FAQs: Pre-schoolers
You'll find useful information on preschoolers with hemophilia in the following frequently asked questions, but for medical advice, be sure
to always contact your doctor or Hemophilia Treatment Centre.
- How can a preschooler with hemophilia be disciplined?
- Can young children with hemophilia participate in sports or join sports teams?
- What treatment or actions need to be taken for a child with mild hemophilia?
- What are the risks of using factor treatments? Can they transmit diseases?
- If someone with hemophilia needs a blood transfusion, do they need to worry about the safety of the blood supply?
Q. How can a preschooler with hemophilia be disciplined?
A. The preschool years is often when children begin to develop strong minds and wills of their own. Every parent and caregiver will have his or her own ideas of how to discipline a child with hemophilia, which can be achieved in different ways. It's very important that every child is taught right and wrong, and with children who have hemophilia, discipline may also be a matter of helping them stay safe. "Time-out" is an excellent method for children, but you can also ask your Hemophilia Treatment Centre for advice.
Q. Can young children with hemophilia participate in sports or join sports teams?
A. It is very important for children with hemophilia to be active and participate in activities with other children—although these should be non-contact sports to protect them from injury and bleeds. These kinds of activities not only helps these children physically, by building strong muscles to support and protect their joints, but it also helps them to feel like they fit in with the other children their age—no child with hemophilia wants to feel or appear like they are not "normal."
There are many sports that a child with hemophilia can do safely. With the parents' support and pre-treatment (that is preventative factor infusions) before the activity, the preschooler with hemophilia can be a valuable member of any team. Coaches and activity leaders should know that hemophilia is a genetic, non-communicable condition, and they should be encouraged to learn more about the disorder and what kinds of activities are safe and risky. There is a lot of useful information on this website, as well as many printed and other online resources available.
Q. What treatment or actions need to be taken for a child with mild hemophilia?
A. A child with mild hemophilia has some naturally occurring clotting factor in their blood, which is usually enough to prevent most bleeding episodes. If the child suffers an injury, you should call their nurse coordinator for advice, and if necessary, the child should be taken to the hospital for an assessment.
Q. What are the risks of using factor treatments? Can they transmit diseases?
A. Recombinant factor concentrates were developed in the 1990s to treat both hemophilia A and hemophilia B, and the risks of being infected by these products are very very small. There are rigorous safeguards in place during the manufacture of these products in order to prevent the transmission of diseases. Factor concentrates first go through a purification process and then the final product undergoes a viral inactivation process. This step involves using different heat treatments and/or solvent detergents to kill any viruses, which might still be in the factor concentrate. These viral inactivation methods are very effective in killing HIV, hepatitis B, and hepatitis C. The concentrate is then further tested for the presence of bacteria or viruses, and to make sure it meets all manufacturing standards, including potency.
As a result, in Canada:
- Since 1988, there have been no HIV infections in people with hemophilia from factor concentrates
- Since 1990, there have been no hepatitis C infections in people with hemophilia from factor concentrates
As a result, in Canada:
Q. If someone with hemophilia needs a blood transfusion, do they need to worry about the safety of the blood supply?
A. The modern factor concentrates used in Canada today, whether plasma-derived or recombinant, have never been known to transmit diseases like HIV, hepatitis B, or hepatitis C. Hepatitis B infection occurs in only about 1 in a million blood transfusions. Those with hemophilia have a greater chance of needing a blood transfusion, but the risk of acquiring Hepatitis B need not be a concern since because they will have been vaccinated against the virus.
For people with hemophilia who received blood products in the 1970s and 1980s, hepatitis C (for which there is no vaccine available) was a serious concern. However, today donor screening methods and viral inactivation procedures have reduced the risk of being infected with hepatitis C to near zero. Fortunately, HIV infection through factor concentrates is also a thing of the past.
It is possible that a new unknown agent could infect the blood supply. But those responsible for hemophilia care and for the blood system, including the CHS, consumer groups, the blood transfusion service (Canadian Blood Services) and organizations around the world, are watchful of new dangers and take their responsibility for the safety of blood products very seriously.