Looking after your child's general health will help them to manage their symptoms and reduce side-effects. It's particularly important to encourage your child to eat a healthy diet and to exercise as much as their condition allows them to.
The importance of a healthy diet
It can help your child to manage their condition if they keep to a healthy weight. Being overweight can make symptoms of arthritis worse and can put extra strain on their joints. Your child will really benefit from a healthy, low-fat, nutritious diet with plenty of vitamins and minerals.
Some children will be given steroids for their arthritis. These drugs can greatly reduce the symptoms of arthritis, such as swelling and pain, but they can lead to weight gain. This is another reason why it's important to watch what your child eats.
Vitamin D and calcium
Taking regular steroids can also leave some people at risk of developing a vitamin D deficiency. Vitamin D helps the body to process calcium, which is needed to develop strong, healthy bones. Making sure that your child has plenty of vitamin D and calcium is important for bone health.
The best way to get vitamin D is through exposure to sunlight. Guidelines vary on how much sunlight people should be exposed to and this will depend on your child’s sensitivity to sunlight.
Most guidelines promote around 10–15 minutes of sunlight exposure every day on bare skin, for example on arms and/or legs, without sun cream in the months of June to September in the UK. People with darker skin need more exposure to sunlight and more exposure is needed in the winter.
Be careful not to let your child's skin get red or burnt.
Oily fish (salmon, mackerel) are the best natural sources of vitamin D in food. Many products also have vitamin D added to them, including:
- orange juice
Foods and drinks that have a lot of calcium include:
- dairy products (soya milk is the best source of calcium as a non-dairy alternative to milk)
- green vegetables such as kale, collard greens and broccoli
- certain nuts.
Many foods have calcium added, such as cereals and soy products.
Finding the right balance of allowing your child some treats within a healthy diet is something that will come naturally to you as a parent. You don't want your child to feel like they are being punished.
Encouraging your child to eat plenty of fresh fruit and vegetables is very important. Healthy alternatives to fatty or sugary treats could include:
- dried fruit
- cereal bars
- baked alternatives to crisps
- wholemeal muffins
- oatmeal biscuits
- carrot sticks and dip
- popcorn which is low in sugar and salt.
It's important to remember that while encouraging your child to make positive health choices is absolutely the right thing to do, some children naturally carry a bit of weight at different stages when they're growing up. So it's very important for your child's emotional well-being that while you instill a desire to be fit and healthy, you don't encourage them to be preocuppied about their weight.
Read more about diet.
Arthritis can affect many areas of your life. It's important to look after your child's mental health as well as their physical health.
Talk about your child's condition
Your child will probably feel angry, scared and upset at having this condition at a young age. These feelings are natural, and a sympathetic ear, kindness and plenty of attention from loved ones can go a long way to help.
Caring and experienced healthcare professionals will also be on hand to help and to answer any questions. Encourage your child to ask you and their healthcare professionals questions.
It's important to take care of your own well-being too. As a parent, it can be a worrying time, so don't be afraid of discussing your worries with people you trust.
It's usually sensible to openly discuss your child's condition and management of their healthcare with them and the rest of your family. It can also be helpful to talk to another family who've been through the same experience. Discuss this with your paediatric or adolescent rheumatology team if you'd like the chance to do this.
There can be many different types of treatment for arthritis. It's important to be aware of what medication your child is taking and to know where you can go if you have any questions.
Talk to your rhemumatology team
Your rheumatology team will give you information on your child's condition and their management plan. Write down any questions and bring them to clinic.
Make sure you have the contact details of your rheumatology team, especially the clinical nurse specialists, so you can call them if you have any questions or concerns that can't wait until clinic.
Contact your rheumatology team (again usually through the clinical nurse specialist) if you're concerned with your child's joints or other aspects of their health that you think could be linked to their condition. Get in touch if you have concerns with medications, including around side-effects.
Your child's arthritis doesn't have to stop them enjoying school and doing well there. Some early planning, plenty of communication with teachers and listening to your child can make a big difference.
Talk to teachers
Regular two-way communication with your child’s school is recommended. Telling school staff about your child’s arthritis as soon as possible is very sensible. Teachers can look out for difficulties (physical or emotional) and help.
An early meeting with the school, involving your child and possibly a member of your rheumatology team, would help.The sooner you can do this after diagnosis, or before your child is about to start at a new school, the better.
The teachers may never have heard of a young person having arthritis before so this will be a good chance to tell them about your child’s condition, symptoms and limitations, and how staff can help your child.
School staff sometimes struggle with the fact that arthritis in young people can vary so much from day to day and also that many of the symptoms are invisible. Highlighting these facts, as well as how the condition and medication may make your child tired or lethargic if this is true, can help understanding.
Teachers have a responsibility and even a legal duty to provide the best standard of teaching, and schools are obliged to encourage inclusivity. Your child’s arthritis mustn't mean that their experience of school life is any less supported, successful, fulfilling or enjoyable than their peers'.Anything you can do to help support your school to make sure that happens will benefit your child.
Encourage teachers and school staff to read our information for teachers for more on how they can best help young people with arthritis.
Absences from school
Your child will need to visit hospital regularly for check-ups and exercise advice. Usually this means going every 3–6 months to an outpatients department for specialist advice.
Young people with arthritis rarely have to stay overnight in hospital. This usually only happens if they’re very ill with systemic-onset JIA or if it’s more convenient to stay a few days while having various tests and treatments.
Hospitals will encourage you to stay with your child and will also provide facilities for play and school lessons.
Growing up brings many new issues for young people. Having arthritis can make these issues more challenging or complicated, and they may need your support through different experiences.
Your child may find it difficult to tell their friends, partners or employers about their arthritis because they’re worried about bullying, negative reactions or being teased.
Practicing a simple phrase might help your child if they want to tell people about their condition or if they get asked questions. They could try: 'I have arthritis, which can make my joints hurt. Arthritis isn't just a condition that affects older people.'
If your child does have problems with teasing or bullying, talking about this can be a difficult but very important step. Many children are nervous to discuss this, even with parents/carers. They often worry that the situation will be worse if those involved find out that they've told someone.
Listen calmly to your child, praising them for raising the issue.
You can help by discussing how to bring up the subject with your child's teachers if there are problems and how to respond to unkind comments or other actions.
Let your child know that school staff can help and make sure they know who to go to if they ever experience bullying. You should discuss the concerns with your child’s teachers immediately. All schools have a policy on how to handle bullying.