| Mental health | Mental health | Mental health | M | English | Psychiatry | Child (0-12 years);Teen (13-18 years) | NA | NA | NA | Caregivers
Adult (19+) | NA | | | | | | | | | | | | Landing Page | Learning Hub | <p>Learn how to support your child’s wellbeing with activity, sleep and nutrition and how to recognize and manage various mental health conditions.<br></p> | <p>This hub includes resources for parents on how to support your child's mental health and general wellbeing through physical activity, sleep and nutrition. It also provides information on the signs, symptoms and treatments of different mental health conditions, including anxiety, bipolar disorder, depression, behavioural disorders, anorexia nervosa and attention deficit hyperactivity disorder.<br></p> | | | <div class="panel panel-primary"><div class="panel-heading clickable">
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<h2 class="panel-title">Wellbeing<br></h2></div><div class="panel-body list-group" style="display:none;"><p>The everyday pressures of growing up can put a strain on any child's mental wellbeing. Find out how physical activity, a healthy sleep routine, screen time limits and balanced nutrition can boost your child's mental health and support them through difficult times.</p></div><ol class="list-group" style="display:none;"><li><div class="panel-heading clickable">
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<h3>Physical Activity</h3></div><ol class="list-group" style="display:none;"><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=642&language=English">Physical activity: Guidelines for children and teens</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=641&language=English">Physical activity: Benefits of exercise for health and wellbeing</a></li></ol></li><li><div class="panel-heading clickable">
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<h3>Sleep</h3></div><ol class="list-group" style="display:none;"><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=645&language=English">Sleep: Benefits and recommended amounts</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=646&language=English">How to help your child get a good night's sleep</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=647&language=English">How to help your teen get a good night's sleep</a></li></ol></li><li><div class="panel-heading clickable">
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<h3>Screen time</h3></div><ol class="list-group" style="display:none;"><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=643&language=English">Screen time: Overview</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=644&language=English">How to help your child set healthy screen time limits</a></li></ol></li><li><div class="panel-heading clickable">
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<h3>Nutrition</h3></div><ol class="list-group" style="display:none;"><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=639&language=English">Nutrition: How a balanced diet and healthy eating habits can help your child's mental health</a></li></ol></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable">
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<h2 class="panel-title">Anxiety disorders<br></h2></div><div class="panel-body list-group" style="display:none;"><p>Every child feels anxiety at some point as a natural part of growing up. An anxiety disorder, however, is when anxious feelings interfere with a child's everyday routine. Learn more about the signs, symptoms and range of anxiety disorders and how they are treated.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=18&language=English">Anxiety: Overview</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=271&language=English">Signs and symptoms</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=270&language=English">Types of anxiety disorders</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=701&language=English">Treatment with medications</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=702&language=English">Psychotherapy and lifestyle changes</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable">
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<h2 class="panel-title">Obsessive compulsive disorder<br></h2></div><div class="panel-body list-group" style="display:none;"><p>Obsessive compulsive disorder (OCD) occurs when a person suffers from troubling and intrusive thoughts and/or follows repetitive or strict routines to feel less worried. Learn about the causes, signs and impact of this disorder and how you can help your child.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=285&language=English">Obsessive compulsive disorder: Overview</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=288&language=English">Signs and symptoms</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=286&language=English">How OCD affects your child's life</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=709&language=English">Psychotherapy and medications</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=287&language=English">How to help your child at home</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable">
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<h2 class="panel-title">Depression<br></h2></div><div class="panel-body list-group" style="display:none;"><p>Depression is an illness that causes someone to feel deep sadness or a lack of interest in activities that they once enjoyed. Discover how this condition affects a child's mood, sleep, concentration and energy levels, and how it can be treated.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=19&language=English">Depression: Overview</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=284&language=English">Signs and symptoms</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=707&language=English">Treatment with medications</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=708&language=English">Psychotherapy and lifestyle changes</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable">
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<h2 class="panel-title">Bipolar disorder</h2></div><div class="panel-body list-group" style="display:none;"><p>When a person has bipolar disorder, they alternate between low and elevated moods for days, weeks or months at a time. Learn about the bipolar disorder spectrum, the symptoms of manic and depressive episodes and how medications, therapy and lifestyle changes can help.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=279&language=English">Bipolar disorder: Overview</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=280&language=English">Signs and symptoms</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=704&language=English">Treatment with medications</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=705&language=English">Psychotherapy and lifestyle changes</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable">
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<h2 class="panel-title">Suicide and self-harm</h2></div><div class="panel-body list-group" style="display:none;"><p>A child who experiences thoughts of suicide or self-harm is often suffering from overwhelming emotional pain. Find out how to help your child cope with difficult emotions, how to support and protect your child and where to find professional help.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=291&language=English">Suicide in children and teens: Overview</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=289&language=English">Self-harm in children and teens: Overview</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=290&language=English">Signs and symptoms of suicide risk</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=293&language=English">How to help your child with difficult emotions</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=292&language=English">How to protect your child from harm</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable">
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<h2 class="panel-title">Eating disorders<br></h2></div><div class="panel-body list-group" style="display:none;"><p>An eating disorder not only risks your child's health but can also disrupt family life. Find out about the symptoms and treatment of anorexia, bulimia, avoidant/restrictive food intake disorder and binge eating disorder and how you can help your child recover.</p></div><ol class="list-group" style="display:none;"><li><div class="panel-heading clickable">
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<h3>Anorexia nervosa</h3></div><ol class="list-group" style="display:none;"><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=268&language=English">Anorexia nervosa: Overview</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=269&language=English">Signs and symptoms</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=267&language=English">Medical complications</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=700&language=English">Treatment options</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=266&language=English">How to help your child at home</a></li></ol></li><li><div class="panel-heading clickable">
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<h3>Bulimia nervosa</h3></div><ol class="list-group" style="display:none;"><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=282&language=English">Bulimia nervosa: Overview</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=283&language=English">Signs and symptoms</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=281&language=English">Medical complications</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=706&language=English">Treatment options</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=294&language=English">How to help your child at home</a></li></ol></li><li><div class="panel-heading clickable">
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<h3>Avoidant/restrictive food intake disorder (ARFID)</h3></div><ol class="list-group" style="display:none;"><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=274&language=English">Avoidant/restrictive food intake disorder: Overview</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=275&language=English">Signs and symptoms</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=273&language=English">Medical complications</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=703&language=English">Treatment options</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=272&language=English">How to help your child at home</a></li></ol></li><li><div class="panel-heading clickable">
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<h3>Binge eating disorder (BED)</h3></div><ol class="list-group" style="display:none;"><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=277&language=English">Binge eating disorder: Overview</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=278&language=English">Signs and symptoms</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=640&language=English">Obesity: Medical complications</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=276&language=English">How to help your child at home</a></li></ol></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable">
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<h2 class="panel-title">Attention deficit hyperactivity disorder (ADHD)</h2></div><div class="panel-body list-group" style="display:none;"><p>Attention deficit hyperactivity disorder (ADHD) involves difficulties with controlling attention and regulating behaviour. Discover the main symptoms of ADHD in children and teens, how the disorder is diagnosed and how to help your child at home and at school.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=1922&language=English">Attention deficit hyperactivity disorder: Overview</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=1923&language=English">Signs and symptoms</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=1997&language=English">How to help your child at home</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=1999&language=English">Communicating with your child's school</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=1998&language=English">Treatment with medications</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable">
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<h2 class="panel-title">Behavioural disorders</h2></div><div class="panel-body list-group" style="display:none;"><p>Behavioural disorders include oppositional defiant disorder and conduct disorder. Learn how these disorders differ from typical misbehaviour, how therapy and medications can help and how you can manage problematic behaviour at home.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=1924&language=English">Behavioural disorders: Overview</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=1925&language=English">Signs and symptoms</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=2000&language=English">Treatment with psychotherapy and medications</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=2001&language=English">How to help your child at home</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable">
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<h2 class="panel-title">Post-traumatic stress disorder (PTSD)</h2></div><div class="panel-body list-group" style="display:none;"><p>Post-traumatic stress disorder (PTSD) is triggered by experiencing or witnessing a terrifying event. Learn about the main symptoms of PTSD, how the condition is diagnosed and how psychotherapy and medications can help your child.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=1927&language=English">Post-traumatic stress disorder: Overview</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=1928&language=English">Signs and symptoms</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=2005&language=English">Treatment with psychotherapy and medications</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable">
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<h2 class="panel-title">Brain disorders and mental health</h2></div><div class="panel-body list-group" style="display:none;"><p>A brain disorder includes a condition, illness or injury that affects the brain and how it develops before or after birth. Find out how a brain disorder can affect your child's learning, mood and social skills, how its impact on mental health is assessed and how to help your child cope.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=1926&language=English">Brain disorders and mental health: Overview</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=2002&language=English">Assessing your child for neuropsychological difficulties</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=2003&language=English">How to help your child cope</a></li><li class="list-group-item">
<a class="overview-links" href="/Article?contentid=2004&language=English">Common treatments</a></li></ol></div> | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/Mental_health_landing-page.jpg | mentalhealth | healthyliving | | |
| Influenza (flu): Seasonal flu and pandemic flu | Influenza (flu): Seasonal flu and pandemic flu | Influenza (flu): Seasonal flu and pandemic flu | I | English | Infectious Diseases | Child (0-12 years);Teen (13-18 years) | Body | Immune system | Conditions and diseases | Caregivers
Adult (19+) | Cough;Fever;Headache;Sore throat | | 2014-02-27T05:00:00Z | | Upton Allen, MBBS, MSc, FRCPC, FAAP;Shawna Silver, MD, FRCPC, FAAP, PEng | | | | 7.00000000000000 | 61.0000000000000 | 750.000000000000 | | Flat Content | Health A-Z | <p>The main goal of the influenza virus is to make copies of itself. Learn how the influenza virus mutates and how pandemics can begin.<br></p> | <h2>Life of the influenza virus</h2>
<p>The <a href="/Article?contentid=912&language=English">influenza</a> (flu) virus's main job in life is to make copies of itself. However, the virus is not very good at it. As the virus makes copies of itself, it makes mistakes called mutations.</p>
<p>Most of these mistakes hurt the virus and it dies or becomes unable to make copies of itself. Other mutations help the virus survive and make it easier for it to make copies of itself. A mutation may make it easier for the virus to spread from one person to another.</p> | | <h2>Key points</h2>
<ul>
<li>The flu virus makes copies of itself quickly and makes mistakes called mutations in its genetic material. These mutations may sometimes be helpful to the virus.</li>
<li>When two different types of flu virus exchange genetic material a new type of flu virus can be created.</li>
<li>If a new virus spreads fast and widely because people do not have immunity against it yet, it may become a pandemic flu.</li>
</ul> | <h2>Small mutations</h2><p>The flu virus makes copies of itself small but helpful mutations occur. After thousands of years, this process has resulted in many types and subtypes of flu. They live in a wide range of hosts, from pigs and birds to civet cats and humans. As hosts are infected and re-infected, they make antibodies to fight the virus which helps the host develop some immunity to the virus.</p><p>Because most of the virus's mutations are small, the host usually has some immunity to the slightly altered virus. This is because the antibodies that the host already has still have some ability to fight the slightly altered virus. The result is although people still get sick, their illness is milder and fewer people get very sick.</p><h2>Larger mutations</h2><p>Copying mistakes are not always small. Sometimes, large mutations occur. Large mutations may occur when two types of influenza that would normally be seen in different organisms infect the same host. For example, a small mutation may allow a pig to be infected with a flu virus normally only seen in birds. At the same time, the pig may also be infected with a flu virus that infects humans. When the viruses are making copies of themselves, genetic material from one virus can combine with the genetic material from the other. This can produce very large and sudden changes in the virus. It can create a new subtype of the virus.</p><p>If this mutation also helps the virus, hosts may have no natural immunity to it. This can cause more people to become infected. There may be more severe illness.</p>
<figure class="asset-c-100"><span class="asset-image-title">Evolution of a pandemic strain of </span><span class="asset-image-title">influenza</span><img src="https://assets.aboutkidshealth.ca/akhassets/H1N1_flu_antigentic_shift_EDIT_ILL_EN.jpg" alt="" /><figcaption class="asset-image-caption">This</figcaption><figcaption class="asset-image-caption"> is a simplified explanation of the process that likely created the H1N1 virus strain (swine flu). Since the new virus is substantially different from the seasonal flu virus, humans have had little time to develop any immunity, making it potentially dangerous.</figcaption> </figure>
<h2>What is pandemic flu?</h2><p>When a copying mistake is large and helps the virus, it makes the mutated virus different from the old virus. Because the virus is new very few people are immune to it. It is easier for this new virus to spread around the world and become a pandemic strain.</p><p>Pandemic flu can be mild or severe. It may infect many people or only a few. It may circulate for many months or die out. Predicting what will happen during a pandemic is very difficult. Pandemic strains of influenza have circulated at least three times in the last 100 years.</p><p>Most people have heard of the Spanish flu of 1918. It killed tens of millions of people. But two other pandemic influenzas have circulated since then: Asian flu in 1957 killed between one and four million people. Hong Kong flu in 1968 killed approximately one million people.</p><p>The 2009 H1N1 pandemic flu infected millions of people. However, relatively few became severely ill. Over time, the virus will continue to mutate. It is difficult to predict what will happen with H1N1 in the future.</p><p>Statement on Seasonal Influenza Vaccine for 2013-2014. (2013, November 14).
<em>Public Health Agency of Canada</em>. Retrieved December 20, 2013.
<a target="_blank" href="http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/13vol39/acs-dcc-4/">http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/13vol39/acs-dcc-4/</a></p><p>Influenza (Seasonal) Fact sheet No211. (2009, April).
<em>World Health Organization</em>. Retrieved December 20, 2013.
<a target="_blank" href="http://www.who.int/mediacentre/factsheets/fs211/en/">http://www.who.int/mediacentre/factsheets/fs211/en/</a></p><p>Seasonal Influenza (Flu) (2013, April 8).
<em>Health Canada</em>. Retrieved December 20, 2013.
<a target="_blank" href="http://www.hc-sc.gc.ca/hc-ps/dc-ma/influenza-eng.php#flu">http://www.hc-sc.gc.ca/hc-ps/dc-ma/influenza-eng.php#flu</a></p><p>Key Facts about Influenza (Flu) & Flu Vaccine. (2013, September 26).
<em>Centers for Disease Control and Prevention.</em> Retrieved December 20, 2013.
<a target="_blank" href="http://www.cdc.gov/flu/keyfacts.htm">http://www.cdc.gov/flu/keyfacts.htm</a></p><p>Protect yourself, your family and your community. (2013, October 31).
<em>Ministry of Health and Long-Term Care.</em> Retrieved December 20, 2013.
<a target="_blank" href="http://www.health.gov.on.ca/en/public/programs/publichealth/flu/">http://www.health.gov.on.ca/en/public/programs/publichealth/flu/</a></p><p>Osterholm, M.T. (2005). Preparing for the Next Pandemic.<em> New England Journal of Medicine</em>,
<i>352</i>(18):1839-1842.</p> | | | | | | | | | | | | | | | | | | | | | | | | | | | | <img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/influenza_seasonal_pandemic.jpg" style="BORDER:0px solid;" /> | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/influenza_seasonal_pandemic.jpg | |
| Asthma: Care after an emergency room visit | Asthma: Care after an emergency room visit | Asthma: Care after an emergency room visit | A | English | Respiratory | Child (0-12 years);Teen (13-18 years) | Lungs | Respiratory system | Conditions and diseases;Drug treatment | Caregivers
Adult (19+) | Cough;Wheezing | https://assets.aboutkidshealth.ca/akhassets/Asthma_ShakePuffer_EN.jpg | 2018-07-19T04:00:00Z | | Kelly Anderson | clodagh.mccarthy@sickkids.ca | Clodagh McCarthy | 693A30232E777C7369636B6B6964735C636C6F64616768206D63636172746879 i:0#.w|sickkids\clodagh mccarthy | | | | | | | Health (A-Z) - Conditions | Health A-Z | <p>Asthma is a condition that affects the lungs and causes breathing difficulties. Learn how to recognize, manage and treat asthma at home. <br></p> | <h2>What is asthma?</h2><p>Asthma is a condition that affects your child’s lungs. When asthma is not well controlled, the airways narrow, swell and produce mucus. This makes it difficult to breathe.<br></p>
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<span class="asset-image-title">Narrowing of airways in asthma</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/Asthma_narrow_airways_MED_ILL_EN.jpg" alt="" />
<figcaption class="asset-image-caption">During an asthma attack, the muscles around the airways get tight. The airways become narrow, swell and produce mucus, making it hard to breathe.</figcaption>
</figure> | | <h2>Key points</h2><ul><li>When asthma is not well controlled, the airways narrow, swell and produce mucus, causing breathing difficulties.</li><li>Early signs of breathing difficulties include coughing and wheezing. Late signs include fast breathing, pale skin and flared nostrils.</li><li>The most effective way to control your child's asthma is to minimize any triggers such as cigarette smoke, dust mites and mould.<br></li><li>The medicines you will use to treat your child's asthma are decided by an "asthma action plan" that you develop with your child's doctor.<br></li></ul> | | <h2>What are the signs and symptoms of asthma?</h2><h3>Early warning signs</h3><p>Early warning signs of breathing difficulties include:</p><ul><li>coughing</li><li>wheezing (noisy breathing)</li><li>being less active than normal</li><li>not keeping up with friends when playing</li><li>difficulty with feeding (for infants).</li></ul>
<figure><span class="asset-image-title">Late warning signs of breathing </span><span class="asset-image-title"></span><span class="asset-image-title">trouble</span><img src="https://assets.aboutkidshealth.ca/akhassets/AsthmaSymptoms_EN.jpg" alt="" /><figcaption class="asset-image-caption">Additional</figcaption><figcaption class="asset-image-caption"></figcaption><figcaption class="asset-image-caption"> late warning signs of breathing trouble include fast breathing, pale skin, blue or grey skin around the mouth and difficulty speaking in full sentences. If you see any of these signs, see a doctor immediately. </figcaption> </figure>
<h3>Late warning signs</h3>
<p>Late warning signs that your child is having trouble breathing include:</p><ul><li>fast breathing</li><li>pale skin</li><li>blue or grey skin colour around the mouth</li><li>difficulty speaking in full sentences</li><li>skin pulling in between or under ribs and in the neck (due to breathing effort)</li><li>nostrils flaring when breathing.<br></li></ul><p>If you see any of these late warning signs,
<strong>see a doctor immediately</strong>.<br></p> | | | | <h2>How is asthma treated?</h2><p>Asthma can be treated with a range of medicines. Your child’s asthma medicines are part of an “asthma action plan” that you will develop with your child’s doctor.</p><h3>Rescue medicine</h3><ul><li>This medicine comes in a blue puffer.</li><li>It relaxes the muscles around the airways to provide immediate relief when your child finds it hard to breathe.</li><li>One example is salbutamol, also known by the brand name Ventolin.</li></ul><h3>Controller medicine </h3><ul><li>This medicine often comes in an orange or a brown puffer.</li><li>It reduces swelling and mucus in the lungs.</li><li>It does not provide immediate relief. Instead, your child should take it regularly, even when they are feeling well.</li><li>One example is fluticasone, also known by the brand name Flovent.</li></ul><h3>Oral steroids (liquid or tablet medicine taken by mouth)</h3><ul><li>These are powerful medicines that reduce swelling in the lungs.</li><li>Your child should take them only for a short time until their asthma is back under control.</li><li>Examples of oral steroids include dexamethasone and prednisolone.</li></ul>
| | <h2>How do I use a puffer to give asthma medicine to my child?</h2><p>Always use a spacer with a puffer to help the medicine enter your child’s lungs.</p><ol class="akh-steps"><li>
<figure>
<img src="https://assets.aboutkidshealth.ca/akhassets/Asthma_ShakePuffer_EN.jpg" alt="" /> </figure>
<p>Remove the cap and shake the puffer five times.</p></li><li>
<figure>
<img src="https://assets.aboutkidshealth.ca/akhassets/Asthma_PufferSpacer_EN.jpg" alt="" /> </figure>
<p>Put the puffer upright into the rubber hole of the spacer. </p></li><li><p>Have your child sit up or stand in a comfortable position and put the mask firmly on their face. Be sure to cover their mouth and nose.</p><div class="akh-series"><ul><li>
<figure><img src="https://assets.aboutkidshealth.ca/AKHAssets/Asthma_OlderChildPositioning_EN.jpg" alt="" /></figure>
<p>Older children can sit or stand in a comfortable position while you give them their puffer.</p></li><li><p>Younger children should be held on a parent’s lap. You can then use the “one-person approach” or “two-person approach” to give medicine to a younger child.</p><div class="asset-2-up">
<figure><span class="asset-image-title">One-person </span>
<span class="asset-image-title"></span><span class="asset-image-title">approach</span><img src="https://assets.aboutkidshealth.ca/akhassets/Asthma_OnePersonApproach_EN.jpg" alt="" /><figcaption class="asset-image-caption">Sit</figcaption><figcaption class="asset-image-caption"></figcaption><figcaption class="asset-image-caption"> in a chair and place your child on your lap. Hug the child tightly with one arm and, with your other hand, press the top of the puffer firmly to release a puff of </figcaption></figure>
<figure>
<figcaption class="asset-image-caption"></figcaption></figure><figure><figcaption class="asset-image-caption">medicine.</figcaption></figure><figure><span class="asset-image-title">Two</span></figure><figure><span class="asset-image-title"></span></figure><figure><span class="asset-image-title">-person </span>
<span class="asset-image-title"></span><span class="asset-image-title">approach</span><img src="https://assets.aboutkidshealth.ca/akhassets/Asthma_TwoPersonApproach_EN.jpg" alt="" /><figcaption class="asset-image-caption">Cross</figcaption><figcaption class="asset-image-caption"></figcaption><figcaption class="asset-image-caption"> your leg over your child’s legs, hold their arms with your own arm and hold their forehead against your chest. Another adult will hold your child’s chin, place the mask firmly over your child’s nose and mouth and press the top of the puffer firmly to release a puff of medicine. </figcaption></figure></div></li></ul></div></li><li>
<figure>
<img src="https://assets.aboutkidshealth.ca/AKHAssets/HowToUse_MDI_with_Spacer_5_EQUIP_ILL_EN.jpg" alt="" /> </figure>
<p>Press the top of the puffer firmly. This will release one puff of medicine. Hold the mask over your child’s nose and mouth for 15 seconds.</p></li><li><p>Encourage your child to take deep breaths.</p></li></ol><p>If your child needs more than one puff of the medicine, remove the puffer from the spacer and repeat steps 1 to 5.</p><h2>What to do when you finish giving asthma medicine with the puffer</h2><div class="akh-series"><div class="row"><div class="col-md-12">
<figure><img src="https://assets.aboutkidshealth.ca/akhassets/HowToUse_MDI_with_Spacer_6_EQUIP_ILL_EN.jpg" alt="" /> </figure>
<p>Take the mask off your child’s face and encourage them to drink or rinse their mouth with water.</p></div></div></div><h2>My child does not like using their puffer. What can I do?</h2><p>Giving puffers may upset a young child. This is natural.</p><p>Try to make it fun for your child by singing, counting, watching a video or showing how to use the puffer on yourself or a teddy bear. Your child will become more comfortable with puffers over time.</p><p>If you would prefer not to wake your child overnight or during a nap, it is fine to give a puffer when they are sleeping.</p><h2>How often do I need to replace my child’s spacer?</h2><p>The spacer you receive from the hospital should be used only for a short time. You will then need to buy a spacer from your pharmacy. Most spacers last about a year before you need to replace them.</p><h2>How do I clean my child’s spacer?</h2><p>Once a week, wash the spacer with soap and warm water by hand and let it air dry. Or you can put the spacer in the top shelf of your dishwasher on a low heat setting.</p><p>It is very important to wash the spacer regularly to clear any build-up of saliva and medicines.<br></p>
<br>
<br> | <h2>How can I control my child’s asthma?</h2><p>The most effective way to control your child's asthma is to minimize any triggers that can make it worse. </p><p>The most common triggers are viral infections such as colds and the flu. Other triggers include:</p><ul><li>cigarette smoke</li><li>air pollution</li><li>dust mites</li><li>cold air</li><li>pet dander</li><li>pollen<br></li><li>mould.<br><br></li></ul>
| | | | | | | | | | | | | | | | | | <p>For more information, contact Ontario Lung Association's Lung Health Information Line on
<strong>1-888-344-LUNG</strong> (5864) from 8.30 to 4.30, Monday to Friday.<br></p> | | | | | | | | | | | |
| Juvenile enthesitis-related arthritis (ERA) | Juvenile enthesitis-related arthritis (ERA) | Juvenile enthesitis-related arthritis (ERA) | J | English | Rheumatology | Child (0-12 years);Teen (13-18 years) | Back;Knee;Ankle;Foot;Hip | Immune system;Ligaments;Tendons | Conditions and diseases | Caregivers
Adult (19+) | NA | https://assets.aboutkidshealth.ca/akhassets/Entheses_affected_by_ERA_MED_ILL_EN.jpg | 2016-08-12T04:00:00Z | | Shirley Tse, MD, FRCPC;Michelle Anderson, BScN;Jo-Anne Marcuz, BSc, MSc PT | | | | 9.00000000000000 | 52.0000000000000 | 894.000000000000 | | Health (A-Z) - Conditions | Health A-Z | <p>Juvenile enthesitis-related arthritis includes swelling and pain where tendons and ligaments attach to bone. It affects more boys than girls.<br></p> | <h2>What is juvenile idiopathic arthritis (JIA)?</h2>
<p>Juvenile idiopathic arthritis (JIA) is arthritis that affects children who are less than 16 years old. It is also called childhood arthritis.</p>
<p>Arthritis means "joint swelling" or "joint inflammation." Arthritis leads to pain, swelling, stiffness and loss of motion in the joints. "Idiopathic" means that we do not know the cause.</p>
<h2>What is enthesitis-related arthritis (ERA)?</h2>
<p>There are many different types of arthritis. Enthesitis-related arthritis (ERA) is one type. Patients with ERA not only have joint swelling or inflammation (arthritis), but also have enthesitis. Enthesitis is swelling or inflammation of the entheses, the connective tissue where tendons or ligaments attach to bone.</p>
<p>Between 10% and 15% of all children with JIA have ERA. It is usually seen in late childhood or adolescence (eight to 15 years of age). It affects boys more often than girls.</p>
<p>The severity of ERA can vary. For some children, it can be mild and last only a short time. For others, it can be more severe and last a long time. Some children may develop inflammation in their back when they are adults.</p>
<p>ERA can also be called spondyloarthritis or ankylosing spondylitis.</p>
<p>These diseases are managed by rheumatologists, doctors who specialize in diseases of the joints and inflammation.</p>
| <h2>Enthesitis-related arthritis is an autoimmune disease</h2>
<p>Inflammation (irritation and swelling) is a normal process in the body. It is how our immune system protects our bodies from bacteria and viruses that cause infection.</p>
<p>In ERA, like other types of childhood arthritis, there is no infection. Instead, the immune system is confused and attacks the cells and tissues in the body’s connective tissues including the joints, tendons and entheses. This leads to redness, swelling, pain, warmth, stiffness or loss of movement in the connective tissue. For this reason, ERA is called an autoimmune disease. So far, we do not know what causes it. There is nothing that you did or did not do to cause your child’s ERA.</p>
| <h2>Key points</h2>
<ul>
<li>ERA is a type of juvenile idiopathic arthritis (JIA).</li>
<li>ERA is a disease that causes pain, swelling and stiffness in the joints of the hips, knees, ankles, feet and lower back.</li>
<li>ERA is an autoimmune disease. We do not know why some people get ERA.</li>
<li>People with ERA may also have inflammation in the eyes, skin or intestines.</li>
<li>There are several steps to diagnose ERA and your child will need various tests.</li>
<li>There are a variety of treatments to help with the pain and inflammation.</li>
</ul>
| | <h2>Signs and symptoms of enthesitis-related arthritis</h2><p>The arthritis in ERA is mainly in the lower limbs (hip, knee, ankle and foot). Arthritis in the back (spondylitis) and the base of the spine at the sacroiliac joint (sacroiliitis) is not as common at first, but can occur later. Children with spondylitis or sacroiliitis often complain of lower back or buttock pain that is worse with rest and better with activity. Arthritis can also occur in the upper limbs, especially the shoulders.</p>
<figure class="asset-c-80">
<span class="asset-image-title">Joints affected by enthesitis arthritis (ERA)</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/Joints_affected_by_ERA_MED_ILL_EN.jpg" alt="" />
<figcaption class="“asset-image-caption”">Arthritis in the lower joints can be part of ERA. Some children have just the arthritis, some have just the enthesitis, some have a combination of both.</figcaption> </figure>
<p>The most common areas affected by enthesitis are the knees, heels and bottom of the feet. As a result, children with enthesitis report heel, foot or knee pain, with or without swelling. To help with enthesitis pain in the foot and heel, your child’s health-care team may recommend supportive footwear and padded heel inserts for your child's shoes.</p><p>Symptoms of ERA can come and go. Sometimes your child may have a flare of their disease when there is more pain and swelling of joints and/or entheses.</p>
<figure class="asset-c-80">
<span class="asset-image-title">Entheses affected by enthesitis arthritis (ERA)</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/Entheses_affected_by_ERA_MED_ILL_EN.jpg" alt="" />
<figcaption class="“asset-image-caption”">Entheses are where tendons and ligaments insert into bone. Enthesitis is inflammation of entheses.</figcaption> </figure>
<h3>Possible other symptoms of ERA</h3><p>For some patients with ERA, inflammation can occur in other areas of the body as well. Not all children with ERA will have these symptoms, but doctors will always be checking for:</p><ul><li>Eye inflammation occurs in up to 30% of children who have ERA. It usually occurs in one eye and can reoccur. Inflammation occurs in the iris, where it is called acute anterior uveitis. The eye is usually red, painful and sensitive to light. Eye inflammation is an emergency. Your child will need to see an eye doctor (ophthalmologist) right away. Your child will need to have routine eye exams with a "slit lamp" to look for early signs of eye inflammation. Please speak to your child’s doctor about how often your child will need to have an eye exam.</li><li>Skin inflammation can also occur in children with ERA. Inflammation in the skin is called psoriasis. This is a persistent skin rash that looks like red patches covered with white scales. It can be found on the scalp, underarms, elbows and around the belly button.</li><li>Bowel inflammation can also occur in children with ERA. Inflammation in the bowel (intestines) is called inflammatory bowel disease (IBD). There are two types of IBD: Crohn's disease, and ulcerative colitis.</li></ul> | | | <h2>Diagnosis of enthesitis-related arthritis</h2>
<p>There are several steps to diagnosing ERA. The doctor will ask you about your child's symptoms and medical history and will also do a physical exam to look for joint inflammation. They may suspect ERA when a child has joint pain and swelling, especially in the lower limbs; pain in the lower back or buttocks; or signs of enthesitis for more than six weeks. The doctor will usually order blood tests, X-rays and sometimes additional tests, like magnetic resonance imaging (MRI), to help diagnose the disease.</p>
<p>One blood test that can be helpful when trying to diagnosis ERA is the HLA-B27 genetic marker. It can tell us who is at higher risk of developing ERA. Most children with ERA are "positive" for the HLA-B27 marker, but it is important to note that:</p>
<ul>
<li>Not every person who carries this marker will have ERA.</li>
<li>A child can have ERA and still be "negative" for HLA-B27.</li>
</ul>
| <h2>Treatment of enthesitis-related arthritis</h2>
<p>ERA is treated with various types of medicine:</p>
<ul>
<li>Some medicine can improve symptoms of inflammation, helping to reduce pain and stiffness and improve movement in the joints.</li>
<li>Some people with ERA need stronger medicine that suppresses the immune system and helps to control inflammation and prevent joint damage.</li>
</ul>
<p>Your child will be followed by a rheumatology team including doctors, nurses, physical therapists, social workers, dieticians and child life specialists. This team has a lot of experience treating children with ERA.</p>
<p>For more information, please see <a href="/Article?contentid=1003&language=English">Juvenile enthesitis-related arthritis: Treatment</a>, <a href="/Article?contentid=14&language=English">Living with ERA</a>, <a href="/Article?contentid=1004&language=English">Exercises for enthesitis and arthritis</a> and <a href="/Article?contentid=15&language=English">Enthesitis-related arthritis: A guide for teenagers</a>.</p> | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/Juvenile_enthesitis-related_arthritis.jpg | |
