Pediatrics
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World Prematurity Day
Each year, on November 17th, we mark World Prematurity Day, a pivotal occasion dedicated to raising awareness about preterm birth and the concerns surrounding the health, well-being, and future of premature babies. It’s a day that unites healthcare professionals, parents, and communities in reflecting on the challenges faced by infants born too soon and in advocating for advancements in neonatal care.
The Scope of Prematurity in Canada
In the expanse of Canadian healthcare, prematurity remains a pressing concern, with approximately 30,000 babies making an early entrance each year. These infants are born before completing the standard 37 weeks of gestation, and their premature start to life comes with a myriad of potential health complications, from respiratory problems to developmental delays.
The Journey of Premature Infants and Their Families
For families, the unexpected arrival of a premature baby can be both awe-inspiring and fraught with anxiety. The neonatal intensive care unit (NICU) becomes a new, temporary home where parents watch their tiny infants fight tremendous battles. These little warriors, hooked to beeping monitors and breathing aids, showcase resilience that belies their delicate form.
The Canadian Healthcare Approach to Prematurity
Canada’s healthcare system is structured to provide comprehensive care for premature infants. From specialized NICU facilities to multidisciplinary teams consisting of neonatologists, nurses, respiratory therapists, and a range of other healthcare professionals, the aim is to deliver the highest standard of care to nurture these vulnerable babies.
Advances in Neonatal Care
Over the years, there have been significant strides in neonatal care. Research and technology have synergized to improve survival rates and outcomes for premature babies. Innovations such as surfactant therapy to aid immature lungs and the development of gentler ventilation techniques have been game-changers in the field.
The Role of Support and Awareness
World Prematurity Day also highlights the importance of support systems for families navigating the complexities of preterm birth. Support groups, counselling services, and educational resources play a vital role in providing comfort and knowledge to parents during this challenging time.
Prevention and Public Health Strategies
Preventing premature births is a public health priority. Strategies such as promoting maternal health, monitoring for signs of preterm labour, and managing conditions like preeclampsia are critical components of prenatal care. Public health campaigns also focus on modifiable risk factors, such as smoking cessation, proper nutrition, and the management of chronic illnesses.
Reflecting on Our Collective Responsibility
On World Prematurity Day, we are reminded of our collective responsibility to support ongoing research, healthcare improvements, and family-centred care initiatives that can make a difference in the lives of premature infants. It’s a day to advocate for policies that ensure every tiny life is given the best start possible, regardless of how early they arrive.
Embracing the Cause Beyond the Day
While World Prematurity Day is an annual event, the message it carries resonates every day of the year. With 30,000 Canadian families experiencing the realities of prematurity annually, it is imperative that awareness translates into action. Let’s pledge to extend our support to these families, not just on November 17th, but throughout the year, ensuring that every child, no matter how small, is afforded the chance to thrive. In embracing World Prematurity Day, we acknowledge not just the challenges, but also the extraordinary progress and the powerful stories of survival that define the journey of premature babies. It is a testament to the strength of the human spirit and the unwavering commitment of the Canadian healthcare community to nurture the next generation, no matter how early they may arrive.
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Insight into Children’s Vision Month
Ensuring optimal ocular health in children serves as the very keystone in safeguarding their overall well-being and development. Children’s Vision Month underscores a paramount necessity for prioritizing early and consistent eye care in the realm of pediatric health. In the boundless terrains of learning and discovery, children’s vision plays a pivotal role, facilitating not just academic pursuits but also their social and developmental milestones. This initiative aims to elevate awareness about the importance of comprehensive eye examinations and the early detection of potential visual impairments or conditions in children.
The Importance of Comprehensive Eye Examinations
Navigating through the intricacies of visual health, one encounters the undeniable truth that many serious eye conditions mask themselves behind a veil of invisibility, showing no obvious symptoms until they reach advanced, and often, more challenging stages to treat. Amblyopia, colloquially known as “lazy eye”, emerges as a quintessential example of a condition that begs early intervention, necessitating addressal while the child is still navigating through their early years. Research indicates that comprehensive eye examinations can pivot the scales favourably, enabling a notable 51% more children to receive successful treatment for amblyopia by the age of 10.
Canadian Standards: Laying Down the Protocol
The Canadian Association of Optometrists, a distinguished body advocating for eye health, solidifies a strong recommendation that underscores the importance of early and consistent eye care for children. Children should be ushered into the realm of eye care with at least one eye examination before they embark on their educational journey, starting school, followed by annual examinations thereafter. This ensures a meticulous and continual assessment of their vision and ocular development, paving the way for optimal visual health and overall developmental prosperity.
Dissecting the Comprehensive Eye Examination
- Health and Vision History Review: An encompassing overview of the child’s health and vision history serves as the primary step, ensuring that any prevalent conditions or potential genetic predispositions are thoroughly acknowledged.
- Multifaceted Vision Tests: This involves an extensive suite of tests including those for nearsightedness, farsightedness, and astigmatism, which are paramount for diagnosing common refractive errors.
- Perceptual Testing: Ensuring optimal colour perception and depth perception, these tests safeguard the child’s navigational and perceptive capabilities within their environments.
- Eye Condition Tests: Specific assessments for conditions like a lazy eye or crossed-eyes are integral, acting as preventive measures for early detection and management.
- Eye Coordination and Focusing Ability: Assessing the eyes’ ability to move and focus in a coordinated and efficient manner, ensuring seamless visual processing and interpretation.
- Ocular Health Assessment: An overall evaluation of ocular health which transcends just visual acuity, looking at the structural and functional integrity of the eyes.
Nurturing a Future of Clear Vision
Children’s Vision Month acts not just as a temporal focus on paediatric ocular health but serves as a collective reminder of the sustained efforts required to preserve and enhance the visual health of the younger generation. Ensuring that children undergo comprehensive eye examinations paves the way for a future where their vision is not a barrier but a facilitator in their journeys towards growth and learning. The hope, encapsulated within this initiative, envisions a future where children are endowed with the best possible ocular health, setting a foundation for academic achievements, social interactions, and holistic development. Let Children’s Vision Month be the catalyst that drives sustained awareness and proactive action in safeguarding the visual health of our future generations, nurturing a future that is not obscured, but vividly clear in its pursuit of excellence and well-being.
The lens through which children perceive the world is pristine and unfiltered; let us safeguard its clarity and enable them to envisage a future, replete with possibilities, through eyes that are nurtured and cared for.
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Child Passenger Safety
From September 16th to 24th, Canada observes Child Passenger Safety Week, underscoring the significance of children’s safety in vehicles. As we navigate the roads and highways, it becomes paramount to ensure that the smallest passengers in our cars are afforded the utmost protection.Understanding the Risks
Children, due to their size and developmental stages, are particularly vulnerable in car accidents. Injuries range from minor scratches to severe traumatic injuries. Some of the common injuries children face as car passengers include:
- Whiplash: Even in a minor fender-bender, a child’s neck can jerk forward and backward abruptly, leading to injuries.
- Head Injuries: A child’s head is proportionally larger compared to their body, making them more susceptible to head injuries in a collision.
- Internal Injuries: Organs, blood vessels, and bones are at risk during high-impact crashes.
- Broken Bones and Fractures: Fragile bones can easily break upon impact.
- Lacerations and Bruises: Loose objects in a car or shattered glass can cause these injuries during a crash.
The Importance of Car Seat Safety
Correctly using child car seats can reduce the risk of fatal injury by up to 71% for infants and 54% for toddlers. Here’s a closer look at how to maximize car seat safety:
- Choose the Right Seat: It’s vital to select a car seat based on your child’s age, weight, and height. The main types of car seats include:
- Infant Car Seats: Designed for newborns and small babies. Always rear-facing.
- Convertible Seats: Can switch from rear-facing to forward-facing as the child grows.
- Booster Seats: For children who’ve outgrown traditional car seats but aren’t large enough for seat belts.
- All-in-One Seats: These can transform from a rear-facing seat to a forward-facing seat and then to a booster seat.
- Positioning is Key: Until age 2, or once they exceed the seat’s rear-facing height or weight limits, children should ride in a rear-facing car seat. After this, they can transition to forward-facing.
- Location: The safest place for a child’s car seat is the car’s back seat, away from active airbags.
- Installation: Make sure the car seat is installed tightly. It shouldn’t move side-to-side or front-to-back more than 2.5 cm (1 inch) when pulled at the belt path.
- Harnessing: Proper harnessing is crucial. Ensure the harness is snug, lying flat without sagging or twisting. The chest clip should be at armpit level.
- Regular Checks: As children grow, check the fit of the seat and harness, making adjustments as necessary.
Other Safety Considerations
- Never Leave Children Alone in a Vehicle: Children are susceptible to temperature extremes. Leaving a child in a car, even for a few minutes, can lead to heatstroke or other risks.
- Teach Vehicle Safety Early: Talk to your kids about the importance of seat belts and car safety. Ensure they understand to always remain seated and buckled up during journeys.
- Watch Out for Blind Spots: Children are small and can easily disappear into a driver’s blind spot. Before reversing or making any movements, ensure no children are around the vehicle.
Child Passenger Safety Week serves as a poignant reminder of the vulnerabilities of young passengers. Through education, adherence to safety standards, and consistent checks, we can vastly diminish the risks they face on the road. Let’s use this week as a catalyst to make every journey with our young ones not just memorable, but safe.
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Recognizing Childhood Cancer Awareness Month
Every September, the world unites in the gold ribbon movement to raise awareness about childhood cancer. The golden emblem stands as a strong reminder of the youngest members of our society bravely facing one of humanity’s toughest adversaries. As September is recognized as Childhood Cancer Awareness Month, it provides an opportunity for individuals and organizations across the globe to stand in solidarity with children affected by cancer, their families, and the professionals dedicated to their care.Why the Need for Awareness?
Childhood cancer, while relatively rare in comparison to adult cancer, still represents a significant concern. Every year, thousands of children are diagnosed, and the effects ripple across families, communities, and societies at large. By increasing awareness, it becomes possible to bolster support for research, enhance funding for vital treatments, and provide emotional and psychological support to affected families.
Common Forms of Childhood Cancer
While there are numerous types of cancers that can affect children, some are more prevalent than others. Here are the most common forms of childhood cancer:
- Leukaemia: This cancer of the blood and bone marrow accounts for about 30% of all cancers in children. The most common types in children are acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML).
- Brain and Central Nervous System Tumours: These are the second most common cancers in children. Medulloblastomas, gliomas, and brain stem gliomas are among the usual types that affect children.
- Neuroblastoma: Originating in certain nerve cells during fetal development, this cancer usually affects children under the age of 5. It typically starts in the adrenal glands, which sit atop the kidneys.
- Wilms Tumour: This is a kidney cancer that predominantly affects children. It usually arises in children aged 3 to 4 and is rare in older kids or adults.
- Lymphoma: This includes both Hodgkin and non-Hodgkin lymphoma. Lymphomas affect the lymphatic system, a vital part of the immune system.
- Rhabdomyosarcoma: This cancer affects the muscles and can start in various places throughout the body.
- Osteosarcoma and Ewing Sarcoma: Both these types are bone cancers. Osteosarcoma is more common in teens and often originates in the bones around the knee. Ewing sarcoma can begin in bones or soft tissues.
The Canadian Contribution
Canada, like many nations, stands committed to the cause. The Childhood Cancer Awareness Month is marked by various events, campaigns, and initiatives throughout the country. Many organizations, hospitals, and support groups work tirelessly to ensure that the best care and resources are available to children and families affected by cancer.
The goal is clear: to find more efficient treatments, to enhance the quality of life for affected children, and ultimately, to find a cure. With continued awareness, research, and support, the hope remains that the youngest among us will have a brighter, cancer-free future.
So, this month, whether you choose to wear gold, donate to a relevant charity, or simply share information about childhood cancer, remember the brave children and families battling this disease and the significance of your contribution. Together, we can make a difference.
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Children’s Safety at Playgrounds
During the summer months, children of all ages take advantage of the chance to play outside, particularly in playgrounds. Playgrounds are spaces that promote physical activity, creativity, and social interaction, but they also present various risks, especially during summer. This article will explore the specific risks that summer brings to playground safety and offer strategies for mitigating these risks to ensure children can play safely and happily in the summer sun.
Heat-Related Risks:
- Overheating and Dehydration: In the summer heat, children can easily become dehydrated or suffer from heat exhaustion. Make sure children take regular breaks to drink water, especially during intense physical activity. Also, watch out for signs of heat exhaustion such as excessive sweating, fatigue, dizziness, and pale skin.
- Hot Playground Equipment: Playground equipment, especially metal or dark-colored surfaces, can heat up quickly in the summer sun, posing a risk of burns. Before children use the equipment, it’s essential to test the temperature with your hand. Encourage children to wear shoes at all times to prevent foot burns from hot surfaces.
Sun-Related Risks:
- Sunburn and Sun Damage: Prolonged exposure to the sun can lead to sunburn and potential long-term skin damage. Always apply a broad-spectrum sunscreen with a high SPF to your child before they head out to play. Remember to reapply every two hours and after heavy sweating or swimming.
- UV Exposure to Eyes: Just like the skin, a child’s eyes can be damaged by UV rays, so make sure your child wears UV-protective sunglasses or hats with wide brims to shade their eyes.
Safety-Related Risks:
- Playground Equipment Safety: Playground equipment can pose risks if not used properly. Ensure the equipment is age-appropriate for your child and in good condition. Check for any sharp edges, loose parts, or rust. Encourage your child to use equipment as intended—no standing on swings, for instance.
- Inadequate Supervision: Active supervision is crucial to prevent accidents. Make sure children are within sight at all times, and intervene when you see unsafe behavior.
Insect and Plant-Related Risks:
- Insect Bites/Stings: Insects are more active during summer, and bites or stings can cause allergic reactions in some children. Keep an eye out for hives or nests and ensure your child applies insect repellent when necessary.
- Poisonous Plants: Teach your child to identify and avoid poisonous plants, such as poison ivy, poison oak, and poison sumac, which can cause allergic reactions.
Safety Measures:
Taking the right measures can drastically reduce these risks. Some important safety measures include:
- Dressing Appropriately: Dress your child in loose, lightweight, and light-colored clothing to help them stay cool. Closed-toe shoes can prevent many foot-related injuries.
- Keeping Hydrated: Always have plenty of water available for your child and remind them to take regular drinks, even if they don’t feel thirsty.
- Planning Playtime: Try to avoid peak sun intensity hours, typically from 10 am to 4 pm. Early morning or late afternoon play can reduce sun and heat exposure.
- Providing Proper Supervision: Always supervise your children when they are playing. The presence of an adult can not only prevent many injuries but also respond promptly if an injury occurs.
- Teaching Safe Play: Teach your child the rules of safe play. These include using equipment correctly, not pushing or roughhousing, and being aware of others when moving around the playground.
- Using Protective Gear: If your child is using a bike, scooter, or skateboard in or near the playground, ensure they wear appropriate safety gear, including helmets and knee and elbow pads.
- Applying Sunscreen: Use a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher. Don’t forget to reapply every two hours and after sweating or swimming.
- Checking Equipment: Before your child uses playground equipment, quickly check it for any potential hazards. Look for sharp points or edges, loose ropes, open “S” hooks, or broken equipment.
Preventing and Treating Injuries:
Despite all precautions, injuries may still occur. The key is to respond appropriately when they do. Have a first aid kit handy at all times and know the basics of treating common playground injuries. This includes cleaning scrapes and cuts, treating minor burns, and applying ice to bruises or sprains. If your child sustains a head injury, seems disoriented, dizzy, or loses consciousness, even momentarily, seek immediate medical attention. Be vigilant for signs of heatstroke, too, such as a high body temperature, hot and dry skin, and a rapid, strong pulse.
Insect bites and stings should be watched carefully. Remove any stingers immediately, clean the area with soap and water, apply a cold pack to reduce swelling, and consider using a topical cream or lotion to alleviate itching. If an allergic reaction occurs, seek medical help promptly.
Summer should be a time for kids to enjoy the great outdoors, and playgrounds are a big part of that experience. The challenges that summer heat brings should not prevent children from enjoying the playground, but they do require a few additional safety measures. By keeping a close eye on your kids, taking preventive steps, and being prepared to handle common injuries, you can ensure your children have a fun and safe summer on the playground. Remember, a safe playground is a fun playground!
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Childhood Cancer in Canada
Each year in Canada, an estimated 1,000 children between the ages of 0 to 14 years will be diagnosed with cancer. Cancer is also the leading cause of death in children between that same age group. An estimated 1 out of every 250 adults between the ages of 20 and 39 are survivors of childhood cancer. Leukemia, lymphomas and cancers of the brain and/or the CNS (Central Nervous System) account for the majority of malignant childhood cancers.
Unlike certain types of cancers that are found in adults, the cause of childhood cancer is relatively unknown. A definitive link to any specific factors – such as environmental or lifestyle factors – has not been fully established. In adults, some of these factors that can contribute to cancer include whether or not the patient is a smoker, overexposure to radiation/carcinogens, hormones, obesity, chronic inflammation, and other viruses. Adults will also usually be at an increased risk of developing cancer if there is a family history of it.
While some children may be too young to discern the diagnosis that they are facing, others will, and it can oftentimes be an overwhelming and undoubtedly scary process. When talking to a child about how to cope with cancer, it is important to be as open and honest as possible, while ensuring you’re using terms that the child is able to understand. For example, rather than using words like “oncologist,” “radiation,” or “chemotherapy,” use words that the child is already familiar with, such as “doctor” and “medicine.” Children will often wonder what they did to deserve being diagnosed with cancer and may feel a sense of blame, so it is also important to reassure them that such a diagnosis is not their fault. As cancer can disrupt a child’s routine, explain to them that they may not be able to do the things they are used to doing – such as going to school or seeing their friends – but try to implement different ways for them to do that, such as communicating with their peers via telephone or video calls, and incorporating at-home activities into their routine, such as colouring and other fun projects. Having a sense of normalcy may help the child feel more at ease despite the difficult diagnosis.
When a child is diagnosed with cancer, they will usually be referred for treatment at a children’s facility – such as BC Children’s Hospital in Vancouver. These types of hospitals are specifically specialized in diagnosing and treating children with cancer and other childhood-related illnesses and diseases, and they provide comprehensive care in addition to support for families.
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Whooping Cough
There are certain medical conditions that can affect children more-so than adults – whopping cough being one of them. While it can impact adults – including those diagnosed with a chronic respiratory illness, or women who are pregnant (especially those in their third trimester) – whooping cough is most commonly seen in infants younger than 6 months of age (who aren’t yet protected by immunizations), or children and teens between aged 11 and 18 with weakened immune systems.
Whooping cough is a highly contagious bacterial infection of the respiratory tract that is caused by the bacterium known as Bordetella pertussis. Whooping cough typically starts with mild cold-like symptoms (such as runny nose, sore throat, and slightly raised temperature.) Approximately one week after the onset of these symptoms, severe coughing spells will follow (as well as the potential to cause trouble with breathing.) These coughing spells can be rapid and uncontrolled, and can last anywhere from 1 to 6 weeks – with the spells oftentimes worsening and becoming more frequent as the illness persists.
As mentioned, whopping cough is contagious and is spread through the air when an infected person coughs or sneezes, while it can also be spread by coming into contact with the infected person’s mucus or saliva.
If left untreated, whooping cough can lead to other complications – especially in babies younger than 1 year of age – and may require hospitalization. Therefore, it’s important to treat it as early as possible with antibiotics. Hospital treatment typically focuses on monitoring breathing and giving oxygen if necessary, ensuring breathing passages are clear, and preventing dehydration. In addition to treating whopping cough with antibiotics, there are other things that you can do to manage symptoms at home, such as by keeping your home free from irritants (i.e., smoke, dust, and chemical fumes), use a humidifier to help loosen mucus and soothe the cough, wash hands often, and drink plenty of fluids (i.e., water, juice, soup.)
Vaccination is the best preventative measure against whooping cough, and is recommended for all babies, children, pre-teens, and pregnant women.
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Reducing Back-to-School Anxiety
For some kids and teenagers, returning to school can also come along with a lot of stress and anxiety. In many cases, that back-to-school anxiety is often associated with things such as being away from parents or other family members (especially for younger children who are starting full-time school for the first time), or having to go to a brand new school (for example, transitioning from elementary school to high school, or moving to a new neighbourhood and having to go to a new school as a result.) There are also cases where children may be bullied in school in the past and might have fears about returning. In addition to these aforementioned reasons, COVID-19 is also adding to the stress and anxiety that children might be experiencing when it comes to their return to classrooms. Thus, it’s important that adults do as much as they can to ease the fear and anxiety that children may be facing and make their return to school a positive experience.
For children who are starting school for the first time, or those going to a new school, one of the most common concerns voiced by kids is their fear of having to make new friends, or not being able to see or spend as much time with friends from their previous school. Some children may also find it hard to interact with those they aren’t already familiar with due to their anxiety holding them back, while others may feel rejected by their peers, which are things that may also result in a decline in their social skills. To better understand what your child is struggling with and why they might be having difficulty making new friends at school, as them some of the following concrete questions – i.e., “Did you play or hang out with anyone new today?”, “What do you like about that person”, “How were the other kids treating you?” Also look for any signs that your child may be having trouble with social skills, such as body language (lack of smiling, eye contact, different facial expressions), voice quality (clarity, volume of speech), and any noticeable changes in their basic conversational skills. If you’ve recently moved to a new neighbourhood, get to know your neighbours and suggest your kids walk to school together with others their age, as this can be another good way for kids to start to build new friendships.
If a child is or has been bullied in school in the past, this can also cause them to want to retreat and avoid their peers or avoid going to school all together. While it can sometimes be difficult to determine if your child has been bullied at school due to them not wanting to talk about it, there are some telltale signs to watch for. For example, they may develop emotional changes (such as crying more, having low self-esteem, appearing moody/angry, or being depressed), may make up excuses as to why they don’t want to go to school, spends less time with friends, comes home from school with missing belongings, expresses physical symptoms such as stomach aches or nausea. If your child exhibits any of these signs, it’s important to start a dialogue with them and assure them that what’s happening to them isn’t their fault. Parents should also let school staff know what’s going on. It can also be beneficial to share yours and your child’s concerns with a doctor, counsellor, or psychologist.
When it comes to COVID-19, this is something that has increased fear, stress and anxiety in all of us – and for different reasons. Younger children in particular, however, may be much more confused by COVID-19. With physical distancing, for example, they may not have been able to see or communicate with their peers as much as they’re used to. Classrooms are also going to look much different than they did in years prior, with more focus on hygiene practices (such as regular hand washing) and learning groups – which is defined as a group of students and staff that primarily interact with each other and who remain together throughout the school’s quarter, semester or year, as opposed to moving from class to class. Things like school recess and lunches may also be staggered so that students aren’t all congregating together at once. In addition, children may also be required to wear face masks at certain times in school where it’s not possible to fully physically distance from others, which some kids may find uncomfortable or annoying to wear. However, explaining to kids why these health and safety measures need to be put in place, as well as explaining to them that the changes are only temporary, can help reduce the fears they may have surrounding the virus. For more information on B.C.’s Back to School Plan, visit backtoschool.gov.bc.ca.
