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Anaphylaxis: How to recognize and respond to a severe allergic reactionAnaphylaxis: How to recognize and respond to a severe allergic reactionAnaphylaxis: How to recognize and respond to a severe allergic reactionAEnglishAllergyChild (0-12 years);Teen (13-18 years)BodyImmune systemConditions and diseasesCaregivers Adult (19+)Abdominal pain;Cough;Diarrhea;Nausea;Vomiting;Rash2021-03-23T04:00:00Z10.200000000000049.2000000000000884.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Anaphylaxis is a severe reaction to an allergen. Learn how to prevent and identify anaphylaxis and how to respond when someone has an anaphylactic reaction.</p><h2>What is anaphylaxis?</h2><p>Anaphylaxis is a severe <a href="/Article?contentid=804&language=English">allergic reaction</a> to certain substances called allergens. When an allergen enters the body of a child with an allergy, the child’s immune system treats it as an invader and overreacts. This reaction happens a few minutes to an hour after the child is exposed to an allergen and can be life threatening.</p><h2>Key points</h2><ul><li>Anaphylaxis is a severe reaction to an allergen such as certain foods, medications and insect bites or stings.</li><li>Common symptoms of anaphylaxis include difficulty breathing, dizziness, hives, swelling of the face and vomiting. If left untreated, anaphylaxis can be life threatening.</li><li>If someone has anaphylaxis, call 911 or go to your nearest emergency department immediately.</li><li>If it is your child’s first episode of anaphylaxis, see an allergist for a full assessment. Your child should be prescribed an epinephrine auto-injector, which they should carry with them at all times.</li></ul><h2>Signs and symptoms of anaphylaxis</h2><p>The signs and symptoms of anaphylaxis may include sudden onset of:</p><ul><li> <a href="/Article?contentid=789&language=English">hives</a>, itching, redness of the skin</li><li>swollen eyes, lips, tongue or face</li><li>difficulty breathing, throat constriction (tightening) or difficulty swallowing</li><li>abdominal (belly) pain, nausea, <a href="/Article?contentid=746&language=English">vomiting</a> or <a href="/Article?contentid=7&language=English">diarrhea</a></li><li>coughing</li><li>stuffy and/or runny nose, watery eyes, sneezing</li><li> <a href="/Article?contentid=779&language=English">fainting</a>, confusion, light-headedness or dizziness</li><li>rapid or irregular heartbeats</li><li>cold, clammy, sweaty skin </li><li>voice changes</li></ul><h2>Common causes of anaphylaxis</h2><p>Common allergens include foods, such as peanuts, tree nuts or eggs; insect bites or stings, such as bee stings, and drugs, such as penicillin.</p><p>An allergen can enter the body in different ways.</p><ul><li>A child may eat or inhale (breathe in) an allergen. It is best to speak to your child’s allergist about the inhaled allergens that would be a problem for your child, as not all of these allergens will cause a severe reaction.</li><li>A child might receive a medication that contains an allergen.</li></ul><p>When the body is exposed to an allergen, it releases chemicals called histamines. These and other chemicals released by the body cause the common signs and symptoms of anaphylaxis.</p><h2>Complications of anaphylaxis</h2><p>Anaphylaxis may cause tightening or blockage of your child’s airway, making it difficult for your child to breathe. It can also lead to a drop in blood pressure. These symptoms can lead to death if not treated.</p><h2>How to prevent repeated episodes of anaphylaxis</h2><p>The best way to prevent anaphylaxis is for your child to avoid known allergens that they are allergic to. Many people are not aware of an allergy until they are exposed to an allergen and have an allergic reaction.</p><p>Following their first episode of anaphylaxis, your child should see an allergist. This is a doctor who specializes in diagnosing and treating allergies.<br></p><p>The allergist will try to figure out the allergen responsible for your child’s anaphylaxis and may also prescribe an <a href="/article?contentid=130&language=English">epinephrine</a> auto-injector such as an EpiPen or Allerject. Your child should carry this medication with them at all times in case of an emergency. Ideally, your child will carry one auto-injector and a second will be readily available nearby.</p><p>Your child should also wear a <a href="https://www.medicalert.ca/">MedicAlert</a> or similar bracelet that indicates their allergies. Talk to your child’s school or daycare about creating an anaphylaxis emergency plan for your child.<br></p><h3>What is an Anaphylaxis Action Plan?</h3><div class="asset-video">https://www.youtube.com/embed/qqf7nQuZGG4</div><p>For more videos from SickKids experts in collaboration with Youngster, visit <a href="https://www.youtube.com/channel/UCoKMd2cYwegtZX19uHdNLQA">Youngster on YouTube</a>.</p><h2>What you can do for your child during anaphylaxis<br></h2><p>Anaphylaxis is a medical emergency. If you suspect your child is having anaphylaxis, call 911 or go to the emergency department <strong>right away</strong>.</p><ul><li>If your child has an emergency anaphylaxis medication, such as an epinephrine auto-injector, inject it right away. You can give a second dose of epinephrine as early as five minutes after the first dose if there is no improvement in symptoms.</li><li>Call 911 or take your child to your nearest emergency department.</li><li>Calm and reassure your child and have them lie down.</li><li>Check your child's airway and breathing. Strained breathing or talking, a hoarse voice or high-pitched breathing sounds are all signs that your child's throat may be swollen.</li><li>Do not give any medication by mouth if your child is having trouble breathing.</li></ul><p>Because symptoms can disappear and then return within a few hours (even with treatment), a child with anaphylaxis will likely stay in the hospital for a period of observation after any anaphylactic reaction.</p><p>If this is your child’s first time having anaphylaxis, they should get a referral to an allergist for a full assessment. They should also receive a prescription for an epinephrine auto-injector.<br></p><h3>When and how to call 911</h3><p>Use this video to teach your child how to call 911 and ask for help if someone is having an anaphylactic reaction. They will also learn about other situations in which they should call 911, as well as when not to call 911.</p><div class="asset-video"> <iframe src="https://www.youtube.com/embed/JdKG_L5YuB8" frameborder="0"></iframe> <br></div><h2>​Virtual care services for children<br></h2><p>Boomerang Health was opened by SickKids to provide communities in Ontario with greater access to community-based services for children and adolescents. For more information on virtual care services in Ontario to support a child with allergies, visit <a href="https://www.boomeranghealth.com/services/allergy/">Boomerang Health</a> powered by SickKids.<br></p><img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/anaphylaxis.jpg" style="BORDER:0px solid;" />anaphylaxisanaphylaxishttps://assets.aboutkidshealth.ca/AKHAssets/anaphylaxis.jpgAnaphylaxis Anaphylaxis is a severe reaction to an allergen. Learn how to prevent and identify anaphylaxis and how to respond when someone has an anaphlactic reaction.Main
COVID-19 vaccinesCOVID-19 vaccinesCOVID-19 vaccinesCEnglishInfectious DiseasesChild (0-12 years);Teen (13-18 years)NANADrug treatmentCaregivers Adult (19+)NA2021-05-28T04:00:00Z10.900000000000049.10000000000001996.00000000000Flat ContentHealth A-Z<p>Learn which COVID-19 vaccines are available in Canada, and find information about vaccine development, vaccine safety and effectiveness, and information about vaccination and children.</p><h2>COVID-19 vaccines approved for use in Canada</h2><p>As of April 2021, four vaccines against COVID-19 are approved for clinical use by Health Canada.</p><p>Two mRNA vaccines:</p><ul><li> <strong>Pfizer</strong>-BioNTech BNT162b2 vaccine</li><li> <strong>Moderna</strong>-NIH mRNA-1273 vaccine</li></ul><p>Two adenoviral vector vaccines:</p><ul><li> <strong>AstraZeneca</strong> and Oxford University ChAdOx1 nCoV-19 vaccine</li><li> <strong>Janssen</strong> (Johnson and Johnson) Ad26.COV2.S</li></ul><h2>Key points</h2><ul><li>Vaccines against COVID-19 have been shown to be safe and effective against the disease.</li> <li>As of May 2021, four COVID-19 vaccines are approved for use by Health Canada.</li><li>Most vaccines can only be given to adults, except for the Pfizer vaccine, which is approved for people aged 12 years of age and older.</li><li>Currently studies are underway looking at the safety of the vaccines and how well they work in children under 12 years of age.</li><li>Parents who are vaccinated against COVID-19 may help protect their children and others against the disease.</li></ul><h2>How do these vaccines work?</h2><p>The vaccines work by teaching your immune cells to recognize a small piece of the SARS-CoV-2 virus called a spike protein. The SARS-CoV-2 virus is the virus that causes COVID-19.</p><h3>mRNA vaccines</h3><p>Pfizer and Moderna use messenger RNA (mRNA)in their vaccines. The mRNA is a small piece of genetic code from the SARS-CoV-2 virus that tells the body to make the spike protein of the coronavirus. The production of the spike protein is recognized by immunity helpers, which will assemble an army of B cells. The B cells produce the antibodies that create immunity against the virus. After the vaccine causes this immune response, the body rapidly gets rid of the spike protein and the mRNA, the antibodies and immune memory remain.</p> <figure class="asset-c-80"><img alt="The mRNA vaccines contain a small piece of genetic code from the SARS-CoV-2 virus that will tell the body make the spike protein of the coronavirus. The production of the spike protein causes the immune system to produce antibodies that create immunity against the virus." src="https://assets.aboutkidshealth.ca/AKHAssets/Covid_vaccine_mRNA.jpg" /><figcaption class="asset-image-caption">Vaccines teach your immune system to recognize the coronavirus by presenting the spike protein to immunity helpers. The mRNA vaccines contain a small piece of genetic code from the SARS-CoV-2 virus that will tell the body make the spike protein of the coronavirus. The immunity helpers will then assemble an army of B cells, which will produce antibodies against this spike protein. B cells also remember how to create these antibodies and they will mature to become memory B cells. They are now prepared to repeat the immune response in the future.<br> After vaccination, if your body encounters the coronavirus, the memory B cells recognize the spike protein on the virus and they will increase the antibody production. The antibodies will bind to the spike protein on the virus, blocking the virus from spreading.</figcaption></figure> <h3>Viral vector vaccines</h3><p>AstraZeneca and Janssen use a modified version of a different virus (a viral vector) in their vaccines. A viral vector is a harmless virus that is used as a delivery system for the vaccine. The “vector” virus that is used is not the virus that causes COVID-19. It is part of the family of adenoviruses, which are among the viruses that can cause the common cold. When a person is given the vaccine, the vector virus tells the body to make the SARS-CoV-2 spike protein. The production of the spike protein is recognized by immunity helpers, which will assemble an army of B cells. The B cells produce the antibodies that create immunity against the virus.</p> <figure class="asset-c-80"> <img alt="The adenoviral vector vaccines contain a small piece of genetic code from the SARS-CoV-2 virus that will tell the body make the spike protein of the coronavirus. The production of the spike protein causes the immune system to produce antibodies that create immunity against the virus." src="https://assets.aboutkidshealth.ca/AKHAssets/Covid_vaccine_viral_vector.jpg" /> <figcaption class="asset-image-caption">Vaccines teach your immune system to recognize the coronavirus by presenting the spike protein to immunity helpers. The adenoviral vector vaccines contain a small piece of genetic code from the SARS-CoV-2 virus that will tell the body make the spike protein of the coronavirus. The immunity helpers will then assemble an army of B cells, which will produce antibodies against this spike protein. B cells also remember how to create these antibodies and they will mature to become memory B cells. They are now prepared to repeat the immune response in the future.<br> After vaccination, if your body encounters the coronavirus, the memory B cells recognize the spike protein on the virus and they will increase the antibody production. The antibodies will bind to the spike protein on the virus, blocking the virus from spreading.</figcaption></figure> <h2>Are mRNA COVID-19 vaccines safe and are there any side effects?</h2><p>Two mRNA vaccines have been approved by Health Canada: The Pfizer vaccine and the Moderna vaccine. They have met the requirements for approval by Health Canada as they have been studied in clinical trials on a large number of people and were shown to be safe. In the studies, the number of people who got the vaccine and had unexpected severe side effects was similar to the number of people who received a placebo (substance or treatment that contains no active ingredients).</p><p>Some people who received injections had side effects, such as fatigue, headache, muscle pain, joint pain, chills and fever. These are side effects that may be seen after any vaccination. Allergic reactions have only rarely occurred.</p><h2>Are viral vector COVID-19 vaccines safe and are there any side effects?</h2><p>Two viral vector-based COVID-19 vaccines have been approved by Health Canada: The AstraZeneca vaccine and the Janssen vaccine. They have met all the requirements for approval by Health Canada as they have been studied in clinical trials on a large number of people and were shown to be safe. Experts are closely monitoring any adverse reactions that could occur following vaccination and taking measures to ensure the safety of COVID-19 vaccines.</p><p>Recently, very rare cases of serious blood clots following vaccination with the AstraZeneca and Janssen vaccines have been reported, and the situation is being closely monitored. Because of this possible side effect, several provinces have decided to pause the rollout and administration of first doses of the AstraZeneca vaccine for people of all ages. At present, the AstraZeneca vaccine is being offered to people 40 years of age and older for second doses only.</p><h2>Is there any chance that the COVID-19 vaccine can give me the virus?</h2><p>No. There is no way you can get COVID-19 from any of the vaccines. None of the vaccines contain the SARS-CoV-2 virus, which causes COVID-19.</p><h2>After vaccination, how long does it take to be protected from COVID-19 and how long does this protection last?</h2><p>After you get the vaccine, immunity usually starts to develop after 14 days. For vaccines that need two-doses, a maximum immune response occurs seven to 14 days after the second dose of the vaccine. Vaccines offer protection against COVID-19 for a minimum of two months. Studies are still ongoing and data is being collected on how long the protection will last.</p><h2>Approval for these vaccines in adults happened very quickly. How is that possible and should I be concerned?</h2><p>Work on coronavirus vaccines has been ongoing for more than 10 years, due in part to the SARS-CoV-1 outbreak in 2003. It was important to develop the COVID-19 vaccine quickly because of how many people were dying and getting sick, and because of the disruptions to everyday life as a result of the pandemic. Even though the vaccines were developed quickly, all the usual steps for the approval of vaccines occurred, including clinical trials with the appropriate number of participants. Because of the large amount of resources that were made available to develop a COVID-19 vaccine and the large number of COVID-19 cases the clinical trials were able to happen quickly. This made it easier to tell quickly whether or not the vaccines worked to prevent cases of COVID-19. The vaccine was rapidly shown to be effective in protecting against COVID-19.</p><h2>Do you recommend that children get the vaccine against COVID-19?</h2><p>Although they are less at risk than older people, some children may still develop severe COVID-19, or may require hospitalization because of COVID-19. The vaccine has been shown to prevent severe illness and hospitalization. Moreover, vaccinating children will become important to reduce the transmission of the virus since they represent a large proportion of the population.</p><h2>I want my child to be vaccinated against COVID-19. When do you think that this will be possible?</h2><p>Starting in December 2020 Canada began vaccinating people who were most at risk of severe COVID-19. This included health-care workers and seniors. These high-risk populations are being vaccinated before vaccines are made available to younger people. In Ontario, since April 2021, people aged 16 years and older can receive the vaccine depending on where they live and if they have a high-risk medical condition. These high-risk conditions include solid organ and hematopoietic stem cell transplant recipients, patients on chemotherapy, patients with kidney, liver or heart disease, amongst others. Patients, or parents of children with these conditions or with another chronic health condition should discuss the availability and the benefits of the COVID-19 vaccine with their health-care providers.</p><p>On May 5, 2021 Canada approved the use of the Pfizer vaccine for children 12 to 15 years of age. In most areas of the country this age group is currently eligible to receive the Pfizer vaccine. It is however difficult to predict when a vaccine will be approved for the majority of children aged 11 years and younger. Data on the safety and how well the vaccines work in children still needs to be collected. Clinical trials are being conducted with all four vaccines, with some vaccines being studied in children as young as 6 months old.</p><p>Here are a few helpful resources about COVID-19 vaccines and youth.</p><ul><li><a href="https://kidshealthfirst.ca/">COVID-19 Vaccines for Ontario Youth</a></li><li><a href="https://www.toronto.ca/wp-content/uploads/2021/05/97d6-COVID-19-Vaccine-Fact-Sheet-Youth.pdf">COVID-19 Vaccine Fact Sheet for Youth Age 12 to 17</a></li><li><a href="https://www.toronto.ca/wp-content/uploads/2021/05/908c-CovidTeenVaxConsentInfographF.pdf">Does my 12+ Child Require Informed Consent to Receive Their Vaccine?</a></li></ul><h3>Eligibility requirements</h3><p>To find information about current eligibility requirements for each province and territory, click on the links below.</p><p> <strong>Alberta</strong><br> <a href="https://www.alberta.ca/covid19-vaccine.aspx">COVID-19 vaccine program</a></p><p> <strong>British Columbia</strong><br> <a href="https://www2.gov.bc.ca/gov/content/covid-19/vaccine/register">How to get vaccinated for COVID-19</a></p><p> <strong>Manitoba</strong><br> <a href="https://www.gov.mb.ca/covid19/vaccine/young-people.html">COVID-19 Immunization for Young People</a></p><p> <strong>New Brunswick</strong><br> <a href="https://www2.gnb.ca/content/gnb/en/corporate/promo/covid-19/nb-vaccine.html">COVID-19 vaccines</a></p><p> <strong>Newfoundland and Labrador</strong><br> <a href="https://www.gov.nl.ca/covid-19/vaccine/gettheshot/">Get the Shot</a></p><p> <strong>Northwest Territories</strong><br> <a href="https://www.nthssa.ca/en/services/coronavirus-disease-covid-19-updates/covid-vaccine">COVID Vaccine</a></p><p> <strong>Nova Scotia</strong><br> <a href="https://novascotia.ca/coronavirus/vaccine/">Coronavirus (COVID-19): vaccine</a></p><p> <strong>Nunavut</strong><br> <a href="https://www.gov.nu.ca/health/information/covid-19-vaccination">COVID-19 Vaccination</a></p><p> <strong>Ontario</strong><br> <a href="https://covid-19.ontario.ca/ontarios-covid-19-vaccination-plan">Ontario’s COVID-19 vaccination plan</a></p><p> <strong>Prince Edward Island</strong><br> <a href="https://www.princeedwardisland.ca/en/information/health-and-wellness/getting-the-covid-19-vaccine">Getting the COVID-19 Vaccine</a></p><p> <strong>Quebec</strong><br> <a href="https://www.quebec.ca/en/health/health-issues/a-z/2019-coronavirus/progress-of-the-covid-19-vaccination/">COVID-19 vaccination campaign</a></p><p> <strong>Saskatchewan</strong><br> <a href="https://www.saskatchewan.ca/government/health-care-administration-and-provider-resources/treatment-procedures-and-guidelines/emerging-public-health-issues/2019-novel-coronavirus/covid-19-vaccine/vaccine-booking">Appointments for COVID-19 Vaccine</a></p><p> <strong>Yukon</strong><br> <a href="https://yukon.ca/en/vaccine-questions">Vaccine questions</a></p><h2>If I am vaccinated against COVID-19, will this protect my child?</h2><p>There is more and more evidence that suggests fully vaccinated people are less likely to develop asymptomatic COVID-19 and potentially less likely to transmit the infection to others. This may be true for vaccinated parents and the risk of transmission to their child. However, more studies are needed to confirm this.</p><h2>If my child develops COVID-19 and I am vaccinated, will I be protected against the disease?</h2><p>It has been shown that people who are vaccinated are protected against COVID-19. If you are vaccinated and your child is later diagnosed with COVID-19, you are less at risk of developing the disease, notably severe disease.</p><h2>Will getting the COVID-19 vaccine help my child go back to school and other regular activities?</h2><p>All children benefit from routine educational, physical and other extracurricular activities. It is expected that when enough people are vaccinated against COVID-19, the risk of infection for your child, and the general population, will go down. Until the population is protected, it is important to continue to follow the advice of public health authorities to reduce the risk of getting and transmitting COVID-19. For current recommendations from SickKids about schools please review the <a href="https://www.sickkids.ca/en/news/archive/2021/updated-covid19-school-operation-guidance-document-released/">updated guidance for school operation during the pandemic</a>.</p><h2>If myself or my child already had COVID-19, should we still get the vaccine?</h2><p>It is recommended that anyone who has had COVID-19 should still get the vaccine, but only after they have recovered from their illness and they have been cleared by their local public health unit. The clinical trials included people who previously had COVID-19, and the vaccine was found to be safe for them. Because it is not known how long antibodies against COVID-19 last after infection and it is possible to get the infection again (sometimes more severely), the vaccine is recommended as it can be helpful in boosting a person's existing immunity to COVID-19.</p><p>For general information on COVID-19, please visit the <a href="https://www.aboutkidshealth.ca/covid-19">COVID-19 learning hub</a>.</p><h2>References</h2><p>Centers for Disease Control and Prevention. (2021, March 8). Science Brief: Background Rationale and Evidence for Public Health Recommendations for Fully Vaccinated People. Retrieved from <a href="https://www.cdc.gov/coronavirus/2019-ncov/more/fully-vaccinated-people.html">https://www.cdc.gov/coronavirus/2019-ncov/more/fully-vaccinated-people.html</a></p><p>Centers for Disease Control and Prevention. (2021, February 26). COVID-19 Vaccination. Retrieved from <a href="https://www.cdc.gov/vaccines/covid-19/index.html">https://www.cdc.gov/vaccines/covid-19/index.html</a></p><p>National Advisory Committee on Immunization. (2021, May 5). Recommendations on the use of COVID-19 vaccines. Retrieved from <a href="https://www.canada.ca/content/dam/phac-aspc/documents/services/immunization/national-advisory-committee-on-immunization-naci/recommendations-use-covid-19-vaccines/recommendations-use-covid-19-vaccines-en.pdf">https://www.canada.ca/content/dam/phac-aspc/documents/services/immunization/national-advisory-committee-on-immunization-naci/recommendations-use-covid-19-vaccines/recommendations-use-covid-19-vaccines-en.pdf</a></p><p>Government of Ontario – Ministry of Health. (2020, March 31). COVID-19 vaccines for Ontario. Retrieved from <a href="https://covid-19.ontario.ca/covid-19-vaccines-ontario">https://covid-19.ontario.ca/covid-19-vaccines-ontario</a></p><p>ImmunizeCanada. (2021, February 18). COVID-19 Info. Retrieved from <a href="https://immunize.ca/covid-19-info">https://immunize.ca/covid-19-info</a></p><p>World Health Organization. (2021, February 19). COVID-19 vaccines. Retrieved from <a href="https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19-vaccines">https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19-vaccines</a></p><p>ImmunizeBC. (2021, March 12). COVID-19 Vaccine Frequently Asked Questions. Retrieved from <a href="https://immunizebc.ca/covid-19-vaccine-frequently-asked-questions">https://immunizebc.ca/covid-19-vaccine-frequently-asked-questions</a></p>https://assets.aboutkidshealth.ca/AKHAssets/COVID-19_Vaccine.jpg Learn which COVID-19 vaccines are available in Canada, and find information on vaccine development, and safety and effectiveness in children.Main
Living with a chronic condition: Supporting yourself as a caregiverLiving with a chronic condition: Supporting yourself as a caregiverLiving with a chronic condition: Supporting yourself as a caregiverLEnglishPsychiatryChild (0-12 years);Teen (13-18 years)NANAConditions and diseasesCaregivers Adult (19+)NA2018-11-26T05:00:00Z9.1000000000000063.6000000000000540.000000000000Flat ContentHealth A-Z<p>Learn how to support your own mental health and wellbeing and how to cope with emotions following the diagnosis of a child’s chronic condition. </p><p>​Following a diagnosis of a child's <a href="/Article?contentid=3400&language=English">chronic condition</a>, it is normal to feel a range of emotions such as guilt, sadness, anger or relief. These emotions might be directed at yourself, your partner, your child, the healthcare team or the world in general.<br></p><h2>Key points</h2><ul><li>​It is natural to feel a range of emotions when your child is diagnosed with a chronic condition.</li><li>Try to use positive coping methods such as exercise, keeping up with hobbies and staying connected with family and friends. This will help you and set a good example for your child.</li><li>Ask your child's healthcare team about social supports that are specific to your child's condition.</li><li>Speak to a trusted friend or healthcare professional if you feel on edge, have ongoing sleep difficulties or no longer enjoy hobbies or other activities.</li></ul><p>Avoid the tendency to ignore your emotions and reactions to your child’s condition. Instead, take care of yourself and use some positive coping methods such as:<br></p><ul><li>going for a walk or doing other exercise</li><li>getting enough sleep</li><li>eating a balanced diet</li><li>continuing with enjoyable activities and hobbies</li><li>staying connected to friends and family.</li></ul><p>This approach helps you not only manage your stress levels but also better care for your child. In fact, research has shown that parents who improve their own stress levels have a positive impact on their child’s health.</p><p>Your child’s healthcare team can help recommend <a href="/Article?contentid=3402&language=English">coping strategies</a> to help both you and your child. This might include meeting others with the same diagnosis as your child or joining a community specific to the chronic condition. These social supports can:</p><ul><li>help you adapt to raising a child with a chronic condition</li><li>offer realistic tips and tricks to manage your time and appointments and manage your child’s symptoms or any medication side effects.</li></ul><p>However, it is always important to talk to your child’s healthcare team before changing anything in your child’s healthcare routine.</p><h2>Setting a positive example for your child or teen</h2><p>As a parent, you are a role model for positive coping, asking for help when you need it and advocating for your child’s or teen’s needs in the healthcare system. Your child will learn how to manage their chronic condition by watching how you cope with it.</p><p>Sometimes you might need to explain why and how a chosen activity is a coping strategy. Tell your child, for instance, if you are going for a walk or run to help with stress or talking about your emotions with close friends to help ease your concerns. When your child sees you making healthy choices and coping well, they are more likely to do the same themselves.</p><h2>Warning signs to seek support for yourself</h2><p>Sometimes, despite your best efforts, you may find it difficult to cope with the reality of a child’s chronic condition. You might need to seek specific support for yourself if you:</p><ul><li>find it hard to understand or remember what healthcare providers are telling you</li><li>cannot fall asleep or stay asleep during the night</li><li>almost always have a feeling of being on edge</li><li>feel resentful towards your child</li><li>find it difficult to enjoy activities that you used to enjoy.</li></ul><p>In these cases, it can be helpful to speak to a trusted friend or professional for support.<br></p><h2>Further information</h2><p>For more information on parenting a child or teen with a chronic condition, please see the following pages:</p><p> <a href="https://akhpub.aboutkidshealth.ca/Article?contentid=3400&language=English">Living with a chronic condition: Overview</a><br></p><p> <a href="https://akhpub.aboutkidshealth.ca/Article?contentid=3401&language=English">Living with a chronic condition: Helping your child manage their health</a></p><p> <a href="https://akhpub.aboutkidshealth.ca/Article?contentid=3402&language=English">Living with a chronic condition: Maintaining your child's everyday routines</a><br></p>https://assets.aboutkidshealth.ca/AKHAssets/iCanCopeSCD/duration_location_frequency_SCD_J4T.jpgSupporting yourself as a caregiverMain
Post-traumatic stress disorder: Signs and symptomsPost-traumatic stress disorder: Signs and symptomsPost-traumatic stress disorder: Signs and symptomsPEnglishPsychiatryPreschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)NANAConditions and diseasesCaregivers Adult (19+)NA2017-07-27T04:00:00Z11.600000000000047.1000000000000784.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Learn about the four categories of post-traumatic stress disorder signs and symptoms.</p><h2>What are the main symptoms of post-traumatic stress disorder in children and teens?</h2><p>The main symptoms of <a href="/Article?contentid=1927&language=English">post-traumatic stress disorder</a> (PTSD) are divided into four categories:</p><ul><li>intrusion symptoms</li><li>avoidance of stimuli associated with the traumatic event</li><li>negative changes in thoughts and mood</li><li>altered reactivity</li></ul><h2>Key points</h2> <ul> <li>PTSD has a number of symptoms related to intrusion, avoidance, negative changes in thoughts and mood and changes in reactivity.</li> <li>Symptoms need to be present for one month or longer for a diagnosis to be made.</li> <li>Your child’s doctor will interview you and your child to help make a diagnosis.</li> <li>Your child’s doctor might recommend that your child see a mental health professional for a further assessment or therapy or recommend medications.</li> </ul><h3>Intrusion symptoms</h3> <p>Intrusion symptoms are those where the traumatic event 'intrudes' on the child or teen's everyday life. They include:</p> <ul> <li>recurring, unwanted and uncontrolled memories of the traumatic event</li> <li>in children, repetitive play with trauma-related themes</li> <li>recurring dreams related to the traumatic event or the emotions the child or teen felt at the time</li> <li>flashbacks about the event — experiencing the traumatic event again, sometimes with a complete loss of awareness of present surroundings</li> <li>intense and prolonged psychological or physical distress at reminders of the trauma</li> </ul> <h3>Avoidance of stimuli associated with traumatic event</h3> <p>As the term suggests, this involves a child or teen avoiding or trying to avoid all memories, thoughts or feelings related to the event. It can also involve avoiding, or trying to avoid, external reminders (such as people, places, conversations, activities, objects or situations) that bring up distressing memories, thoughts or feelings about the traumatic event.</p> <h3>Negative changes in thoughts and mood</h3> <p>A child or teen with PTSD may:</p> <ul> <li>be unable to remember an important aspect of the traumatic event</li> <li>hold persistent and exaggerated negative beliefs or expectations about themselves or those around them</li> <li>blame themselves or others for the causes or consequences of the traumatic event because of persistent and distorted thoughts</li> <li>experience ongoing negative emotions such as fear, horror, anger, guilt or shame</li> <li>lose interest in or cut back on activities that once mattered to them</li> <li>feel detached (separate) from others</li> <li>be persistently unable to experience positive emotions such as happiness, satisfaction or love</li> </ul> <h3>Altered reactivity</h3> <p>If a person experiences PTSD, they may be more reactive to their surroundings and what is said to them. For example, they may:</p> <ul> <li>be more irritable or have <a href="https://akhpub.aboutkidshealth.ca/article?contentid=301&language=English">angry</a> outbursts with little or no provocation </li> <li>be verbally abusive or physically aggressive towards people or objects, including through extreme temper tantrums</li> <li>be more easily startled or more aware of their surroundings</li> <li>find it hard to concentrate</li> <li>have disturbed sleep</li> <li>engage in reckless or self-destructive behaviour</li> </ul><h2>How PTSD affects children </h2> <p>Although they are less able to express themselves, young children likely have thoughts, memories and/or dreams about a traumatic event. Rather than talking about what they think or remember, they are more likely to be irritable and withdrawn and to play out trauma-related themes.</p> <h2>How PTSD affects teens</h2> <p>Teens may withdraw from their usual activities, <a href="https://akhpub.aboutkidshealth.ca/article?contentid=289&language=English">self-harm</a> or engage in impulsive and reckless behaviour such as substance use.</p><h2>How PTSD is diagnosed</h2> <p>Your child's doctor will speak to you and your child and ask you both about:</p> <ul> <li>your concerns and the symptoms that are interfering with your child's everyday functioning</li> <li>the current stressors in your child's life and what could have triggered the onset of the PTSD symptoms</li> <li>your child's development (from pregnancy to the present time)</li> <li>your family's mental health history</li> <li>your family's general functioning and any stressors (such as conflict, impending divorce, bereavement, moving house) that might be contributing to your child's difficulties.</li> </ul> <p>A doctor will only consider PTSD as a diagnosis if your child or teen has been exposed to serious physical injury, sexual violence or actual or threatened death (through violence or by accident). Your child must have either:</p> <ul> <li>directly experienced the violence or injury</li> <li>witnessed the violence or injury in person (not just have seen it on TV, in movies, in videogames or in other media)</li> <li>learned that the violence or injury occurred to a close family member or friend.</li> </ul><h2>What your child's doctor can do for PTSD</h2> <p>If your child is diagnosed with PTSD, you and your child's doctor will decide the most appropriate course of action together. Your doctor may require input from your child's teacher or other family members.</p> <p>Your doctor may also suggest that your child see a <a href="/Article?contentid=2005&language=English">therapist or a psychiatrist</a> or recommend that your child take <a href="/Article?contentid=2005&language=English">medications</a>.</p><h2>Further information</h2> <p>For more information on post-traumatic stress disorder (PTSD), please see the following pages:</p> <p><a href="/Article?contentid=1927&language=English">PTSD: Overview</a></p> <p><a href="/Article?contentid=2005&language=English">PTSD: Treatment with psychotherapy and medications</a></p>https://assets.aboutkidshealth.ca/AKHAssets/post_trumatic_stress_disorder_signs_and_symptoms.jpgPTSD: Signs and symptoms The main symptoms of post-traumatic stress disorder are divided into four categories. Learn about these symptoms and about diagnosis.Main
Sex, gender and sexual orientation: An OverviewSex, gender and sexual orientation: An OverviewSex, gender and sexual orientation: An OverviewSEnglishAdolescentTeen (13-18 years)NANASupport, services and resourcesTeen (13-18 years)NAhttps://assets.aboutkidshealth.ca/AKHAssets/Gender_Stick_Person.jpg2021-04-12T04:00:00Z10.200000000000046.10000000000001252.00000000000Flat ContentHealth A-Z<p>It is common for people to confuse sex, gender and sexual orientation, but they are all different things. Read more to better understand the complete story of who you are on the inside and how you want to present to the world.</p><h2>What is gender?</h2><p>Traditionally, gender has been defined as being either one of the two sexes: male or female. But gender is actually a much broader concept. There is a lot more to gender than the sex you were assigned at birth, and it does not tell the complete story of who you are.</p><h2>Key points</h2><ul><li>There are four main concepts of identity to understand, and each one is distinct: sex, gender identity, gender expression and sexual orientation.</li><li>Sex is determined by biological features including chromosomes, hormones, internal reproductive organs and external sexual anatomy.</li><li>Gender identity is how you feel about your gender on the inside as a woman, a man, both, in between or something else.</li><li>Gender expression is how you demonstrate your gender to the world, and it may match traditional gender norms or may differ from those norms.</li><li>Sexual orientation is who you are attracted to, sexually and romantically (emotionally).</li></ul><h2>Identity</h2><p>It is common for people to confuse sex, gender and even sexual orientation, but they are all different things. Each category exists independently and has its own spectrums. It can be helpful to visualize these concepts through the illustration below.</p> <figure class="asset-c-80"> <img src="https://assets.aboutkidshealth.ca/AKHAssets/Gender_Stick_Person.jpg" alt="A grey stick person with gender identity at the head, sex at the groin, sexual orientation at the heart and gender expression all encompassing." /></figure> <h2>What is sex?</h2><p>Sex is determined by biological features including chromosomes (e.g., XX, XY), hormones (e.g., estrogen, progesterone, testosterone), internal reproductive organs (e.g., uterus, vagina, prostate) and external sexual anatomy (e.g., vulva, penis, testicles). People are usually assigned male or female at birth and this marker goes on legal documents such as your birth certificate.</p><h3>What does it mean to be intersex?</h3><p>Intersex is a term that describes someone who is born with or develops reproductive or sexual anatomy that doesn’t seem to fit the typical definitions of female or male. One example of an intersex person might be someone who has androgen insensitivity syndrome (AIS). When a person has AIS, their body is resistant to certain sex hormones and can develop differently than what would be expected for the chromosomes that person was born with.</p><p>Some people who are intersex will choose to self-identify as intersex and some will adopt a gender identity that best reflects how they feel on the inside.</p><h2>What is gender identity?</h2><p>Gender identity is how you feel about your gender on the inside. It is the psychological sense of feeling like a woman, a man, both, in between or something else. Your gender identity is something that you come to understand for yourself. The most common gender identity is cisgender – someone who feels their gender identity matches their assigned sex at birth – but there are many other recognized gender identities. These include, but are not limited to, the following:</p><ul><li>Agender – someone who identifies as having no gender</li><li>Bigender – someone who identifies as having two full genders</li><li>Gender creative – children who identify and express their gender in ways that are different than what society/cultures expect</li><li>Gender fluid – someone who sees their gender as changeable</li><li>Genderqueer – someone who does not conform to society’s expectations for their gender roles or gender expression</li><li>Non-binary –someone whose gender identity is neither male nor female</li><li>Pangender – someone who identifies with multiple and/or all genders</li><li>Trans or transgender – someone whose gender identity differs from their assigned sex at birth</li><li>Two-spirit – a term used by some Indigenous communities to describe the sexual and gender diversity in Indigenous cultures</li></ul><p>Most children by the age of three are aware of their own gender, although it is okay to question your gender identity as you grow older. The formation of your identity can be influenced by biological sex, hormones and the environment. Identity can also shift and evolve over time.</p><h2>What is gender expression?</h2><p>Gender expression is how you present to the world. It is the way you demonstrate who you are, and it can match traditional gender norms but does not have to. Gender expression can be motivated by your gender identity, sexuality, mood and many other things (e.g., needing to wear a uniform for work or a costume for a performance).</p><p>You can demonstrate your gender through your name, pronoun choice, clothing, voice, hairstyle and the ways that you act and interact with others (intentionally or unintentionally). Gender expression is most commonly classified as either masculine, feminine or androgynous, which has elements of both masculinity and femininity. The ways you communicate your gender is flexible and may change depending on the day or setting:</p><ul><li>You may wear an androgynous uniform at work and wear bright feminine colours at home.</li><li>You might keep your hair neat and short during the day and wear fun wigs at night.</li><li>Your may have a deep masculine voice when you are sad and moody, but use a higher-pitched feminine tone when you are feeling giddy and excited.</li></ul><h3>What are gender norms?</h3><p>Your gender expression is interpreted by others around you based on the traditional gender norms of your society and culture. Gender norms are the expectations that your society traditionally has for women and men (e.g., men wear pants; women wear dresses). These can include expectations about how each gender should:</p><ul><li>be classified, identified and treated under the law</li><li>speak and be spoken to</li><li>perform their respective gender roles</li><li>dress or wear their hair</li><li>play with toys and engage in sports activities</li><li>form relationships and families</li><li>be educated and which industries they should work within</li></ul><p>There are many different norms for gender expression, and they vary by culture, generation, region, and between communities and peer groups. Because gender expression and norms are constantly changing, it is important to remember that there is no one “right” way to demonstrate gender. Your gender expression is your choice.</p><h2>What is sexual orientation?</h2><p>Your sexual orientation is who you are attracted to, sexually and/or romantically. Sexual attraction is the desire to have sexual contact with someone, while romantic attraction is the desire for emotional relationships and intimacy. The label of your sexual identity will usually describe the relationship between your gender identity and the gender identities of the people you are attracted to. The most common sexual orientation is straight – someone who is primarily attracted to the opposite gender – but there are many other recognized sexual orientations. These include, but are not limited to, the following:</p><ul><li>Gay – a male who is attracted to males</li><li>Lesbian – a female who is attracted to females</li><li>Bisexual – a male or female who is attracted to both males and females (not always equally or at the same time)</li><li>Pansexual – someone who is attracted to people of any gender</li><li>Asexual – someone who is not sexually attracted to any gender</li><ul><li>Some asexual people experience romantic attraction, and others do not</li></ul><li>Queer – a general term for someone who is not straight</li></ul><p>If your sexual orientation is not straight, you may identify as belonging to the “queer community” or the LGBTQ2S+ community. LGBTQ2S+ stands for lesbian, gay, bisexual, transgender, queer/questioning and two-spirit; and the plus indicates that nobody is left out.</p><h2>Resources</h2><p>Killermann, S (2015, March 27). Breaking through the Binary. Retrieved from <a href="https://www.genderbread.org/wp-content/uploads/2017/02/Breaking-through-the-Binary-by-Sam-Killermann.pdf">https://www.genderbread.org/wp-content/uploads/2017/02/Breaking-through-the-Binary-by-Sam-Killermann.pdf</a>.</p><p>Exploring Gender Diversity. <em>Trans Care BC</em>. Retrieved from <a href="http://www.phsa.ca/transcarebc/Documents/HealthProf/Exploring_Gender_Diversity.pdf">http://www.phsa.ca/transcarebc/Documents/HealthProf/Exploring_Gender_Diversity.pdf</a>.</p><p>Gender. <em>Trans Care BC</em>. Retrieved from <a href="http://www.phsa.ca/transcarebc/trans-basics/gender">http://www.phsa.ca/transcarebc/trans-basics/gender</a>.</p><p>Sex&U. <em>The Society of Obstetricians and Gynaecologists of Canada</em>. Retrieved from <a href="https://www.sexandu.ca/">https://www.sexandu.ca/</a>.</p><p>Sexual Orientation. <em>HealthLinkBC</em>. Retrieved from <a href="https://www.healthlinkbc.ca/health-topics/abj9152">https://www.healthlinkbc.ca/health-topics/abj9152</a>.</p><p>What is intersex? <em>interACT: Advocates for Intersex Youth</em>. Retrieved from <a href="https://interactadvocates.org/">https://interactadvocates.org/</a>.</p>genderoverviewSex, gender, and sexual orientation It's common for people to confuse sex, gender and sexual orientation, but they are all different things. Read more about each of these terms.Teens



Blood, blood components and blood typesBlood, blood components and blood typesBlood, blood components and blood typesBEnglishCardiologyChild (0-12 years);Teen (13-18 years);Adult (19+)HeartCardiovascular systemNAAdult (19+)NA2021-01-28T05:00:00Z6.5000000000000074.3000000000000755.000000000000Flat ContentHealth A-Z<p>Learn about what blood does for the body, the different components of blood and what different blood types mean.</p><h2>What does blood do for the body?</h2><p>Without blood, the body could not function. Blood carries the oxygen we breathe into our lungs to the parts of the body that need it. It also brings carbon dioxide back from the body to the lungs, so that it can be removed when we breathe out. Carbon dioxide is produced when the cells in the body make energy to power the body.</p><h2> Key points </h2><ul><li>Blood carries oxygen all over the body and brings carbon dioxide to the lungs so it can be exhaled.</li><li>Blood contains red blood cells, white blood cells, platelets, and plasma.</li><li>There are four major blood types: A, B, AB, and O.</li><li>Different blood types cannot be mixed together. </li></ul><h2>What are the different blood components?</h2><p>Blood is made up of red blood cells, white blood cells, platelets, and plasma.</p><h3>Red blood cells</h3><p>Red blood cells are red because they contain a protein called haemoglobin. Oxygen and carbon dioxide attach to the iron in haemoglobin to be transported. The red blood cells carry oxygen from the lungs to the rest of the body and carry carbon dioxide from the body back to the lungs. Blood high in oxygen is bright red, while blood low in oxygen is blue.</p><p>Your body has millions of red blood cells. Each one lives for about 120 days. The bone marrow in the body is constantly making more red blood cells to refresh your blood, so you always have enough. </p><h3>White blood cells</h3><p>White blood cells fight off infection in the body. When they detect infection, they either attack it with antibodies or they surround bacteria and get rid of it.</p><p>White blood cells do not live as long as red blood cells. There are fewer white blood cells than red blood cells in the blood, although the body makes more white blood cells if it is about to fight an infection.</p><h3>Platelets</h3><p>Platelets help blood clot to stop the bleeding from a cut or other injury.</p><h3>Plasma</h3><p>Plasma is a clear liquid that makes up over half of the blood volume in the body. It carries the blood cells and platelets around the body. Plasma contains several important proteins and components to help fight off infections and to help with blood clotting.</p><h2>What are the different blood types?</h2><p>There are four major blood types: A, B, AB, and O. The genes we inherit from our parents determine our blood type. Different blood types cannot be mixed together, or the blood cells could start to clump together. When people have operations and need blood transfusions, the doctors need to know ahead of time what their blood type is so they can give them transfusions of the correct blood type.</p><h3>Rhesus (Rh) factor</h3><p>A person's red blood cells may also contain a protein called the Rhesus factor (Rh factor), which appears to help energize the body's cells. If you have the Rh factor, you are Rh positive, or Rh+. If you do not have the Rh factor, you are Rh negative, or Rh-. </p><p>Whether you have the Rhesus factor is indicated with your blood type. For example, if you have type A blood and are Rh positive, your blood type would be indicated as A positive, or A+. When children or adults need blood transfusions, they must receive blood that is Rhesus compatible.</p><table class="akh-table"><thead><tr><th>People with this blood type...</th><th>...can donate to people with these blood types:</th></tr></thead><tbody><tr><td>A+</td><td>A+, AB+</td></tr><tr><td>A-</td><td>A+, A-, AB+, AB-</td></tr><tr><td>B+</td><td>B+, AB+</td></tr><tr><td>B-</td><td>B+, B-, AB+, AB-</td></tr><tr><td> AB+</td><td> AB+</td></tr><tr><td> AB-</td><td> AB+, AB-</td></tr><tr><td>O+</td><td>A+, B+, AB+, O+</td></tr><tr><td>O-</td><td>A+, A-, B+, B-, AB+, AB-, O+, O-</td></tr></tbody></table><p>People with type A blood can donate to other people with type A, or people with type AB. People with type B can donate to other people with type B, or people with type AB. </p><p>AB blood can only be donated to someone else with AB blood. People with AB blood are considered to be the universal recipients (receivers), since they can safely receive any type of blood.</p><p>O- is known as the universal donor since people with any type of blood can safely be given O- as part of a transfusion. O+ blood may be given to any other Rh+ blood type. </p><p>People with type O blood can only receive blood donations from another type O blood donor.</p>https://assets.aboutkidshealth.ca/AKHAssets/cuts_scrapes_children_first_aid.jpgMain
DiarrheaDiarrheaDiarrheaDEnglishGastrointestinalChild (0-12 years);Teen (13-18 years)Large Intestine/ColonLarge intestine;RectumConditions and diseasesAdult (19+)Diarrhea2019-10-30T04:00:00Z8.1000000000000059.10000000000001120.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Diarrhea causes frequent, loose bowel movements. Read about the causes of diarrhea in babies and children, how to take care of them, and how to prevent dehydration.</p> <h2>What is diarrhea?</h2><p>Diarrhea is when your child has watery stool that is more frequent than their usual number of stools. There are many different causes of diarrhea. In children, it is most often caused by a virus that infects the lining of the intestines, called <a href="https://www.aboutkidshealth.ca/Article?contentid=907&language=English">gastroenteritis</a>. Other causes include bacterial infections, parasitic infections, food poisoning or medications such as antibiotics. Diarrhea caused by antibiotics is known as <a href="/Article?contentid=820&language=English">antibiotic-associated diarrhea</a>. Diarrhea is also caused by medical conditions that affect how food is absorbed from the intestines.<br></p><p>During the first few months of life, it is normal for many breastfed babies to have bowel movements with very loose stool. This is unlikely diarrhea.</p><h2>Key points</h2> <ul> <li>Diarrhea is frequent bowel movements and loose or watery stool. </li> <li>Diarrhea can cause dehydration.</li> <li>Signs of dehydration include dry mouth, sunken eyes, not peeing often and low energy. </li> <li>When your child has diarrhea, continue with their regular diet. Give plenty of fluids.</li> <li>If your child is a baby check with the doctor about giving certain fluids. </li> <li>Talk to your doctor before giving your child an oral rehydration solution to prevent dehydration. </li> <li>Talk to your doctor if your child is not able to drink fluids, has blood in their stool, or has pain that does not go away.</li> <li>Talk to your doctor if your child seems to be getting sicker. </li> </ul><h2>Signs and symptoms of severe diarrhea</h2><p>Signs of diarrhea include:</p><ul><li>sudden increase in the number of bowel movements</li><li>stool that contains mucus or blood</li><li>stool with a very bad smell</li></ul><p>Severe diarrhea can be harmful because it causes dehydration. <a href="/Article?contentid=776&language=English">Dehydration</a> is a loss of fluid in the body. Infants can lose too much fluid very quickly. </p><p>Signs of dehydration include:</p><ul><li>dry mouth </li><li>fewer tears when crying </li><li>sunken eyes </li><li>not urinating (peeing) as often as usual or less than three times per day<br></li><li>dark urine </li><li>sunken fontanelle (the "soft spot" on the top of the baby's head) in babies less than a year old </li><li>low energy </li></ul><h3>Diarrhea can last up to one week</h3><p>Diarrhea can last from one to seven days. During this time, give your child plenty of fluids to prevent dehydration. Your child should continue eating to keep healthy. Talk to your doctor if diarrhea continues for more than two to three weeks.<br></p><h2>Infectious diarrhea spreads easily</h2><p>Diarrhea caused by viruses and other infections is very contagious. Wash yours and your child's hands well with soap and water after every trip to the bathroom or diaper change. Children are considered contagious for as long as they have diarrhea.<br></p><h2>How to take care of your child with diarrhea at home<br></h2><p>In general, the best treatment for diarrhea is to prevent dehydration by giving your child plenty of fluids.</p><h3>Diarrhea in babies less than 6 months old<br></h3><p>Breastfed babies should continue to breastfeed while they have diarrhea. If you need to stop breastfeeding for any reason, make sure to pump your breasts until you can start breastfeeding again.</p><p>Formula-fed babies should continue to take their usual formula while they have diarrhea. Do not dilute the formula. </p><p>If you think your baby has diarrhea and is not <a href="https://www.aboutkidshealth.ca/vomiting">vomiting</a>, continue breastfeeding or offer their usual formula, but offer the feedings more frequently.<br></p><p>Do not give other types of liquids, such as juice, rice water, sports drinks, tea or homemade drinks to your baby.</p><p>If the diarrhea is very severe or you notice signs of dehydration, you may give your child an oral rehydration solution (ORS), such as Pedialyte or Enfalyte. Give the ORS after or between feedings. The ORS should NOT replace breast milk. </p><p>If your baby is not drinking as much as usual, use a dropper to give either expressed breast milk, formula or ORS. Give your baby 1 teaspoon (5 mL) of fluid every three minutes. Increase the amount as tolerated.<br></p><h3>Diarrhea in babies who eat solid foods</h3><p>If your baby eats solid foods and has diarrhea, continue with their regular diet.</p><h3>Diarrhea in toddlers and children<br></h3><p>If the diarrhea is mild, limit your child's intake of juice, ginger ale and other soft drinks. These drinks contain sugars that can make the diarrhea worse. Drinks with caffeine, such as colas, also make diarrhea worse.</p><p>If the diarrhea is frequent and very watery, give your child plenty of fluids. If your child is showing signs of dehydration, you can give them diluted apple juice (half apple juice and half water) or their preferred liquid. You may also give your child ORS (such as Pedialyte, Enfalyte or Pediatric Electrolyte).<br></p><p>Sometimes your child can develop a temporary lactose intolerance and diarrhea may worsen after drinking milk. Your child can try drinking lactose-free milk for one to two weeks until their gut heals.<br></p><p>Your child should keep eating solid foods while they have diarrhea. Good nutrition will help their recovery.<br></p><h3>Treating diaper rash</h3><p>Diarrhea can be very irritating to the skin of the diaper area. Apply creams or ointments to your child's skin to reduce <a href="https://www.aboutkidshealth.ca/Article?contentid=26&language=English">diaper rash</a>. Use zinc-containing ointments. Clean your child's skin immediately after each bowel movement. Then, apply a very thick layer of protective ointment.<br></p><h2>Do not give medicine for diarrhea unless your doctor says to do so</h2><p>There are no proven safe and effective prescription or over-the-counter medications for diarrhea caused by viruses. Some medication can cause excessive sleepiness, worsen cramping or cause other problems. Others may be unsafe for children.</p><p></p>Antibiotics can make diarrhea worse. They can interfere with healthy bacteria that live in the gut.<p></p><p>Do not give your child a medicine for diarrhea without talking to your doctor.<br></p><h2>When to see a doctor</h2> <p><strong>Make an appointment with your child's regular doctor if:</strong></p> <ul> <li>your child is showing mild signs of dehydration but can drink some fluids </li> <li>your child has been vomiting more than 48 hours </li> <li>your child is less than three months of age </li> <li>your child has fever and is older than three months old<br></li> <li>your child has mucus in the diarrhea </li> <li>your child has severe diarrhea (more than eight times per day) for more than two days </li> <li>your child has mild diarrhea for more than two weeks</li> </ul> <p><strong>Go to the nearest Emergency Department or call 911 if:</strong></p> <ul> <li>your child is showing signs of dehydration and is not able to drink fluids </li> <li>your child has vomit or diarrhea that is green or bloody </li> <li>your child has severe abdominal (belly) pain that is getting worse and is not relieved by passing stool </li> <li>your child appears to be very sick </li> <li>your child has a fever and/or diarrhea that does not go away, and is less than three months of age</li> </ul>diarrheadiarrheahttps://assets.aboutkidshealth.ca/AKHAssets/antibiotic-associated_diarrhea.jpg Diarrhea causes frequent, loose bowel movements. Read about the causes of diarrhea in babies and children and how to prevent dehydration.Main
Spina bifidaSpina bifidaSpina bifidaSEnglishNeurologyNewborn (0-28 days)SpineSpinal CordConditions and diseasesCaregivers Adult (19+)NAhttps://assets.aboutkidshealth.ca/akhassets/spina_bifida_V2_EN.jpg2017-11-07T05:00:00Z9.4000000000000056.00000000000002064.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Spina bifida occurs when a baby’s spine and spinal cord do not develop properly in the womb, leaving an opening in the spine. Learn about the four different types of spina bifida, their causes and how it is diagnosed.</p><h2>What is spina bifida?</h2><p>The spinal cord is a thick bundle of nerves that carries messages between the brain and the rest of the body. It floats in a liquid called cerebrospinal fluid (CSF). This liquid nourishes and protects the brain and spinal cord. The CSF is covered by a lining made of three thin layers called the meninges. This lining is normally protected by the bones of the back (the vertebrae).</p><p>In people with spina bifida, the bones that protect the spinal cord have not formed completely while the baby is developing in the mother’s womb. This leaves the lining, the CSF, and the spinal cord unprotected. This happens very early in pregnancy.</p><p>Spina bifida can happen anywhere along a baby’s back between the head and the hips. It happens most often in the lower back. This area is called the lumbar or lumbosacral spine.</p><p>Children with spina bifida may have health problems because of this condition. They may experience changes or loss of feeling in their legs, have decreased movement of their legs or not be able to move their legs at all. They may also have problems with their bladder and bowel function.</p><p>About 2.6 in every 10,000 babies are born with some form of spina bifida.</p><h2>The four main types of spina bifida</h2><p>There are four main types of spina bifida:</p><ul><li>spina bifida occulta</li><li>lipomyelomeningocele</li><li>meningocele</li><li>myelomeningocele</li></ul><p>“Meningo” refers to the lining of the vertebral canal. “Myelo” refers to the spinal cord itself. “Cele” means something bulging out.</p> <figure class="asset-c-80"> <span class="asset-image-title">Types of spina bifida</span> <img src="https://assets.aboutkidshealth.ca/akhassets/spina_bifida_V2_EN.jpg" alt="Vertebrae, spinal cord and meninges in normal spine, and illustrations of spines with the four forms of spina bifida" /> <figcaption class="asset-image-caption">There are four common types of spina bifida: spina bifida occulta, lipomyelomeningocele, meningocele and myelomeningocele. Spina bifida occurs when a baby’s spine and spinal cord do not develop properly in the womb, leaving an opening in the spine. When this happens the spinal fluid, the nerves and the lining of the spinal cord (meninges) can bulge out through this defect in the baby’s back.</figcaption> </figure> <h3>Spina bifida occulta</h3><p>Spina bifida occulta is the mildest form of spina bifida. It occurs when a small section of the outer part of the vertebrae (the bones of the spine) have not completely closed, leaving an opening. In this type of spina bifida, the spinal cord and its coverings (the meninges) are usually not damaged and they do not protrude or bulge through the opening. There may be a dimple, tuft of hair, birthmark or fatty bulge at the site of the defect. This type of spina bifida may not be detected before birth. Many people may have this type of spina bifida and not be aware of it.</p><h3>Lipomyelomeningocele</h3><p>A lipomyelomeningocele (ly-po-my-low-meh-nin-go-seal) is a form of spina bifida where the outer part of the vertebrae have not completely closed, leaving an opening. Some abnormal fatty tissue pushes through the opening and may cause compression of the nerves.</p><h3>Meningocele</h3><p>A meningocele (meh-nin-go-seal) is a more severe form of spina bifida. It occurs when the outer part of the vertebrae have not completely closed, leaving an opening. The spinal cord itself may not be affected, but its protective coverings (the meninges) may be damaged and pushed through the opening to form a sac containing CSF. This sac is often covered with skin.</p><p>With a meningocele, the spinal cord stays inside the back where it belongs. This means that children with a meningocele may have normal movement and normal feeling in their legs and feet.</p><h3>Myelomeningocele</h3> <p>A myelomeningocele (my-low-meh-nin-go-cele) is the most severe form of spina bifida. It occurs when the outer part of the vertebrae have not completely closed, leaving an opening. With a myelomeningocele, both the covering of the spinal cord (the meninges) and the spinal cord itself are pushed out through the opening. Usually they protrude into a covered, fluid-filled sac that has a very thin membrane and can easily split, exposing its delicate contents.</p><p>Because part of the spinal cord bulges into the sac, the spinal cord fails to develop properly and nerves are damaged. Most children with a myelomeningocele will have some difficulty with movement and feeling in their legs and feet, and may be paralyzed.</p><h2>Key points</h2><ul><li>Spina bifida means that the bones that protect the spinal cord have not formed completely.</li><li>In babies with spina bifida, the cerebrospinal fluid (CSF), the nerves and the lining of the spinal cord can bulge out through a defect in the baby’s back.</li><li>There are four common types of spina bifida: Myelomeningocele, meningocele, lipomyelomeningocele and spina bifida occulta.</li><li>What causes spina bifida is unknown but spina bifida and other neural tube defects are less likely to occur when women get enough folic acid.</li></ul><h2>Causes of spina bifida</h2><p>All of the causes of spina bifida are not known but there are genetic, environmental and nutritional risks linked to spina bifida.</p><ul><li>Some spina bifida is found in families, meaning there may be a genetic link.</li><li>What you eat during pregnancy may have an impact on healthy growth of the spinal cord.</li><li>Some medications that interfere with the body’s ability to use folate and folic acid could increase risk.</li><li>Women with diabetes whose blood sugars are not well controlled have a higher risk.</li><li>Increased body temperature (for example from using a sauna or hot tub) in early weeks of pregnancy may increase risk.</li></ul><p>Spina bifida and other neural tube defects are less likely to occur when women get enough folic acid. These defects occur in early pregnancy, often before many women even know they are pregnant. If there is any possibility of becoming pregnant, it is important to have a well-balanced diet rich in folic acid. If you are planning to become pregnant, it is essential that you begin taking folic acid daily, at least three or four months before you start trying to conceive. Talk with your doctor about the right dosage for you. The usual recommended dose is 400 micrograms (mcg) of folic acid a day. Often this can be found in a prenatal vitamin. If you have had a pregnancy affected by spina bifida, or a family history of spina bifida or are taking certain medications, you may require a higher dose of folic acid.</p><h2>Diagnosis of spina bifida</h2><p>Spina bifida can be diagnosed during pregnancy or after the baby is born.</p><h3>During pregnancy</h3><p>There are tests that can be done during pregnancy that can indicate if the baby has a high chance of having spina bifida.</p><ul><li>Alpha-fetoprotein (AFP) blood test – AFP is a protein made by unborn babies. AFP crosses from the baby through the placenta to the mother. A test is done that measures AFP levels in the mother's blood. If there are high levels of AFP in the mother's blood this might mean that the baby has spina bifida.</li><li>Ultrasound – this is a common test during pregnancy that allows health-care providers to see images of the unborn baby. In some cases, an ultrasound can show if the baby has spina bifida.</li><li>Amniocentesis – this is a test that takes a small sample of amniotic fluid from the mother’s womb. If this fluid has a higher than average level of AFP then the baby might have spina bifida.</li><li>Fetal MRI – if initial tests suggest there is a high chance of spina bifida then a fetal MRI can be done. This is an MRI that is done on the pregnant mother to assess the unborn baby.</li></ul><p>Spina bifida occulta may not be diagnosed until late childhood, adulthood or may not be diagnosed at all.</p><h2>Treatment of spina bifida</h2><p>Meningocele where only the meninges are pushed through the opening and myelomeningocele where the meninges and spinal cord are pushed out through the opening are both treated with surgery. Older infants and young children with lipomyelomeningocele may require surgery if they develop symptoms. Spina bifida occulta does not usually require treatment.</p><p>To learn more about the treatment of spina bifida please read <a href="/Article?contentid=2532&language=English">Spina bifida: Treatment and caring for your child after surgical repair</a>.</p><h2>Health problems linked to or caused by spina bifida</h2><p>Every child with spina bifida is different with their own medical, mobility and learning challenges. Some children may only be mildly affected while others may have more severe disabilities. Being born with spina bifida brings life-long challenges. Your child’s health-care team will work together with you to help your child achieve their greatest potential.</p><p>The following health issues are common for children with spina bifida.</p><h3>Hydrocephalus</h3><p>About 80 percent of babies born with spina bifida, primarily those with myelomeningocele, will also have <a href="/Article?contentid=858&language=English">hydrocephalus</a>. Hydrocephalus is an abnormal build-up of CSF in the ventricles inside the brain.</p><h3>Chiari malformation</h3><p>Nearly all babies born with myelomeningocele have a <a href="/Article?contentid=853&language=English">Chiari malformation</a> type 2. This is when the lower part of the brain (the brainstem) sits too low in your child’s upper spine area. Some children with Chiari malformation type 2 may have feeding problems (for example, weak suck when feeding, gagging, choking, trouble swallowing), breathing trouble and some may have weakness of the arms. Surgery may be required to decrease the pressure on the lower part of the brain.</p><h3>Leg function (movement) and sensation (feeling)</h3><p>In children with spina bifida, the nerves in the spinal canal are often damaged or improperly formed, and therefore they may not able to control the muscles properly or sometimes feel properly. Some children may be paralyzed, not able to move their legs at all, while others can stand and walk to some extent.</p><h3>Muscles and bones</h3><p>Muscles and bones may also be affected by spina bifida. A baby with spina bifida may be born with <a href="/Article?contentid=1192&language=English">clubfoot</a>, this is when the baby's feet are turned in at the ankle.</p><p>The baby's hips may also be affected as different muscles may be stronger than others interfering with how the hips move and function. This can cause dislocation of the hip.</p><p>Muscles around the spine may also be affected. Any difference in muscle strength can affect the position of the spine and cause an abnormal curve.</p><p>If your child has clubfoot or any leg bone issues an orthopaedic surgeon will speak to you about options for correcting this in the future.</p><h3>Bladder problems</h3><p>With spina bifida, the nerves that tell the bladder to empty and release urine (pee) are often weak or not working. This means you may have to help your baby to pee and empty their bladder. When your baby is born, a tube or catheter will be put inside their bladder through the urethra every few hours to see if they can pee on their own and empty their bladder. The urethra is the tube inside the body that carries urine from the bladder to the outside of the body. If your baby is unable to fully empty their bladder, they are at risk for an infection and possibly damage to their kidneys. You may need to learn how to empty your baby’s bladder using a catheter before you can take them home. Instructions for <a href="/Article?contentid=978&language=English">boys</a> and <a href="/Article?contentid=979&language=English">girls</a> are slightly different. A member of the urology team will talk to you about this.</p><h3>Bowel problems</h3><p>Sometimes the nerves that make the bowels move are weak or not working. The nurse will be assessing how well your baby’s bowels move. The nurse can teach you how to help your baby’s bowels move better and how to protect your baby’s skin around their anus.</p><h3>Latex allergies/sensitivity</h3><p>Babies with spina bifida have a high risk of developing a latex sensitivity or allergy. It is important to make sure that products such as gloves, catheters and soothers do not contain latex.</p><h3>Tethered cord</h3><p>In children with spina bifida, sometimes the spinal cord gets stuck at the site where the vertebrae have not closed completely. This is called a <a href="/Article?contentid=861&language=English">tethered cord</a>.</p><h2>Looking ahead</h2><p>Babies born with spina bifida require ongoing assessment as they grow and develop. They will be followed by a number of different medical teams. Some children may be in special spina bifida clinics.</p><h2>Resources</h2><p>There are many resources available to help you learn more about spina bifida.</p><p>Spina Bifida and Hydrocepahlus Association of Ontario<br> <a href="http://www.sbhao.on.ca/" target="_blank">http://www.sbhao.on.ca/</a></p><p>Holland Bloorview Kids Rehabilitation Hospital<br> <a href="http://www.hollandbloorview.ca/" target="_blank">http://www.hollandbloorview.ca/</a></p><p>Public Health Agency of Canada. (2013). <em>Congenital Anomalies in Canada 2013: A Perinatal Health Surveillance Report</em>. Retrieved from http://publications.gc.ca/collections/collection_2014/aspc-phac/HP35-40-2013-eng.pdf.</p> June is Spina Bifida Awareness Month. Learn about the four different types of spina bifida, their causes and how it is diagnosed.Main
Thyroid disease and diabetesThyroid disease and diabetesThyroid disease and diabetesTEnglishEndocrinologyChild (0-12 years);Teen (13-18 years)Pancreas;ThyroidEndocrine systemConditions and diseasesAdult (19+)NAhttps://assets.aboutkidshealth.ca/akhassets/IMD_thyroid_gland_EN.jpg2017-11-20T05:00:00Z11.600000000000024.4000000000000343.000000000000Flat ContentHealth A-Z<p>Learn about thyroid disease and diabetes including the causes and signs and symptoms.</p><h2>​​What is the thyroid?</h2> <p>The thyroid is a gland located in the middle of the lower front of the neck. It produces hormones (called thyroid hormones) that are important for:</p> <ul><li>growth</li> <li>body temperature control</li> <li>digestion</li> <li>body weight</li> <li>mood.</li></ul><h2>Key points</h2> <ul><li>Despite proper diabetes control, 20-25% of people with type 1 diabetes will develop thyroid problems.</li> <li>Thyroid problems include Hashimoto's thyroiditis (hypothyroidism) and Grave's disease (hyperthyroidism).</li></ul><div class="akh-series"><div class="row"><div class="col-md-12"> <figure><span class="asset-image-title">Thyroid gland</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_thyroid_gland_EN.jpg" alt="Thyroid gland located in the front of the throat shown with surrounding structures labelled" /> </figure> <p>Like the <a href="/Article?contentid=1468&language=English">pancreas</a> in diabetes, the thyroid can be attacked by the immune system. The immune system makes proteins called antibodies that attack the thyroid. This attack can cause the thyroid to either slow down (<a href="/Article?contentid=2309&language=English">hypothyroidism</a>) or in rare cases, to become overactive (hyperthyroidism). About 20 to 25% of people with <a href="/Article?contentid=1719&language=English">type 1 diabetes</a> will develop thyroid problems, regardless of how well they control their diabetes or for how long they have had diabetes. </p></div></div></div> <figure> <span class="asset-image-title">Thyroid function</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Thyroid_function_MED_ILL_EN.jpg" alt="Location of the pituitary gland in the brain and the thyroid gland in the throat both labelled" /> <figcaption class="asset-image-caption">The pituitary gland releases hormones, including thyroid stimulating hormone (TSH), that control the thyroid gland. The thyroid gland releases hormones that control many body functions.</figcaption> </figure> <h2>Hashimoto’s thyroiditis (hypothyroidism)</h2><p>In Hashimoto’s thyroiditis, the immune system damages the thyroid gland, leading it to become underactive. Underactive thyroid is called hypothyroidism. Symptoms of hypothyroidism include:</p><ul><li>slower growth</li><li>weight gain</li><li>tiredness or sluggishness</li><li>dry skin and hair</li><li>problems concentrating</li><li>constipation</li><li>irregular menstrual periods</li><li>weakness.</li></ul><p>Under activity of the thyroid is detected by regular checks of thyroid function. The check involves measuring levels of the thyroid stimulating hormone (TSH) and measuring antibodies against the thyroid. TSH is a hormone (chemical messenger) made by a gland in the brain called the <a href="https://pie.med.utoronto.ca/htbw/module.html?module=brain-child">pituitary gland</a>. </p><h2>Grave’s disease (hyperthyroidism)</h2><p>Grave’s disease happens rarely in people with diabetes. It is an immune system disorder that makes the thyroid overactive, meaning the thyroid makes too much thyroid hormone. Overactive thyroid is called hyperthyroidism. Symptoms include:</p><ul><li>weight loss</li><li>increased appetite</li><li>mood swings</li><li>shakiness and sweating</li><li>diarrhea</li><li>bulging eyes.</li></ul><p>Over active thyroid is often treated with​ a medication called methimazole that decreases the thyroid hormone levels.</p> ​​ About 20 to 25% of people with type 1 diabetes will develop thyroid problems. Learn about the causes and symptoms of thyroid disease. Main

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