Evidence-based advice for babies and children from the 2009 Rourke Well
The Nipissing Developmental Screens are now available free of charge to all Ontarians. This helps you to see if your child is developing well; the screens are available at http://www.ndds.ca, and you will need to register. Please bring a copy of the Screen to the office if you have any concerns.
A communication checklist to help monitor your child's hearing and speech progress is available at http://www.tpsls.on.ca/brochures/checklist/chekeng.pdf. Please bring this to the office if you have concerns.
The following are guidelines and links found in the 2009 Rourke Well Baby Record. They contain evidence-based advice on taking care of your baby.
nutrition guidelines – Nutrition for Healthy Term Infants
with no other liquids or solid foods is recommended for the first six months of
life for healthy infants who are not premature. Breast milk is the best food for infants, and breastfeeding (with
additional solid food) may continue for up to two years and beyond.
Breastfeeding reduces bowel and respiratory infections, such as diarrhea or
Routine Vitamin D supplementation of 10 μg = 400 IU/day (20 μg = 800 IU/day in
northern communities) is recommended for all breastfed full term infants until
the diet provides a sufficient source of Vitamin D (about 1 year of age).
D - www.cps.ca/english/statements/II/ii02-02.htm
Ankyloglossia (tongue tie)
and breastfeeding - www.cps.ca/english/statements/CP/cp02-02.htm
medications during breastfeeding – Medications and Mothers’ Milk by T. Hale
Motherisk - www.motherisk.org
Children age 2 and
Transition to lower fat diet: A gradual transition from the high-fat infant diet to a
lower-fat diet (max 30% fat / 10% saturated fat) begins after age 2 years.
Children need a healthy diet as per Canada
’s Food Guide
Motor vehicle collisions
Transport Canada recommendations for Car seats:
Use rear-facing infant seat until at least 1 year old AND 10 kg (22 lb.)
Use forward-facing child seat from at least 1 year of age AND 10 kg
(22 lb.) to 22 kg (48 lb.)
– max height/wt may vary with
car seat model
Use booster seat from at least 18 kg (48 lb.) to 36 kg (80 lb.) and up to 145 cm (4' 9")
Use lap and shoulder belt in the rear seat
for older children over 8 yrs who are at least 36 kg (80 lbs) and 145 cm (4' 9") and fit vehicle restraint system.
Bicycle: wear bike helmets
Water safety: Encourage swimming lessons (after age 4
years). Encourage pool, diving, and boating safety to reduce the risk of
Burns: Install smoke detectors in the home on
hot water at a temperature < 49°C.
Choking: Use safe toys and safe food (avoid hard, small
and round, smooth and sticky solid foods until age 3 years).
Falls: Assess home for hazards, e.g. never leave baby
alone on change table or other high surface; do not use baby walkers; use window
guards and stair gates.
Poisons: Keep medicines and cleaners locked up and out of
Have Poison Control Centre number handy; in Ontario: 1-800-268-9017. Do not use syrup of ipecac to make child vomit.
Safe sleeping environment: www.cps.ca/english/statements/CP/cp04-02.htm
Co-sleeping: Put infant in a government-approved crib in
parents’ room for the first 6 months of life. Room sharing is protective
against Sudden Infant Death Syndrome.
For more safety information: www.safekidscanada.ca
Complementary and alternative medicine (
- Homeopathy - www.cps.ca/english/statements/CP/cp05-01.htm
Pacifier use: is a parental choice. Pacifier use may
decrease risk of SIDS, but may lead to breastfeeding difficulties, and should be
restricted in children with chronic and recurrent ear infections. - www.cps.ca/english/statements/CP/cp03-01.htm
• Fever advice/thermometers: Fever ≥ 38°C in an infant < 3 months needs urgent evaluation. Acetaminophen (Tylenol, Tempra) or Ibuprofen (Motrin, Advil) are both effective. Acetaminophen (Tylenol) is the first choice for fever control under 6 months of age; after that ibuprofen or acetaminophen may be used. Alternating acetaminophen with ibuprofen for fever control is not recommended.
• Sun exposure/sunscreens/insect repellents: Minimize sun exposure. Wear protective clothing, hats, properly applied sunscreen with SPF ≥ 30 for those > 6 months of age. No DEET in < 6 months; 6-12 months 10% apply maximum once daily.
pesticide exposure. Encourage pesticide-free foods.
• Lead Screening is recommended for children who:
in the last 6 months lived in a house or
apartment built before 1950;
Websites about environmental issues:
- Health and housing - www.cmhc-schl.gc.ca/
- Environmental health section of CDC - www.cdc.gov/node.do/id/0900f3ec8000e044
- Commission for Environmental Cooperation – www.cec.org/children
- Dental cleaning: Fluoride toothpaste should be used twice per day with a minimum amount of water used to rinse the mouth after brushing. Children under 6 years of age should be supervised during brushing and only use a small amount (e.g. pea-sized portion) of toothpaste. Children under 3 years of age should have their teeth brushed by an adult using only a smear of toothpaste.
- Fluoride supplements are not recommended under 6 yrs of age unless the child is considered at high risk for dental caries. www.cda-adc.ca/_files/position_statements/fluorides.pdf
To prevent dental caries:
avoid sweetened liquids and constant sipping of milk or natural juices in both
bottle and cup.
occurs in 20% of infants and toddlers who do not require night feeding.
Helpful things to do: Positive bedtime routines (including training the
child to fall asleep alone), removing nighttime positive reinforcers,
keeping morning awakening time consistent, and rewarding good sleep
Guides for discipline:
-Best Start Ontario
your kids to learn to read. Useful things to do: Watching
less television, playing fewer video games or computer games and reading more to your children.