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Cow's milk allergy (CMA) is one of the most common food allergies in the first years of life, with worldwide prevalence estimated to range from 2% to 5%. While the majority of children with CMA will eventually develop tolerance to cow's milk proteins (it is estimated that >75% of children with CMA develop tolerance to cow's milk proteins by the age of 3 years, and >90% develop tolerance by the age of 6 years), the selection of an appropriate cow's milk (CM) alternative for those with CMA is vital to ensure adequate growth and development during childhood. The increasing number of CM alternative products on the commercial market with markedly different nutritional content and micronutrient fortification adds a layer of complexity that can be challenging for both families and clinicians to navigate. This article aims to provide guidance and clarity to Canadian paediatricians and primary care clinicians on recommending the most appropriate, safe, and nutritionally optimal CM alternatives for individuals with CMA, and beyond. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Our objective was to describe the prevalence of urinary tract infection (UTI) and invasive bacterial infection (IBI) in febrile infants during the coronavirus disease 2019 pandemic. METHODS: We conducted a multicenter cross-sectional study that included 97 hospitals in the United States and Canada. We included full-term, well-appearing infants 8 to 60 days old with a temperature of ≥38°C and an emergency department visit or hospitalization at a participating site between November 1, 2020 and March 31, 2022. We used logistic regression to determine trends in the odds of an infant having UTI and IBI by study month and to determine the association of COVID-19 prevalence with the odds of an infant having UTI and IBI. RESULTS: We included 9112 infants; 603 (6.6%) had UTI, 163 (1.8%) had bacteremia without meningitis, and 43 (0.5%) had bacterial meningitis. UTI prevalence decreased from 11.2% in November 2020 to 3.0% in January 2022. IBI prevalence was highest in February 2021 (6.1%) and decreased to 0.4% in January 2022. There was a significant downward monthly trend for odds of UTI (odds ratio [OR] 0.93; 95% confidence interval [CI]: 0.91-0.94) and IBI (OR 0.90; 95% CI: 0.87-0.93). For every 5% increase in COVID-19 prevalence in the month of presentation, the odds of an infant having UTI (OR 0.97; 95% CI: 0.96-0.98) or bacteremia without meningitis decreased (OR 0.94; 95% CI: 0.88-0.99). CONCLUSIONS: The prevalence of UTI and IBI in eligible febrile infants decreased to previously published, prepandemic levels by early 2022. Higher monthly COVID-19 prevalence was associated with lower odds of UTI and bacteremia. [ABSTRACT FROM AUTHOR]

It has long been established that bullying has many negative impacts on the mental health of adolescents. Young people who are victimized by bullying may cope by drawing on available assets to protect themselves from harm. One such asset with ancient roots but with the potential for contemporary application is the concept of spiritual health—the idea that the connections in our lives (whether to ourselves, others, nature, or something transcendent) affect our well-being. In this study, we examined 12,593 Canadians aged 11–15 years to determine the effects of being victimized by bullying on their mental health, as measured by frequent subjective health complaints. We then explored whether strong spiritual health connections were effect modifiers that buffer such negative pathways, thereby acting as protective health assets. Data were obtained from the 2017/18 Canadian Health Behaviour in School-aged Children study. Generalized linear regression models were used to estimate associations and evaluate effect modification in different age and gender groups. Approximately 21% of participants reported being victimized by bullying. Strength of "connections to self" (i.e., a sense of meaning/purpose or joy and happiness in one's life) was found to act as an effect modifier, but in girls alone. Contrary to expectations of a buffering effect, the strongest associations between victimization and frequent health complaints were identified for girls with high connections to self. Relative risks for poor mental health among these highly self-connected girls were 1.63 [95% CI: 1.26–2.12] and 1.25 [1.06–1.47] for younger and older girls, respectively. We interpreted this unexpected finding in light of cognitive theories of trauma, which suggest that adverse events may lead to worse health outcomes among those who place particular value on their world being meaningful, controllable or benevolent. Implications for clinical intervention and health promotion are considered. [ABSTRACT FROM AUTHOR]

Objectives Screening for hypertension in children is recommended by pediatric consensus guidelines. However, current practice is unknown. We evaluated rates of blood pressure assessment and hypertension recognition in primary care. Methods This retrospective cohort study evaluated electronic medical record data from the Canadian Primary Care Sentinel Surveillance Network between 2011 and 2017. Children aged 3 to <18 years with at least one clinical encounter were included. Screening, follow-up, and hypertension recognition rates were evaluated. Descriptive statistics and multivariate logistical regression were used to determine patient and provider characteristics associated with increased screening and recognition of pediatric hypertension. Results Among 378,002 children, blood pressure was documented in 33.3% of all encounters, increasing from 26.7% in 2011 to 36.2% in 2017; P=0.007. Blood pressure was documented in 76.0% of well child visits. Follow-up visits occurred within 6 months for 26.4% of children with elevated blood pressure, 57.1% of children with hypertension, and within 1 month for 7.2% of children with hypertension. Patient factors associated with increased blood pressure screening include being overweight (OR 2.15, CI 2.09 to 2.22), having diabetes (OR 1.69, CI 1.37 to 2.08), chronic kidney disease (OR 7.51, CI 6.54 to 8.62), increased social deprivation (OR 1.10, CI 1.09 to 1.11), and urban residence (OR 1.27, CI 1.15 to 1.4). Overall prevalence of hypertension was 1.9% (n=715) and of those, 5.6% (n=40) had recognized hypertension. Factors associated with increased recognition include male sex, overweight, and hyperlipidemia. Conclusions Rates of hypertension screening and recognition are low in primary care settings in Canada, suggesting pediatric hypertension should be a priority for implementation and dissemination of interventions. [ABSTRACT FROM AUTHOR]

A number of studies have demonstrated that patients with autoimmune disease have lower levels of vitamin D prompting speculation that vitamin D might suppress inflammation and immune responses in children with juvenile idiopathic arthritis (JIA). The objective of this study was to compare vitamin D levels in children with JIA at disease onset with healthy children. We hypothesized that children and adolescents with JIA have lower vitamin D levels than healthy children and adolescents. Data from a Canadian cohort of children with new-onset JIA (n = 164, data collection 2007-2012) were compared to Canadian Health Measures Survey (CHMS) data (n =4027, data collection 2007-2011). We compared 25-hydroxy vitamin D (25(OH)D) concentrations with measures of inflammation, vitamin D supplement use, milk intake, and season of birth. Mean 25(OH)D level was significantly higher in patients with JIA (79 ± 3.1 nmol/L) than in healthy controls (68 ± 1.8 nmol/L P <.05). Patients with JIA more often used vitamin D containing supplements (50% vs. 7%; P <.05). The prevalence of 25(OH)D deficiency (<30 nmol/L) was 6% for both groups. Children with JIA with 25(OH)D deficiency or insufficiency (<50 nmol/L) had higher C-reactive protein levels. Children with JIA were more often born in the fall and winter compared to healthy children. In contrast to earlier studies, we found vitamin D levels in Canadian children with JIA were higher compared to healthy children and associated with more frequent use of vitamin D supplements. Among children with JIA, low vitamin D levels were associated with indicators of greater inflammation. [ABSTRACT FROM AUTHOR]

Hearing loss is an important health concern in Canada's Arctic. The objective of this research was to provide information on the prevalence of childhood hearing loss in Nunavut. This cross-sectional study involved comprehensive audiologic assessments of school-aged children in six communities to determine overall and community-specific prevalence of hearing loss. Data were collected about hearing aid use and factors affecting use through a parent questionnaire. Assessments were completed for 644 children in kindergarten to grade 6. 124 (19.3%) children had hearing loss of ≥ 30 dB HL at one or more frequencies in at least one ear (93.5% conductive loss). Applying a Canadian prevalence study definition, 148 (23.5%) children had hearing loss. Tympanic membrane perforations were present in 36.8% (n = 28) of children with unilateral and 45.8% (n = 22) with bilateral loss. The prevalence of hearing loss in Canada's North was almost three times that reported for non-indigenous children. One in five school-aged children was found to have hearing loss that is likely to affect classroom learning and social/emotional development. A hearing health strategy tailored to this population is critically needed. [ABSTRACT FROM AUTHOR]

Background We assess the impact of the 2017 American Academy of Pediatrics (AAP) guidelines on the prevalence of high blood pressure (BP) in generally healthy Canadian children and identify risk factors associated with high BP (elevated, stage 1, or stage 2 at a single visit). Methods A cohort of 7,387 children aged 6 to 18 years in the Canadian Health Measures Survey (CHMS, 2007 to 2015) had BPTru oscillometry with centiles and stages assigned using both the 2017 AAP guidelines and the 2004 Fourth Report from the National Institute of Health/National Heart Lung and Blood Institute (NIH/NHLBI). Results Although both shifted upwards significantly, mean population systolic BP and diastolic BP percentiles are now 24.2 (95% confidence interval: 23.3 to 25.2) and 46.4 (45.3 to 47.6). As a result, the population prevalence of high BP increased from 4.5% (3.9 to 5.2, NIH/NHLBI) to 5.8% (5.0 to 6.6, AAP), less than in US children measured by auscultation (14.2%, 13.4 to 15.0). Children with high BP were more likely to be overweight/obese, to be exposed to prenatal/household smoking, and to have hypertriglyceridemia, without differences in dietary salt, infant breastfeeding, neonatal hospitalizations, or exercise frequency. Conclusion The 2017 AAP guidelines increase the prevalence of high BP in Canadian children; Canadian prevalence appears lower than in the USA. This may reflect differences in measurement methods or in the prevalence of childhood overweight/obesity between countries, that is, 31.1% (28.9 to 33.3) versus 40.6% (39.5 to 42.0), respectively. Those with high BP were more likely to have other cardiac risk factors, including overweight/obesity, prenatal/household smoking exposure, and hypertriglyceridemia. [ABSTRACT FROM AUTHOR]

Objective: Weight loss attempts occur as early as childhood. The impacts of weight loss attempts and weight‐related stress on the occurrence of obesity during childhood remain unknown. We aimed to: (a) assess the prevalence of self‐reported weight loss attempts and weight‐related stress in 8–10 year‐old children and (b) determine associations with adiposity 2 years later. Method: Data were collected from a cohort study of 564 Canadian children aged 8–10 years, having one or both biological parents with obesity (Quebec Adipose and Lifestyle Investigation in Youth cohort). Self‐reported weight loss attempts and weight‐related stress were assessed at baseline in the child's questionnaire. Adiposity was measured at baseline and 2 years later using body mass index z‐scores (zBMI), waist‐to‐height ratio (WHtR), and percentage of body fat (%BF) obtained from dual‐energy x‐ray absorptiometry. Linear and logistic regression analyses were used while adjusting for potential confounders. Results: Forty‐eight percent of children reported previous weight loss attempts and 20% reported weight‐related stress. Self‐reported weight loss attempts and weight‐related stress were associated with higher zBMI, WHtR, and %BF 2 years later in adjusted models, although estimates were attenuated when including baseline adiposity measures. Self‐reported weight loss attempts, but not weight‐related stress, increased the risk of becoming overweight among children who were normal weight at baseline. Discussion: Weight loss attempts are prevalent in children with parental obesity. Children reporting weight loss attempts and weight‐related stress tend to have higher adiposity 2 years later and are more likely to become overweight. [ABSTRACT FROM AUTHOR]

This study aimed to examine the association between breastfeeding and childhood obesity. A multinational cross‐sectional study of 4,740 children aged 9–11 years was conducted from 12 countries. Infant breastfeeding was recalled by parents or legal guardians. Height, weight, waist circumference, and body fat were obtained using standardized methods. The overall prevalence of obesity, central obesity, and high body fat were 12.3%, 9.9%, and 8.1%, respectively. After adjustment for maternal age at delivery, body mass index (BMI), highest maternal education, history of gestational diabetes, gestational age, and child's age, sex, birth weight, unhealthy diet pattern scores, moderate‐to‐vigorous physical activity, sleeping, and sedentary time, exclusive breastfeeding was associated with lower odds of obesity (odds ratio [OR] 0.76, 95% confidence interval, CI [0.57, 1.00]) and high body fat (OR 0.60, 95% CI [0.43, 0.84]) compared with exclusive formula feeding. The multivariable‐adjusted ORs based on different breastfeeding durations (none, 1–6, 6–12, and > 12 months) were 1.00, 0.74, 0.70, and 0.60 for obesity (Ptrend =.020) and 1.00, 0.64, 047, and 0.64 for high body fat (Ptrend =.012), respectively. These associations were no longer significant after adjustment for maternal BMI. Breastfeeding may be a protective factor for obesity and high body fat in 9‐ to 11‐year‐old children from 12 countries. [ABSTRACT FROM AUTHOR]

Background: To develop a pediatric-specific hypertension algorithm using administrative data and use it to evaluate the association between acute kidney injury (AKI) in the intensive care unit (ICU) and hypertension diagnosis 5 years post-discharge. Methods: Two-center retrospective cohort study of children (≤ 18 years old) admitted to the pediatric ICU in Montreal, Canada, between 2003 and 2005 and followed until 2010. Patients with a valid healthcare number and without end-stage renal disease were included. Patients who could not be merged with the provincial database, did not survive admission, underwent cardiac surgery, had pre-existing renal disease associated with hypertension or a prior diagnosis of hypertension were excluded. AKI defined using the Kidney Disease: Improving Global Outcomes (KDIGO) definition. Using diagnostic codes and medications from administrative data, novel pediatric-specific hypertension definitions were designed. Both the evaluation of the prevalence of hypertension diagnosis and the association between AKI and hypertension occurred. Results: Nineteen hundred and seventy eight patients were included (median age at admission [interquartile range] 4.3 years [1.1–11.8], 44% female, 325 (16.4%) developed AKI). Of these patients, 130 (7%) had a hypertension diagnosis 5 years after discharge. Patients with AKI had a higher prevalence of hypertension diagnosis [non-AKI: 84/1653 (5.1%) vs. AKI: 46/325 (14.2%), p <.001]. Children with AKI had a higher adjusted risk of hypertension diagnosis (hazard ratio [95% confidence interval] 2.19 [1.47–3.26]). Conclusions: Children admitted to the ICU have a high prevalence of hypertension post-discharge and children with AKI have over two times higher risk of hypertension compared to those with no AKI. [ABSTRACT FROM AUTHOR]

Introduction: Overweight and obesity (OW/OB) rates are increasing among Canadian children and youth, with rates currently affecting one-third of 5–17 year olds. OW/OB is associated with numerous physical and psychosocial consequences, which are compounded when a child has a pre-existing disability. This is concerning considering children with disabilities experience OW/OB at two to three times the rate of their typically developing peers. While the number of weight management programs have been increasing, they are generally designed to meet the needs of typically developing children and often exclude children with disabilities. This review identifies existing weight management programs for youth with disabilities, and examines their characteristics and outcomes. Methods: A scoping review was conducted using rapid review principles. Three health and social science databases were searched using terms related to "disabilities", "obesity", and "weight management", limited to 2007–2017. Articles meeting the inclusion criteria were summarized and analyzed thematically. Results: Five articles met inclusion criteria, and described four separate weight management programs. All included children and youth with intellectual disabilities, with one including children with physical disabilities. Programs had three traits in common: (1) utilizing inter/multidisciplinary teams; (2) using technology to deliver the program; and (3) engaging the family during the entire program. All articles reported that the programs reduced body mass index. Conclusion: The scarcity of programs designed to meet the unique needs of youth with disabilities is alarming. Although a robust evidence base is lacking, current research provides some directions into components that should be considered when designing future interventions. 1. Clinicians should be aware of the high prevalence of overweight and obesity and the resultant consequences in children with disabilities. 2. The use of inter/multidisciplinary teams, technology, and family engagement all appear to be promising approaches to creating successful weight management programs: a. Weight-management programs should utilize inter/multidisciplinary teams to consider physical, social and psychological aspects of weight and health, to allow treatment plans to encompass a wider range of suggestions and recommendations. b. Health care providers should consider using technology as a platform to deliver weight-management programs and services and/or to directly track progress. c. Families are powerful agents of change, and should be consulted and involved in the delivery of weight-management programs. [ABSTRACT FROM AUTHOR]

Objectives With no nationally-endorsed guidelines and the emergence of newer diagnostic tools, there exists significant variation in the management of febrile infants <90 days. We sought to evaluate the prevalence and content of clinical decision tools (CDTs) for the emergency department (ED) and inpatient management of febrile young infants across Canada. Methods We undertook a cross-sectional analysis of febrile young infant CDTs from ED and inpatient units at all 16 Canadian tertiary paediatric hospitals. Additional data were collected using an electronic survey of ED and inpatient representatives, characterizing their clinical settings and diagnostic test availability. Content of all existent CDTs was independently reviewed using list items determined a priori. The primary outcome was the proportion of EDs and inpatient units with CDTs. Results Information regarding CDTs was gathered from all 16 EDs and 16 inpatient units. CDTs were infrequently available (9/32, 28%), and were more common in the ED than inpatient setting (8/16 versus 1/16, P=0.02). Review of existing CDTs revealed inter-centre differences for inclusion ages, treatment regimens, lumbar puncture recommendations, diagnostic testing and normal laboratory values. Despite availability reported at nearly all centres, C-reactive protein and respiratory virus testing were recommended in 3/9 and 5/9 CDTs, respectively. Procalcitonin testing was available at only 2/16 (13%) centres, and not incorporated into any CDTs. Conclusions CDTs for the management of febrile young infants are infrequently available among Canadian tertiary paediatric centres, and rarely incorporate newer diagnostic tests. Heterogeneity among existent CDTs highlights the need for evidence-based unified ED and inpatient national guidelines. [ABSTRACT FROM AUTHOR]

This study examined the variation among ethnic populations in prevalence of anemia, vitamin D and B12 deficiencies among refugee children. A retrospective chart review of 388 government assisted refugee children ≤ 16 years of age, seen at the Refugee Health Clinic in Kitchener, Canada from January 2009 to December 2014 was conducted. Vitamin D levels were only collected until December 1st 2010 (116 children). 15.7% were anemic (25% < 5 years, 8.7% 5-11 years, and 18.3% 12-16 years old) with Somali children having the lowest hemoglobin levels compared to those from Iraq, Afghanistan and Myanmar. 53.5% were vitamin D deficient (25(OH)D < 50 nmol/L), seen most commonly in Iraqis and Afghans. 11.2% had vitamin B12 levels < 150 pmol/L. Providers’ knowledge of prevalence of nutritional deficiencies related to region of origin, can guide appropriate screening and treatment options to promote longer term cognitive, physical and developmental health. [ABSTRACT FROM AUTHOR]

The limited implementation of a trauma-informed approach in Canadian mental health care may partly reflect limited knowledge regarding the prevalence and/or impact of childhood trauma among service users. This study examined the prevalence of childhood maltreatment in a sample of 136 Canadian adult mental health service users, and examined its cumulative burden in relation to psychiatric distress and suicidality. Eighty-six percent reported some form of childhood maltreatment, with the majority experiencing multiple traumas. Cumulative trauma was significantly associated with psychiatric distress and history of suicide attempt. The findings suggest implications for Canadian mental health practice, policy, and further research. [ABSTRACT FROM AUTHOR]

Background and Objective: Incidence rates of type 1 diabetes have long been on the rise across the globe, however, there is emerging evidence that the rate of rise may be slowing. The objective of this study was to describe trends in the incidence and prevalence of type 1 diabetes in a sample of Canadian children and youth. Methods: Cases were extracted using linked administrative datasets and a validated diabetes case‐finding definition. Incidence and prevalence trends were analyzed using the JoinPoint regression analysis program. Results: A small increase in the incidence of type 1 diabetes was observed over the 11‐year period from 2002‐2003 to 2012‐2013. Total incident cases per year ranged from 201 (2005‐2006) to 250 (2007‐2008). Total prevalent cases per year ranged from 1790 (2002‐2003) to 2264 (2012‐2013). Incidence was highest among children aged 5 to 14 years, and lowest in the youngest (1‐4 years) and oldest (15‐19 years) age brackets. The most significant increase in incidence was in children aged 10 to 14 years. Age‐standardized prevalence increased significantly throughout the study period. Conclusion: These results are similar to data from the United States but differ from European data with respect to the annual percent change for incidence as well as age‐specific incidence trends. In keeping with the low mortality rates associated with type 1 diabetes, the prevalence continues to rise. [ABSTRACT FROM AUTHOR]

Background: High rates of food insecurity are documented among Inuit households in Canada; however, data on food insecurity prevalence and seasonality for Inuit households with children are lacking, especially in city centres. This project: (1) compared food consumption patterns for households with and without children, (2) compared the prevalence of food insecurity for households with and without children, (3) compared food consumption patterns and food insecurity prevalence between seasons, and (4) identified factors associated with food insecurity in households with children in Iqaluit, Nunavut, Canada.Methods: Randomly selected households were surveyed in Iqaluit in September 2012 and May 2013. Household food security status was determined using an adapted United States Department of Agriculture Household Food Security Survey Module. Univariable logistic regressions were used to examine unconditional associations between food security status and demographics, socioeconomics, frequency of food consumption, and method of food preparation in households with children by season.Results: Households with children (n = 431) and without children (n = 468) participated in the survey. Food insecurity was identified in 32.9% (95% CI: 28.5-37.4%) of households with children; this was significantly higher than in households without children (23.2%, 95% CI: 19.4-27.1%). The prevalence of household food insecurity did not significantly differ by season. Demographic and socioeconomic characteristics of the person responsible for food preparation, including low formal education attainment (ORSept = 4.3, 95% CI: 2.3-8.0; ORMay = 3.2, 95% CI: 1.8-5.8), unemployment (ORSept = 1.1, 95% CI: 1.1-1.3; ORMay = 1.3, 95% CI: 1.1-1.5), and Inuit identity (ORSept = 8.9, 95% CI: 3.4-23.5; ORMay = 21.8, 95% CI: 6.6-72.4), were associated with increased odds of food insecurity in households with children. Fruit and vegetable consumption (ORSept = 0.4, 95% CI: 0.2-0.8; ORMay = 0.5, 95% CI: 0.2-0.9), as well as eating cooked (ORSept = 0.5, 95% CI: 0.3-1.0; ORMay = 0.5, 95% CI: 0.3-0.9) and raw (ORSept = 1.7, 95% CI: 0.9-3.0; ORMay = 1.8, 95% CI: 1.0-3.1) fish were associated with decreased odds of food insecurity among households with children, while eating frozen meat and/or fish (ORSept = 2.6, 95% CI: 1.4-5.0; ORMay = 2.0, 95% CI: 1.1-3.7) was associated with increased odds of food insecurity.Conclusions: Food insecurity is high among households with children in Iqaluit. Despite the partial subsistence livelihoods of many Inuit in the city, we found no seasonal differences in food security and food consumption for households with children. Interventions aiming to decrease food insecurity in these households should consider food consumption habits, and the reported demographic and socioeconomic determinants of food insecurity. [ABSTRACT FROM AUTHOR]

There is a growing interest in English-speaking jurisdictions, including Australia, North America, Canada, the United Kingdom and New Zealand, about the prevention of sexual abuse perpetrated by children against other children. The aim of this review was to identify opportunities for research, policy and practice which could enhance the prevention agenda relating to the perpetration of sexual abuse by children through conducting a Critical Interpretive Synthesis. Eleven electronic databases were searched in the period from 22 April to 23 May 2013 and included: SocINDEX, Social Services Abstracts, Applied Social Sciences Index and Abstracts, Family and Society Studies Worldwide, Project Muse, PsychINFO, Family and Society Plus, Jstor, Expanded Academic ASAP, Web of Science and Google Scholar. Key individual journals were also searched, including Child Abuse and Neglect and the Journal of Interpersonal Violence, as well as the grey literature. The search was guided by the research question: How could the prevention agenda relating to sexual abuse perpetrated by children be enhanced? The systematic literature search yielded 3323 titles, and 34 of these papers were included in the final synthesis. The authors identified five domains operating in the evidence base: characteristics, causes, communications, interventions and treatments. A synthesising construct emerged from the review: prevention-enhancing interactions. This construct referred to the potential for enhancing the prevention agenda which exists as the evidence domains interact with one another, and with the public health model of prevention. The authors consider this review to be a timely contribution to the current agenda pertaining to sexual abuse perpetrated by children. It provides researchers, policy makers and practitioners in the field with an evidence-informed conceptualisation of opportunities for enhancing prevention work. [ABSTRACT FROM AUTHOR]

The objective of this study was to provide contemporary sleep duration estimates of Canadian school-aged children and adolescents and to determine the proportion adhering to the sleep duration recommendations. This study included 24 896 participants aged 10-17 years from the 2013/2014 Canadian Health Behaviour in School-aged Children study ( HBSC), a nationally representative cross-sectional study. Bedtime and wake-up times were reported by participants and their sleep duration was calculated. Participants were then classified as having a sleep duration that met the recommended range (9-11 h per night for 10-13-year-olds or 8-10 h per night for 14-17-year-olds), a sleep duration that was shorter than the recommended range or a sleep duration that was longer than the recommended range. An estimated 68% of children aged 10-13 years and 72% of adolescents aged 14-17 years sleep for the recommended amount per night when averaged across all days of the week. Short sleepers represent 31% of school-aged children and 26% of adolescents. Long sleepers are rare (<2% overall). Children and adolescents sleep ~1 h more at weekends compared to weekdays. Approximately 5% of the participants typically went to bed after midnight on weekdays and 31% did so at weekends; these proportions reached 11 and 45%, respectively, within 16-17-year-olds. In general, differences in sleep times between boys and girls are small and not clinically significant. In conclusion, almost one-third of Canadian children and adolescents sleep less than the recommended amount. Public health efforts should continue to monitor the sleep of Canadian children and adolescents and identify subgroups of the population more likely to be affected by insufficient sleep. [ABSTRACT FROM AUTHOR]

Introduction: Excess weight is a key risk factor for chronic disease, and the systematic collection, analysis and reporting of key trends are important to surveillance of overweight and obesity. Methods: We used univariate analyses to calculate current prevalence estimates of excess weight among Canadian children and youth. Results: Almost 1 in 7 children and youth is obese. Rates vary based on sociodemographic factors such as age, sex, socioeconomic status and place of residence. Overall, the rates of excess weight have been relatively stable over the past decade. Conclusion: Ongoing monitoring of childhood obesity will provide useful information to assist with sustained actions to promote healthy weights. [ABSTRACT FROM AUTHOR]

Background. Ear infections in children are a major health problem and may be associated with hearing impairment and delayed language development. Objective. To determine the prevalence and the associated risk factors of ear infections in children 6–17 years old residing on two reserves and rural areas in the province of Saskatchewan. Methodology. Data were provided from two rural cross-sectional children studies. Outcome variable of interest was presence/absence of an ear infection. Logistic regression analysis was conducted to examine the relationship between ear infection and the other covariates. Results. The prevalence of ear infection was 57.8% for rural Caucasian children and 43.6% for First Nations children living on-reserve. First Nations children had a lower risk of ear infection. Ear infection prevalence was positively associated with younger age; first born in the family; self-reported physician-diagnosed tonsillitis; self-reported physician-diagnosed asthma; and any respiratory related allergy. Protective effect of breastfeeding longer than three months was observed on the prevalence of ear infection. Conclusions. While ear infection is a prevalent condition of childhood, First Nations children were less likely to have a history of ear infections when compared to their rural Caucasian counterparts. [ABSTRACT FROM AUTHOR]

Background: Limited cutaneous synthesis due to low sun exposure and inadequate dietary intake makes vitamin D supplementation a necessity for many Canadian children. Identification of the factors associated with supplement use is necessary for public health awareness campaigns, but they have not been identified previously. Therefore, the purpose of this study was to assess the prevalence and the determinants of the use of vitamin D supplements among children in the province of Alberta, Canada.Methods: In 2014, a representative sample of grade five students (10-11 y) in Alberta (n = 2686) was surveyed. Data on dietary intake and use of vitamin D supplements were obtained using a modified Harvard Youth/Adolescent Food Frequency questionnaire. Mixed effect multiple logistic regression was employed to identify the key correlates of supplement use.Results: Use of vitamin D supplements by children was 29.45 % although only 11.83 % took supplements daily. Children who resided in a metropolitan area (OR = 1.32; 95 % CI:1.06-1.65), were more physically active (2nd tertile: OR = 1.39; 95 % CI:1.09-1.78 and 3rd tertile: OR = 1.70; 95 % CI:1.33-2.16), or whose parents completed college (OR = 1.35; 95 % CI:1.05-1.74) were more likely to take vitamin D supplements. Prevalence of use was highest among those who had a high vitamin D diet and those with under/normal body weight status, although supplement use was not statistically associated with either dietary vitamin D intake or weight status.Conclusions: A considerable proportion of children did not take vitamin D supplements. Region of residence, physical activity level and parental education were determinants of supplement use, independent of child's gender, household income, weight status and dietary practices. We suggest prioritizing public health efforts to support strategies to make parents aware of the importance of providing the correct dose of vitamin D supplements for their children to meet dietary recommendations. [ABSTRACT FROM AUTHOR]

Background: Iron deficiency in early childhood has been associated with poor developmental outcomes. Little is known about the nutritional health of young children receiving care at Canadian Community Health Centres (CHCs). Our objectives were to describe iron deficiency among toddlers at an Ontario CHC, to compare young children attending CHCs and non-CHCs, and assess the feasibility of conducting research on children in CHC settings. Methods: One CHC, Kingston Community Health Centres (CHC) with two clinical sites and one community programming site was added to the nine non-CHC pediatric and primary care clinics in the existing TARGet Kids! research network. A cross-sectional feasibilitystudy was conducted.and. Healthy children, ages 12–36 months were Enrolled. iron deficiency without inflammation (ferritin< 14 μg/L and CRP < 10 mg/L) and serum ferritin were assessed. Adjusted multivariable regression analyses were used to evaluate an association between CHC enrolment and iron status. Results: The CHC cohort (n = 31) was older, had lower household income, lower maternal education, higher nutrition risk scores, higher cow's milk intake, shorter breastfeeding duration and higher prevalence of unhealthy weights compared with the non-CHC cohort (n = 875). There was no association between CHC status and serum ferritin (difference in median serum ferritin 4.78 μg/L, 95% confidence interval [CI] -2.5, 14.3, p = 0.22) or iron deficiency (OR 0.55, 95% CI 0.11, − 2.73, p = 0.46) using multivariable linear and logistic regression, respectively. Conclusion: Despite differences in sociodemographic variables, we did not detect a difference in iron status between toddlers enrolled at CHCs compared to non-CHC settings. Further research is needed to understand the health effects of poverty generally, and iron deficiency specifically among children receiving care at CHCs. [ABSTRACT FROM AUTHOR]