AboutKidsHealth is a health education website for children, youth and their caregivers.



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+)NA2018-11-26T05:00:00ZSara Ahola Kohut, PhD, C.Psych9.1000000000000063.6000000000000540.000000000000Flat 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="http://szqhb.com/Exercising/index.php?i=7967&u=//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="http://szqhb.com/Exercising/index.php?i=7967&u=//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 caregiver
Cast care: Arm or leg castCast care: Arm or leg castCast care: Arm or leg castCEnglishOrthopaedics/MusculoskeletalChild (0-12 years);Teen (13-18 years)Arm;LegsSkeletal systemNon-drug treatmentCaregivers Adult (19+)NA2019-04-02T04:00:00ZPreeti Grewal, RN, MN, APN;Jean Hohs, RTOrthopaed;Catharine Bradley, MSc, BSc (PT);Benjamin A. Alman, MD, FRCSC;Charlotte Grandjean-Blanchet, MD;Anne Murphy, NP, MN;Derek Gauthier, RT(Orthopaed)4.3000000000000087.6000000000000884.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Read about how to take care of your child's arm or leg cast and learn the warning signs of a problem.</p><div class="asset-video"> <iframe src="https://www.youtube.com/embed/tP_fq26Bxz8?rel=0" frameborder="0"></iframe> </div><h2>About your child's cast</h2><p>Casts and splints hold a part of the body in place. They are used to treat a suspected injury, a fracture or other medical conditions. Casts are put on by an orthopaedic technologist or doctor. All casts are made of plaster or fibreglass with soft cotton underneath to protect the skin. </p><h3>The plaster cast</h3><ul><li>When applied, the plaster may feel warm at first. This is normal.</li><li>The cast will feel firm to touch in 10 to 15 minutes, but it will take up to 48 hours (2 days) to dry all the way through.</li><li>While drying, the cast may feel cold and clammy until it dries all the way through.</li><li>Plaster casts are not waterproof or water resistant. </li><li>Plaster casts and splints are covered by your provincial health insurance in Ontario. </li></ul><h3>The fibreglass cast</h3><ul><li>Fibreglass is applied the same way as plaster.</li><li>Fibreglass dries in about 1 hour. It is lighter in weight and stronger than plaster.</li><li>Fibreglass casts are water resistant but are NOT waterproof. </li><li>In some cases, fibreglass casting may be used with waterproof liner to make a waterproof cast. Ask your orthopaedic technologist if your child may be eligible for a waterproof cast. </li><li>There is a charge for fibreglass casts and other orthopaedic devices. </li></ul><h2>Key points</h2><ul><li>Your child's cast may be made of plaster or fibreglass.</li><li>Look at your child's cast four or five times a day.</li><li>There may be a problem with your child's cast if your child's fingers or toes are blue, white or swollen; if your child cannot bend or straighten the fingers or toes; if your child's arm or leg is numb or tingles; if there is a bad smell coming from the cast; if the cast feels tight to your child; or if the cast is soft or broken.</li></ul><h2>Signs of a problem with your child's cast</h2><p>Look at your child’s cast four or five times per day. Seek urgent medical advice if your child has any of the following complications:</p><h3>Fingers or toes that are blue, white or very swollen</h3><p>Your child’s fingers or toes should be warm and normal in colour. You can compare the temperature, colour and size with your child’s other arm or leg.</p> <figure class="asset-c-80"> <img src="https://assets.aboutkidshealth.ca/akhassets/Signs_of_tight_cast_EQUIP_ILL_EN.jpg" alt="Discoloured hand in a cast compared to non-injured hand" /> <figcaption class="asset-image-caption">If a cast is too tight, the skin may appear pale or bluish beyond the end of the cast when compared with the skin of a non-injured area. </figcaption></figure> <p>Your child should not wear nail polish or rings while wearing a cast. You need to be able to see if the nails are blue.</p><h3>Smells and odours from the cast</h3><p>It is normal for casts to start to smell if they have been in place for a long time. We worry about bad or foul smells, as they may indicate an infection under the cast.</p><h3>A cast that feels tight to your child</h3><p>If your child’s cast feels tight, it may mean that the arm or leg is swollen inside the cast. The swelling can make it difficult for blood to circulate through the arm or leg.</p><h3>A cast that is causing pain to your child </h3><p>If your child is complaining of a persistent pain, often described as burning, pushing or squeezing, it may mean that there is pressure against the skin underneath the cast. This may be in a different location than your child’s injury. </p><h3>A cast that is soft or broken</h3><p>If the cast is soft or broken, it may need to be repaired or replaced.</p><h2>Taking care of your child at home</h2><p>The cast will change how your child uses the arm or leg. They will not be able to use it normally.</p><p>Please follow all the instructions you were given about how much physical activity your child should be doing with the cast on.</p><h2>Taking care of your child's cast at home</h2><ul><li>Keep your child's cast clean and dry.</li><li>If possible, try to bathe your child using a cloth or sponge with soap.</li><li>Clean a soiled cast with a damp cloth. Leave the area open to the air until it is dry. You can also use a hair dryer on a cool or cold setting.</li><li>Do not put anything under the cast to scratch, such as pens or baby powder. It is normal for it to be itchy under the cast. You can try to relieve itchiness by using a hair dryer on a cool or cold setting.</li><li>Do not cut or change the shape of your child's cast.</li><li>Check the skin along the cast edges. Look for any blisters or redness.</li><li>Put the casted arm or leg up onto a pillow while your child is resting.</li><li>Encourage your child to move all other body parts that are not immobilized in cast. Speak to your doctor, nurse practitioner or orthopaedic technologist for guidance. </li></ul><h2>What to do if you have concerns</h2><p>Take your child to see your family doctor or paediatrician for all non-urgent concerns. </p><h2>When to return to the Emergency Department</h2><p>You should go to the Emergency Department or see your orthopaedic team immediately in the following situations:</p><ul><li>You cannot control your child’s pain with pain medications</li><li>There is new, increased swelling or skin discolouration</li><li>New numbness or tingling that doesn’t resolve with regular movement </li><li>There is a foul smell coming from the cast</li><li>If the cast becomes very wet, breaks or falls off</li></ul><h2>Removing the cast</h2><p>Circumferential, or full circular casts are taken off with an electric cast cutter. This is not painful, but it is noisy. Your child will be given ear muffs during the procedure.</p><p>Casts that are not circumferential, such as splints, can be removed with scissors. </p><p>You may be asked to remove your child’s splint at home. This can be done safely by using a pair of scissors to cut along the soft edge of the splint. Try cutting one layer of material at a time to avoid injuring the skin. If you need assistance, please see your family doctor. </p> <figure class="asset-c-80"> <img src="https://assets.aboutkidshealth.ca/AKHAssets/CastCare_EN.png" alt="Cutting the layers of the splint" /> <figcaption class="asset-image-caption">To remove the splint at home, hold the bandage scissors parallel to your child’s cast as your start to cut. Then, cut the layers in an upward scooping motion, so the ends of the scissors point away from the child’s skin.</figcaption> </figure> <h2>At SickKids:</h2><p>You may contact the orthopaedic clinic directly <strong>only if your child has already been seen</strong> in the orthopaedic or fracture clinics. If your child has only been seen in the emergency department, you may contact the emergency department or your primary care provider for assistance. The orthopaedic team may be reached as follows: </p><ul><li>Orthopaedic Clinic: fracture.clinic@sickkids.ca</li><li>Ward 5A (if your child was admitted): 416-813-6948</li><li>More information regarding the Orthopaedic Clinic can be found at: <a href="http://www.sickkids.ca/areas-of-care/clinics/orthopaedic-clinic.html">www.sickkids.ca/areas-of-care/clinics/orthopaedic-clinic.html</a></li></ul><img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/cast_care_arm_leg_cast.jpg" style="BORDER:0px solid;" />castcasthttps://assets.aboutkidshealth.ca/AKHAssets/cast_care_arm_leg_cast.jpg
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;Rash2019-04-01T04:00:00ZVy​ Kim, MD, FRCPC;Anna Kasprzak, RN;Laura Umbrello, MD, FAAP9.0000000000000056.2000000000000822.000000000000Health (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 a reaction. </p><h2>What is anaphylaxis?</h2><p>Anaphylaxis is a severe <a href="http://szqhb.com/Exercising/index.php?i=7967&u=//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 injector, which they should carry with them at all times. <br></li></ul><h2>Signs and symptoms of anaphylaxis</h2><p>The signs and symptoms of anaphylaxis may include sudden onset:</p><ul><li> <a href="http://szqhb.com/Exercising/index.php?i=7967&u=//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="http://szqhb.com/Exercising/index.php?i=7967&u=//Article?contentid=746&language=English">vomiting</a> or <a href="http://szqhb.com/Exercising/index.php?i=7967&u=//Article?contentid=7&language=English">diarrhea</a></li><li>coughing</li><li>stuffy and/or runny nose, watery eyes, sneezing</li><li> <a href="http://szqhb.com/Exercising/index.php?i=7967&u=//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 reaction.</li><li>A child might receive a medication via an injection 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 any known allergens. Many people are not aware of an allergy until they are exposed to an allergen and have an anaphylactic 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.</p><p>The allergist will try to figure out the allergen responsible for your child’s anaphylaxis and may also prescribe an <a href="http://szqhb.com/Exercising/index.php?i=7967&u=//article?contentid=130&language=English">epinephrine</a> auto-injector such as EpiPen. Your child should carry this medication with them at all times in case of an emergency. Ideally, your child will carry one 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.</p><h2>What you can do for your child during anaphylaxis</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 (EpiPen), 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.</p><img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/anaphylaxis.jpg" style="BORDER:0px solid;" />anaphylaxisanaphylaxishttps://assets.aboutkidshealth.ca/AKHAssets/anaphylaxis.jpgAnaphylaxis
Insect bitesInsect bitesInsect bitesIEnglishDermatologyChild (0-12 years);Teen (13-18 years)SkinSkinConditions and diseasesCaregivers Adult (19+)NA2014-05-30T04:00:00Z​Shawna Silver, MD, FRCPC, FAAP, PEng7.9000000000000061.0000000000000797.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Discover how to recognize, treat and prevent insect bites and bee stings, and when to seek medical attention. </p> <p>Insect bites and stings occur when an insect feeds off a person's skin or tries to defend itself.</p><p>Different insects bite and sting in different ways. Common biting or stinging insects include mosquitoes, blackflies, bed bugs, fleas, ticks, fire ants, bees and wasps. Bees often leave stingers in the wound.</p><p>Insect bites usually cause mild swelling, redness and itchiness limited to the small area around the bite or sting. Some children, however, can experience potentially life-threatening reactions. This is called an anaphylactic reaction and requires immediate medical attention. In children who are at risk, <a href="http://szqhb.com/Exercising/index.php?i=7967&u=//Article?contentid=781&language=English">anaphylaxis</a> is most commonly caused by bees, wasps and hornets. Other insects can transmit disease. For example, some mosquitoes can transmit malaria or West Nile virus and some ticks can transmit <a href="http://szqhb.com/Exercising/index.php?i=7967&u=//Article?contentid=909&language=English">Lyme disease</a>.</p><h2>Key points</h2> <ul> <li>Insect bites often cause swelling and redness. Some children experience severe and potentially life-threatening reactions.</li> <li>Common biting or stinging insects include mosquitoes, blackflies, bees and wasps.</li> <li>Some children respond well to antihistamine medication; others may just need some ice.</li> <li>Prevent insect bites and stings by covering the body with light-coloured clothing and applying insect repellent to exposed skin.</li> <li>DEET is a very effective insect repellent, but use it carefully according to your child's age. If using sunscreen and insect repellent, apply sunscreen first.</li> </ul><h2>Signs and symptoms of an insect bite or sting</h2><p>Signs and symptoms of insect bites and stings vary according to the type of insect and your child's reaction.</p><p>Normally, an insect bite or sting causes:</p><ul><li>a small, red, raised bump, pimple or blisters</li><li>itchiness and irritation around the bump.</li></ul><p>The symptoms can last from a few hours up to two days.<br></p><p>Some children develop a big firm swollen area around the bite. This is not an allergic reaction. It is known as a large local reaction and rarely leads to a skin infection.</p><p>If your child has an anaphylactic reaction, they may develop <a href="http://szqhb.com/Exercising/index.php?i=7967&u=//article?contentid=789&language=English">hives</a>, facial or mouth swelling, or breathing problems or they may collapse. Use an epinephrine auto-injector, if your child has one, and call for emergency assistance.</p><h2>How to treat insect bites and stings</h2> <ul> <li>Cold, damp compresses or ice can relieve some of the swelling.</li> <li>Over-the counter topical medications (medications you put on the skin) may also help to relieve the itch.</li> </ul> <p>Some children may respond well to antihistamine medication for itching, but this medication can cause drowsiness.</p><h2>Preventing insect bites and stings</h2> <p>Your child is more likely to be bitten or stung in warm and damp weather and in the evening and at night. Here are some ways you can reduce your child's exposure to insects.</p> <ul> <li>Apply insecticide or insect repellent to clothing and exposed skin.</li> <li>Wear long pants and socks.</li> <li>Wear light-coloured clothing.</li> <li>Avoid areas where insects breed and live.</li> <li>Stay inside when insects are most active.</li> <li>Use insecticide-impregnated mosquito nets, especially for infants aged less than six months.</li> <li>Take specific precautions, such as taking anti-malarial medications, as needed.</li> </ul> <h3>Be careful with DEET insect repellent</h3> <p>DEET is one of the most effective repellents for mosquitoes and biting flies, but it should be used with caution for children.</p> <ul> <li>Babies less than six months old: Do not use any insect repellents with DEET.</li> <li>Children aged six months to two years: Use a product with 10 per cent DEET or less and apply it once a day.</li> <li>Children aged two to 12 years: Use a product with 10 per cent DEET or less and apply it no more than three times a day.</li> <li>Children aged over 12: Use a product with up to 30 per cent DEET.</li> </ul> <p>The higher the amount of DEET, the longer the protection will last.</p> <h3>How to apply DEET to your child's skin</h3> <ul> <li>Apply it to exposed skin, following the manufacturer's instructions.</li> <li>Do not apply it to your child's face or hands or any areas where the skin is cut, grazed or irritated.</li> <li>Once the DEET is applied, wash hands and avoid touching the lips and eyes.</li> </ul> <h3>How to use insect repellent and sunscreen effectively</h3> <ul> <li>Apply <a href="http://szqhb.com/Exercising/index.php?i=7967&u=//Article?contentid=308&language=English">sunscreen</a> about 30 minutes before you apply any insect repellent.</li> <li>Do not use a single product that combines insect repellent with sunscreen. The insect repellent can make the sunscreen less effective and the sunscreen can increase how much insect repellent is absorbed by the body. In addition, you will normally need to apply sunscreen every two to three hours; it is not safe to apply insect repellent as frequently.</li> </ul><h2>When to see a doctor after an insect bite or sting</h2> <p>If your child has been bitten or stung, see a doctor right away if:</p> <ul> <li>you are in an area where the insects are known to transmit diseases</li> <li>your child develops an unusual rash, a <a href="http://szqhb.com/Exercising/index.php?i=7967&u=//Article?contentid=30&language=English">fever</a> or other symptoms.</li> </ul>insectbitesinsectbiteshttps://assets.aboutkidshealth.ca/AKHAssets/insect_bites.jpg
Sun: Protecting your child"s skinSun: Protecting your child's skinSun: Protecting your child's skinSEnglishDermatologyChild (0-12 years);Teen (13-18 years)SkinDermatologic systemConditions and diseasesCaregivers Adult (19+)NA2013-09-19T04:00:00ZMiriam Weinstein, MD, FRCPC;Michelle Lee, RN;Jackie Su, RN;Elena Pope, MD, MSc, FRCPC;Charis Kelly, RN(EC), MN6.7000000000000067.7000000000000511.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Too much sun exposure can damage your child's skin. Learn how choosing the correct sunscreen and wearing proper clothing can help to protect your child's skin.</p><p>​​Too much sun exposure can cause severe sunburns, including blisters, illness, shivering and <a href="http://szqhb.com/Exercising/index.php?i=7967&u=//Article?contentid=30&language=English">fever</a>. In the long term, too much sun exposure can also cause early aging of the skin and even skin cancer.</p><p>It is important to protect your child's skin from the sun. This can include applying sunscreens, wearing sun-protective clothing and avoiding the sun completely.<br></p><h2>Key points</h2> <ul> <li>Too much sun exposure can cause sunburns and long-term skin damage, including early aging of the skin and cancer. </li> <li>It is important to protect your child's skin from the sun. This can include applying sunscreens, wearing sun-protective clothing and avoiding the sun completely. </li> <li>Your child or teenager should not use tanning beds.</li> </ul><h2>General tips to protect the skin</h2> <ul> <li>The sun's rays are at their strongest between 11am and 3pm.</li> <li>The sun's rays can still reach your child on cloudy days.</li> <li>The fairer your child's skin, the greater the chance that your child will get a sunburn.</li> <li>Babies under six months should stay in the shade at all times. Sunscreens are not recommended for this age group.</li> </ul> <h2>Sunscreens</h2> <p>Sunscreens that your child can use on the skin:</p> <ul> <li>protect against the sun's harmful rays (UV rays) </li> <li>protect against sunburn </li> <li>help prevent sun-related skin changes such as wrinkles, pigment (skin colour) changes and skin cancer.</li> </ul> <p>Choose a sunscreen that protects against both UVA and UVB. These are the damaging components of sunlight.</p> <p>Sun protection factor (SPF) refers to the degree of protection from UVB rays. It does not include protection against UVA rays.</p> <p>Chemicals that protect the skin against UVA include:</p> <ul> <li>oxybenzone </li> <li>avobenzone </li> <li>ecamsule </li> </ul> <p>Sunscreens that contain ingredients such as titanium dioxide and zinc dioxide protect against both UVA and UVB.</p> <h3>Choosing and using sunscreen</h3> <p>Follow these steps when choosing and using sunscreen:</p> <ul> <li>Choose a sunscreen that has an SPF of 30 or higher.</li> <li>Apply sunscreen liberally and often to all parts of the body that are exposed to the sun, especially the face and neck.</li> <li>Re-apply sunscreen every two to three hours, especially if your child has been perspiring from doing outdoor activities or their skin has become wet, for example from playing in water or swimming.</li> </ul> <h2>Other tips for reducing sun exposure</h2> <ul> <li>Avoid tanning beds. Studies have shown that using tanning beds increases your risk for skin damage and skin cancer significantly.</li> <li>Avoid going out in the sun between 11am and 3pm. This is when UV radiation is the strongest. Do outdoor activities earlier or later in the day.</li> <li>Avoid sunbathing. Look for areas that are shaded or covered instead of sitting in the direct sun.</li> <li>Wear loose, long-sleeved cotton tops and pants. These help keep your child covered and cool during the day. Cotton and linen are the best materials for staying cool. </li> <li>Wear a sunhat.</li> </ul> <h2>Medications and sun exposure</h2> <p>Certain medications may cause skin to become more sensitive to sunlight. Talk to your doctor or pharmacist for more information.</p><img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/Sun_protecting_your_childs_skin.jpg" style="BORDER:0px solid;" />https://assets.aboutkidshealth.ca/AKHAssets/Sun_protecting_your_childs_skin.jpgSun safety Learn how choosing the correct sunscreen and wearing proper clothing can help to protect your child's skin from the sun.



VitiligoVitiligoVitiligoVEnglishDermatologyChild (0-12 years);Teen (13-18 years)SkinSkinConditions and diseasesCaregivers Adult (19+)NAhttps://assets.aboutkidshealth.ca/akhassets/PMD_vitiligo_darker_skin_EN.jpg2016-06-24T04:00:00ZMichael Bishara, BSc, MD, FRCPC;Irene Lara-Corrales, MSc, MD9.4000000000000054.8000000000000850.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Vitiligo is a condition that causes skin and sometimes hair to turn white. Learn about its causes and how it is diagnosed and treated.</p><h2>What is vitiligo?</h2><p>Vitiligo is a condition that causes patches of skin, and sometimes hair, to turn white. This skin condition occurs in roughly one person in a hundred and affects girls and boys equally.</p><div class="asset-2-up"> <figure><img src="https://assets.aboutkidshealth.ca/akhassets/PMD_vitiligo_darker_skin_EN.jpg" alt="Vitiligo darker-skinned knee" /> </figure> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/PMD_vitiligo_lighter_skin_EN.jpg" alt="Viligo on lighter-skinned knee" /> </figure><br></div><h2>Key points</h2><ul><li>Vitiligo is a skin condition that makes parts of the skin or hair turn white. It is thought to be an autoimmune reaction but can also sometimes occur after a cut or other injury to the skin.</li><li>Treatments include creams and lotions, medications and light therapy. These may not always completely remove vitiligo and cannot prevent new patches from forming.</li><li>See a doctor if your child’s vitiligo does not improve or looks different than before or if you have concerns about changes in their health.</li></ul><h2>How does vitiligo affect the body?</h2> <p>Vitiligo is a condition that affects skin or hair colour only. It is usually more obvious in those with darker skin. It can occur anywhere on the body, causing skin colour differences of various shapes and sizes. However, some areas of the body are more commonly affected than others.</p> <p>In rare cases, patients with vitiligo may have other autoimmune diseases. For example, their immune system may also attack their thyroid gland. If your child is diagnosed with vitiligo, their doctor should order blood tests to check for any other autoimmune disease.</p><h2>What causes vitiligo?</h2> <p>The exact cause of vitiligo is not known, but it is thought to be an autoimmune reaction. This means that it occurs when the immune system attacks healthy cells in the body. In vitiligo, the cells that are attacked are called melanocytes. These are special cells that give skin and hair its pigment (colour).</p> <p>Vitiligo may affect more than one person in a family, suggesting that genetics may be a factor. Patients sometimes also notice that their vitiligo starts after a cut or other injury to their skin. You may hear your doctor call this a Koebner phenomenon.</p><h2>How is vitiligo diagnosed?</h2> <p>Your child’s doctor will often diagnose vitiligo simply by looking at your child’s skin. Because vitiligo is less obvious in paler skin, the doctor might sometimes use a special light called a Wood’s Lamp to help them detect changes more easily. If your child needs to be examined with the aid of a Wood’s Lamp, they may be asked to go into a dark room so that the light can be shone on their skin.</p><h2>How is vitiligo treated?</h2> <p>Different treatments are possible depending on how much vitiligo is present and where it appears on the body.</p> <h3>Topical treatments</h3> <p>Topical treatments are ointments, creams, gels or lotions that are applied directly to the skin. They include topical steroid medications.</p> <p>Calcineurin inhibitors are topical medications that help regulate the immune system in the skin. They are especially useful when applied to the face, skin folds and flexural areas such as inside the elbow or the back of the knee.</p> <p>Topical treatments are recommended for small areas of vitiligo, but they may be more challenging to use, and carry side effects, if vitiligo is more widespread. Depending on the part of their body that is affected, your child might receive different mixes and strengths of a topical steroid.</p> <h3>Light therapy</h3> <p>Light therapy involves focusing a special ultraviolet light on the affected areas of skin. The treatment usually requires several sessions and is reserved for patients with very widespread vitiligo, for whom applying a topical medication is challenging.</p> <p>This treatment requires a person to stand still in a small space with lamps around them, as they may be burned if they move. For this reason, light therapy may not be suitable for young children. Some concerns have also been raised about light therapy and the long-term increased risk for skin cancer, especially in those with paler skin.</p> <p>Other treatments such as laser therapy and skin grafting are also possible, but there is limited information about their use in children.</p> <h3>How effective are treatments for vitiligo?<br></h3> <p>Unfortunately vitiligo is a very unpredictable disease. Even with all the available treatments, some areas may not return to their usual colour. In addition, there is no way for doctors to prevent new areas of vitiligo from developing.<br></p> <p>Because treatment is not always successful, some patients may choose not to do anything or will instead use special make-up on the affected skin to make it blend in with the rest of the body.</p><h2>When to see a doctor for vitiligo</h2> <p>After initial diagnosis and treatment, see your child’s doctor if:</p> <ul> <li>your child’s vitiligo is getting larger, not improving or looks different than before</li> <li>you suspect your child has been experiencing symptoms such as gaining or losing weight easily or feeling tired easily. Their doctor can order blood tests to rule out related systemic conditions such as <a href="https://akhpub.aboutkidshealth.ca/article?contentid=841&language=English">anemia</a> or <a href="https://akhpub.aboutkidshealth.ca/article?contentid=2309&language=English">hypothyroidism</a>.<br></li> </ul><h2>Does my child’s vitiligo need any special long-term care?</h2> <p>Yes, the areas affected by vitiligo will need good <a href="https://akhpub.aboutkidshealth.ca/article?contentid=308&language=English">sun protection</a> to avoid <a href="https://akhpub.aboutkidshealth.ca/article?contentid=768&language=English">sunburn</a> and minimize the risks of skin cancer.</p>
Spina bifidaSpina bifidaSpina bifidaSEnglishNeurologyNewborn (0-28 days)SpineSpinal CordConditions and diseasesCaregivers Adult (19+)NAhttps://assets.aboutkidshealth.ca/akhassets/spina_bifida_V2_EN.jpg2017-11-07T05:00:00ZPatricia Rowe, RN(EC), MN, NP-Pediatrics;Sara Breitbart, RN(EC), MN, NP-Pediatrics;Peter Dirks, MD, PhD, FRCSC;James Drake, BSE, MB, BCh, MSc, FRCSC9.4000000000000056.00000000000002064.00000000000Health (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="http://szqhb.com/Exercising/index.php?i=7967&u=//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="http://szqhb.com/Exercising/index.php?i=7967&u=//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="http://szqhb.com/Exercising/index.php?i=7967&u=//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="http://szqhb.com/Exercising/index.php?i=7967&u=//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="http://szqhb.com/Exercising/index.php?i=7967&u=//Article?contentid=978&language=English">boys</a> and <a href="http://szqhb.com/Exercising/index.php?i=7967&u=//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="http://szqhb.com/Exercising/index.php?i=7967&u=//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.
Keeping kids on the moveKeeping kids on the moveKeeping kids on the moveKEnglishPreventionChild (0-12 years);Teen (13-18 years)NANAHealthy living and preventionCaregivers Adult (19+)NA2014-07-16T04:00:00ZShaw​na Silver, MD, FRCPC, FAAP, PEng8.7000000000000060.70000000000001059.00000000000Flat ContentHealth A-Z<p>Find out how active transportation and child-friendly communities can help children be more independent and physically active.</p><p>The growing popularity of cars in North America over the past 50 years has created suburbs and towns that require many people to drive every day. As a result, children are often travelling by car instead of walking, bicycling or using another form of transportation. This reliance on cars can have a major impact on children’s health and development and on the types of neighbourhoods in which they live.</p><h2>Key points<br></h2> <ul> <li>Heavy car use can make children less active, less connected from the environment and less independent.</li> <li>Active transportation involves travelling on foot or by bike for some journeys instead of relying on a car.</li> <li>Parents can encourage active transportation by taking part in car-free days, helping a child find the best walking and cycling routes nearby and getting involved in making a child’s school safer for those who walk or cycle there.</li> <li>Child-friendly communities can make active transportation more realistic because they are safe and accessible and integrate nature, local amenities and the needs of different age groups.<br></li> </ul><h2>How car use affects children</h2><p>Car use affects children's health, development and safety in a number of ways.</p><ul><li>Children who are less <a href="http://szqhb.com/Exercising/index.php?i=7967&u=//Article?contentid=642&language=English">physically active</a> have an increased risk of health problems, including being <a href="http://szqhb.com/Exercising/index.php?i=7967&u=//Article?contentid=640&language=English">overweight</a>.</li><li>Children who see life mainly “through the car windshield” are less connected with the environment around them.</li><li>Heavy traffic reduces children's ability to travel independently. <a href="http://szqhb.com/Exercising/index.php?i=7967&u=//Article?contentid=1955&language=English">Safety</a> concerns may mean that they cannot walk or bicycle around their neighbourhood or go to nearby parks, schools and stores.</li><li>Traffic limits children's ability to play in the front yard or the street, which in turn limits how long they play and the richness of that play.</li></ul><p>Urban planners, local government, real estate developers and public transit authorities, among others, all influence how neighbourhoods develop and what type of transport is available. But despite the involvement of many groups in creating communities, there are still ways for parents to get children moving differently to and from school and make communities safer.</p><h2>How parents can create child-friendly journeys</h2><h3>Encourage active transportation</h3><ul><li>Active transportation means making a journey on foot or by bicycle instead of by car or bus. Next time you make a trip, consider if walking or bicycling could get you and your child to your destination instead.</li><li>Involve your child in decisions about how to get around. Given the choice, many children would prefer walking, bicycling or in-line skating to taking the car to get where they want to go.</li><li>Be a role model. Use active transportation for your own journeys whenever you can.</li><li>Walk and bicycle with your child. Help them find the best routes to where they want to go and teach them how to get around safely.</li><li>If your child must use public transit, start teaching them how to use it at a young age.</li><li>Take part in car-free days. Encourage your neighbours and co-workers to take part as well.</li><li>Start a "walking school bus" to get your child and your neighbours' children to school. A physically active school commute can be a fun social time for kids.</li><li>Get involved in making your child's school safer for children who walk there. Try to get the school to give priority to pedestrians instead of cars and reduce engine idling and traffic congestion at drop-off points.</li><li>Find out if your child's school has safe and secure storage for bicycles. If not, encourage the school to provide it.</li></ul><h3>Advocate for a "child-friendly community"</h3><p>Sometimes, certain conditions need to be in place for active transportation to be a realistic option. This is where the concept of a "child-friendly community" arises.</p><p>In his Bill of Rights for Kids, Colorado architect Harry Teague advocates for child-friendly communities that:</p><ul><li>are safe and accessible</li><li>are built to an appropriate scale</li><li>integrate nature, work and the needs of different ages and sexes into the surroundings</li><li>show elements of tradition</li></ul><p>The following sample questions can help you decide if your own neighbourhood is a healthy, friendly place for your family.</p><p> <em>Safety</em></p><ul><li>Is there a lot of traffic? What is the speed limit?</li><li>Are there sidewalks on at least one side of every street?</li><li>Are there bike paths or bike lanes?</li><li>Are there narrow streets to slow down drivers and help pedestrians and cyclists cross?</li><li>On busier streets, are there many crosswalks and traffic lights?</li><li>Are there "eyes on the street" - neighbours and workers who will keep an eye out for trouble and be able to give help if needed? Do homes have front porches and windows facing the street?</li><li>Is there enough street lighting?</li></ul><p> <em>Accessibility</em></p><ul><li>Is the neighbourhood close enough to where children need and want to go - schools, parks, playgrounds, recreational facilities, stores, libraries, friends and family - for them to walk or bicycle there?</li><li>Is it cut off by a major road or highway?</li><li>Is it near public transit that goes somewhere useful or will kids have to take a number of buses?</li><li>Are there places to park a bicycle when shopping or going to the library?</li><li>Do other people walk or bicycle?</li></ul><p> <em>Integration</em></p><ul><li>Do other kids live nearby?</li><li>How easy is it for kids in the neighbourhood to play together in a casual, unstructured way?</li><li>Can you and your family get to know neighbours and local shopkeepers?</li><li>Does the community have a mix of features such as schools, parks, recreational facilities, places of worship, stores, a library, doctor, dentist or opportunities for after-school or summer jobs?</li><li>Do people of different ages and backgrounds live in the area?</li><li>Have natural areas in the neighbourhood been preserved?</li><li>If your housing needs change, are different types of housing – large and small houses or apartments – available in the neighbourhood?</li></ul><p> <em>Tradition</em></p><ul><li>Are there monuments, landmarks or natural areas that can anchor kids to their community?</li><li>What are the plans to develop the area in the future?</li></ul><p>If your neighbourhood falls short in some areas, you might decide to share your findings with neighbours and bring your requests as a group to your local government representative.</p><h2>Why child-friendly communities matter</h2><p>A neighbourhood that is good for kids is good for the whole family and the whole community. Specifically, child-friendly communities give children the best opportunity to make active transportation a reality for their regular journeys.</p> <br>https://assets.aboutkidshealth.ca/AKHAssets/keeping_kids_on_the_move_the_role_of_active_transportation.jpgKeeping kids on the move
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.jpg2017-11-20T05:00:00ZCatherine Pastor, RN, MN, HonBScVanita Pais, RD, CDEAndrea Ens, MD, FRCPCJennifer Harrington, MBBS, PhD11.600000000000024.4000000000000343.000000000000Flat 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="http://szqhb.com/Exercising/index.php?i=7967&u=//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="http://szqhb.com/Exercising/index.php?i=7967&u=//Article?contentid=2309&language=English">hypothyroidism</a>) or in rare cases, to become overactive (hyperthyroidism). About 20 to 25% of people with <a href="http://szqhb.com/Exercising/index.php?i=7967&u=//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.

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