| Acne (acne vulgaris) | Acne (acne vulgaris) | Acne (acne vulgaris) | A | English | Dermatology | Pre-teen (9-12 years);Teen (13-18 years) | Skin | Skin | Conditions and diseases | Caregivers
Adult (19+) | NA | | 2015-01-14T05:00:00Z | | Miriam Weinstein, MD, FRCPC | | | | 8.20000000000000 | 58.5000000000000 | 1522.00000000000 | | Health (A-Z) - Conditions | Health A-Z | <p>Acne is the most common skin condition in teens. Discover the different types and causes and how they can be treated.<br></p> | <p>Acne, clinically known as acne vulgaris, is the most common skin disease. It affects 85% of teenagers, some as young as 12, and often continues into adulthood. It is also called "pimples," "zits" or "blemishes".</p> | | <h2>Key points</h2><ul><li>Acne vulgaris is the most common skin disease in teenagers.</li><li>Acne occurs deep within the skin, and severity and outcomes vary from person to person.</li><li>Acne causes comedones (whiteheads and blackheads), papules, pustules or even nodules.</li><li>Picking, squeezing and popping can lead to scarring.</li><li>Acne is manageable with the appropriate treatment. Ask your doctor or your dermatologist about your options.<br></li></ul> | | | <h2>What causes acne?</h2>
<figure>
<span class="asset-image-title">Anatomy of the skin</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/IMD_skin_anatomy_EN.jpg" alt="Identification of a hair, sebaceous gland, sweat gland and blood vessels in the skin" />
<figcaption class="asset-image-caption">Acne occurs when the sebaceous glands produce more oil, clogging different parts of skin tissue.</figcaption> </figure>
<p>The skin is formed by many layers of tissue, containing hair, glands, muscles, sensory receptors and blood vessels. During puberty, a group of hormones are released called androgens. Androgens allow the sebaceous glands in the skin to produce an oily substance called sebum. Acne is in part caused by this increase in sebum that naturally occurs during puberty.<br></p><p>Normal amounts of sebum keep skin and hair from drying out. However, excess oil can mix with dead skin cells and clog hair follicles (the tiny tunnels that lead to the root of the hair) and pores (the opening in the skin where the hair passes through).</p><p>A common type of bacteria that lives on the skin, known as
<em>Propionibacterium acnes</em>, sometimes contributes to acne by causing inflammation. The acne signals white blood cells to the area, which damage the tissue and cause an inflammatory response. This causes swelling and infection.</p><p>Acne leads to persistent redness and inflammation, especially on the face, scalp, back and chest, where the most sebum is produced.</p><p>Acne varies from mild to severe, depending on what kind of blemishes appear. The different types of acne include:<br></p><ul><li>comedones</li><li>papules</li><li>pustules</li><li>nodules</li></ul><p>Comedones are pores that are blocked with oil and dead skin cells. They can be open ("blackheads") or closed by the skin ("whiteheads").</p><p>A blackhead is generally level with the skin surface and cannot be removed by normal washing of the face.</p>
<figure class="asset-c-80">
<span class="asset-image-title">Open comedo (blackhead)</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_blackhead_EN.png" alt="Cross section of skin with an oxidized sebum, which appears black at the top, and a surface view of skin with blackheads" />
<figcaption class="asset-image-caption">The pore of a blackhead is open. When the sebum comes into contact with the air, oxygen exposure causes it to appear black.</figcaption></figure>
<p>A whitehead is slightly raised from the skin, but there is no inflammation.</p>
<figure class="asset-c-80"><span class="asset-image-title">Closed comedo (whitehead)</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_whitehead_EN.png" alt="Cross section of skin with a trapped sebum and clogged pore, and a surface view of skin with whiteheads" /><figcaption class="asset-image-caption">A whitehead is formed when pores are blocked with sebum and dead skin cells. The pore in a whitehead is not open at the top.</figcaption> </figure>
<p>Papules are red, small, hard bumps that are slightly raised on the skin. In clusters, they can feel like sandpaper to the touch. White blood cells enter the follicle, causing inflammation.</p>
<figure class="asset-c-80">
<span class="asset-image-title">Papule</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_papule_EN.png" alt="Cross section of skin with inflammation and white blood cells around sebum, and surface view of skin with papules" />
<figcaption class="asset-image-caption">Papules are red, painful bumps caused by inflammation of the hair follicles.</figcaption></figure>
<p>When the white blood cells in a papule make it to the surface of the skin, a pustule is formed. Pustules appear as red, inflamed circles with a central, raised bump that is yellowish or white. The bump is filled with pus. Pus is the result of inflammation and contains white blood cells, dead skin cells and bacteria.</p>
<figure class="asset-c-80">
<span class="asset-image-title">Pustule</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_pustule_EN.png" alt="Cross section of pus under the skin and white blood cells that have moved toward the surface, and surface view of pustules" />
<figcaption class="asset-image-caption">Pustules form a few days after the white blood cells in a papule make it to the surface of the skin. Pustules are typically called "pimples" or "zits".</figcaption></figure>
<p>When a papule or pustule expands, it can cause more severe inflammation in the surrounding skin. This can lead to nodules, which are deep, red, round bumps that can have a diameter of 6 to 20 mm. They are sometimes referred to as cysts.</p><p>Nodules are formed by irritated, inflamed hair follicles that have ruptured deep under the skin. They can be throbbing and painful, even without touching.</p>
<figure class="asset-c-80">
<span class="asset-image-title">Nodule</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_nodule_EN.png" alt="Cross section of pus and inflammation under the skin with large swollen bump on skin surface, and surface view of nodule" />
<figcaption class="asset-image-caption">Nodules are often large, inflamed, red, swollen and painful to the touch.</figcaption></figure> | | | <h2>Psychological impact of acne</h2>
<p>Acne can have a profound impact on a person's quality of life, particularly for teenagers. Reactions can range from minimal distress to more significant depression, anxiety and, less commonly, thoughts of suicide or self-harm. For these reasons, treating acne matters.</p>
<h2>Treatment of acne</h2>
<p>Treatment depends on the severity and type of acne. An effective treatment will help reduce future breakouts and improve the skin's appearance. Keep in mind that up to six weeks of treatment might be necessary to start noticing results.</p>
<p>In most cases, your doctor or dermatologist will prescribe topical treatments (applied directly on the skin). Sometimes the doctor may prescribe an oral treatment (taken by mouth).</p>
<h3>Cleansing skin</h3>
<p>Acne is a process deep within the skin. Washing your face regularly helps remove dead skin cells and excess oil, but does not play a significant role in the prevention or management of acne.</p>
<p>If you have acne, avoid scrubbing your face when washing, because this may worsen inflammation and irritation. Instead, gently wash your face with warm water. You may also use a mild cleansing product if you want.</p>
<h3>Topical retinoids</h3>
<p>Topical retinoids unplug comedones and improve the process of shedding the old cells. They may also help reduce any inflammation.</p>
<p>Some side effects may occur when using a topical retinoid. These include mild irritation, redness (erythema), dryness, peeling and sensitivity to sun. If you are pregnant, or thinking about having a baby, talk to your doctor or dermatologist before using a topical retinoid, as they should not be used during pregnancy.</p>
<p>Avoid skin damage, such as waxing or exfoliation (e.g., facials) when taking retinoids.</p>
<p>Common topical retinoids are available in cream and gel form. There are benefits to both creams and gels, depending on the severity of acne and the sensitivity of your skin. Retinoids are also available in many strengths and formulations. Therefore, there is no one better option; your doctor will recommend a retinoid most appropriate for you.</p>
<h3>Topical antimicrobials</h3>
<p>Topical antimicrobials are used to kill bacteria that contribute to inflammation. They also help fight inflammation directly. One option is benzoyl peroxide, which is available over the counter. When benzoyl peroxide touches the skin, oxygen is created. <em>P. acnes</em> cannot survive in the presence of oxygen.</p>
<p>Use caution when applying benzoyl peroxide because it is a potent bleaching agent that can damage fabrics. The pharmacist can answer any questions you might have.</p>
<h3>Oral antibiotics</h3>
<p>An oral antibiotic (taken by mouth) is sometimes used to treat more significant acne, especially in cases where the acne has spread to the back and chest. Such as topical treatments, oral antibiotics reduce inflammation.</p>
<p>Antibiotics can also stop <em>P. acnes</em> from multiplying. However, the use of antibiotics should be limited because bacteria can develop a resistance to them.</p>
<h3>Combined treatment</h3>
<p>A combined treatment can be an effective means of treating acne. In this case, a topical retinoid and an antimicrobial cream or gel can be used together. Sometimes they are combined into one product, while other times they are used separately. For example, a topical antimicrobial may be applied in the morning and a topical retinoid may be used at night.</p>
<p>Oral medications are also used in combination with a topical treatment. Most people taking a pill benefit from a topical cream or gel.</p>
<p>Your doctor or dermatologist will advise you on how and when to use a combined treatment for acne.</p>
<h3>Oral isotretinoin</h3>
<p>Isotretinoin (known as Accutane in North America; Clarus and Epuris in Canada; and Roaccutane in Europe) is a chemical compound related to vitamin A. In most cases, isotretinoin is used to treat severe nodular and scarring acne because:</p>
<ul>
<li>it reduces sebum secretion</li>
<li>it prevents the formation of comedones</li>
<li>it acts as an anti-inflammatory</li>
<li>it stops <em>P. acnes</em> from generating in hair follicles and sebaceous glands</li>
</ul>
<p>However, this type of acne treatment must be closely monitored because isotretinoin has a number of side effects. More common side effects include dry skin, lips, nose and eyes. All side effects will begin to disappear when treatment stops.</p>
<p>However, there are more severe side effects. For example, isotretinoin can interfere with the development of a fetus. If you are pregnant or thinking about having a baby, talk to your doctor or dermatologist about the side effects of isotretinoin. There are also concerns about depression, inflammatory bowel disease and impact on liver.</p>
<h3>Hormonal therapy</h3>
<p>Treating acne with female hormones is an effective treatment option for some female patients. This means taking an oral contraceptive (the birth control pill). This type of treatment limits sebum secretion by reducing androgen levels. Other topical and oral treatments can be used along with oral hormonal therapy.</p>
<p>Treating acne using hormones is not for everybody. For more information, talk to your doctor or dermatologist.</p> | | | <h2>Scar prevention</h2>
<p>If left untreated, some acne can cause scarring. It is not always easy to predict which acne will cause scarring; it is a complex problem.</p>
<p>Handle acne with care. Manipulating, squeezing and popping increases the likelihood of scarring. The best way to prevent scarring is to actively treat the acne. Treatment is not only for those who have severe acne; no matter how little or how much acne you might have, you can seek treatment for your skin.</p> | | | | | | | | | | | | | | | | | | | | <img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/acne_vulgaris.jpg" style="BORDER:0px solid;" /> | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/acne_vulgaris.jpg | | Discover the different types and causes of acne and how they can be treated. | Main | | |
| Peanut allergy | Peanut allergy | Peanut allergy | P | English | Allergy | Child (0-12 years);Teen (13-18 years) | Body | Immune system | Conditions and diseases | Caregivers
Adult (19+) | NA | | 2014-12-18T05:00:00Z | | Vy Kim, MD, FRCPC;Anna Kasprzak, RN | | | | 9.20000000000000 | 57.7000000000000 | 885.000000000000 | | Health (A-Z) - Conditions | Health A-Z | <p>A peanut allergy is a life-long reaction to the proteins in found peanuts. Find out how to help your child manage it.<br></p> | <h2>What is a peanut allergy?</h2><p>A peanut allergy occurs when the body reacts to the proteins in peanuts. This allergy is treated separately from other
<a href="/Article?contentid=812&language=English">nut allergies</a>. While other nuts grow on trees, peanuts (like beans, peas and lentils) belong to the legume family and grow underground.<br></p>
<h2>If my child has an allergy to peanuts, must they avoid all other nuts?</h2><p>People who are allergic to peanuts might not have an allergy to tree nuts. However, a person can be allergic to both.</p><h2>How serious is a peanut allergy?</h2><p>A peanut allergy carries the risk of <a href="/Article?contentid=781&language=English">anaphylaxis</a>, a severe and life threatening allergic reaction.</p><p>Some children are so sensitive to peanuts that inhaling a small amount of peanut protein (for example a tiny amount of shelled peanut in the air) can trigger a reaction. However, a person with a peanut allergy will not develop symptoms when exposed to the smell of peanuts, for example in peanut butter. The smell may trigger a response in a child with a peanut allergy because of their fear of peanuts, but this is not the same as physical allergic symptoms.</p><h2>Will my child always have a peanut allergy?</h2><p>Yes, a peanut allergy can be severe and life-long.</p> | <h2>Other names for peanuts</h2>
<p>Peanuts can have different names in ingredient lists. Learning these names can help you catch any hidden sources of peanuts in food.</p>
<p>When buying packaged foods, always check the list of ingredients in the store and again when you bring the product home. It is also a good idea to check the ingredients every time you buy the food in case the recipe has changed. You can also call the manufacturer to ask about any recipe changes.</p>
<p>The following table lists some names for peanuts. Use it when you are grocery shopping or calling food manufacturers.</p>
<table class="akh-table">
<tbody>
<tr>
<td>Arachis oil</td>
<td>Beer nuts</td>
</tr>
<tr>
<td>Cacahouette</td>
<td>Goober nuts, goober peas (boiled peanuts)</td>
</tr>
<tr>
<td>Ground nuts</td>
<td> </td>
</tr>
</tbody>
</table> | <h2>Key points</h2>
<ul>
<li>A peanut allergy can be life long and carries the risk of anaphylaxis, a severe and sometimes life-threatening allergic reaction. </li>
<li>Peanuts are treated as a separate allergen from tree nuts because they are part of the legume family.</li>
<li>Many different products contain peanuts, including baked goods, curries, egg rolls, cereals, chocolate, sauces and hydrolyzed plant or vegetable protein.</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 peanuts.</li>
<li>If your child's diet is limited because of a peanut, a registered dietitian can offer advice on getting a balanced diet.</li>
</ul> | | | <h2>Possible sources of peanuts</h2>
<p>Peanuts are used in a range of dishes, packaged food and snacks. Below is a list of some of the many food products that contain peanuts.</p>
<table class="akh-table">
<tbody>
<tr>
<td>African, Chinese, Indonesian, Mexican, Thai and Vietnamese dishes, for example curries, chilies, egg rolls or satays</td>
<td>Artificial nuts (peanuts that have been altered to look and taste like almonds, pecans and walnuts), such as mandelona or Nu-Nuts</td>
</tr>
<tr>
<td>Baked goods and baking mixes</td>
<td>Cereals and muesli</td>
</tr>
<tr>
<td>Chocolate and other snack foods</td>
<td>Desserts</td>
</tr>
<tr>
<td>Fried foods</td>
<td>Hydrolyzed plant protein/vegetable protein (source may be peanut)</td>
</tr>
<tr>
<td>Nut meats, nut butter</td>
<td>Peanut oil</td>
</tr>
<tr>
<td>Soup, sauces and gravy</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 peanuts?</h2>
<p>The main nutrients in peanuts include protein, omega-3 fats, fibre, magnesium, phosphorus, potassium, folate and vitamin E. Your child can still get these nutrients even if they must avoid peanuts.</p>
<h3>Nutrients in peanuts that are found in other foods</h3>
<table class="akh-table">
<thead>
<tr><th>Nutrient</th><th>Where to find it</th></tr>
</thead>
<tbody>
<tr>
<td>Protein</td>
<td>Meat, fish, poultry, eggs, cheese, milk, beans, soy</td>
</tr>
<tr>
<td>Omega 3</td>
<td>Salmon, tuna, mackerel, flaxseed oil, walnuts, edamame (soy beans), radish seeds, omega-3 eggs fortified with DHA</td>
</tr>
<tr>
<td>Fibre</td>
<td>Vegetables, fruit, whole grains</td>
</tr>
<tr>
<td>Magnesium</td>
<td>Wheat germ, peas, pumpkin, squash or sesame seeds</td>
</tr>
<tr>
<td>Phosphorus</td>
<td>Wheat germ, rice bran, wheat bran, cheese, beans, sardines, tempeh</td>
</tr>
<tr>
<td>Potassium</td>
<td>Bananas, papaya, sweet potato, leafy green vegetables, milk, yogurt, beans (navy, pinto, black), lentils, chickpeas, beef, pork, fish</td>
</tr>
<tr>
<td>Folate</td>
<td>Leafy green vegetables, beans (navy, pinto, kidney, garbanzo), lentils</td>
</tr>
<tr>
<td>Vitamin E</td>
<td>Spinach, red pepper, Swiss chard, wheat germ cereal, egg, sunflower seeds</td>
</tr>
</tbody>
</table> | | | | <h2>When to see a dietitian for a peanut allergy</h2>
<p>If you have removed many foods from your child's diet because of a peanut or tree nut 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> | | | | | | | | | | | | | | | | | | | <img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/peanut_allergy.jpg" style="BORDER:0px solid;" /> | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/peanut_allergy.jpg | Peanut allergy | | Main | | |
| Strep throat | Strep throat | Strep throat | S | English | Infectious Diseases | Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years) | Mouth;Trachea;Esophagus | Mouth;Esophagus;Trachea | Conditions and diseases | Caregivers
Adult (19+) | Fever;Sore throat | | 2014-08-14T04:00:00Z | | Shawna Silver, MD, FRCPC, FAAP, PEng | | | | 7.40000000000000 | 66.5000000000000 | 988.000000000000 | | Health (A-Z) - Conditions | Health A-Z | <p>Strep throat is a throat infection caused by a type of bacteria called streptococci. Learn how you can take care of your child.</p><br> | <h2>What is strep throat?</h2><p>Strep throat is a throat infection caused by a type of bacteria called streptococcus. </p><p>Strep throat is more common in children four to eight years old and is rare in children younger than two years of age. </p><p>The most common cause of strep throat is Group A beta-haemolytic streptococcus (GABS). This bacteria can also cause complications in other parts of the body.</p> | | <h2>Key points</h2>
<ul>
<li>The main symptoms of strep throat are fever and sore throat.</li>
<li>If you suspect that your child might have strep throat, see a doctor for a throat swab.</li>
<li>Make sure your child finishes any antibiotics they are prescribed to prevent relapse and complications.</li>
<li>Use soft foods, cold drinks and pain medications, if needed, to reduce any pain.</li>
<li>Make sure that any other family members or close contacts with similar symptoms see their healthcare provider.</li>
</ul> | | <h2>Signs and symptoms of strep throat</h2>
<p>The symptoms for strep throat are similar to symptoms for a sore throat caused by a virus or other illnesses. The most common symptoms are:</p>
<ul>
<li><a href="/Article?contentid=30&language=English" style="line-height:18px;background-color:initial;">fever</a></li>
<li><a href="https://akhpub.aboutkidshealth.ca/article?contentid=748&language=English">sore throat</a></li>
<li>loss of interest in eating or drinking because of pain</li>
<li>difficulty swallowing</li>
<li><a href="https://akhpub.aboutkidshealth.ca/article?contentid=748&language=English">enlarged red tonsils</a>, sometimes covered with white-yellow coating.</li>
</ul>
<p>Some children may have other symptoms such as <a href="/Article?contentid=29&language=English">headache</a>, nausea, vomiting, abdominal pain and muscle pain.<br></p> | | <h2>Reduce the spread of the infection</h2>
<p>Strep throat can spread easily to family members and your child's classmates. Any child or adult who lives in your home and has the same symptoms in the five days after your child is diagnosed should have a throat swab.</p>
<p>Your child's infection is no longer contagious after your child has been on antibiotics for 24 hours. This means that your child can return to school after one day if they are feeling better.</p>
<h3>Other tips to prevent the spread of infection</h3>
<ul>
<li><a href="/Article?contentid=1981&language=English">Wash hands</a> with warm soapy water or alcohol-based hand rub often.</li>
<li>Do not let your child share drinking glasses or eating utensils with friends or classmates.</li>
<li>Be sure to wash your child's glasses and utensils in hot soapy water or a dishwasher.</li>
<li>Have your child sneeze into their elbow or cover their mouth and nose when coughing.</li>
<li>Avoid kissing and having close facial contact with your child until they are better.</li>
</ul>
| <h2>How is strep throat diagnosed?</h2>
<p>To find out the cause of your child's sore throat, the doctor will take a throat swab. This involves wiping a thin cotton bud along the side and back of your child's throat. The swab is then sent to a lab to be tested for GABS bacteria. Your doctor will normally receive the results within a day or two.</p>
<p>Some clinics may use a rapid test (which gives results within minutes) to identify strep. Rapid tests are only useful if they show that your child has the streptococcus bacteria (known as a positive result). A negative rapid test result does not always mean that your child does not have strep throat. The result should always be checked by taking a throat swab.</p>
<p>A throat swab is very important for diagnosis as strep throat looks similar to <a href="/Article?contentid=748&language=English">viral pharyngitis</a>, which cannot be treated with antibiotics.</p>
| <h2>How is strep throat treated?</h2>
<p>If the throat swab is positive for GABS, the doctor will prescribe oral antibiotics (antibiotics to be taken by mouth) for your child. Strep throat can sometimes get better without medication, but a GABS infection can cause complications if it is not treated.</p>
| <h2>Complications of strep throat</h2>
<h3>Throat abscess</h3>
<p>A throat abscess (a collection of pus in the throat tissues) can develop from strep throat. The symptoms include high fever, muffled voice, difficulty opening the mouth, increased salivation and drooling and neck swelling. See a doctor if these symptoms occur.</p>
<h3>Rheumatic fever</h3>
<p>Although rare, rheumatic fever can also develop as a complication of strep throat. The condition can involve the skin, joints, heart and brain. Treating the strep throat with antibiotics almost always prevents rheumatic fever.</p>
<h3>Other complications</h3>
<p> These can include joint inflammation (arthritis) and kidney inflammation. GABS is also the bacteria responsible for <a href="/Article?contentid=751&language=English">scarlet fever</a>.</p>
| <h2>Taking care of your child at home</h2>
<h3>Manage the fever and pain</h3>
<p><a href="/Article?contentid=62&language=English">Acetaminophen</a> or <a href="/Article?contentid=153&language=English">ibuprofen</a> can be used to treat fever or pain. <a href="/Article?contentid=77&language=English">ASA (acetylsalicylic acid)</a> should not be given to children.</p>
<h3>Complete the antibiotics</h3>
<p>The fever and the throat pain usually improve about three days after your child starts taking antibiotics. However, even if your child seems to be better, it is very important to complete the entire course of antibiotics. This will make sure the infection does not return and will also prevent complications and antibiotic resistance.</p>
<h3>Offer your child soft foods and a liquid diet</h3>
<p>Eating and drinking may be painful for a child with strep throat. Here are some tips to make it easier for them.</p>
<ul>
<li>If your child is having trouble swallowing, give soft foods that are easy to swallow, such as soups, ice cream, pudding or yogurt.</li>
<li>Give plenty of liquids. Sipping with a straw or sippy cup may help.</li>
<li>If your child is more than 12 months old, try giving one or two teaspoons (5 to 10 mL) of pasteurized honey to soothe the throat and ease the cough.</li>
<li>Let an older child try gargling with warm salt water to soothe their throat.</li>
</ul>
<p>Ice cubes and lozenges may provide some relief for older children or teens. Do not give them to younger children, however, because they are a choking hazard.</p> | | <h2>When to get medical attention</h2>
<p>Call your child's regular doctor if:</p>
<ul>
<li>the fever does not go away within three days of starting antibiotics</li>
<li>your child develops a fever, a rash, joint swelling, blood in the urine or shortness of breath.<br></li>
</ul>
<p>Go to the nearest Emergency Department or call 911 if your child:<br></p>
<ul>
<li>is unable to drink or eat and is becoming dehydrated</li>
<li>has trouble breathing.<br></li>
</ul>
| | | | | | | | | | | | | | | | | | | <img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/strep_throat.jpg" style="BORDER:0px solid;" /> | | | | | | strepthroat | strepthroat | https://assets.aboutkidshealth.ca/AKHAssets/strep_throat.jpg | Strep throat | | Main | | |
| Acute pain: How to assess in infants and toddlers | Acute pain: How to assess in infants and toddlers | Acute pain: How to assess in infants and toddlers | A | English | Pain/Anaesthesia | Newborn (0-28 days);Baby (1-12 months);Toddler (13-24 months) | NA | Nervous system | Symptoms | Adult (19+)
Caregivers | Pain | | 2019-01-25T05:00:00Z | | Rebecca Pillai Riddell, PhD, CPsych | | | | 10.5000000000000 | 42.5000000000000 | 1136.00000000000 | | Health (A-Z) - Conditions | Health A-Z | <p>Find out how your infant's or toddler's acute pain is assessed at home and in medical settings.<br></p> | <h2>What causes acute pain in infants and toddlers?</h2><p>In infants and toddlers, common causes of acute pain include:</p><ul><li>teething</li><li>a bump or fall</li><li>ear infections</li><li>vaccinations by needle</li><li>heel lances to obtain a blood sample</li><li>procedures such as inserting a catheter (thin tube) or doing a lumbar puncture.</li></ul><p>As a rule, anything that causes pain in older children or adults (such as inserting a needle or catheter) will also cause pain in your infant or toddler. So if your young child is having a procedure that you would find painful, they are likely experiencing at least as much pain as you would experience.</p><p>Indeed, certain procedures may be more painful for young children because their brains cannot yet help them cope with pain, for example by using distraction. Never discount your young child's pain-related distress even if they have an injury or procedure that you would not find painful.<br></p> | | <h2>Key points</h2><ul><li>In infants and toddlers, common causes of acute pain include teething, bumps or falls and vaccinations by needle.</li><li>Signs of acute pain in this age group include irritability, whimpering, sudden changes to facial expression and flailing of arms or legs.<br></li><li>In medical settings, health-care providers assess pain by using standard tools and checking your baby's heart and breathing rate and their oxygen levels.</li><li>Always feel free to share your own opinion and any concerns about your child's pain with the health-care team.</li></ul> | | <h2>Assessing acute pain at home </h2><p>Because your young child cannot speak yet, you can only tell how much pain they are experiencing through the painful situation and their behaviour. In this case, the context means thinking about whether the procedure would be painful for an older child or could be painful for a young child even if not painful for someone older. Based on this information, you would then watch for any changes in your child's behaviour.</p><p>Behavioural signs of acute pain include:<br></p><ul><li>irritability</li><li>sharp changes in facial expressions (for example grimacing with eyes shut and brow bulging)</li><li>crying or whimpering</li><li>flailing or thrashing arms or legs</li><li>changes in their feeding, playing, sleeping routines</li><li>rigidness or limpness</li><li>changes in breathing</li><li>changes in how they interact with people and things around them. <br></li></ul> | | | <h2>Assessing acute pain in medical settings</h2><p>In the hospital, your child's health-care team uses a range of tools determine how much pain an infant is feeling. </p><p>In the NICU setting, one of the most common tools for assessing pain in infants is the <a href="https://www.semanticscholar.org/paper/The-premature-infant-pain-profile-revised-%28PIPP-R%29:-Stevens-Gibbins/76e49d44432665d7dffd5a9a7a2fdd55466f7f32/figure/0" target="_blank">Premature Infant Pain Profile-Revised (PIPP-R)</a>. This tool rates many of the behaviours that a child might display at home as well as physiological signs (signs inside the body), such as your infant's:</p><ul><li>heart rate<br></li><li>oxygen saturation (how much oxygen is in their blood)<br></li><li>breathing rate.</li></ul><p>For older infants and children aged up to two, health-care providers usually use the <a href="http://www.olchc.ie/Healthcare-Professionals/Nursing-Practice-Guidelines/Pain-FLACC-Behavioural-Pain-Assessment-Scale-2015.pdf" target="_blank">Faces, Legs, Activity, Cry and Consolability (FLACC) scale</a>. This tool looks at several of the behaviours described above.<br></p><p><span aria-hidden="true"></span>In medical settings, your child's health-care team plays an important role in clarifying the level and cause of pain, but feel free to share your opinions and concerns about your infant's pain with them. <br></p> | | | | | | | | | | | | | | | | | | | | | | <h2>Websites</h2><p>Comforting Your Baby in Intensive Care<br>
<a href="http://familynursing.ucsf.edu/comforting-your-baby-intensive-care" target="_blank">http://familynursing.ucsf.edu/comforting-your-baby-intensive-care</a></p><h2>Videos</h2><p><a href="https://www.youtube.com/watch?v=9OgCQKOnn-I" target="_blank">Bringin' up Baby: Soothing the Pain</a> (3 mins 50 secs)<br>Psychological and physical strategies for parents to reduce vaccination pain in healthy infants</p><p><a href="https://www.youtube.com/watch?v=5Oqa1Fag5eQ" target="_blank">Reduce the pain of vaccination in babies</a> (13 mins 08 secs)<br> Tips for parents on helping healthy infants get through vaccinations</p><p><a href="https://www.youtube.com/watch?v=-Y49FOGtmwo" target="_blank">Easing your baby's pain: A mother's story</a> (3 mins 07 secs)<br> Three ways to instantly reduce your infant's pain in the NICU</p><p><a href="https://www.youtube.com/watch?v=3nqN9c3FWn8" target="_blank">The Power of a Parent's Touch</a> (2 mins 40 secs)<br> How breastfeeding and skin-to-skin contact can help when an infant is experiencing a painful procedure</p> | <p>Content developed by Rebecca Pillai Riddell, PhD, CPsych, OUCH Lab, York University, Toronto, in collaboration with:<br>Lorraine Bird, MScN, CNS, Fiona Campbell, BSc, MD, FRCA, Bonnie Stevens, RN, PhD, FAAN, FCAHS, Anna Taddio, BScPhm, PhD<br> Hospital for Sick Children</p>
<h3>References</h3><p>Anand, K.J.S. (2012). Assessment of neonatal pain. In J. A. Garcia-Prats & M. S. Kim (Eds.), UpToDate. UpToDate: Waltham, MA.</p><p>International Association for the Study of Pain (2010) Fact Sheet on Mechanisms of Acute Pain. <a href="https://s3.amazonaws.com/rdcms-iasp/files/production/public/Content/ContentFolders/GlobalYearAgainstPain2/AcutePainFactSheets/3-Mechanisms.pdf" target="_blank">https://s3.amazonaws.com/rdcms-iasp/files/production/public/Content/ContentFolders/GlobalYearAgainstPain2/AcutePainFactSheets/3-Mechanisms.pdf</a> [Accessed March 29, 2018]</p><p>Mathew, P.J., & Mathew, J.L. (2003). Assessment and management of pain in infants. Postgraduate Medical Journal, 79(934), 438-443.</p><p>McGrath, P.J. (1985). CHEOPS: a behavioral scale for rating postoperative pain in children. Adv Pain Res Ther, 9, 395.</p><p>Merkel, S., Voepel-Lewis, T., & Malviya, S. (2002). Pain Assessment in Infants and Young Children: The FLACC Scale: A behavioral tool to measure pain in young children. AJN The American Journal of Nursing, 102(10), 55-58.</p><p>Ohlsson, A., & Shah, P.S. (2015). Paracetamol (acetaminophen) for prevention or treatment of pain in newborns. Cochrane Database Syst Rev, 6(6).</p><p>Pillai Riddell, R., Lisi, D., Campbell, L. (2013). Pain Assessment in Neonates. In Encyclopedia of Pain, 2<sup>nd</sup> edition.</p><p>Pillai Riddell, R.R, Racine, N.M., Gennis H.G., Turcotte, K., Uman, L.S., Horton, R.E., Ahola Kohut, S., Hillgrove Stuart, J., Stevens, B., & Lisi, D.M. (2015). Non-pharmacological management of infant and young child procedural pain. Cochrane Database of Systematic Reviews, Issue 12. Art. No.: CD006275</p><p>Pillai Riddell, R., O'Neill, M., Campbell, L., Taddio, A., Greenberg, S., Garfield, H. (2018). The ABCDs of Pain Management: A Double-Blind Randomized Controlled Trial for a Brief Educational Video for Parents of Young Children undergoing Vaccination.
<em>Journal of Pediatric Psychology.</em> Volume 43, Issue 3, 1 April 2018, Pages 224-233,
<a href="https://doi.org/10.1093/jpepsy/jsx122" target="_blank">https://doi.org/10.1093/jpepsy/jsx122</a></p><p>Pillai Riddell, R.R., Racine, N.M., Gennis, H.G., Turcotte, K., Uman, L.S., Horton, R.E., ... & Lisi, D.M. (2015). Non‐pharmacological management of infant and young child procedural pain. The Cochrane Library.</p><p>Stevens, B., Yamada, J., Campbell-Yeo, M. Gibbins, S., Harrison D., Dionne, K., Taddio, A., McNar C Willan, A., Ballantyne, M., Widger, K., Sidani, S., Estabrooks, C., Synnes, A., Squires J., Victor, C., and Riahi, S. (2018). The minimally effective dose of sucrose for procedural pain relief in neonates: a randomized controlled trial.
<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5824554/" target="_blank">BMC Pediatr</a>. 2018; 18: 85.</p><p>Stevens, B.J., Gibbins, S., Yamada, J., Dionne, K., Lee, G., Johnston, C., & Taddio, A. (2014). The premature infant pain profile-revised (PIPP-R): initial validation and feasibility. The Clinical journal of pain, 30(3), 238-243. </p><p>Stevens, B.J., Abbott, L.K., Yamada, J., Harrison, D., Stinson, J., Taddio, A., & Campbell, F. (2011). Epidemiology and management of painful procedures in children in Canadian hospitals.
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<em>183</em>(7), E403-E410.</p><p>Stevens, B., Yamada, J., Lee, G.Y., & Ohlsson, A. (2013). Sucrose for analgesia in newborn infants undergoing painful procedures. Cochrane Database Syst Rev, 1(1).</p><p>Taddio, A., McMurtry, C.M., Shah, V., Riddell, R.P., Chambers, C.T., Noel, M., & Lang, E. (2015). Reducing pain during vaccine injections: clinical practice guideline.
<em>Canadian Medical Association Journal</em>, <em>187</em>(13), 975-982.</p> | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/ear_infections_sore_throat_babies.jpg | Acute pain: Infants and toddlers | Find out how acute pain is identified and assessed, at home and in medical settings, in children not old enough to speak. | Main | | |
