| Iron deficiency anemia and protein-losing enteropathy related to excessive milk intake | Iron deficiency anemia and protein-losing enteropathy related to excessive milk intake | Iron deficiency anemia and protein-losing enteropathy related to excessive milk intake | I | English | Nutrition | Child (0-12 years) | NA | NA | Conditions and diseases | Adult (19+)
Caregivers | NA | | 2019-01-16T05:00:00Z | | Laila Premji, MD, FRCPC;Zamin Ladha MD, MSc | | | | 9.00000000000000 | 55.4000000000000 | 2219.00000000000 | | Health (A-Z) - Conditions | Health A-Z | <p>Milk can be a part of a healthy, balanced diet. However, drinking too much milk can lead to low levels of iron in the blood and some children can then lose protein from the gut.<br></p> | <h2>Excessive milk intake</h2><p>The recommended amount of cow’s milk for toddlers is 250 to 500 mL (1–2 cups or 8–16 oz.) per day. Some toddlers drink more milk than the recommended number of servings. This "milk diet" can lead to iron deficiency. A small group of these children also experience protein loss from the digestive system or gut. Iron deficiency can lead to anemia (low red blood cell count) and protein loss leads to hypoalbuminemia (low levels of albumin in the blood). Treatment usually requires limiting milk intake, offering iron rich solid food, and in children with moderate to severe anemia, iron supplements.</p>
| <p>Breast milk or formula is a good source of iron for the first six months of life. Iron stores in babies naturally decrease by four to six months of age. After six months, the amount of iron in breast milk is not enough, and solid foods are usually introduced.</p><p>When introducing solid foods, infants should start with meat or meat alternatives, in order to get enough iron and protein in their diet. Meat alternatives include fish, egg yolk, tofu, lentils and cheese. Iron-fortified cereals are also a good source of iron that can be started at four to six months of age. Breast milk and/or formula should continue until nine to 12 months of age, when homogenized (3.25%) cow’s milk may be started to complement solid food.</p><h3>Iron deficiency anemia</h3><p>Iron is an important mineral that we get from our diet that is needed to make haemoglobin. Haemoglobin is a protein in red blood cells that allows the cells to carry oxygen to the tissues in our body. Anemia occurs when you have low levels of haemoglobin in your body. When the anemia is caused by not having enough iron this is called iron deficiency anemia.</p><p>When a child has anemia, they are not getting enough oxygen delivered to the tissues in their body. This can cause them to look pale and tired, and cause weakness.</p><h3>Protein losing enteropathy</h3>
<p>Drinking too much milk can also cause protein loss from the gut (protein losing enteropathy).</p><p>Children with protein losing enteropathy have severe protein loss through the gut and this results in low protein levels in the blood.</p><p>The main protein found in the blood is called albumin. Having low levels of the protein albumin in the blood (hypoalbuminemia) can cause the blood vessels to leak fluid into the tissue. Extra fluid in the tissue can cause swelling (edema) of the legs, back and face. Hypoalbuminemia also puts you at risk for infections.</p><p>Hypoalbuminemia and edema can be caused by other disorders. Your child’s doctor will ask questions about your child’s overall health, symptoms of diarrhea or blood in the stool, and family history of gut, liver, kidney or heart diseases.</p><p>If there are no other causes for protein loss, it is possible that too much milk is the cause.</p> | <h2>Key points</h2><ul><li>Too much milk can lead to iron deficiency anemia and protein loss from the gut.</li><li>Milk intake should be limited to a maximum of 500 mL (2 cups or 16 oz.) per day for toddlers and young children.</li><li>The main treatment for iron deficiency and protein loss from the gut due to excess milk intake is to reduce the amount of milk your child drinks and to increase the amount iron rich foods in their diet. For moderate to severe anemia, iron supplements are also needed.</li><li>See a doctor if your child drinks a lot of milk and is tired, weak, pale or has a swollen face, legs and feet.</li>
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| | <h2>Signs and symptoms of iron deficiency anemia and protein losing enteropathy</h2><p>Symptoms of anemia depend upon its severity, how fast the drop in levels of haemoglobin occurred and its cause. It also depends on how well a child’s body adapts to a low level of haemoglobin.</p><p>Symptoms of anemia include:</p><ul><li>pale skin</li><li>lack of energy</li><li>shortness of breath after exercise or play</li></ul><p>Protein losing enteropathy and hypoalbuminemia causes the blood vessels to leak fluid into surrounding tissue.<br></p><p>Symptoms of protein losing enteropathy and hypoalbuminemia include:</p><ul><li>progressive swelling of the feet, legs and face</li><li>muscle cramps or weakness</li><li>extra fluid around the lungs (pleural effusion)</li><li>swelling of the abdomen (ascites)</li></ul>
| <h2>Risk factors and prevalence of iron deficiency anemia</h2><p>Iron deficiency anemia is the most common type of anemia.</p><p>Around the world, iron deficiency anemia affects approximately 750 million children. In Canada, it is seen in 3.5% to 10.5% of the general population. Children have a greater risk of iron deficiency anemia due to their rapid growth, particularly in the first two years of life.</p><p>Children who are most at risk of developing iron deficiency anemia are those who are fed only breast milk or non-iron fortified cow’s milk formulas after six months of age, and those who drink an excess of cow’s milk. Children who are given cow’s milk before 12 months may also be at increased risk of developing iron deficiency anemia because their gut may not be ready to digest cow’s milk yet.</p>
| <h2>Cause of iron deficiency anemia and protein losing enteropathy</h2><h3>Iron deficiency anemia</h3><p>Iron deficiency anemia from excessive milk intake is caused by three things.</p><ul><li><strong>Not enough iron:</strong> Milk contains very little iron. In addition, if a child drinks too much milk, they will be too full to eat good amounts of iron rich foods.</li><li><strong>Poor iron absorption:</strong> Milk and other dairy products can interfere with the gut’s ability to absorb iron from other sources, such as meat and meat alternatives, and dark green vegetables.</li><li><strong>Microscopic bleeding:</strong> Too much milk can damage the lining of the gut (milk enteropathy). Milk enteropathy causes microscopic bleeding from the gut that you may not be able to see. Any type of bleeding from the body results in a loss of iron. Over time, this bleeding can cause very low levels of haemoglobin, contributing to the iron deficiency anemia.</li></ul><h3>Protein losing enteropathy</h3><p>It is not fully understood how milk intake leads to protein loss in the gut. One theory suggests a process called villous atrophy. The small intestine part of our gut has finger-like projections on its walls called villi. The villi play an important role in the absorption of nutrients. It is believed that an excess intake of cow’s milk can cause the villi to shrink (villous atrophy) and not absorb nutrients well. Villous atrophy causes the bowel walls to become leaky, allowing protein to leak through.</p> | <h2>Diagnosis of anemia and protein losing enteropathy</h2><h3>Iron deficiency anemia</h3><p>Iron deficiency anemia can be diagnosed by your child’s doctor. They will do a physical exam and ask about your child’s energy levels, general health, diet and family history.</p><p>A blood test, called a complete blood cell count (CBC), can make the diagnosis of anemia by measuring haemoglobin levels. When the anemia is caused by iron deficiency, the red blood cells will also look smaller and lighter in colour when seen under a microscope.</p><p>A ferritin test may also be done. Ferritin is a protein found in the body that stores iron. A low ferritin level can indicate iron-deficiency.</p><p>Additional useful tests that measure the body’s iron are called iron studies.</p><h3>Protein losing enteropathy</h3><p>Protein losing enteropathy and hypoalbuminemia are suspected in children with swelling and low albumin levels in the blood. Your child’s doctor will examine them for swelling of the legs, feet and face. They will also examine your child’s heart, lungs and abdomen for extra fluid.</p><p>A blood test is often done to check the blood albumin level. A urine test may also be done to make sure there is no protein loss from the kidneys. When the cause of low albumin is not clear, further tests may be done including stool tests. One of the stool tests that may be performed is a 24-hour collection of stool to check for a protein called alpha-1-antitrypsin. By comparing the amount of this protein in the stool to the amount in the blood, doctors can tell whether there is protein loss through the gut.</p>
| <h2>Treatment of iron deficiency</h2><h3>Diet</h3><p>Limiting milk intake to a maximum of 16 ounces per day is usually the only treatment needed. The iron levels will gradually rise and protein loss from the gut will decrease.</p><p>Iron rich foods can also help to treat iron deficiency. Many iron rich foods, such as meat and meat alternatives, are also high in protein. Offer your child foods such as meat and meat alternatives, and iron-fortified cereals a few times each day. From one year of age, young children should begin to have a regular schedule of meals and snacks. In general, you may follow the advice in <a href="https://food-guide.canada.ca/en/">Canada’s Food Guide</a>.</p><p>Limiting milk does not mean stopping it completely. It is known that milk is a good source of calcium, vitamin A and vitamin D. From one to two years of age, children should drink 250 to 500 mL (1–2 cups or 8–16 oz.) of homogenized (3.25% M.F.) cow’s milk per day. They should not drink more than 500 mL (2 cups or 16 oz.) per day.</p>
<h3>Iron supplement</h3><p>Your child’s doctor might also prescribe iron supplements. After a few weeks, values such as the haemoglobin level generally start to improve. Treatment is usually continued for at least three months to fully replenish iron stores in the body.</p><p>Iron supplementation can cause an upset stomach. Your doctor might divide the dose in half and ask you to give it two times per day instead of as one large daily dose.</p><p>Dairy products (milk, cheese, yogurt) can have a negative effect on the absorption of iron. Try to give iron supplements two hours before or after eating or drinking any dairy products.</p><p>Vitamin C can help iron absorption from foods. Oranges and other citrus fruit are good sources of vitamin C. Be careful with offering too much juice, as it is high in sugar.</p><p>Protein losing enteropathy and hypoalbuminemia caused by too much milk gets better fairly quickly when the milk intake is limited to an appropriate amount.</p> | <h2>Complications of anemia and hypoalbuminemia</h2><p>Untreated anemia in children can have serious effects on a child’s growth. Untreated anemia can affect intellectual ability and overall development. This can lead to problems with attention, reading ability and school performance. In rare cases, extreme anemia can cause a stroke.</p><p>Hypoalbuminemia can also have serious effects on a child’s growth. Excess fluid around the lungs can cause problems with breathing. In rare cases, excess fluid can build up around the heart making it harder for the heart to pump. Protein loss in the gut can also cause a loss of the proteins needed to fight infection and prevent clots, putting children at risk of severe infections or blood clots.</p>
| <h2>Helping your child</h2><p>Limiting milk intake can be challenging. Many toddlers enjoy drinking milk in a bottle, and associate drinking milk with their bedtime ritual.</p><p>Here are some tips on how to help limit your child’s milk intake:</p><ul><li>If your child drinks more than 1200 mL (5 cups or 40 oz.) of milk per day, wean them slowly to smaller amounts. Cut the amount by half to start.</li><li>Offer solid foods first and only offer milk at the end of the meal. Alternatively, you could offer water with meals and milk only a couple of times a day with a snack. This way your child will not fill up on milk first.</li><li>Switch to a sippy cup early. This will prevent your child from taking the milk to bed and associating drinking milk with falling asleep.</li><li>Do not allow your child to sleep with a bottle of milk in bed. If you are having trouble with this then slowly start to dilute the milk with water until you are offering just water. This will also help in avoiding dental caries.</li>
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| | | <h2>Follow-up</h2><p>Iron supplementation should be continued for at least three to six months to replenish the amount of iron that is stored in the body.</p><p>After starting treatment, your doctor will schedule a follow-up appointment. A repeat blood test is not always needed if your child’s symptoms improve with iron treatment and changes in diet.</p>
| | | | | | | | | | | | | | | | | <h2>References</h2><ol><li>Abdullah, K., Zlotkin, S., Parkin, P. & Grenier, D. Iron-deficiency Anemia in Children. Canadian Paediatric Surveillance Program, resource article, 2011 (Accessed December 3, 2017).</li><li>Allen, R.E. & Myers, A.L. Nutrition in Toddlers. American Family Physician. 2006; 74(9): 1526-1532.</li><li>Bondi, S.A. & Lieuw, K. Excessive Cow’s Milk Consumption and Iron Deficiency in Toddlers: Two Unusual Presentations and Review. Infant, Child, & Adolescent Nutrition. 2009; 1(3). DOI: 10.1177/1941406409335481.</li><li>Critch, J.N. Nutrition for healthy term infants, six to 24 months: An overview. Paediatric Child Health. 2014; 19(10): 547-549.</li><li>Food Sources of Iron. Dietitians of Canada. (Accessed December 3, 2017).</li><li>Grueger, B. Weaning from the Breast. Paediatric Child Health 2013; 18(4): 210.</li><li>Kazal, L.A. Prevention of Iron Deficiency in Infants and Toddlers. American Family Physician. 2002; 66(7): 1217-1224.</li><li>Rabinowitz, S. & Ebigbo, N. Pediatric Protein-Losing Enteropathy. Medscape, Pediatrics; General Medicine, 2017 < https://emedicine.medscape.com/article/931647-overview> (Accessed December 3, 2017).</li></ol>
| | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/Drinks_for_your_toddler_or_preschooler.jpg | Excessive milk intake | Milk is part of a healthy diet. But too much milk can lead to low levels of iron in the blood and some children can lose protein from the gut. | |
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<i class="mdi mdi-chevron-down"></i></span><h2 class="panel-title">Attention deficit hyperactivity disorder (ADHD)</h2></div><div class="panel-body list-group" style="display:none;"><p>Attention deficit hyperactivity disorder (ADHD) involves difficulties with controlling attention and regulating behaviour. Discover the main symptoms of ADHD in children and teens, how the disorder is diagnosed and how to help your child at home and at school.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"><a class="overview-links" href="/Article?contentid=1922&language=English">Attention deficit hyperactivity disorder: Overview</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=1923&language=English">ADHD: Signs and symptoms</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=1997&language=English">ADHD: How to help your child at home</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=1999&language=English">ADHD: Communicating with your child's school</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=1998&language=English">ADHD: Treatment with medications</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable">
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<i class="mdi mdi-chevron-down"></i></span><h2 class="panel-title">Behavioural disorders</h2></div><div class="panel-body list-group" style="display:none;"><p>Behavioural disorders include oppositional defiant disorder and conduct disorder. Learn how these disorders differ from typical misbehaviour, how therapy and medications can help and how you can manage problematic behaviour at home.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"><a class="overview-links" href="/Article?contentid=1924&language=English">Behavioural disorders: Overview</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=1925&language=English">Behavioural disorders: Signs and symptoms</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=2000&language=English">Behavioural disorders: Treatment with psychotherapy and medications</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=2001&language=English">Behavioural disorders: How to help your child at home</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable">
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<i class="mdi mdi-chevron-down"></i></span><h2 class="panel-title">Post-traumatic stress disorder (PTSD)</h2></div><div class="panel-body list-group" style="display:none;"><p>Post-traumatic stress disorder (PTSD) is triggered by experiencing or witnessing a terrifying event. Learn about the main symptoms of PTSD, how the condition is diagnosed and how psychotherapy and medications can help your child.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"><a class="overview-links" href="/Article?contentid=1927&language=English">Post-traumatic stress disorder: Overview</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=1928&language=English">PTSD: Signs and symptoms</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=2005&language=English">PTSD: Treatment with psychotherapy and medications</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable">
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<i class="mdi mdi-chevron-down"></i></span><h2 class="panel-title">Brain disorders and mental health</h2></div><div class="panel-body list-group" style="display:none;"><p>A brain disorder includes a condition, illness or injury that affects the brain and how it develops before or after birth. Find out how a brain disorder can affect your child's learning, mood and social skills, how its impact on mental health is assessed and how to help your child cope.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"><a class="overview-links" href="/Article?contentid=1926&language=English">Brain disorders and mental health: Overview</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=2002&language=English">Brain disorders: Assessing your child for neuropsychological difficulties</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=2003&language=English">Brain disorders: How to help your child cope</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=2004&language=English">Brain disorders: Common treatments</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable">
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<i class="mdi mdi-chevron-down"></i></span><h2 class="panel-title">Parenting a child with a chronic condition</h2></div><div class="panel-body list-group" style="display:none;"><p>A chronic conditions can affect a child's mental health and everyday routines. Discover how parents and caregivers can help manage both their child's health care and routines, and support their own mental health.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3400&language=English">Living with a chronic condition: Overview</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3401&language=English">Living with a chronic condition: Helping your child manage their health</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3402&language=English">Living with a chronic condition: Maintaining your child's everyday routines</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3403&language=English">Living with a chronic condition: Supporting yourself as a caregiver</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable">
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<i class="mdi mdi-chevron-down"></i></span><h2 class="panel-title">Substance use disorder</h2></div><div class="panel-body list-group" style="display:none;"><p>Substance use is the use of alcohol, tobacco and other drugs for pleasure or enjoyment. Learn about the signs and symptoms of substance use and how you can help your teen if you suspect they have a substance use disorder.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3663&language=English">Substance use disorder: Overview</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3664&language=English">Substance use disorder: Signs and symptoms</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3665&language=English">Substance use disorder: How to help your teen at home</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable">
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<i class="mdi mdi-chevron-down"></i></span><h2 class="panel-title">Understanding somatization</h2></div><div class="panel-body list-group" style="display:none;"><p>Somatization involves expressing distress through physical symptoms. Find out about the mind-body connection, signs of somatization and the various ways to support your child or teen.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3667&language=English">Mind-body connection</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3668&language=English">Somatization: Signs and symptoms</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3669&language=English">Somatization: Common treatments</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3770&language=English">Somatization: How to help your child or teen cope</a></li></ol></div> | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/Mental_health_landing-page.jpg | mentalhealth | healthyliving | | | | |
| Celiac disease: Tips to maintain the gluten-free diet | Celiac disease: Tips to maintain the gluten-free diet | Celiac disease: Tips to maintain the gluten-free diet | C | English | Gastrointestinal | Baby (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) | Small Intestine | Small intestine | Non-drug treatment | Caregivers
Adult (19+) | NA | | 2017-02-06T05:00:00Z | | Peggy Marcon, MD, FRCPC;Inez Martincevic, MSc, RD;Catharine Walsh, MD, MEd, PhD, FAAP, FRCPC | | | | 8.90000000000000 | 57.0000000000000 | 1725.00000000000 | | Health (A-Z) - Procedure | Health A-Z | <p>Children with celiac disease must follow a strict gluten-free diet. This article contains tips to help your child maintain their special diet.</p> | <h2>What is celiac disease?</h2><p><a href="/Article?contentid=816&language=English">Celiac disease</a> is an autoimmune condition in which contact with gluten (a family of food proteins) triggers a reaction by the body’s defense (immune) system. The immune response to gluten—no matter where in the body the contact happened—damages the lining of the gut (small intestine) making it difficult to absorb nutrients.</p><p>Common symptoms of celiac disease include
<a href="/article?contentid=7&language=English">diarrhea</a>,
<a href="/article?contentid=6&language=English">constipation</a>,
<a href="/article?contentid=29&language=English">headaches</a>, tiredness and <a href="/article?contentid=841&language=English">anemia</a>. Some people experience no symptoms at all.<br></p><p>Celiac disease is a life-long condition. There is no medication for celiac disease. The only treatment is a strict gluten-free diet for life. The gluten-free diet will help heal the gut, improve symptoms that may have been present, and keep your child healthy.<br></p> | <figure class="asset-small"><img src="https://assets.aboutkidshealth.ca/akhassets/gluten_free_symbol_EN.jpg" alt="" /> </figure>
<h2>What is the gluten-free diet?</h2><p>A strict
<a href="https://akhpub.aboutkidshealth.ca/Article?contentid=956&language=English">gluten-free diet</a> means no trace amounts of gluten. Gluten is naturally found in all forms of:</p><ul><li>wheat</li><li>rye</li><li>barley</li><li>triticale (rye and barley mix).</li></ul><p>Wheat-based products, such as breads, pasta and baked goods, are obvious sources of gluten. However, there are also many foods where gluten is hidden, such as soups, salad dressings and ice creams. </p><p>Always read the labels of all foods and non-food items (such as medications) to find out if they contain any sources of gluten.</p> | <h2>Key points</h2><ul><li>Celiac disease is an autoimmune condition in which any contact with gluten (a family of food proteins) triggers a reaction from the body’s defense (immune) system.</li><li>Gluten is found in rye, barley, triticale and all forms of wheat.</li><li>The only treatment for celiac disease is a strict <a href="https://akhpub.aboutkidshealth.ca/Article?contentid=956&language=English">gluten-free diet</a> for life. The gluten-free diet will help heal the gut, improve symptoms that may have been present, and keep your child healthy.</li><li>To maintain a strict gluten-free diet, you should avoid cross-contamination (gluten transferred from one food or object to a gluten-free food or object) at home and outside your home.</li><li>When eating out, make sure everyone understands that your child’s gluten-free diet is the only medical treatment for celiac disease.</li></ul><br> | | | | | | | | <h2>Tax credit</h2>
<p>The purchase of gluten-free products for a person with celiac disease is considered a medical expense and can be filed as such with your taxes with <a href="http://www.cra-arc.gc.ca/menu-eng.html">Canada Revenue Agency</a>. You will be required to have the following documentation:</p>
<ul>
<li>a letter from a health-care practitioner certifying that the person requires gluten-free products due to celiac disease</li>
<li>a summary of each item purchased during the 12-month period for which the expenses are being claimed</li>
<li>a receipt to support the cost of each gluten-free product claimed</li>
</ul>
<p>For more information, visit the <a href="http://www.cra-arc.gc.ca/menu-eng.html">Canada Revenue Agency</a> website. <br></p> | | | | | | | | | | | | | <h2>How to avoid cross-contamination</h2><p>Cross-contamination occurs when gluten is not intentionally (not on purpose) transferred from one food or object to another food or object. It is important to avoid all sources of cross-contamination.</p><h3>At home</h3><p>Washing:</p>
<ul><li>
<a href="/Article?contentid=1981&language=English">Wash hands</a> between handling gluten-containing and gluten-free foods.</li><li>Wash hands and toys that have been contaminated with gluten.</li><li>Wash the counters carefully before preparing a gluten-free meal.</li><li>Clean all pots, pans, utensils and counter tops with soap between uses.</li></ul><p>In the kitchen:</p><ul><li>Keep gluten-free foods separated from foods that contain gluten.</li><li>Use a separate toaster, grill, colander and cutting board for all gluten-free products. If you use your grill for foods that contain gluten, wrap the gluten-free item in foil before cooking.</li><li>Use plastic or metal baking utensils and cutting boards instead of wooden ones because gluten sticks to wood.</li><li>Use condiments from a squeeze bottle when available or have separate containers for those used with gluten-free products (for example, butter or margarine dish).</li></ul><p>Avoid foods potentially contaminated with gluten: </p><ul><li>Do not buy foods that have no nutrition or allergy information on the label.</li><li>Do not eat gluten-free foods that are on the same plate as gluten-containing food (for example trays with fruits, cheese and gluten-containing crackers).</li></ul><h3>Outside of the home</h3><p>You have no control over your environment when you and your family are outside your home. Keep in mind that:</p><ul><li>Toys and play surfaces at day cares, school or others’ homes may be contaminated with gluten. Avoid touching or placing your child’s food on these surfaces.</li><li>Do not buy foods from bulk bins. Products in bulk bins can become contaminated when scoops are used in more than one bin. There is no assurance that the other customers will be as cautious as you.</li><li>Do not buy foods from stores where no nutrition or allergy information are on the label. This may happen with foods imported from other countries.</li><li>Contact food companies when in doubt about processing and gluten contamination.</li><li>Choose packaged deli meats. At the deli counter gluten-free meats are cut using the same slicer without cleaning between uses, which is a source of contamination.</li><li>Avoid buffets as foods may become contaminated with gluten when customers use the same serving utensils between dishes.</li><li>Avoid french fries and other gluten-free foods if they have been cooked in oil which has been contaminated with gluten. This may be the case if battered foods or seasoned foods have been fried in the same fryer.</li><li>Meat can become contaminated if it is cooked on a grill which is also used to cook gluten-containing foods.</li></ul><p>At school</p><ul><li>Speak to your child’s school about the need for your child to be on a strict gluten-free diet.</li><li>Ask the school about gluten-free menu options. It is important to check directly with the food provider about potential sources of contamination.</li><li>Make sure your child understands why they should not trade food with other students.</li></ul> | <h3>Before going out to eat</h3><p>Call the restaurant beforehand. Tell them that your child’s gluten-free diet is medical treatment for celiac disease, and not an intolerance or sensitivity.</p><p>Visit the restaurant’s website to check its menu, list of ingredients and allergy warnings.</p><p>Select a restaurant where communication will be easy and where the specifics of the strict gluten-free diet will be understood. For example, you should make sure that language will not be a barrier to communication.</p><p>If you do not have time to call ahead, inform your server and the chef of the strict gluten-free diet when you arrive. Try to go to restaurants during hours when it is less busy. With more time, restaurant staff may have more resources to focus on the specifics of the strict gluten-free diet.</p><p>Bring gluten-free breads, crackers and favourite condiments—including salad dressing—to the restaurant.</p><h3>At the restaurant</h3><p>Remember to always ask about cross-contamination. You may want to explain what cross-contamination is. You can say, “Cross-contamination happens when gluten from one food or object comes in contact with another food or object.” Ask for food to be prepared on clean surfaces with clean utensils and gloves.</p><p>Avoid all seasonings, sauces (for instance soy sauce), croutons, soups and gravies. Be specific when ordering. You can say “I want no gravy on my plate.” </p><p>Ask what food is deep fried in the same oil or fryer. You can explain that french fries, tofu, nachos and wings cooked in the same oil as nuggets or onion rings (which are sources of gluten) will be cross-contaminated and are unsafe for your child.</p><p>Ask for allergy or nutrition information lists.</p><p>Avoid buffets.</p><h2>Tips for calling food companies</h2><h3>Finding contact information</h3><p>If you are not sure about a food product or an ingredient in a non-food product, call the company. Find and write down or take a picture of the contact information for the company from the package. In Canada, this is usually a 1-800 phone number.</p><p>If you cannot find a contact phone number, record the name of the company. You can look for the company’s name in the phonebook or search for the contact information on the Internet.</p><p>Record the name of the product and the UPC code number; this is the number at the bottom of the bar code.</p><h3>What to ask</h3><p>Call the company and ask to speak with customer service. Ask specific questions about the product, such as “Is this product gluten-free?” or “Does the product contain oats, barley, wheat, rye, triticale, or any components of these ingredients?”</p><p>If the company is unable to confirm that the product is gluten-free, then do not eat or use that product. Remember that ingredient lists change and you may need to update this information at a later date. </p><p>Some companies maintain a list of products that are considered “gluten-free”. The company can send you the list at your request. Some companies list gluten-free information on their website. Make sure that the information has been recently updated (within the last year). </p> | | | | | <h2>Resources</h2>
<h3>Websites</h3>
<p>The <a href="http://www.celiac.ca/">Canadian Celiac Association</a> and its local chapters offer many resources to help maintain a gluten-free diet and more.</p>
<p>The <a href="http://www.glutenfreecert.com/about-us/gluten-free-certification-program/">Gluten-Free Certification Program</a> provides information about gluten-free products that are safe to eat for people with celiac disease.</p>
<h3>Handbook</h3>
<p><em>Acceptability of Foods and Food Ingredients for Gluten-free Diets</em> is a pocket dictionary published by the Canadian Celiac Association. It references food ingredients and additives under "allowed" or "not allowed" categories to guide people on gluten-free diets.</p>
<h3>App</h3>
<p><em>Acceptability of Foods and Food Ingredients for Gluten-free Diets</em> pocket dictionary is also available as an iTunes application. Search “<a href="http://www.glutenfree247.ca/">Gluten free 247</a>” for the version created by the Canadian Celiac Association.</p>
<p>Other apps to help manage celiac disease are available. Check each app review and ask other families for their opinion to choose an app best suited for your needs.</p>
<h3>Books</h3>
<p><strong>Celiac disease</strong></p>
<ul>
<li><em>Managing Diabetes and Celiac Disease Together</em>, by the Canadian Celiac Association</li>
<li><em>Gluten-Free Diet: A Comprehensive Resource Guide</em>, by Shelley Case</li>
</ul>
<p><strong>Children’s books</strong></p>
<ul>
<li><em>Growing up Celiac</em>, by the Canadian Celiac Association</li>
<li><em>Eating Gluten-Free with Emily: A Story for Children with Celiac Disease</em>, by Bonnie J. Kruszka (5 year olds)</li>
<li><em>No More Cupcakes and Tummy Aches: A Story for Parents and their Celiac Children to Share</em>, by Jax Peters Lowell (3-8 year olds)</li>
<li><em>Kids with Celiac Disease: A Family Guide to Raising Happy, Healthy, Gluten-Free Children</em>, by Danna Korn</li>
<li><em>The GF Kid: A Celiac Disease Survival Guide</em>, by Melissa London (8-12 year olds)</li>
</ul>
<p><strong>Cook books</strong></p>
<ul>
<li><em>Incredible Edible Gluten-Free Foods for Kids: 150 Family-tested recipes</em>, by Sheri L. Sanderson</li>
<li><em>Great Food Gluten Free</em>, by Jeanette Mahoney</li>
<li><em>Gluten Free on a Shoestring</em>, by Nicole Hunn</li>
<li><em>The How Can It Be Gluten Free Cookbook</em>, by America’s Test Kitchen</li>
</ul> | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/Nutrition_and_JIA.jpg | Maintaining a gluten-free diet | Children with celiac disease must follow a strict gluten-free diet. This article contains tips to help your child maintain their special diet. | |
| Substance use and substance use disorder: Overview | Substance use and substance use disorder: Overview | Substance use and substance use disorder: Overview | S | English | Adolescent;Psychiatry | Pre-teen (9-12 years);Teen (13-18 years) | NA | NA | Conditions and diseases | Adult (19+)
Caregivers | NA | | 2019-01-30T05:00:00Z | | Karen Leslie, MD, MEd, BSc | | | | 9.90000000000000 | 55.1000000000000 | 990.000000000000 | | Health (A-Z) - Conditions | Health A-Z | <p>Substance use is the use of alcohol, tobacco and other drugs for pleasure or enjoyment. Find out which substances teens use most often, and why, and what to do if you are concerned about substance use.</p> | <h2>What substances do pre-teens and teenagers use most often?</h2><p>Over the past decade, alcohol and cannabis have become teens’ and pre-teens’ most frequently used substances.</p><p>A concerning trend is that more teens are now also using e-cigarettes (or ‘vaping’). In recent research, more teens reported vaping than smoking a cigarette over the previous year.</p><p>Teens also seek to ‘get high’ with over-the-counter cold medications and prescription medications, including painkillers, ADHD medications and sedatives.</p> | <h2>When do children and teens begin to try substances?</h2><p>Research indicates that the average age of first use of alcohol is 15.8 years. For cannabis, the average age of first use is 15.4 years.</p><p>A smaller percentage of younger teens report using substances. For example, an Ontario school-based study shows that, over the previous year, one in 10 grade 7 students (about age 12) reported drinking alcohol and one in 50 grade 7 students used cannabis.</p><p>Binge drinking (having five or more drinks at one time) is common among teens and often takes place during drinking games. In a recent Ontario study, almost 40 per cent (two in five) of grade 12 students reported binge drinking in the previous month.</p><p>Some children may try a small amount of alcohol or tobacco at a younger age as part of their family’s cultural or religious practices. There is little evidence to say that drinking at a younger age either prevents or promotes future problematic substance use.<br></p> | <h2>Key points</h2><ul><li>Alcohol and cannabis are the substances most frequently tried by adolescents.</li><li>Teens with other mental health illness, including depression and anxiety, are at increased risk of having a substance use disorder.</li><li>As a parent, you are key in noticing changes in your teen's behaviour and in bringing your concerns to your teen in a non-judgmental way.</li></ul> | | <h2>At what point should I become concerned that my child has a substance use disorder?</h2><p>The more regularly a teen uses a substance, the more likely they are to experience related <a href="/Article?contentid=3664&language=English">problematic signs and symptoms</a>.</p><p>Firstly, regular substance use can be associated with a range of physical and mental health problems, difficulties at school and at home and trouble with the law. The health risks of substance use increase when a person uses more than one substance at a time, especially with alcohol.</p><p>Secondly, substance use can lead to dependence. When someone is physically dependent on a substance, they build up a tolerance to it and must use more of it over time to get the same effect. If they stop or try to use less of the substance, they experience physical symptoms (also known as withdrawal symptoms). The level of dependence is based on the substance, the amount your child or teen takes and how frequently they use it.</p><p>In addition, teens who have substance use disorders:</p><ul><li>miss school, work or other responsibilities due to substance use</li><li>crave whatever substance(s) they are using</li><li>fail to quit using despite trying to.<br></li></ul> | <h2>Does anything make a substance use disorder more likely?</h2><p>A substance use disorder is more likely to develop if: </p><ul><li>a child or teen has a mental health condition (see below)</li><li>there is a family history of addiction</li><li>there is a history of abuse or other adverse childhood experience (also referred to as ACE) </li><li>a child or teen identifies as LGBTQ2+</li><li>a teen is street-involved (homeless).</li></ul><h2>Do issues with substance abuse occur with other mental health conditions?</h2><p>About one-third to half of young people with a mental health condition such as <a href="https://www.aboutkidshealth.ca/Article?contentid=19&language=English">depression</a>, <a href="https://www.aboutkidshealth.ca/Article?contentid=18&language=English">anxiety</a> or <a href="https://www.aboutkidshealth.ca/Article?contentid=1922&language=English">ADHD</a> will also develop a substance use disorder. This is called as a concurrent disorder. Of teens with a substance use disorder, one third to half will develop a concurrent mental health condition.<br></p> | | | | | <h2>What should I do if I am concerned that my child or teen has a problem with substance use?<br></h2><p>Monitor your child's behaviour and have an open conversation with them about anything you have observed and your concerns that they might be using drugs or alcohol. When <a href="/Article?contentid=3665&language=English">addressing substance use with your child or teen</a>, focus your concerns on their health and wellbeing.<br></p> | | <h2>When to see a doctor or health professional for specific help<br></h2><p>If you have any concerns about problematic substance use, encourage your teen to see, or bring your teen for an assessment by, a health professional or another helping professional such as a guidance counsellor.</p><p>Let your teen know that you understand they may not want to share certain things with you as their parent or caregiver but that they can get information about their health and raise any concerns privately with their doctor.</p><p>As teens are generally healthy as a group, they may not see the need for an annual check-up. But it is a good idea to encourage your teen to have a check-up with their doctor or nurse practitioner to review their general physical, mental and social health. The check-up is an opportunity to identify the factors that might put your teen at risk for problematic substance use. It also allows a teen to talk to their health-care provider about any aspect of their health.</p> | | | | | | | | | | | | | | | | | | <h2>References<br></h2><p>Boak, A., Hamilton, H.A., Adlaf, E.M., & Mann, R.E. (2017). Drug use among Ontario students, 1977-2017: Detailed findings from the Ontario Student Drug Use and Health Survey (OSDUHS). <em>CAMH Research Document Series No. 46</em>. Retrieved from
<a href="https://www.camh.ca/-/media/files/pdf---osduhs/drug-use-among-ontario-students-1977-2017---detailed-findings-from-the-osduhs.pdf?la=en&hash=2B434CDAAD485834497E3B43F2264BDEB255F29F">https://www.camh.ca/-/media/files/pdf---osduhs/drug-use-among-ontario-students-1977-2017---detailed-findings-from-the-osduhs.pdf?la=en&hash=2B434CDAAD485834497E3B43F2264BDEB255F29F</a></p><p>Canadian Centre on Substance Use and Addiction (n.d.).
<em>The Real Deal on Youth and Drugs</em>. Retrieved from
<a href="http://www.ccsa.ca/Eng/topics/Children-and-Youth/Real-Deal-on-Youth-and-Drugs/Pages/default.aspx">http://www.ccsa.ca/Eng/topics/Children-and-Youth/Real-Deal-on-Youth-and-Drugs/Pages/default.aspx</a></p><p>Canadian Centre on Substance Use and Addiction (2016).
<em>Marijuana: Fact and Fiction</em>. Retrieved from
<a href="http://www.ccdus.ca/Resource%20Library/CCSA-Marijuana-Fact-and-Fiction-Infographic-2016-en.pdf">http://www.ccdus.ca/Resource%20Library/CCSA-Marijuana-Fact-and-Fiction-Infographic-2016-en.pdf</a></p><p>Canadian Centre on Substance Use and Addiction (2017).
<em>Canadian Drug Summary: Alcohol</em>. Retrieved from
<a href="http://www.ccsa.ca/Resource%20Library/CCSA-Canadian-Drug-Summary-Alcohol-2017-en.pdf">http://www.ccsa.ca/Resource%20Library/CCSA-Canadian-Drug-Summary-Alcohol-2017-en.pdf</a></p><p>Health Canada (2018).
<em>Canadian Student Tobacco, Alcohol and Drugs Survey 2016-2017</em>. Retrieved from
<a href="https://www.canada.ca/en/health-canada/services/canadian-student-tobacco-alcohol-drugs-survey.html">https://www.canada.ca/en/health-canada/services/canadian-student-tobacco-alcohol-drugs-survey.html</a></p> | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/hemophilia_and_cigarette_smoking.jpg | Substance use disorder: Overview | Find out which substances teens use most often, and why, and what to do if you are concerned about your teen’s substance use. | |
| Cystic fibrosis (CF) | Cystic fibrosis (CF) | Cystic fibrosis (CF) | C | English | Genetics | Child (0-12 years);Teen (13-18 years) | Lungs;Pancreas | Pancreas;Lungs | Conditions and diseases | Caregivers
Adult (19+) | NA | | 2014-04-25T04:00:00Z | | Felix Ratjen, MD, PhD, FRCPC;Louise Taylor, RN(EC), MN, NP | | | | 7.40000000000000 | 67.0000000000000 | 1341.00000000000 | | Health (A-Z) - Conditions | Health A-Z | <p>Learn what causes cystic fibrosis, what the signs and symptoms are, and what treatments are available.</p> | <h2>What is cystic fibrosis?</h2><p>Cystic fibrosis or CF is a disease that mainly affects the
<a href="https://pie.med.utoronto.ca/htbw/module.html?module=lung-child">lungs</a> and digestive system (or digestive tract). Although CF can be treated and CF patients can usually lead fairly normal lives, there is no cure for CF. Today, half of Canadians with CF live into their 40s and beyond.</p>
<figure>
<span class="asset-image-title">Cystic fibrosis</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/Cystic_fibrosis_MED_ILL_EN.jpg" alt="Stomach, pancreas, small intestine and lung identified in upper body of a child, with a close-up showing mucus in the airways" />
<figcaption class="asset-image-caption">In cystic fibrosis, mucus in the lungs and digestive tract is stickier than normal. Mucus builds up and causes lung congestion and problems with digestion.</figcaption>
</figure>
<h3>CF affects the lungs</h3><p>Normal mucus is thin and slippery. It keeps the lungs clean by removing dirt and germs from the lungs' airway tubes. In CF, mucus is sticky and clogs the tubes. This can make breathing difficult. Bacteria can collect in the tubes because the mucus cannot clear as quickly as it should. This leads to cycles of infection and inflammation (swelling in the airway tubes). These infections can damage the lung tissues.</p><h3>CF may also affect the digestive system</h3><p>CF may also affect the digestive system, especially the pancreas. The pancreas is an organ just below the stomach that makes enzymes to help digest food in the small intestine. Enzymes help with digestion and break down the food particles small enough to be absorbed. In CF, mucus blocks the ducts (tube-like channels that carry fluid) of the pancreas.</p><p>When the ducts from the pancreas to the small intestine are blocked by mucus, the enzymes cannot reach the small intestine. This means food is not properly digested. When this happens, a child with CF does not get enough nutrition from their food. As a result, a child with CF may take replacement enzymes in order to grow normally and may have to eat a bit more food.</p> | | <h2>Key points</h2>
<ul>
<li>CF is a genetic disease that affects the lungs and digestive system.</li>
<li>It is not contagious.</li>
<li>With treatment and regular follow-up, most children with CF can live fairly normal lives.</li>
</ul> | | <h2>Signs and symptoms of cystic fibrosis</h2>
<p>In most children, CF mainly affects both the lungs and the digestive system. The symptoms of CF are variable ranging from mild to severe.</p>
<h3>Signs and symptoms of CF include:</h3>
<ul>
<li>trouble breathing</li>
<li>cough that produces thick mucus</li>
<li>difficulty gaining weight</li>
<li>bowel movements that are bulky, frequent and foul-smelling</li>
<li>skin that tastes salty</li>
<li>repeated lung infections</li>
<li>delayed passage of <a href="/Article?contentid=1115&language=English">meconium</a> or meconium ileus (a blockage in the small intestine by the newborn's feces)</li>
</ul>
<p>The symptoms of CF are often confused with other conditions such as asthma, chronic bronchitis, pneumonia or celiac disease because they have similar symptoms as CF.</p> | <h2>Cystic fibrosis is a genetic disease</h2><p>About one in every 3,600 children are born with CF. CF is a genetic disease, meaning it is passed from parents to their children. About one in every 25 Canadians carries the mutated gene that can cause CF. The probability may be lower depending on your ethnic background.</p><p>A gene is a section of DNA that gives an instruction to a cell. Most of the time, the instruction is a "recipe" for making a protein.</p><p>CF is caused by a mutation in the gene for the CFTR (cystic fibrosis transmembrane conductance regulator) protein. CF is a recessive genetic condition. This means that a person needs to have two copies of the mutated gene to develop CF. People with only one copy of the CF mutation are called "carriers" and do not have symptoms. Most parents do not know they are carriers of the CF gene. To develop CF, a child must inherit two copies of the CF gene, one from each parent.<br></p><p>Two parents with the CF gene may have children with CF, children who are carriers or children who are not. The risk of having a child with CF is the same with each pregnancy.</p><p>CF is not contagious. You cannot catch it from someone else.</p>
<figure class="asset-c-80">
<span class="asset-image-title">Inheritance of cystic fibrosis</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/Cystic_fibrosis_inheritance_MED_ILL_EN.jpg" alt="Chromosome distribution from parents carrying cystic fibrosis" />
<figcaption class="asset-image-caption">In this example, both parents are carriers of one normal cystic fibrosis (CF) gene and one mutated CF gene. Their children may inherit one, two, or no copies of the CF gene. If a baby inherits one copy of the mutated gene, they will be carriers like their parents, but will not have CF. If a baby inherits two mutated copies, they will have CF.</figcaption>
</figure> | | <h2>How cystic fibrosis is diagnosed</h2>
<p>In almost all of Canada, babies are diagnosed with CF in the first two weeks of life through the <a href="http://www.sickkids.ca/CGenetics/What-we-do/Newborn-screening-program/index.html">Newborn Screening Program</a>.</p>
<ul>
<li>Genetic tests are used to diagnosis CF. Genetic tests can diagnose CF before a child is born.</li>
<li>Shortly after a baby is born, the doctor may take a small sample of blood from the baby as part of the newborn screening program. Testing starts by looking for an enzyme called IRT. If the level of IRT is high, the doctor will perform a DNA test looking for the most common CF mutations. If the screen is positive, the doctor will refer your child to a specialist centre for confirmation and follow-up.</li>
<li>Doctors usually order a sweat test if they suspect CF. This is a simple test that measures the amount of salt in the sweat. It will not hurt your child. Heat or medicine is applied to a local (small) area of the skin. If the sweat contains more salt than usual, this may mean your child has CF.</li>
<li>Doctors may perform a test to check for enzymes in the intestine.</li>
</ul> | <h2>How cystic fibrosis is treated</h2>
<p>There is no cure for CF. With appropriate treatment and regular follow-up, most children with CF can live fairly normal lives up to at least their 40s.</p>
<p>CF treatment is tailored to your child's needs. It also depends upon the stage of the disease and which organs are affected.</p>
<h3>Treating the lungs</h3>
<p>A lot of CF treatments focus on the lungs. The treatments work to loosen and thin the mucus that clogs the airways. Chest X-rays may be taken to see if there are any changes in the lungs.</p>
<h3>Treatments followed at home may include:</h3>
<ul>
<li>Physiotherapy is done by tapping or "clapping" on the chest in different positions twice a day for babies and young children.</li>
<li>PEP (positive expiratory pressure) mask therapy is taught to older children and adults with CF to help clear their lungs.</li>
<li>Other forms of chest physiotherapy to help loosen the mucus that clogs the lungs can also be taught by the clinic physiotherapist.</li>
<li>Oral (through the mouth), inhaled (breathing) or intravenous (IV or using a needle) antibiotics are often used when someone with CF has a lung infection.</li>
<li><a href="/Article?contentid=1973&language=English">Exercise</a>.</li>
<li>Medications to help open the airways and thin mucus are inhaled using a puffer or a small compressor machine with a nebulizer, which makes the medication easy to inhale through a mask or a mouthpiece.</li>
</ul>
<h3>To avoid infection, children with CF should also:</h3>
<ul>
<li>Avoid contact with people with a cold or illness</li>
<li>Avoid contact with other people with CF</li>
<li>Have their usual <a href="/Article?contentid=1986&language=English">immunizations</a> (shots)</li>
</ul>
<p>In some cases, when treatments can no longer maintain a person's health or organ function, the person may require a lung transplant.</p>
<h3>Treatments for the digestive tract include:</h3>
<ul>
<li>taking pancreatic enzymes with meals to help digestion</li>
<li>taking supplements and special CF vitamins to promote good nutrition</li>
<li>eating a special diet with increased calories and fat</li>
<li>adding salt to the diet to replace the excess amounts lost by sweating</li>
</ul> | | <h2>Activity</h2>
<p>Children with CF are encouraged to play games and sports. Ask your child's doctor how much activity they can do. Sports such as running and swimming are often helpful because they help clear the lungs of mucus.</p>
<p>Children with CF lose a lot of salt during exercise and hot weather, more than people without CF do. It is important to make sure your child replaces fluids and salt by drinking enough and eating enough salt.</p> | | | | | | | | | | | | | | | | | | | <h2>For more information</h2><p>Visit:</p><ul><li> Cystic Fibrosis Canada: <a href="http://www.cysticfibrosis.ca/">www.cysticfibrosis.ca</a></li><li> The Cystic Fibrosis Foundation: <a href="http://www.cff.org/">www.cff.org</a></li><li> Canadian Society for Exercise Physiology: <a href="http://www.csep.ca/english/view.asp?x=804/">www.csep.ca</a>; see Physical Activity option.</li><li> Newborn Screening for Cystic Fibrosis: <a href="http://www.cysticfibrosis.ca/advocacy/newborn-screening/">www.cysticfibrosis.ca/advocacy/newborn-screening</a><br></li></ul> | | <img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/cystic_fibrosis.jpg" style="BORDER:0px solid;" /> | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/cystic_fibrosis.jpg | | May is Cystic Fibrosis Month. Learn what causes cystic fibrosis, what the signs and symptoms are, and what treatments are available. | |
