.9000000000000626.000000000000Health (A-Z) - ConditionsHealth A-Z<p>A child or teen may turn to self-harm as a way to relieve emotional pain. Find out about the main causes and coping methods.</p><h2>What is self-harm?</h2><p>Self-harm can include cutting, burning or hitting oneself. Children and teens who self-harm may be trying to relieve emotional pain or suffering or create a physical wound to represent their emotional suffering.</p><h2>If my child self-harms, does it mean they are suicidal?</h2><p>No, self-harm is not always associated with <a href="/Article?contentid=291&language=English">suicidal thoughts</a>.</p><h2>Key points</h2> <ul> <li>Self-harm can include cutting, burning or hitting oneself to relieve emotional pain. Not everyone who self-harms has thoughts of suicide.</li> <li>Stressful life events and existing mental health conditions, such as depression or anxiety, are the main causes of self-harming​ thoughts and behaviour.</li> <li>If you learn that your child is harming themselves, talk to them about any stressful events and their impact on them.</li> <li>Someone who engages in self-harm may benefit from safer coping strategies such as using ice cubes or icepacks on the skin, flicking an elastic band on the wrist or doing high intensity exercise.</li> </ul><h2>What causes self-harming thoughts and behaviour?</h2><p>Self-harming thoughts and behaviour can have a wide range of causes. These can include stressful life events and existing mental health conditions.</p><h3>Stressful life events</h3><p>Stressful events may lead a child or teen to feel overwhelmed or trapped in a situation. They might include, for example, a relationship break-up, conflict with family or friends, bullying (online or face-to-face), failing a test or experiencing a loss such as a death or the divorce of parents.</p><h3>Mental health conditions</h3><p>A number of mental health conditions can increase a teen's risk for self-harm. These include:</p><ul><li><a href="/Article?contentid=19&language=English">depression</a></li><li> <a href="/Article?contentid=18&language=English">anxiety disorders</a></li><li>substance use disorders</li><li>some personality disorders (such as borderline personality disorder)</li><li><a href="/Article?contentid=1922&language=English">attention deficit hyperactivity disorder (ADHD)</a></li><li><a href="/Article?contentid=1927&language=English">post-traumatic stress disorder (PTSD)</a></li><li>eating disorders such as <a href="/Article?contentid=268&language=English">anorexia</a>, <a href="/Article?contentid=282&language=English">bulimia</a> and <a href="/Article?contentid=277&language=English">binge eating disorder</a></li><li><a href="/Article?contentid=279&language=English">bipolar disorder</a></li><li>schizophrenia</li></ul><h2>When to seek medical help for self-harm</h2> <p>Once you learn that your child is self-harming, speak to your family doctor or paediatrician, as the behaviour may be a symptom of an underlying mental health condition.</p><h2>Further information</h2><p>For more information on protecting your child or teen from suicide or self-harm, please see the following pages:</p><p><a href="/Article?contentid=291&language=English">Suicide in children and teens: Overview</a></p><p><a href="/Article?contentid=290&language=English">Suicide risk: Signs and symptoms</a></p><p><a href="/Article?contentid=293&language=English">Suicide and self-harm: How to talk to your child about their emotions</a></p><p><a href="/Article?contentid=292&language=English">Suicide and self-harm: How to protect your child</a></p><h2>Resources</h2><p>In Canada, children and teens in distress can contact KidsHelpPhone on <a href="http://www.kidshelpphone.ca/" target="_blank">KidsHelpPhone.ca</a> or call 1-800-688-6868.</p>https://assets.aboutkidshealth.ca/AKHAssets/self_harm_overview.jpg
Self-image and changes to appearance from leukemiaSSelf-image and changes to appearance from leukemiaSelf-Image and Changes to Appearance from LeukemiaEnglishOncologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemConditions and diseasesAdult (19+)NA2018-03-06T05:00:00ZOussama Abla, MDDanielle Weidman, MDKarin Landenberg, MD000Flat ContentHealth A-Z<p> Learn how to help your child accept changes in appearance caused by leukemia treatment.</p><p>Your child or teenager may look different as a result of their leukemia treatment. For example, they may have lost their hair, or may have scarring, weight changes, or skin problems such as acne. </p> <p>Remind them that most of these changes are temporary and will go away with time.</p> <p>Many children and teenagers become self-conscious or embarrassed about these changes. They may feel nervous about whether their peers will accept their changes in appearance. It will take time and they may need extra support to adjust to this life-changing situation.</p><h2> Key points </h2><ul><li>Children and teens may undergo changes in their appearance from leukemia treatment, such as hair loss, weight changes, scarring, or skin problems.</li><li> If you show distress at your child's changed appearance, it may upset them more.</li><li> Several organizations offer tools for people with cancer to feel better about their appearance.</li><li> Emphasize your child's strength in dealing wiih their illness and changes in appearance, and that these changes are mostly temporary.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/Self-image_and_changes_to_appearance.jpg
Sensitive gag reflex: Transition to textured foodsSSensitive gag reflex: Transition to textured foodsSensitive gag reflex: Transition to textured foodsEnglishNutritionBaby (1-12 months);Toddler (13-24 months)Mouth;EsophagusMouth;EsophagusConditions and diseasesCaregivers Adult (19+)NA2009-11-10T05:00:00ZSuzanne Breton, BScOT, O.T.Reg. (Ont.);Eyal Cohen, MD, MSc, FRCP(C);Sherna Marcus, BScOT, O.T.Reg. (Ont.);Irene Ushycky, DSP6.5000000000000077.3000000000000934.000000000000Health (A-Z) - ConditionsHealth A-Z<p>If your child gags when given pureed foods that are not smooth, it may be because of a sensitive gag reflex. Read tips for overcoming a sensitive gag reflex.</p><p>Some babies and children have problems taking and swallowing food that is not smooth. These children will often do well with smooth pureed foods, such as commercial first baby foods in jars. When they are given pureed foods that are not smooth, they will often gag and sometimes <a href="/Article?contentid=746&language=English">vomit</a> (throw up). As a result, their parents will often go back to the smooth purees, which the child likes.</p> <p>These children continue to eat only smooth pureed foods and do not have the chance to learn to eat foods with texture. They also do not have the chance to learn to chew. Some children will be able to tolerate food with lumps in their mouth but will gag if they try to swallow lumps. As a result, these children will spit out lumps and only swallow the smooth part of food. </p> <h2>Key points</h2> <ul> <li>Some children will gag or vomit when they are given pureed foods that are not smooth. This is often caused by a very sensitive gag reflex. </li> <li>Offering only smooth foods and hoping that the problem will go away does not always work. </li> <li>There are a few things you can do to help make your child's gag reflex less sensitive. </li> </ul><h2>What causes this problem</h2> <p>Children who gag when trying to eat foods that are lumpy or have texture often have a very sensitive gag reflex. The gag reflex helps us to expel food that our bodies feel is unsafe for us to swallow. The gag is usually triggered somewhere on the tongue. </p> <p>Children with a very sensitive gag reflex tend to gag more easily than other children on food that is not smooth. This often looks very scary, as the child can turn red and appear quite distressed. Sometimes the gagging will lead to vomiting. </p> <h3>The difference between a sensitive gag reflex and a swallowing problem</h3> <p>It is common for parents to think that gagging when eating is caused by a problem with swallowing. However, there is a difference between a sensitive gag reflex and a swallowing problem: </p> <ul> <li>Children who have a very sensitive gag reflex will gag when new foods are still in their mouth, before they have tried to swallow the food. This can occur when the food is near the front, middle or back of the mouth. </li> <li>Children with a swallowing problem have trouble after the food has been swallowed. They may gag or choke. </li> </ul> <h2>Chewing problems can also cause gagging</h2> <p>Children can have problems with textured food because they have trouble chewing:</p> <ul> <li>Some children have difficulty chewing solid food in order to make it safe to swallow. These children will try to swallow a piece of food before it is properly broken down. This can cause them to gag and sometimes choke. This is often seen when children are first learning to chew. </li> <li>Children who have delays in their motor skills will often also have delays in their chewing skills as well. </li> </ul> <p>If your child is gagging with some solids, make sure they can properly chew the food that they are being given.</p><h2>How you can help your child with a very sensitive gag reflex</h2> <p>Children who have a very sensitive gag reflex usually need some help to improve. Just going back to offering only smooth foods and hoping that as the child gets older, their feeding will improve, does not always work. Most children with very sensitive gag reflexes need to experience the feeling of texture in their mouth and throat in order to make their gag reflex less sensitive. </p> <p>Smooth foods with lumps, such as yogurt with pieces of fruit, are often the most difficult for children with a very sensitive gag reflex. This is because the child feels a smooth texture and then the lump is a surprise. This can cause the child to gag. </p> <h3>Tips to help your child tolerate textured food</h3> <p>To make the gag reflex less sensitive and help children tolerate food in their mouth that is not smooth, you can try the following:</p> <ul> <li>Add texture to the food, but still keep it all the same texture. That is, you can make the food more grainy but with no lumps. You can do this by taking the smooth food that the child likes to eat and adding something like wheat germ or graham cookie crumbs. This will make the food less smooth, but there will be no surprise lumps. You can start off by adding only a very small amount of the wheat germ or graham cookie crumbs. As the child improves, you can add more. This will help the child slowly get used to the feeling of texture in their mouth and throat. </li> <li>If your child is able, allow them to feed themselves for all or part of the meal. Children with sensitive gags often do better if they can feed themselves. </li> <li>Even if your child is not able to tolerate lumpy or textured pureed foods, they may be ready to try solids that dissolve easily, such as baby crackers or cookies. Children with sensitive gag reflexes often do better with solids that dissolve easily, rather than lumpy pureed foods. </li> <li>Brushing your child's teeth will also often help to make their gag less sensitive. </li> <li>If your child enjoys putting toys in their mouth, provide teething toys that have bumps and different textures. </li> </ul> <p>If your child continues to have trouble swallowing textured foods, speak to your child's doctor.</p> https://assets.aboutkidshealth.ca/AKHAssets/sensitive_gag_reflex.jpg
Sensory and motor services for autism spectrum disorder (ASD)SSensory and motor services for autism spectrum disorder (ASD)Sensory and motor services for autism spectrum disorder (ASD)EnglishNeurologyChild (0-12 years)NANervous systemConditions and diseasesAdult (19+)NA2009-03-09T04:00:00ZJanice Mulligan MSW, RSWRadha MacCulloch, MSWWendy Roberts MD. FRCPCLee Steel8.2000000000000059.0000000000000440.000000000000Flat ContentHealth A-Z<p>Provides information about resources you can access to address sensory motor issues in your child who has autism.</p> <br><p>Occupational therapists (OTs) can help children with autism spectrum disorder (ASD) with difficulties they have with their fine and gross motor skills and five senses.</p> Many children with autism spectrum disorder (ASD) have problems with fine motor skills. These include writing, cutting with scissors, or fastening buttons. They may also have issues with gross motor skills. These include riding a bike, skipping, or jumping. Occupational therapists (OT) help with these kinds of problems. Some children with ASD also have difficulty with one or more of their senses: sight, hearing, smell, touch, and taste. OTs who are trained in “sensory integration” can help in this area.<p><br></p><h2> Key points </h2><ul><li>Occupational therapists (OTs) can help children with autism with problems associated with gross or fine motor skills. Specially-trained OTs can also help children with ASD who have difficulty with one or more of their senses.<br></li><li>OTs work with children in hospitals, in the community, in schools, clinics, children’s centres, and private practice.</li></ul>
SepsisSSepsisSepsisEnglishInfectious DiseasesChild (0-12 years);Teen (13-18 years)NANAConditions and diseasesCaregivers Adult (19+)NA2017-07-19T04:00:00ZDeborah Schonfeld MD, FRCPC;Maya Harel-Sterling​, MD10.000000000000052.0000000000000709.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Sepsis occurs when a local infection spreads to the entire body. Find out what causes sepsis and how sepsis is treated. </p><h2>What is sepsis?</h2><p>Sepsis is a serious condition that occurs as a complication of a severe local infection (an infection affecting one part of the body). If left untreated, sepsis can damage the body’s organs, for example the <a href="https://pie.med.utoronto.ca/htbw/module.html?module=bladder-child">kidneys</a>, liver, <a href="https://pie.med.utoronto.ca/htbw/module.html?module=lung-child">lungs</a> or <a href="https://pie.med.utoronto.ca/htbw/module.html?module=brain-child">brain</a>, and possibly lead to death.</p> <figure class="asset-c-100"><span class="asset-image-title">Development of sepsis</span> <img alt="Illustration of the development of sepsis from local infection to organ damage and death, if left untreated" src="https://assets.aboutkidshealth.ca/akhassets/sepsis_development_EN.jpg" /> <figcaption class="asset-image-caption">Sepsis is most often caused by bacteria but can also be caused by viral or fungal infections.</figcaption> </figure><h2>Key points</h2> <ul> <li>Sepsis can occur as a complication of a severe infection, and is caused by the body’s immune response to the infection.</li> <li>Signs and symptoms of sepsis include common infection symptoms along with a fast heart rate, fast breathing, low blood pressure, pale or patchy skin, excessive sleepiness or disorientation.</li> <li>If your child is showing signs or symptoms of sepsis, they are treated right away even if the diagnosis is not yet confirmed through blood tests. Initial treatment includes antibiotics, intravenous fluids and/or oxygen.</li> <li>Regular hand washing and routine immunizations can help prevent some causes of sepsis.</li> </ul><h2>What are the signs and symptoms of sepsis?</h2> <p>A child with sepsis may display typical signs of an infection, including <a href="/Article?contentid=30&language=English">fever</a>, <a href="/Article?contentid=774&language=English">cough</a> or <a href="/Article?contentid=7&language=English">diarrhea</a>, along with:</p> <ul> <li>a <a href="/Article?contentid=894&language=English">fast heart rate</a></li> <li>fast breathing</li> <li>low blood pressure</li> <li>cool or clammy skin</li> <li>excessive sleepiness </li> <li>disorientation (not knowing where they are)</li> </ul><h2>What causes sepsis?</h2> <p>Sepsis is most often caused by bacteria. Some common bacterial causes include <em>Staphylococcus aureus</em>, various types of <em>Streptococcus</em> species and <em><a href="/Article?contentid=509&language=English#ecoli">E. coli</a></em>. Sepsis can also be caused by viral or fungal infections. Sometimes the specific infection and source of sepsis cannot be identified.</p> <p>Bacteria cause local infections such as <a href="/Article?contentid=784&language=English">pneumonia</a>, <a href="/Article?contentid=935&language=English">urinary tract infections</a> and infections of the <a href="/Article?contentid=509&language=English">gastrointestinal tract</a> or skin. If bacteria from these infections enter the bloodstream, the infection can spread to the rest of the body. This forces the body’s immune system to release antibodies and other molecules to fight the infection.</p> <p>The strong immune response, along with the bacteria already in the body, creates a lot of <a href="/Article?contentid=926&language=English">inflammation</a>. This inflammation damages tissue and interferes with blood flow. The change in blood flow can lead to a dangerous drop in blood pressure, which stops oxygen from reaching the body’s organs and tissues. This series of events is known as sepsis.</p> <h2>Who can develop sepsis?</h2> <p>Any child with an infection can develop sepsis. However, there is a higher risk for:</p> <ul> <li>newborns and young infants</li> <li>children who have recently had surgery</li> <li>children with weakened immune systems, for example due to cancer or an organ transplant</li> <li>children with chronic (long-term) diseases, such as gastrointestinal conditions or kidney disease</li> </ul> <p>Some medications, such as steroids used over a long time and other forms of chemotherapy, can also put children at higher risk of developing sepsis.</p><h2>How is sepsis diagnosed?</h2> <p>If a doctor suspects sepsis after examining your child, they will seek to confirm the diagnosis through a number of blood tests.</p> <p>The tests can reveal if your child has an infection, for instance through a high white blood cell count or signs of bacteria, or if their organs are not working properly, for example through higher levels of certain enzymes, waste materials or other substances.</p> <p>The doctor may also test samples of urine and, sometimes, spinal fluid (with a <a href="/Article?contentid=1336&language=English">lumbar puncture</a> or spinal tap) to check for bacteria or viruses.</p><h2>How is sepsis treated?</h2> <p>Your child will be admitted to hospital for treatment even if sepsis is only suspected, as it can take some time for test results to come back. Initial treatment for sepsis includes <a href="https://akhpub.aboutkidshealth.ca/article?contentid=1120&language=English">antibiotics</a>, intravenous (IV) fluids and oxygen.</p> <p>Sometimes children with sepsis need to be admitted to the intensive care unit (ICU) for closer monitoring and further treatment. For instance, if a child has a severe case of low blood pressure, they may need special types of medications to raise it. Or if sepsis has caused organ damage, a child may need dialysis, in the case of kidney failure, or a ventilator to help with breathing, in the case of lung damage.</p>https://assets.aboutkidshealth.ca/akhassets/sepsis_development_EN.jpg

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