letter from region of waterloo public health - Parent Guide

11 downloads 320 Views 10MB Size Report
NEWBORN REGISTRATION – REGISTER YOUR CHILD WITH THE 4 IN 1 NEWBORN BUNDLE BEFORE THEIR FIRST BIRTHDAY .... see WYNI ap
99 Regina Street South, Waterloo ON N2J 4V3 150 Main Street, Cambridge ON N1R 6P9 519-575-4400 (TTY: 519-575-4608) www.regionofwaterloo.ca/ph

Find us on Facebook: /ROWPublicHealth Follow us on Twitter: @ROWPublicHealth

Dear Parent(s), Congratulations on the birth of your new baby! You have the most important role in the life of your new baby. In the birth package you received from the hospital or your midwife, there is information on healthy child growth and development, and community programs to support you and your child. There are also two resources to support you as a parent: • Tips for New Parents: Making the most of the early years • Healthy Babies Healthy Children: Supporting you and your child Keep this New Parent Resource Guide handy for future reference as your child develops, and take it with you to ALL of your baby’s appointments for updating. Show your health care provider the Passport to Health and your Baby’s Feeding Record. Please note, it is important that your newborn is seen by a health care provider within 48 hours of leaving the hospital. If you have any questions about your baby or supports available to your family, please contact Region of Waterloo Public Health at 519-575-4400 to speak to a public health nurse. Sincerely, Lesley Rintche, RN, BScN

Manager, Child and Family Health and Nursing Practice

Important phone numbers:

Police, Fire, Ambulance, Emergency ........................................................................................................................................... 911 Community Information Services ................................................................................................................................................211 Addictions, Mental Health and Crisis Services (HERE247) ..........................................................................1-844-437-3247 Women’s Crisis Services .................................................................................................... 519-742-5894 or 1-800-410-4482 Telehealth (including breastfeeding support) 24 hours a day, seven days a week ................................. 1-866-797-0000 ......................................................................................................................................................................... TTY: 1-866-797-0007 EatRight Ontario .....................................................................................................................................................1-877-510-5102 Healthy Babies Healthy Children ........................................................................................................................... 519-575-4400 Ontario Early Years Centres .............. Cambridge 519-740-8353; Kitchener 519-571-1626; Waterloo 519-741-8585

PASSPORT TO HEALTH Parents please ask your hospital nurse or midwife for the information below. Take it with you on visits to your health care provider. Baby’s Name: ________________________________ Gender: Female ___________

Male___________

Baby’s Birthdate:______________________________

Mother’s Name: _______________________________ Mother’s Birthdate: ____________________________ Partner’s Name: _______________________________ Circle Unit of Measurement

Birth Weight: _________________ grams or lbs/oz

Take your baby for well-baby/child visits at these times: • 48 hours after hospital discharge to a health care provider (doctor, nurse practitioner, midwife). If you attend Public Health Breastfeeding Services, Postbirth Clinic (PBC), or bili clinic you do not need to book a separate 48 hour check-up with your family health care provider. • Again, within the first week after discharge to your ongoing health care provider • At 2 weeks of age • Regular visits at 1, 2, 4, 6, 9, 12, 15, 18 and 24 months; and then once a year • See page 38 for information about the 18 month enhanced well-baby visit

Length: _______ cm or inches Head Circumference: _____ cm or inches At well-baby/child visits your health care provider will check your child’s growth and development and give routine vaccines (see page 7). Apgar Score: 1 minute:_____ 5 minutes: ______ For more information go to: www.caringforkids.cps.ca Bili Results: ________ Date: (Hours old) _________ Mother to visit OB/GYN at 6 weeks postpartum Repeat Bili: _________ Date: ___________________ Coombs Positive (+): ________ Negative (-): ______ Blood Type (Group & Rh): ___________________ Feeding Method on Discharge:__________________ Discharge Date:______________________________ Discharge Weight: ____________ grams or lbs/oz Follow-up appointment dates and times: Bili Clinic: ___________________________________ Post Birth Clinic: _____________________________

WEIGHT GAIN/GROWTH It is normal for newborn babies to lose some weight during the first 3 to 4 days after birth. Babies usually return to their birth weight in 10 to 14 days. Babies usually have growth spurts at around 2 to 3 weeks, 6 weeks, 3 months and 6 months of age. Infants usually double their birth weight by 4 to 5 months and triple their birth weight by 1 year. Track your child’s growth below. Your health care provider will plot your baby’s growth on a growth chart to check your child’s growth pattern over time. For more information, go to www.dietitians.ca/growthcharts If you have concerns about your child’s growth, contact your health care provider.

Public Health Breastfeeding Services: ____________________ Other: _______________________________________ Post Discharge Clinic: Post birth Weight: ________ grams or lbs/oz

Bili

Date

Weight grams or lbs/oz

Length inches or cm

Date:___________

First appointment with your health care provider:

NEWBORN REGISTRATION – REGISTER YOUR CHILD WITH THE 4 IN 1 NEWBORN BUNDLE BEFORE THEIR FIRST BIRTHDAY Every child born in Ontario must be registered to be eligible for child benefits. The Newborn Registration Service allows you to register your baby’s birth and apply for their birth certificate, Canada Child Benefits and Social Insurance Number at the same time. Go to: http://www.serviceontario.ca/newborn parentguide.ca

|

1

The all-in-one resource for busy parents!

RESOURCE GUI DE PARENT GUIDE INC. PHONE: (519) 645-7342 EMAIL: [email protected] WEBSITE: parentguide.ca PUBLISHER: Jennifer McCallum FACILITATOR: Peter Barnes DESIGN: Brandon Caskanette SALES: [email protected] (519) 645-7342

CREDITS EDITORIAL CONTRIBUTORS:

School Age

Thank you to Kimberly Ridsdale for the 2017 cover photograph. Your child could be on the cover next year! Enter our annual photo contest! Coming Spring 2017!

Active for Life 25,37 A Million Messages 28 Best Start Resource Centre 15,16, 17, 18, 20, 21, 23, 40, 42, 52 Cambridge Memorial Hospital 1,4, 5 CanAdaptt 23, 52, 58 Canadian Cancer Society 52 Canadian Dermatology Association 53 Canadian Medical Association 50 Canadian Partnership for Children’s Health & Environment 52 Canadian Paediatric Society 1,12,22-27,33-35,43,51 Canadian Self-Regulation Initiative 42 Canadian Society for Exercise Physiology 25,37,40 Center on the Developing Child at Harvard 6 Circle of Security 25 Community Dental Health Services Research Unit (Ontario Government) 48 Dr. Michelle Mottola - UWO 59 Early Literacy Alliance of Waterloo Region 40 Grand River Hospital 1,4, 5,12,13,51 Government of Canada 30, 31 Health Canada 19,20, 27, 32-34,52,53 57-59 Hospital for Sick Children 24,36 Infant Mental Health Promotion 6 Institute of Child Study 26 Kidsability 39 Machealth Public 56 Middlesex London Health Unit 32,56 Ministry of Children and Youth Services 38 Ministry of Transportation of Ontario 29 Motherisk 23, 58 NCAST (2000) 41 Nipissing District Developmental Screen 38 NutriSTEP® 33, 42 OneList Waterloo Region 54, 55,56 Ontario Association of Optometrists 42 Ontario Ministry of Health and Long Term Care 7, 57 Ontario Society of Physical Activity Promoters in Public Health 37 Pediatric Dentistry and Orthodontics 48,49 Pleased be Seated Coalition 29 Pregnets 52,58 Public Health Agency of Canada 24,36, 57 Region of Durham 44 Region of Waterloo Positive Parenting Community Committee 44 Region of Waterloo: Public Health and Emergency Services 1,4, 5,16-46 ,48-59 Registered Nurses Association of Ontario 18,24 SIDS Canada 24 Society of Gynecologists and Obstetricians 14, 56, 57 Toronto Public Health 21 Windsor Essex County Health Unit 47 World Health Organization 1,19, 56

All rights reserved. Reproduction in whole or in part without written permission from the publisher is prohibited.

EDITORIAL REVIEW COMMITTEE The following Region of Waterloo Public Health staff contributed to the review and updating of this guide:

RESOURCE GUIDE

COVER PHOTOGRAPHY: www.kimmikphotography.ca

ISBN# 978-1-927542-13-2

FOLLOW US ON: Facebook - www.facebook.com/ParentGuide Twitter - @parentguide Instagram - parentguide Copyright 2017. New Parent Resource Guide 14th Edition

2

|

NEW PARENT RESOURCE GUIDE 2017

Debbie Wang Deborah Azim Fleming Judith Kitching

Julie Hill Karin Morell Karl Fuss

Marie Debrun Patricia Maxwell Rebecca Dahle

Samantha Pestl Sarah Harjee Sheryl Wilk

Thanks also to the Region of Waterloo staff and managers, Region of Waterloo hospital partners and other community partners who provided updated content and support. Accessible formats of this resource are available upon request. Please call 519-575-4400 (TTY 519-575-4608) to request an accessible format.

The New Parent Resource Guide and partners assume no liability for any errors or omissions in advertising, editorial, and/or listings. The information in this guide is not intended to replace or substitute the individualized care that you receive from your qualified healthcare provider. All advertising and editorial copy is provided as a resource only. Editorial, listings, and advertising in the New Parent Resource Guide does not constitute an endorsement of any kind, nor does exclusion indicate lack of endorsement. Every effort was made to locate all relevant resources.

LETTER FROM REGION OF WATERLOO PUBLIC HEALTH As parents to be and parents, you have the most important role in the life of your unborn baby, newborn and young child. That is why Region of Waterloo Public Health is pleased to sponsor the 2017 edition of the New Parent Resource Guide. In these pages, you will find information, services and supports to help you get your child off to the healthiest start possible. Best wishes for you and your family,

Dr. Liana Nolan

Medical Officer of Health, Region of Waterloo

Congratulations! You are about to begin the most exhilarating, emotional, exhausting, and fabulously rewarding time of your life. This guide is intended to be a reference for you to keep handy for many years to come. Take a read through it now so that you know where to return to when you are looking for answers. Thank you to the many community organizations and businesses that have supported us in the printing of the 2017 edition. We pride ourselves in working with only the best and most credible resources in our community. By working closely together, we can assure you that you are receiving consistent and up-to-date information. You will notice that only key contacts are included in this guide. For a full list of resources in your community, visit our website at www.parentguide.ca Enjoy this special time and treasure each moment. Remember that you are not alone and we are here to help you every step of the way.

Jennifer

Jennifer McCallum, Publisher and Founder ENGAGING PARENTS SINCE 2001

The all-in-one resource for busy parents!

RESOURCE GUI DE

Scan to visit our website

parentguide.ca

|

3

BABY’S FEEDING RECORD Your baby needs to get at least 8 feeds in a 24-hour period. This may mean waking your baby through the night, to make sure they get at least 8 feeds, until your baby has regained their birth weight. For when to see your health care provider and information on dehydration see page 12 Feeding Date/Time

Skinto-Skin ()

Left ()

Right ()

Sucking Drinking (Does swallow) ()

Expressed Breast Sucking Milk (Does Amount not swallow) (mL or oz) (if applies) ()

Urine (Pee) ()

Stool (Poop) Colour ()

Comments or Questions

Ensure baby is drinking. Use breast compressions to increase milk flow when baby is sucking but not drinking. For breastfeeding support, call Region of Waterloo Public Health at 519-575-4400 (9:00 a.m. to 4:00 p.m. Monday to Friday) or Telehealth Ontario at 1-866-797-0000 (24 hours/7 days a week). see WYNI app https://www.wechu.org/feeding-your-baby/wyni-breastfeeding-information-when-you-need-it for a helpful way to track your babies feeding”

4

|

NEW PARENT RESOURCE GUIDE 2017

BABY'S FEEDING RECORD

Feeding Date/Time

Skinto-Skin ()

Left ()

Right ()

Sucking Drinking (Does swallow) ()

Expressed Breast Sucking Milk (Does Amount not swallow) (mL or oz) (if applies) ()

Urine (Pee) ()

Stool (Poop) Colour ()

Comments or Questions

parentguide.ca

|

5

The First Five Years Matter the Most A good start helps your baby later in school and in life

Actions to Support Your Baby’s Growth and Development q Newborn and older Breastfeed your baby. For free breastfeeding support call Public Health at 519-575-4400. Meet with your health care provider for check-ups at: q 48 hours after hospital discharge q 1 and 2 weeks q 1, 2, 4, 6, 9, 12, 15, 18 and 24 months; and then once a year Have your child immunized on time everytime. Visit www.regionofwaterloo.ca/ImmunizationSchedule q Newborn and older Make your home a safe place for your child. Complete a home safety checklist at www.regionofwaterloo.ca/childhomesafety q Newborn to 12 weeks Get to know more about your baby’s sleep cycle and how to respond. Reserve a free spot at www.earlyyearsinfo.ca/sleep-sessions Newborn and older q Start thinking about your child care needs. Register for licensed child care near you at www.onelistwaterlooregion.ca

PUBLIC HEALTH AND EMERGENCY SERVICES

6

|

519-575-4400 (TTY: 519-575-4608)

NEW PARENT RESOURCE GUIDE 2017

q 1 month and older Check your baby’s growth with the Nippising Developmental Screen at www.ndds.ca q 1 month and older Sign up for a free library card. Read with your baby every day. q 6 months and then once a year Visit the eye doctor to have your baby’s eyes checked; free if you have an Ontario Health Insurance Plan. Visit www.optom.on.ca q 12 months and older Visit the dentist to have your child’s teeth checked. Call 519-575-4400 for information about financial assistance for dental care.

q 18 months to 5 years Find out if your child is a healthy eater using Nutri-eSTEP at www.nutritionscreen.ca q 3 to 5 years Register your child for kindergarten.

■ ■* ■ ■ ■**

Meningococcal Conjugate ACYW-135

■**

Hepatitis B

** HPV These vaccines areingiven in school. **HB and vaccines are given schools. Men-C-ACYW135 is given in community clinics.

■*

Measles, Measles, Mumps, Mumps, Chickenpox Rubella, (Varicella) Rubella Chickenpox (MMR) (MMRV)

Accessible formats of this document are available upon request. Please call 519-575-4400 (TTY 519-575-4608) to request an accessible format.





Meningococcal Conjugate C (Men-C-C)

All adults aged 18 and older are now eligible to receive one lifetime (publicly funded) dose of the Tdap vaccine. This lifetime dose replaces one of the Td booster doses given every 10 years. Adapted from Ontario Ministry of Health & Long Term Care. (2016). https://www.ontario.ca/page/vaccines









Rotavirus

* Men-C-C and MMR vaccines must be given after the first birthday.

Every year (in autumn)

14–16 years old (10 years after 4–6 year old booster)

Grade 7 students

4–6 years old

18 months old

15 months old





6 months old

12 months old



4 months old

Diphtheria, Diphtheria, Pertussis, Pertussis, Pneumococcal Tetanus, Polio, Conjugate Tetanus, Haemophilus (Pneu-C-13) Polio Influenzae (Tdap-IPV) (DTaP-IPV-Hib)



Diphtheria, Tetanus, Pertussis (Tdap)



Seasonal Influenza (Flu)

August 2016

Mandatory vaccinations

■**

HPV

SCHEDULE 1. Routine Schedule for Children Beginning Immunization in Early Infancy (starting 2 months of age)

2 months old

Age at vaccination: Completed months and years

For more information, call Region of Waterloo Public Health and Emergency Services at 519-575-4400 ext. 13007 (TTY 519-575-4608), or go to Canadian Paediatric Society: www.cps.ca or Ministry of Health and Long Term Care: www.ontario.ca/vaccines.

In July 2014, new vaccines were added to the schedule of immunizations your child must have for school attendance. Parents are now required to provide proof of their child’s immunizations for Meningococcal disease (Meningitis), Pertussis

Publicly Funded IMMUNIZATION SCHEDULE for Ontario

(Whooping Cough) and Varicella (Chickenpox; required only for children born 2010 or later) in addition to immunizations for Measles, Mumps, Rubella, Tetanus, Diphtheria, and Polio. Proof of immunization or a valid statement of exemption should be provided directly to Public Health and Emergency Services. Failure to notify Public Health and Emergency Services could result in suspension from school.

Every child should get routine vaccinations from their health care provider according to the immunization schedule on this page. These are paid for by the Ontario government. If you do not have a health care provider or health card, contact Region of Waterloo Public Health and Emergency Services to discuss your options to ensure your child receives their vaccines.

IMMUNIZATIONS

parentguide.ca

|

7

TABLE OF CONTENTS

NOW THAT YOUR BABY IS HERE 12,13 ...... NOW YOUR BABY IS HERE 14 ...... BIRTH CONTROL FOR NEW PARENTS

HELP AND SUPPORT 15 ...... ABUSE 16,17 ...... MENTAL HEALTH AND WELLNESS

BREASTFEEDING/FEEDING YOUR CHILD 18 ...... SKIN-TO-SKIN 19,20,21,22,23 ...... BREASTFEEDING YOUR BABY

CARING FOR A NEWBORN 24 ...... SAFE SLEEP 25 ...... TUMMY TIME 26 ...... SOOTHING YOUR CRYING BABY 27 ...... NEVER SHAKE A BABY

SAFETY 28 ...... BABIES DON’T BOUNCE 29 ...... BUCKLE ME UP 30,31 ...... SAFETY IN THE HOME

FEEDING YOUR CHILD 32 ...... FIRST FOODS 33 ...... MILK AND YOUR GROWING CHILD 34 ...... FEEDING YOUR TODDLER AND PRESCHOOLER

8

|

NEW PARENT RESOURCE GUIDE 2017

TABLE OF CONTENTS

PARENTING TOILET LEARNING ...... 35 HEALTHY SLEEP HABITS ...... 36 PHYSICAL LITERACY ...... 37 YOUR CHILD’S DEVELOPMENT ...... 38 DON’T WAIT AND SEE ...... 39 SPEND TIME WITH YOUR CHILD ...... 40 COMFORT PLAY TEACH ...... 41 HEALTHY EMOTIONS ...... 42 TEMPER TANTRUMS ...... 43 POSITIVE PARENTING ...... 44 PARTNER SUPPORT ...... 45

HEALTH AND WELLBEING TALK FOR TOTS ......

46

TEETHING ......

47

DENTAL CARE ......

48,49

FEVER AND SICKNESS ......

50,51

HEALTH AND THE ENVIRONMENT ......

52,53

PREPARING YOUR FAMILY FOR CHANGES/PREGNANCY PREPARING YOUR CHILD FOR CHILD CARE ......

54

PREPARING FOR YOUR NEXT PREGNANCY ......

56

PREPARING YOUR CHILD FOR A NEW BABY ......

56

YOUR HEALTHY PREGNANCY ......

57,58,59

NEED HEALTH CARE NOW? SEE PAGE 82 FOR A LIST OF URGENT CARE CLINICS AND WALK-IN CLINICS NEAR YOU!

parentguide.ca

|

9

DIRECTORY IN ALPHABETICAL ORDER BREASTFEEDING/FEEDING YOUR CHILD BREAST PUMP RENTALS AND SALES...........................................64

INFANT FEEDING ROOMS..............................................................65

BREASTFEEDING EDUCATION/SUPPORT....................................64

CHILD CARE AND EDUCATION CHILD CARE RESOURCES..............................................................68

HOME EDUCATION.......................................................................71

CHILD CARE SUBSIDY....................................................................68

LANGUAGE.......................................................................................71

BEFORE/AFTER SCHOOL PROGRAMS.........................................68

LITERACY..........................................................................................71

CHILD CARE.....................................................................................69

SCHOOL BOARDS...........................................................................72

COMMUNITY INFORMATION LIVING, WORKING, PLAYING..........................................................74

MULTICULTURAL GROUPS............................................................77

MUNICIPAL CONTACTS.................................................................75

NEWCOMERS...................................................................................77

LIBRARIES.......................................................................................76

WEB SITES WORTH VISITING.......................................................78

HEALTH AND WELLBEING ALLERGIES AND ASTHMA.............................................................80

IMMUNIZATIONS.............................................................................81

DENTISTRY......................................................................................80

MENTAL HEALTH...........................................................................82

DIETITIANS......................................................................................80

PERSONAL CARE............................................................................82

EMERGENCIES................................................................................80

PHONE SUPPORT..........................................................................82

FIND A HEALTH CARE LOCATION................................................80

SMOKING CESSATION...................................................................82

FINDING A FAMILY DOCTOR........................................................80

URGENT CARE CLINIC...................................................................82

FITNESS..........................................................................................80

WALK-IN CLINICS...........................................................................82

HEALTH UNITS/PUBLIC HEALTH..................................................81 HOSPITALS.......................................................................................81

HELP AND SUPPORT ABUSE..............................................................................................84

FAMILY/GROUP SUPPORT...........................................................86

ADDICTION SUPPORT....................................................................84

FOOD BANKS................................................................................86

BEREAVEMENT...............................................................................84

HELP LINES.....................................................................................86

COUNSELLING.................................................................................84

HOUSING......................................................................................88

EMPLOYMENT.................................................................................85

SHELTERS........................................................................................88

FAMILY AND CHILDREN’S SERVICES..........................................85

PARENTING

10

|

ADOPTIONS....................................................................................90

PARENTING GENERAL....................................................................91

JUST FOR PARTNERS...................................................................90

PARENTING SUPPORT GROUPS/PROGRAMS...........................92

ONTARIO EARLY YEARS CENTRES.............................................90

POSTNATAL/POSTPARTUM MENTAL HEALTH SUPPORT........93

NEW PARENT RESOURCE GUIDE 2017

DIRECTORY IN ALPHABETICAL ORDER

PREGNANCY AND LABOUR SUPPORT CORD BLOOD BANKING................................................................96

MIDWIFERY INFORMATION/SERVICES.....................................96

DOULAS.........................................................................................96

PREGNANCY SUPPORT..............................................................97

FAMILY PLANNING.........................................................................96

PRENATAL CLASSES/PROGRAMS..............................................97

PROGRAMS AND ACTIVITIES CAMPS...............................................................................100

MUSEUMS..........................................................................102

CHILDREN’S PROGRAMS............................................................101

MUSIC................................................................................102

SAFETY CAR SEAT SAFETY........................................................................104

RECALLS/PRODUCT SAFETY....................................................104

POISON....................................................................................104

SAFETY AND SECURITY............................................................104

SHOPPING AND PROFESSIONAL SERVICES BABY ACCESSORIES...................................................................108

DIAPERS....................................................................................109

BABY FURNITURE........................................................................108

FINANCIAL.........................................................................109

CLOTHING - GENTLY USED........................................................108

PHOTOGRAPHY..........................................................................110

CLOTHING - MATERNITY..............................................................109

SPECIAL NEEDS DEVELOPMENTAL/PHYSICAL CONCERNS/

SPEECH AND LANGUAGE.............................................................112

SPECIAL NEEDS/AUTISM.............................................................112

VISION.....................................................................................112

FINANCIAL ASSISTANCE.............................................................112

INDEX..............................................................................................113

MORE ARTICLES AND RESOURCES AT

COUPONS................................................................................123

The all-in-one resource for busy parents!

RESOURCE GUI DE

parentguide.ca

|

11

NOW YOUR BABY IS HERE NEWBORN SCREENING After birth, every baby may participate in the Ontario Newborn Screening Program which is a simple blood test that screens for 29 disorders. Identifying issues early is important for your baby’s health. Results are reported to your health care provider. https://www.newbornscreening.on.ca/ HEARING SCREENING All infants are offered the Ontario Infant Hearing Program which is a simple, painless, hearing test done in hospital or community, shortly after birth. JAUNDICE SCREENING Jaundice is common in newborns. Jaundice is caused by the normal break down of red blood cells in your baby which then release bilirubin. This bilirubin gives a yellow colour to the skin and eyes of newborns. Most jaundice shows up in the first 3 to 5 days after birth and does not hurt your baby. If the bilirubin level in your baby’s blood gets too high, it can cause a problem for your baby.

DEHYDRATION: Babies can quickly become dehydrated. They can either not get enough fluid or lose too much fluid. Call your health care provider or visit the emergency department. Signs your baby is dehydrated: • decreased urination • difficult to wake and sleepy • dark and strong smelling urine • weak cry • increased thirst • absence of tears • dry skin, mouth and tongue • faster heart beat • sunken eyes • greyish skin • sunken soft spot (fontanelle) on your baby’s head

A blood test is done on the baby to measure the bilirubin level at 24 to 72 hours of age. If your baby has a high level of bilirubin you may be asked to have a follow-up appointment; a second blood test; or your baby may need treatment at the hospital. Call your health care provider if you notice your baby’s skin is becoming more yellow or your baby is not feeding well or is sleepy all the time. WHEN TO SEE A HEALTH CARE PROVIDER Call your health care provider if your baby: • Is not feeding well or is refusing to feed • Is sleepy all the time and is hard to wake up • Has skin and/or whites of the eyes that appear yellow, or are becoming more yellow • Has fewer wet diapers or bowel movements than expected (see page 21) • Shows signs of dehydration For more information go to: www.caringforkids.cps.ca

12

|

NEW PARENT RESOURCE GUIDE 2017

What to Expect in the First Three Months By Best Start www.beststart.org/resources/hlthy_chld_dev/ K82-E-hospitalhandout.pdf

NOW YOUR BABY IS HERE

MOTHER’S PHYSICAL CHANGES AFTER HAVING A BABY NORMAL EXPECTATIONS

WHEN TO GET HELP

VAGINAL FLOW

It is normal to bleed for 2 to 6 weeks. The colour and amount will change gradually from bright red to pink to a small amount of brown. From time to time you may have a brighter flow.

If the bleeding increases (fills one pad in 30 minutes with bright red blood, or you pass an egg sized clot), go to the hospital Emergency Department immediately.

PERINEUM (Area between your vagina and rectum)

Your perineum may be swollen or sore. Practice good hand washing when using the bathroom and changing pads. For a few days you may wish to continue using the plastic cleansing bottle with warm water after peeing. Change your sanitary pad frequently. Any stitches you have will dissolve in a few days. You may use a sitz bath for stitches.

If you have a fever, increased pain, redness, swelling, or a foul smelling discharge from your stitches, call your health care provider, or go to the hospital Emergency Department or an Urgent Care Clinic.

INCISION AFTER A CAESAREAN BIRTH (C-section)

Once the dressing has been removed from your incision, you may shower as often as you like. Let the warm water run over your incision and pat it dry gently. Wear loose clothing that does not rub or irritate. For support and comfort, you can cover the incision with a light pad. If the nurse has applied steri strips to your incision before discharge and they haven’t fallen off, please remove these after 7 days unless your health care provider has told you something else.

If you have a fever, redness, tenderness, swelling, discharge or the incision starts to open, call your health care provider, or go to the hospital Emergency Department or an Urgent Care Clinic.

BREASTS (Engorgement)

Your breasts will begin to feel heavier 48 to 72 hours after delivery. The fullness may last 1 to 3 days, depending on measures taken for relief. If milk is not adequately removed from the breast, painful engorgement may occur. Put the baby to breast more often or hand express to relieve the fullness. You may use cool cloths and pain medication (acetaminophen [Tylenol] or ibuprofen [Advil/Motrin]) to help you feel more comfortable and relaxed, and to facilitate the breast milk letdown.

If you experience a red, hot, painful area on your breast, have fever or flu-like symptoms, call your health care provider. If you have tender, sore or cracked nipples get breastfeeding support. See page 22 for where to go for help.

PAIN MANAGEMENT

In the hospital you may have been taking acetaminophen or ibuprofen for pain and a stool softener. Each day you should require less pain medication and your body should be improving and feeling more normal.

If you cannot reduce the amount of pain medication you require or find you need more, call your health care provider, or go to the hospital Emergency Department or an Urgent Care Clinic. If you have chest or leg pain go to the hospital Emergency Department immediately.

BOWEL MOVEMENTS

You will most likely have a bowel movement within 2 to 3 days following the birth of your baby. To provide support to your perineal stitches during a bowel movement, hold a clean sanitary pad over them. To keep bowel movements soft, drink lots of fluids and eat fruits and vegetables, whole grains, oats, and bran products.

HEMORRHOIDS

If you have hemorrhoids (swollen veins around the rectum), you may find ice packs helpful for the first 24 to 48 hours. A special cream or witch hazel compress (available at most pharmacies) can also be used for relief.

SEXUAL HEALTH AFTER THE BIRTH OF YOUR BABY You may have sexual intercourse when your bleeding has stopped, your stitches have healed, your abdominal incision is no longer tender and when you feel emotionally ready. Be aware that you can get pregnant again very soon after birth, even if you are breastfeeding. See page 14 for birth control information. For more information call Region of Waterloo Public Health at 519-575-4400. parentguide.ca

|

13

BIRTH CONTROL FOR NEW PARENTS During the prenatal period it is a good idea to consider your birth control options after delivery. There are many birth control options that are safe and effective during breastfeeding. The timing of introduction of any birth control method is important. To discuss your options, speak to your health care provider, a lactation consultant or a public health nurse. Contact the Sexual Health Program at 519-883-2267. Methods Lactational Amenorrhea Method (LAM)

Barrier Methods (condoms, spermicides, diaphragm, cervical cap)

Non-Hormonal Intrauterine Devices (IUD) Hormonal Intrauterine Systems (IUS) Progestin Only Birth Control (progestin only pills, Depo provera) Combined Hormonal Birth Control (the pill, the patch, vaginal ring) Surgical Sterilization Procedures (permanent)

Emergency Contraceptive Pills (ECP) (Plan B) Does not terminate or interrupt a pregnancy

14

|

Description Breastfeeding can be used as a natural form of birth control after giving birth as long as: 1. Your monthly periods have not returned 2. Your baby is under 6 months 3. Your baby gets all food from sucking at the breast, breastfeeds at least every 4 hours and doesn’t have more than one 6 hour stretch between breastfeeding in 24 hours. *98% effective if all 3 criteria are absolutely followed. Female condoms are polyurethane sheaths that line the vagina to stop sperm from going into the vagina. *79-95% effective. Male condoms are a thin covering of latex that is rolled onto the erect penis to stop sperm from going into the vagina. * 85–98% effective. Spermicides are chemicals that kill sperm and are inserted into the vagina before sex. *71–82% effective. Diaphragms/cervical caps cover the cervix to block sperm from going into the uterus. These must be used in combination with spermicide. *Diaphragm 84-94% effective; Cervical cap 40-91% effective A small T-shaped device, usually wrapped with copper, that is inserted into the uterus by a health care provider. It changes the chemistry in the uterus to stop sperm from reaching an egg. Reliable, long-term birth control for up to 5 years, but can be removed at any time. *99.1% effective. A small T-shape device containing a hormone that thickens the cervical mucus, thins the lining of the uterus and may also stop an egg from being released. It is inserted into the uterus by a health care provider. Reliable, long-term birth control for up to 5 years, but can be removed at any time. *99.8% effective. Progestin only birth control comes as either a daily oral mini-pill or an injection (Depo provera) which is given by a health care provider every 10-13 weeks. They contain a hormone that thins the lining of the uterus, thickens the cervical mucus and may stop an egg from being released. *Pill 92–99.7% effective; Depo provera 97-99.7% effective. Contains small amounts of hormones (progestin and estrogen) that stop an egg from being released each month and thickens cervical mucus. *92–99.7% effective. Female sterilization is when a doctor cuts or blocks the tubes that carry the eggs to the uterus. This is done in a hospital. *99.5% effective. Male sterilization is when a doctor cuts or blocks tubes that carry sperm from the testicles. This may be done in a doctor’s office. *99.9% effective. These pills must be taken as soon as possible and within 5 days of unprotected sex .This is an emergency method. *Effectiveness ranges from 95% on Day 1, to 58% on Days 3–5.

NEW PARENT RESOURCE GUIDE 2017

Additional Information Consult with a public health nurse or lactation consultant before starting this method.

These methods are hormone free, user controlled and only needed when you are actually having sex. Condoms can be used immediately after birth. Only condoms prevent sexually transmitted infections. Diaphragms and cervical caps cannot be used until 6 weeks post delivery and should be fitted or refitted postpartum. Can be inserted 6 weeks after birth.

Can be inserted 6 weeks after birth. If breastfeeding is well established breast milk supply is usually not affected. If breastfeeding is well established breast milk supply is usually not affected.

Can be started 3 weeks after birth if not breastfeeding. In breastfeeding women, research has shown estrogen can reduce breast milk supply. Speak with your healthcare provider. Male sterilization can be done at any time. Can be used anytime following birth. Available over the counter at drug store (pharmacy) or Sexual Health Clinic. May be less effective in women over 165lb (75kg). Talk to a health care professional before use.

ABUSE ARE YOU AND YOUR BABY/CHILD SAFE? Does your partner… q yell at you? q call you names? q blame you for being pregnant? q break your things? q hurt or kill your pets? q threaten to hurt you? q always need to be in charge? q keep you from seeing friends and family?

q q q q q q q

keep you from seeing your health care provider? control what or how much you eat? control the money? threaten to take the kids away? hit or kick you? hurt your breasts, belly or between your legs? force you to have sex?

If you said YES to any of the above questions, you and your baby/child may be in DANGER. All kinds of ABUSE can hurt you. Abuse can cause you to: q feel sad and alone q feel anxious q feel bad about yourself q have pain and injuries q turn to alcohol and drugs q not eat or sleep well q If you are pregnant, you could lose your baby

Abuse during pregnancy can cause your baby to: q be born too small q be born too early q be stillborn q have injuries or infections q have later health problems q be abused after birth

Abuse usually gets worse over time. If you are pregnant, it will NOT STOP when your baby is born. Talk to someone you TRUST. There is support. You are not alone. What can you do? q tell someone you trust what is going on q find people to help you: family and friends, a public health nurse, your doctor or midwife, a counsellor, your prenatal educator, a shelter for women q get services to develop a safety plan q get help if you choose to leave the abusive relationship q hide your electronic tracks www.wcswr.org/cover-your-tracks Are you a family member, neighbour, friend, co-worker? Want to know how to help? Visit www.neighboursfriendsandfamilies.ca Adapted with permission by the Best Start Resource Centre WHERE TO GET HELP • In an emergency, call Police at 911 • Women’s Crisis Services of Waterloo Region 1-800-410-4482 or visit www.wcswr.org • Assaulted Women’s Helpline 1-866-863-0511, TTY# 1-866-863-7868, #SAFE (#7233) or visit www.awhl.org; offers help in 150 languages 24 hours a day, 7 days a week • Family Violence Project of Waterloo Region 519-743-6333 or visit www.fvpwaterloo.ca • Waterloo Region Sexual Assault/Domestic Violence Treatment Centre 519-749-6994 or visit www.keepingsafe.ca parentguide.ca

|

15

MENTAL HEALTH AND WELLBEING DURING PREGNANCY AND LIFE WITH A NEW BABY

SELF CARE IS FOR EVERYONE It is important to take care of yourself throughout your life. This is especially true when you are planning a pregnancy, are pregnant, have had a baby or are a new parent. The following are things you can do to take care of yourself • Eat well; eat a variety of foods as recommended by the Canada’s Food Guide. Drink plenty of fluids. For more information about what to eat call EatRight Ontario at 1-877-510-5102 • Take time to relax and reduce your stress level • Do something you like to do What a partner, family and friends can do: • Listen and provide support to the new parent • Encourage the new parent to seek professional help • Educate yourself about mental health • Ask how you can help

• Build a support network • See your health care provider regularly • Reach out and get help if you feel mentally or physically unwell • Exercise regularly and get enough sleep

• Help with housework and meals (or arrange for help) • Develop your relationship with the baby • Take some time for yourself • Find someone to talk to

READ MORE ON THIS TOPIC at Life with a New Baby website: www.lifewithnewbaby.ca, Best Start Resource Centre for mental health www.beststart.org, Pregnancy is Not Always What You Expect http://www.beststart.org/resources/ppmd/TakeCareMentalHealth_EN_rev.pdf, or Canadian Mental Health Association www.cmha.ca

WHAT IS “BABY BLUES”? Up to 80% of women feel sad or anxious during the first weeks after the birth of a baby - it’s often called the “baby blues”. If these symptoms continue or become worse, a woman may be experiencing depression. Depression and anxiety around the birth (or adoption) of a baby can affect up to 20% of mothers.

16

|

NEW PARENT RESOURCE GUIDE 2017

MENTAL HEALTH AND WELLBEING

DURING PREGNANCY AND LIFE WITH A NEW BABY

During pregnancy or after the baby is born 1 in 5 women may experience difficult moods (Perinatal Mood Disorders) including depression and anxiety. Men can also experience emotional difficulty. Have you had some of these symptoms for more than two weeks? You may: q Not feel like yourself q Be sad and tearful q Feel exhausted, but unable to sleep q Have changes in eating or sleeping patterns q Feel overwhelmed and can’t concentrate q Have no interest or pleasure in activities you used to enjoy q Feel hopeless or frustrated q Feel restless, irritable or angry q Feel extremely high and full of energy q Feel anxious - you may feel this as aches, chest pain, shortness of breath, numbness, tingling or “lump” in the throat q Feel guilty and ashamed, thinking you are not a good parent q Not bond with the baby, or feel afraid to be alone with the baby q Have repeated scary thoughts about the baby

Very rarely women may feel like hurting themselves or their baby. If this happens to you or a loved one, get help right away. Call 911, go to your local hospital emergency department, or call the Here 24/7 Crisis Line at 1-844-437-3247 (HERE247). This is not your fault. You are not alone. There is help available. A parent’s mental health and wellness is important to the family’s wellbeing. Talking with someone you trust about the way you are feeling can help you get the care you need. This may include counselling, support groups or medication ordered by your health care provider. Don’t wait! There is help for you and your family If you are experiencing a lot of stress or other mental health concerns, reach out for help from: • Your health care provider (family doctor, midwife, nurse, obstetrician/gynecologist [OB/GYN]) • Your counsellor, social worker or clergy • Region of Waterloo Public Health 519-575-4400 • Call 1-844-437-3247 (HERE 247) to access addictions, mental health and crisis services • Mental Health Services – Information Ontario: 1-866-531-2600 (24 hours a day) Source: Best Start, 2013 (www.beststart.org)

parentguide.ca

|

17

SKIN-TO-SKIN AND BABY’S FEEDING CUES

SKIN-TO-SKIN It’s easy! Here’s how: Place your baby wearing only a diaper, with their tummy on your bare chest. If you wish, you can then place a light blanket over both of you. Encourage your partner to hold your baby skin-to-skin as well.

Your bare chest is the best place for your baby to be. Healthy babies should be placed skin-to-skin as soon as possible after birth for at least an hour to help your baby adjust to their new environment. When your baby is skin-to-skin, they can hear you, smell you, see you and it can help you get to know each other. Premature babies and those delivered by C-section also benefit from skin-to-skin. As your baby grows, continue cuddling them skin-to-skin often. BENEFITS OF SKIN-TO-SKIN FOR BABIES: • Cry less and are calmer • Stay warmer • Stabilizes blood sugar, heart rate and breathing • Protected by some of your good bacteria • Breastfeed better

BENEFITS OF SKIN-TO-SKIN FOR PARENTS: • Reduced stress • Increases bonding and attachment • Learn when your baby is getting hungry • Gain confidence caring for your baby • Helps mothers with breastfeeding • Improves mother’s milk supply

If you are feeling tired while holding your baby skin-to-skin, see page 24 for safe sleep practices. LEARN YOUR BABY’S FEEDING CUES Watch your baby, not the clock. Feed your baby when they start to show early feeding cues. EARLY FEEDING CUES: • Makes sucking noises • Searches with an open mouth • Sticks their tongue out and licks • Brings hands to mouth • Restlessness

LATE FEEDING CUES: • Crying • Fussiness • Exhaustion • Falls asleep

SIGNS YOUR BABY IS FULL: • Turns head away • Feels settled and relaxed • Arms and legs stretched out • Stops sucking

If you have been told that your baby has jaundice, you may need to wake your baby up for feeds. See page 12 for more information. 18

|

NEW PARENT RESOURCE GUIDE 2017

BREASTFEEDING YOUR BABY BREASTFEEDING Breastfeeding is the normal and natural way of feeding infants. Your breast milk is perfectly suited to your infant and it changes as your baby grows. The World Health Organization, Health Canada and The Canadian Paediatric Society recommend that babies be given only breast milk for the first 6 months of life. Breast milk should continue to be given up to 2 years of age and beyond, along with appropriate foods for your baby’s age and stage. Supportive family and friends can help to make breastfeeding successful. The Ontario Human Rights Code supports the right of mothers to breastfeed anytime, anywhere.

WHY SHOULD I BREASTFEED? The benefits of breastfeeding increase the longer you breastfeed. Breastfeeding has many benefits for baby, mother and society, as it: • Promotes the healthy growth and development of infants • Protects infants from illness • Helps mothers recover from childbirth • Is environmentally friendly and free INFANTS WHO DO NOT BREASTFEED ARE AT GREATER RISK OF:

MOTHERS WHO DO NOT BREASTFEED ARE AT GREATER RISK OF:

• Ear, lung and bowel infections

• Breast and ovarian cancers

• Asthma and allergies

• Osteoporosis

• Obesity and diabetes

• Rheumatoid arthritis

• Sudden Infant Death Syndrome (SIDS)

• Chronic diseases

• Some childhood cancers • Infection from contaminated artificial baby milk (formula) If you have made an informed decision to feed artificial baby milk (formula) to your baby, call Region of Waterloo Public Health at 519-575-4400 or visit www.regionofwaterloo.ca/ArtificialBabyMilk/Formula for more information.

READ MORE ON THIS TOPIC Best Start www.beststart.org La Leche League www.lllc.ca Region of Waterloo Public Health www.regionofwaterloo.ca/breastfeeding

parentguide.ca

|

19

BREASTFEEDING YOUR BABY GETTING STARTED Skin-to-skin contact is important for babies. Holding your baby skin-to-skin often in the first few weeks while you are awake can help establish breastfeeding and increase your milk supply. This time spent together will also help you get to know your baby’s feeding cues. To read more about skin-to-skin and feeding cues see page 18.

LAID BACK BREASTFEEDING Laid back breastfeeding is a natural way for your baby to latch on to your breast. Start by sitting in a comfortable laid back position. Hold your baby skin-to-skin in between your breasts with their tummy on your chest using your arms to support their back and bottom. This position will allow your baby’s natural reflexes to guide them to your breast. Remember tummy on mommy!

MILK SUPPLY Breastfeed often and as soon as possible after birth to establish your milk supply. On day 2-3 most babies will want to feed more frequently. Many mothers worry they do not have enough milk but the more your baby feeds with a good latch, the more milk you will make. As your baby grows you may notice a pattern of frequent feeds before a growth spurt. It is normal for some babies to feed frequently during the night. If you make an informed decision to use artificial nipples (bottles) and pacifiers (soothers), avoid using these products during the first 4-6 weeks while breastfeeding is being established as they decrease the amount of time your baby spends at the breast.

VITAMIN D Health Canada recommends a daily vitamin D supplement of 400 IU (10 µg) for babies and young children (from birth to 2 years) being breastfed or receiving breast milk.

HOW DO I KNOW IF MY BABY HAS A GOOD LATCH? A good latch is the key to successful breastfeeding. Your baby is latched well if: • You feel your breast is being "pulled" with no pain • You hear a quiet "ka" sound and see your baby swallowing • You see a wide open mouth with lips curled out and baby’s chin is pressed into your breast • Your nipples look the same shape, just longer after a feeding

EXPRESSING BREAST MILK Expressing breast milk means removing milk from your breasts. It can be done by hand or with a pump. You can express breast milk to soften engorged breasts or to collect milk to give to your baby if you are going to be separated. It is important to handle and store expressed breast milk safely.

TO BOOK A BREASTFEEDING CLINIC APPOINTMENT WITH A PUBLIC HEALTH NURSE, CALL THE REGION OF WATERLOO PUBLIC HEALTH AT 519-575-4400 OR VISIT WWW.REGIONOFWATERLOO.CA/ BREASTFEEDINGSERVICES

20

|

NEW PARENT RESOURCE GUIDE 2017

2 DAYS

At least 2 WET

1 WEEK 4 DAYS

At least 4 WET

6 DAYS

Size of an egg

7 DAYS

2 WEEKS

At least 3 large, soft and seedy YELLOW

At least 6 HEAVY WET WITH PALE YELLOW OR CLEAR URINE

Size of an apricot

5 DAYS

3 WEEKS

This document has been prepared with funds provided by the Government of Ontario.

Some breastfed babies will have very large watery stools. After 6 weeks of age some breastfed babies may have one soft stool every 1-7 days. This is normal as long as baby is healthy, gaining weight well and still having at least 6 heavy wet diapers in 24 hours.

03/2009

From Day 4 onward your baby should gain 20 to 35g per day (2/3 to 1-1/3 oz) and regain his or her birth weight by 10 to14 days.

At least 3 BROWN, GREEN, OR YELLOW

At least 3 WET

Size of a walnut

3 DAYS

Babies lose an average of 7% of their birth weight in the first 3 days after birth. For example, a 3.2 kilogram or 7-pound baby will lose about 230 grams or 1/2 pound.

At least 1 to 2 BLACK OR DARK GREEN

At least 1 WET

Size of a cherry

1 DAY

Reprinted with permission by the Best Start Resource Centre

Your Baby’s Weight

Per day, on average over 24 hours

Soiled Diapers: Number and Colour of Stools

Per day, on average over 24 hours

Wet Diapers: How Many, How Wet

Your Baby’s Tummy Size

Your Baby’s Age

HOW DO I KNOW BREASTFEEDING IS GOING WELL? Babies need to feed at least 8 times in 24 hours. Follow this chart for the number of wet and dirty diapers your baby should have. Your baby should move actively, wake easily and have a strong cry. After feeding they should come off the breast looking relaxed.

BREASTFEEDING YOUR BABY

parentguide.ca

|

21

BREASTFEEDING YOUR BABY WHEN SHOULD I GET HELP? It is important to call your doctor, midwife, public health nurse (519-575-4400), lactation consultant or Telehealth Ontario 24/7 Breastfeeding Supports (1-866-797-0000) if: • Your baby is very hard to wake for a feed • Your baby is crying and will not settle after feedings • Your nipples are sore and are not getting better • You have fever, chills, flu-like symptoms or a red painful area on your breast • Your baby is not having enough wet and dirty diapers (see the chart on page 21) If you need support or information, the following services can help: NAME OF SERVICE

DESCRIPTION

LOCATION & CONTACT INFORMATION

Breastfeeding Support Services at Grand River Hospital

Breastfeeding support for patients and women who delivered at Grand River Hospital. Call for more information and for an appointment. Support available from 0-7 days after birth.

Grand River Hospital 835 King St W Kitchener 519-749-4355

Covered by OHIP

By appointment 7 days a week - In person - Telephone

Cambridge Paediatric & Breastfeeding Clinic

Book an appointment with a lactation consultant. A referral from your doctor or midwife is required.

200 Franklin Blvd. Cambridge

Covered by OHIP

By appointment - In person

Public Health Breastfeeding Services

One on one breastfeeding support with a public health nurse. Not available on weekend/holidays.

Waterloo Region*

Free

Monday - Friday - In person - Telephone

Midwifery Groups: Blue Heron Born Cambridge Genesis K-W St. Jacobs

Breastfeeding support for midwifery clients from birth to six weeks after birth.

Waterloo Region*

Free

By appointment - In person

Two Rivers Family Health Team

Lactation consultant available for patients of the Two Rivers Family Health Team in Cambridge.

350 Conestoga Blvd. Unit 15 Cambridge 519-629-4615 ext. 271

Covered by OHIP

By appointment - In person

Breastfeeding Buddies

Get matched with a trained volunteer who has breastfed. One to one phone support and community sites. Breastfeeding Café weekly. Call for details.

Waterloo Region* 519-772-1016

Free

Varies - In person - Telephone

La Leche League

Group meetings or telephone help provides motherto-mother breastfeeding support. Accredited Leaders lead discussions where mothers receive breastfeeding information and support in their role as a breastfeeding parent.

Waterloo, Kitchener and Cambridge locations 519-579-3800 1-800-665-4324 www.lllc.ca

Free

Meeting times vary by location. Call for the meeting times for the location you are interested in. - In person - Telephone

Private Lactation Consultant Services

International Lactation Consultant Association (ILCA). See website “search tool” to search for a practicing lactation consultant.

www.ilca.org

Fees vary

By appointment - In person

COST

519-620-3600

519-575-4400

Contact your Midwife

*Cambridge, Kitchener, Waterloo, North Dumfries, Woolwich, Wilmot and Wellesley 22

|

TIMES AVAILABLE AND SERVICES OFFERED

NEW PARENT RESOURCE GUIDE 2017

BREASTFEEDING YOUR BABY IS IT SAFE FOR ME TO DRINK ALCOHOL WHEN BREASTFEEDING? Alcohol passes into breast milk so the safest choice is to avoid drinking alcohol while breastfeeding. If you are going to have an occasional alcoholic drink: • Breastfeed before you drink • Limit the amount you drink to one standard drink • Wait 2.5 to 3 hours after having one standard drink before the next feeding • If you plan on having more than one drink, express and store breast milk before drinking For more information contact Motherisk at 1-877-327-4636, or visit http://www.motherisk.org/women/updatesDetail.jsp?content_id=347 A STANDARD DRINK IS: 341 mL (12 oz) glass of 5% alcohol content (beer, cider or cooler) 142 mL (5 oz) glass of wine with 12% alcohol content 43 ml (1.5 oz) serving of 40% distilled alcohol content (rye, gin, rum, etc.)

IF I SMOKE SHOULD I BREASTFEED? Breastfeeding is the healthiest choice for your baby even if you smoke. If you do smoke, it is best for your health and your baby’s health if you quit. If you are having difficulty quitting smoking, talk to your doctor about nicotine replacement therapy (NRT). To decrease the effects of smoking on your baby: • Breastfeed before you smoke or use NRT • Do not allow smoking in the house and car • Remove the clothing you wore when smoking and wash your hands, before holding your baby For free information and help with quitting or cutting down call Smoker’s Helpline at 1-877-513-5333.

BREASTFEEDING AND RETURNING TO WORK In Ontario, the Human Rights Code protects your right to breastfeed anytime, and anywhere. This includes your right to be accommodated when you return to work or school so that you can continue to breastfeed for as long as you choose. Many mothers continue to breastfeed when they return to work or school. Plan ahead and consider times in your schedule to express your milk or breastfeed your baby. Consider meeting with your employer before returning to work so that you can discuss a schedule and an acceptable space to accommodate your needs. For more information on your right to breastfeed visit the Ontario Human Rights Commission website: http://www.ohrc.on.ca/en/pregnancy-and-breastfeeding-brochure HOW DO I KNOW MY BABY IS READY FOR SOLID FOOD? Wait until your baby is 6 months old and showing signs of being ready before offering solids (see page 32 for more information on signs of readiness).

parentguide.ca

|

23

SAFE SLEEP

Z

Preventing sudden infant death in Canada

z

Z

Safe Sleep for Your Baby

z

Provide a smoke-free environment before and after your baby is born.

Always place your baby on his or her back to sleep, at naptime and night time.

Your baby is safest when he or she sleeps in a fitted one-piece sleepwear that is comfortable at room temperature and does not cause your baby to overheat.

Provide your baby with a safe sleep environment that has a firm surface and no pillows, comforters, quilts, bumper pads or toys.

Sharing the same sleep surface with your baby is not safe. Place your baby to sleep in a crib, cradle, or bassinet next to your bed.

Breastfeeding can protect your baby.

Original concept developed by Public Health Agency of Canada, for more information go to www.publichealth.gc.ca/safesleep. INFANT SLEEP HABITS

In the first few months, babies sleep patterns are not regular. They may sleep 2 to 4 hours at a time and may want to feed when they wake up. After 3 months, most babies begin to feed less often and sleep longer at night with daytime naps. For a baby, six hours is a long time to sleep. If they go to sleep at 7:00 p.m. they might be up by 1:00 a.m. to feed and be changed. The following chart is a general guide to the amount of sleep over a 24-hour period (includes night-time and day-time naps): AGE OF INFANT

AMOUNT OF SLEEP OVER A 24-HOUR PERIOD

Birth to 2 months

16-18 hours

2 to 6 months

14-16 hours

6 months to 1 year

13-15 hours

Starting around 3 months of age babies have more regular cycles of sleep and you can begin a sleep routine by putting your baby down to sleep at the same times every day. TIPS: • Learn the signs that show your baby is tired and ready for sleep (yawning, rubbing eyes, fussing and crying). Don’t wait until they are over-tired. They will have a harder time falling asleep • Put baby down on THEIR BACK WHEN SLEEPY but awake so they learn to fall asleep on their own • Keep night feedings/diaper changes quiet with the lights low For information about sleep for toddlers and preschoolers, see page 36. For more information go to www.caringforkids.ca or www.aboutkidshealth.ca Find out how you can help your new baby (0-3months old) sleep. Sign up for the free Sleep and Your New Baby session offered at your local Ontario Early Years Centre. Register online at http://www.earlyyearsinfo.ca/. 24

|

NEW PARENT RESOURCE GUIDE 2017

TUMMY TIME TUMMY TIME TO PLAY

Tummy time is play time with your baby lying on a hard surface while on their stomach, with a parent or caregiver within reach. It lets your baby see the world from a different view which is important for their development and helps to prevent your baby from getting a flat head (see below). Being on their stomach helps babies to develop their neck muscles, arm strength and helps prepare them for crawling. For newborns to 3 months: • Place your baby’s chest on a rolled towel for a few minutes while they are awake to play • Place toys on both sides of your baby’s head so your baby can see them When your baby can lift their head: • Use mirrors and toys around your baby to encourage reaching • Play Peek-A-Boo; hold up a blanket between you and encourage your baby to pull down the blanket Little by little, increase the amount of tummy time you spend with your baby. Start with once or twice a day for a minute or two. When your baby starts to fuss, pick up your baby.

BEING ACTIVE WITH YOUR BABY (0-12 MONTHS) Infants should be physically active several times a day for their growth and development. Being active as an infant includes: tummy time (see above), reaching for & grasping toys, rolling on the floor, crawling and learning to walk. • Get down on the floor/ground and play with your baby every day • Infants should not sit for more than 1 hour at a time when awake (such as in a high chair or car seat) • Children under 2 years of age should have no screen time (time in front of a TV or computer screen) For the complete physical activity guidelines for infants, go to: www.csep.ca/guidelines

PREVENTING FLAT HEAD When placed on their back, babies usually turn their head to the same side and the skull can flatten. A little bit of flattening goes away on its own. More serious flattening may last, but will not affect a baby’s brain. Check with your health care provider if you have any concerns. To help prevent a “flat head”: • Each day, switch your baby’s head position from one end of the crib to the other end; toes to headboard one day, toes to footboard the next and so on • Limit the time your baby’s head lies against a flat surface such as sitting in a car seat or stroller • From birth, play daily with your baby during tummy time (see above) For more information go to: www.caringforkids.cps.ca

parentguide.ca

|

25

SOOTHING YOUR CRYING BABY Crying is normal for babies. It is your baby’s way of talking to you or telling you something is wrong. Learn to recognize and respond to early signs that your baby needs you. Don’t wait until your baby is really upset before responding or it will be harder to soothe your baby. See the chart below for possible reasons your baby may be crying, and some things you can do.

POSSIBLE REASON

WHAT YOU CAN DO

Hunger

• Feed and burp your baby. Your baby may be hungrier on some days

Needs to be held or to be close to a person Also may be “Just Unknown”

• Hold your baby “skin-to-skin” (see page 18) • Hold your baby close and give your full attention • Cuddle, coo, read and sing to your baby • Rock your baby gently, walk around, and dance slowly • Take a bath with your baby

Pain or discomfort

• Pick up and comfort your baby, change their diaper, burp/rub baby’s back • Changing baby’s position may help

Too hot or too cold

• Dress the baby for the temperature of the room and the weather

Tired or over-stimulated

• Loosely swaddle your baby while in your arms with at least one arm free so baby can soothe themselves with their hand • Turn lights off and keep the surroundings quiet • Talk to the baby in a soft, smooth and continuous voice • Rock the baby gently • Place the baby on their back in the crib and create soft background noise

Needs a change

• Read, sing and talk to your baby • Play with your baby – give your baby tummy time (see page 25) • Change rooms so the baby can look at different things • Take the baby for a walk in the stroller or go for a car ride with the baby

Illness

• Check the baby for signs of illness (see page 51) • If the baby’s cry sounds different or the baby cannot be soothed after trying everything, see your doctor or call Telehealth Ontario at 1-866-797-0000

Adapted with permission from the Institute of Child Study. This chart is an adaptation of one funded by the Ontario Neurotrauma Foundation to the Institute of Child Study, University of Toronto. It is available in 21 languages from this website http://legacy.oise.utoronto.ca/research/ONF-SBSPrevention//?cms_page=ONF-SBSPrevention/index.html

DID YOU KNOW? • Babies cry an average of 2 to 2.5 hours a day, peaking around 2 months and gradually decreasing by 4 or 5 months of age • Most babies cry more at night • Most babies have at least one fussy time each day; it is often in the evening Healthy babies cry and sometimes nothing works to stop the crying; just keep trying to soothe them. If you are feeling frustrated or angry by the baby’s crying, put the baby down in a safe place and call someone to help you. See page 27 for important information. Visit the Canadian Paediatric Society website at www.caringforkids.cps.ca for more information. 26

|

NEW PARENT RESOURCE GUIDE 2017

NEVER SHAKE A BABY!

WHAT IS SHAKEN BABY SYNDROME? Shaken Baby Syndrome is a name used to describe what happens when a baby or young child is shaken with force. This causes the brain or eyes to bleed and may cause broken bones or even death. Shaken Baby Syndrome is a form of child abuse and can happen in a moment of frustration or anger; the damage is life long. Infant crying is the most common trigger for Shaken Baby Syndrome. • Never Shake a Baby even for a moment! • Never use physical discipline when caring for a baby or child (no spanking, slapping or shaking) • Learn how to deal with your feelings of tiredness, frustration and anger • Know all your baby’s caregivers; talk with them about what to do when the baby cries (see page 26) PLAN AHEAD – TIPS FOR PARENTS • Plan ahead when you are pregnant to have extra help so you can sleep and rest regularly • Practice staying calm, be active, eat well, learn ways to relax, join a support group • Place the baby in the crib if you need relief from their crying – take a break and call someone • If you are feeling frustrated or angry, talk to a friend, family member, or health professional • Know the caregiver. Never leave your child with someone you don’t trust, someone who has trouble controlling their anger, or someone who does not want to care for your baby

FOR MORE INFORMATION GO TO: CANADIAN PAEDIATRIC SOCIETY www.caringforkids.cps.ca BEST START RESOURCE CENTRE www.beststart.org TRANSLATION OF RESOURCES IS AVAILABLE IN MULTIPLE LANGUAGES

parentguide.ca

|

27

BABIES DON’T BOUNCE

Falls are the number one cause of all childhood injuries. Over 1800 children under six years of age visit the Emergency Department each year in Waterloo Region due to injuries from falls.

Protecting Your Baby from Falls • Always stay with your baby when they are on a raised surface such as a change table, bed, sofa or a counter at the doctor’s office or health centre. • Place car seats, baby chairs, and bassinets on the floor instead of on a counter, bed or sofa. Your baby could wiggle to the edge and fall, even when strapped in. • Install a stair gate at the top of each stairwell before your baby reaches four months of age. This is when most babies start to crawl. • Use the safety straps in your stroller, high chair, change table, car seat and baby seat. They help keep your baby in place and prevent falls. • Many babies are hurt by falling out of cribs. To protect your baby: – Move the crib mattress to the lowest point as soon as your baby can sit up. – Your child is ready for a toddler bed when they show signs of being able to climb out of the crib. – Do not place crib near a window. All parents and caregivers want to keep their children safe. Preventing injuries takes action. Always stay with your child and be aware of what your child is able to do. Put your child’s safety first – you have to do what you know is safe every time. Make safety your habit.

Falls are the leading cause of injury to babies and children.

Supervision is the best prevention! Being at your baby’s side is the best way to prevent falls. Never leave your baby alone on a raised surface like a couch, bed or change table.

Keeping your child safe from falls Birth to 18 months: You need to be touching or holding your child. 18 months to 4 years: You need to stay close to your child – be within arm's reach at all times. 4 to 6 years: You need to be paying attention to what your child is doing. You need to teach your child safety rules, remind your child of the rules, and watch to make sure your child is following the rules. Key tips for preventing falls for babies and children: • • • •

Buckle Up – use safety straps when available. Look First – supervise your baby on high surfaces. Use the Gear – install stair gates to prevent falls. Wear the Gear – wear a helmet for all wheeled activities.

Region of Waterloo Public Health 519-575-4400 (TTY 519-575-4608) www.regionofwaterloo.ca/ph Original concept developed by Alberta Health Services

28

|

NEW PARENT RESOURCE GUIDE 2017

Buckle me up!

PUBLIC HEALTH AND EMERGENCY SERVICES

Car crashes are a leading cause of injury related death among children. When used correctly, car seats and booster seats can reduce the risk of injury or death in a crash. Car seats and booster seats are required by law in Ontario.

It is important that you do not rush your child to the next stage. Keep your child in a rear-facing car seat as long as possible to decrease the risk of head and spinal cord injuries.

I am a baby My rear-facing car seat protects my head, neck and soft bones. Keep me this way until after I am one year old. I will fit into some rear-facing seats until I’m 18 kg (40 lb).

My harness: • • • •

Is below my shoulder Is one finger tight at my collar bone Has my chest clip at armpit level Lays flat and is snug

My seat: • Is at a 45 degree angle • Moves less than 2.5 cm (1 in) side to side or forward where connected

I am a toddler it is ok if my feet touch!

I must be at least one year old, 10 kg (22 lb) and can walk unassisted to be in a forward-facing car seat. Keep me rear-facing as long as possible.

My harness: • • • • •

Is below my shoulder when rear-facing Is above my shoulder when forward-facing Is one finger tight at my collar bone Has my chest clip at armpit level Lays flat and is snug

My seat: • When my seat is forward-facing, the tether strap is attached to the tether anchor and is pulled tight • Moves less than 2.5 cm (1 in) side to side or forward where connected

I am a school-aged child I must be at least 18 kg (40 lb) to sit in a booster seat. My booster seat helps the seat belt to fit me better.

My shoulder belt: • • • •

Crosses the centre of my shoulder Crosses the centre of my chest Lays flat Is pulled snug

My lap belt: • Rests on my upper leg (thigh) • Does not ride up on my belly • Is pulled snug

www.regionofwaterloo.ca/CarSeatSafety

|

www.ontario.ca/CarSeats

SAFETY IN THE HOME

Is your home safe for young children? Home Safety Checklist

General Home Safety Check off what you are already doing, circle what you would like to try. Prevent burns

Prevent fire

❏ Set hot water tank temperature to 49°C/120°F ❏ Put screen in front of fireplace

❏ Have a smoke alarm and carbon monoxide detector on every level of your home and outside sleeping areas

Prevent choking and suffocation

❏ Test and check smoke alarms and carbon monoxide detectors every year

❏ Do not give nuts, hot dogs, whole grapes, hard candy, gum or raisins to children under four years of age ❏ Cut blind and curtain cords short and place them out of child’s reach ❏ Keep plastic bags out of reach or tie them in knots ❏ Throw out corners cut off milk bags

Prevent falls ❏ Keep furniture away from windows ❏ Attach furniture like a dresser, bookcase or TV to the wall ❏ Climbing on tables, counter and other raised surfaces should not be allowed ❏ Keep windows and doors locked ❏ Use window guards to prevent windows from opening more than ten cm (four inches)

❏ Keep lit candles away from children, pets, furniture and curtains ❏ Lock matches and lighters out of child’s reach

Prevent poisoning ❏ Label house plants and keep them out of reach ❏ Lock chemicals and cleaning products out of child’s reach. Choose friendlier cleaning products like vinegar and baking soda ❏ In older homes, check for lead paint and asbestos

Prevent shocks ❏ Install plug covers in electrical outlets ❏ Keep electrical cords out of sight, behind furniture

❏ Keep doors, stairs and floor clear of toys, clothes, shoes ❏ Install safety gates at top and bottom of stairs ❏ Always hold, follow or watch your child

This list gives you a place to start, but you can do more to make your home safer!

For more information contact: Region of Waterloo Public Health 519-575-4400 TTY: 519-575-4608 www.regionofwaterloo.ca/ph Canadian Partnership for Children’s Health and Environment www.healthyenvironmentforkids.ca For product recalls (including toys) Health Canada www.healthycanadians.gc.ca Parachute Canada, Preventing Injuries. Saving Lives. www.parachutecanada.org Click on “Injury Topics”

30

|

NEW PARENT RESOURCE GUIDE 2017

SAFETY IN THE HOME

You can help prevent injuries in your home. Supervision is the best prevention. Check off what you are already doing, circle what you would like to try. Where do you start? 1. 2. 3.

Get on your hands and knees to see what may put your child in danger. Know what your child can do and what they may be doing next like rolling, standing, walking, climbing and running. Stay close by and watch your child to help prevent injuries.

Kitchen Safety Prevent burns

❏ Keep kettles, hot foods and liquids at the back of the counter ❏ Cook on back burners of the stove, and turn handles inward ❏ Do not open the oven door if child is close by ❏ Stir food or liquid heated in microwave first, then test temperature ❏ Do not hold child when cooking ❏ Do not hold child when eating hot foods, drinking hot drinks or when cooking ❏ Cool food before feeding your child

Prevent cuts and bruises

❏ Lock cupboards and drawers that contain sharp, heavy or dangerous items ❏ Place heavy items like pots at the bottom of the cupboard ❏ Dry and put away knives and glassware

Prevent poisoning

❏ Store cleaning products out of reach in a locked cupboard

Bathroom Safety Prevent burns and cuts

❏ Lock curling irons and razors out of reach ❏ Test the water temperature with your elbow before putting child in bathtub ❏ Turn off the hot water tap first and the cold water tap last

Prevent falls

❏ Wipe up spills ❏ Use a non-slip rug on floor ❏ Put a non-slip bathtub mat in the bathtub

Prevent drowning

❏ Keep bathroom door closed ❏ Keep the lid on toilet seat down ❏ Always stay with a young child while in the bathtub or bathroom ❏ Empty water from bathtub after bath

Prevent poisoning

❏ Ensure medications have child safe lids and are out of reach in a locked cupboard

Bedroom Safety Crib safety

Play Safety Prevent animal bites

Prevent falls

Prevent choking and suffocation

❏ Make sure crib meets safety standards and is in good condition ❏ Keep hand on child and use safety strap when using diaper change table ❏ Keep diaper change items within reach ❏ Stop using crib if child can climb out ❏ Keep children less than six years off the top bunk of bunk beds

Prevent choking and suffocation

❏ Do not use heavy blankets, quilts, pillows, stuffed animals or bumper pads in crib ❏ Keep infants off adult beds, including waterbeds ❏ Do not give a pillow to a child under two years ❏ Always hold your infant when feeding them

❏ Do not leave children alone with pets

❏ Keep small items like balloons, beads or coins out of reach ❏ Use toys made for the child’s age ❏ Check toys for removable, loose or broken parts like wheels, squeakers, magnets or long strings ❏ Use a toy box with no lid, or with non-locking lid that has air holes

Prevent poisoning

❏ Use non-toxic crayons, paints, markers, and waterbased glue ❏ Avoid soft plastic and vinyl toys. Look for PVC-free and phthalate-free toys

Be prepared Put emergency numbers by your phone: – “911” – Poison Control: 1-800-268-9017 – Your doctor’s phone number

Emergency Room – Cambridge Memorial Hospital: 519-740-4922 – Grand River Hospital: 519-749-4242 – St. Mary’s Hospital: 519-749-6410

Get a first aid kit, know where it is and how to use it. Take a first aid and CPR course.

parentguide.ca

|

31

FIRST FOODS - STARTING AT SIX MONTHS Wait until your baby is six months old and showing signs of being ready, before offering solids. Iron-rich foods such as meat, meat alternatives and infant cereal with added iron should be the first foods offered to your baby. After introducing iron-rich foods, offer a variety of vegetables, fruit, milk products and grain products from your family table prepared safely for your baby.

SIGNS YOUR BABY IS READY FOR SOLIDS:

Introduce textures according to your baby's stage of

• Sits up in a high chair

development. Increase the texture from puréed, finely

• Shows interest in food when sees others eating • Opens mouth wide for food • Closes lips over spoon • Swallows food in mouth • Turns body or head away when full

TIPS FOR STARTING SOLID FOODS • Feed your baby in a sitting position facing you • At first, offer a teaspoon (5mL) or less of food once a day using a spoon • Gradually increase the amount of food and the number of times food is offered in a day • After eating a new food, if your baby shows signs of allergy (such as vomiting, diarrhea or rash), stop feeding the food. If your child has trouble breathing, call 911 • When starting foods that are common food allergens such as eggs, fish, milk, soy and wheat, introduce only one a day and wait 2 days for signs of allergy before offering another new food • Offer finger foods prepared safely for your baby • Let your baby decide whether or not to eat and how much to eat • Don’t force your baby to eat a food. Offer it again another day • Do not give your baby honey or food made with honey for the first year. It can cause food poisoning (botulism) For a complete guide to introducing solids to your baby safely, contact Region of Waterloo Public Health at 519-575-4400 or go to: www.regionofwaterloo.ca/ph and search Teddy Bear’s Picnic. For more information call EatRight Ontario at 1-877-510-5102 or go to: www.eatrightontario.ca 32

|

TEXTURE

• Controls head well

NEW PARENT RESOURCE GUIDE 2017

minced and soft mashed foods, to lumpier foods over time, as soon as your baby is able to manage. Many babies can handle lumpy textures at 6 months. If you wait too long to offer lumpier foods, it may be harder to get your baby to eat them. By 9 months of age, babies should be able to manage small pieces of tender cooked diced, minced or shredded soft foods. Even if your baby has no teeth they can learn to chew. By 12 months of age, children should be eating the same food as the family with changes to make it safe to eat. For example, cut grapes, wieners and sausages lengthwise and then into small pieces. WARNING: Children under 4 years of age should not be given seeds, nuts, popcorn, hard candy, round or sticky foods that may cause them to choke. See the resource ‘Choking prevention tips’ at: www.regionofwaterloo.ca/nutrition for more information.

MILK AND YOUR GROWING CHILD From birth to 6 months, all your baby needs is breast milk. At 6 months when your baby shows signs of being ready (see page 32), offer solid food in addition to breast milk. Health Canada recommends breastfeeding for up to two years of age or longer. Weaning is the gradual process of giving your child other food while continuing to breastfeed. There is no best time to stop breastfeeding; it is different for every mother and child. When you and your baby are ready, weaning should be gradual to allow your milk supply to decrease slowly, without discomfort. If you choose to stop feeding your baby breast milk when your baby is younger than 9 months of age, you will need to feed your baby commercial artificial baby milk (formula). For important information about how to sterilize equipment and to prepare and feed artificial baby milk (formula), talk to your health care provider or call Region of Waterloo Public Health at 519-575-4400. If you choose to stop feeding your baby breast milk when your baby is between 9 and 12 months of age, you Babies can go from breastfeeding to drinking from an open cup. Help your baby learn to drink may wean your baby to artificial baby milk (formula) or pasteurized whole cow’s milk (see information below). from an open cup by offering sips of water starting at six months of age. At first your baby will You may wean to an open cup.

need lots of help but they will get better with practice. For information on how to wean to a bottle or cup, call Region of Waterloo Public Health at 519-575-4400 or visit www.regionofwaterloo.ca/ph.

INTRODUCING COW’S MILK Pasteurized cow’s milk (homogenized, 3.25% MF) may be offered when your baby is 9 to 12 months old and eating a variety of iron-rich foods each day such as meat, poultry, fish, eggs, legumes, tofu and iron fortified infant cereal. THINGS TO KEEP IN MIND: • Only give pasteurized milk. Unpasteurized milk contains bacteria that can harm your baby • Lower fat milk (skim, 1% or 2%) should not be given until your baby is at least 24 months of age. Your young child needs the higher fat content of whole milk for proper growth and brain development • Soy, rice and other plant-based beverages are not suitable as a child’s main milk source during the first two years

parentguide.ca

|

33

FEEDING YOUR TODDLER AND PRESCHOOLER Children learn eating habits early in life, so it is important to get them off to a good start. By following these messages you will help your child to become a healthy eater.

HEALTHY CHOICES START NOW - AS A PARENT OR CAREGIVER, YOU DECIDE: • WHAT FOODS TO OFFER

• Continue to breastfeed for up to two years of age and beyond



• Offer a variety of foods from the four food groups of Canada’s Food Guide every day.



For more information go to www.healthcanada.gc.ca/foodguide



• Include a vegetable or fruit at each meal and snack



• Always have a nutritious food item on the table that your child likes and will eat



• Serve healthy beverages such as milk or water instead of sugar sweetened drinks



• Avoid offering juice; offer fruit instead. If offering juice, limit to 125 mL (1/2 cup) a day



• Offer water for thirst between scheduled meals and snacks

• WHEN TO OFFER MEALS AND SNACKS

• Young children need 3 small meals and 2-3 snacks each day



• Provide healthy meals and snacks every 2-3 hours at around the same times each day

• WHERE YOUR CHILD WILL EAT

• Children eat best sitting down at a table



• Sit and eat with your child – this lets you supervise them and model healthy eating



• Turn off the TV and do not allow toys, phones or other distractions at the meal table

OFFER WATER FOR THIRST BETWEEN SCHEDULED MEALS AND SNACKS.

LET YOUR CHILD DECIDE: • WHICH FOODS TO EAT (IF ANY)

• Prepare one meal for the family and let your child choose what to eat



• If your child does not want to try a new food, that’s okay; they may need to see a food

many times before they will try it. DO NOT FORCE YOUR CHILD TO EAT

• HOW MUCH TO EAT

• The amount of food your child eats will change from meal to meal and day to day



• Let your child eat as little or as much as they want, it’s okay to leave food on the plate



• Keep portion sizes small.



    Offer more if they are still hungry after finishing



• Between meal and snack



    times encourage your



    child to be active to help



    them get hungry

FOR MORE INFORMATION: Visit EatRight Ontario at: www.eatrightontario.ca or call 1-877-510-5102 Go to: www.ellynsatterinstitute.org

34

|

NEW PARENT RESOURCE GUIDE 2017

DO YOU WANT TO KNOW IF YOUR CHILD IS A HEALTHY EATER? Go to http://www.eatrightontario.ca/en/Children.aspx

TOILET LEARNING

MAKING IT A POSITIVE EXPERIENCE Children will learn to give up diapers when they (not you) are ready. Most children are ready to begin toilet learning between the ages of 2 and 4 years when they: • Want to use the toilet or potty • Can walk to the potty and sit on it • Can stay dry in diapers for several hours • Can use words or gestures to let you know they need to go • Can follow one or two simple instructions • Want to be independent • Have regular bowel patterns HELPFUL TIPS • Use clothes that your child can easily pull down • Make routines; invite your child to sit on the potty at regular times during the day, like before and after sleeping, after meals and before leaving home • Notice your child’s efforts in trying to use the potty, even if they have an accident • Talk to other caregivers about how they can support your child’s learning • Give daily time, attention and encouragement to your child as they learn to use the toilet • Children will learn to give up diapers when they (not you) are ready • Help your child wash their hands after every time they use the toilet

CONSTIPATION Bowel habits are different for every child. Some children go more than once a day; others may skip a day or two. This pattern alone is not a sign of constipation. If your child has painful bowel movements that are hard, dry, pebble-like and difficult to pass, your child may be constipated. If your child is younger than six months of age, talk to your health care provider about what to do. What you can do for children older than six months: • Offer more fluids such as water during the day • Offer foods that are high in fibre such as whole grains, fruits, vegetables, beans and lentils • Help your child be more active during the day and be relaxed about toilet learning Important: Do not give your baby or child laxatives, enemas, suppositories, or any medications without talking to your health care provider first. For more information on toilet training or constipation, visit: Canadian Paediatric Society at www. caringforkids.cps.ca

parentguide.ca

|

35

HEALTHY SLEEP HABITS Sleep is very important to your child’s healthy growth, development, learning and well-being. A lack of sleep affects a child’s: • behaviour

• attention

• learning • memory

Most toddlers and preschoolers are able to sleep through the night. Children may wake at night if they are upset, sick, growing quickly or having changes in routine. At this stage, let the child try to fall back to sleep on their own. If they do not settle after a few minutes, go in to care for them without offering to feed them (a drink of water is fine). If your child has slept poorly, they may need longer naps the next day (and so will you!). HOW MUCH SLEEP DOES MY CHILD NEED? Every child is different. Some sleep a lot and others much less. The following chart is a general guide to the amount of sleep a child needs over a 24-hour period including night-time and day-time naps.

Age of child

Hours of sleep over a 24-hour period

Toddlers (1 - 3 years)

10 - 13 hours

Preschoolers (3 - 5 years)

10 - 12 hours

School aged children (5 - 10 years)

10 - 12 hours

From the Canadian Paediatric Society: www.caringforkids.cps.ca For information about sleep for infants, see page 24. BEDTIME ROUTINES Good sleep habits start from birth. It takes time for a child to learn healthy sleep habits. Parents can help their children learn those habits by keeping the same bedtime every night and having a bedtime routine. A bedtime routine can include having a bath, brushing their teeth, reading a story, singing softly or other quiet actions that relax your child. Keep the routine simple so it can be used anywhere, anytime. Ask everyone who looks after your child to follow the same routine; this way your child will know when it is time to go to sleep. For more information visit: • About Kids Health: www.aboutkidshealth.ca and search “Growing consequences of not enough sleep” • The Canadian Paediatric Society: www.caringforkids.cps.ca and search “Healthy sleep for your baby and child” If you are concerned about your child’s sleep, talk to your health care provider. Find out how you can help your new baby (0-3 months old) sleep. Sign up for the free sleep and your new baby session offered at your local Ontario Early years Centre. Register online at www.earlyyearsinfo.ca. 36

|

NEW PARENT RESOURCE GUIDE 2017

PHYSICAL LITERACY PHYSICAL LITERACY: Physical literacy is about developing the movement skills and confidence to be physically active. Children develop physical literacy through daily active play where they run, jump, hop, throw, catch, kick, swim, skate and more. By exploring a variety of activities and play in both structured and unstructured settings, children develop the foundation to live an active life. Children who are physically literate and active are more likely to:    - Be active throughout their lives - Be ready to learn and succeed in school - Be happy, have fun, and feel good about themselves   - Get along with others

For more information and resources you can use to help your child develop physical literacy, visit: www.haveaballtogether.ca and www.activeforlife.com

MOVE MORE… SIT LESS™ MOVE MORE: Children 1 - 4 years of age should get at least 180 minutes (3 hours) of physical activity spread throughout the day, including a variety of activities in different environments and activities that develop movement skills. Physical activity for a toddler or preschooler means doing any activity that gets them moving. This includes walking, running, dancing, climbing stairs, playing outside and exploring. By 5 years of age children should be getting at least 60 minutes (1 hour) of energetic play each day, such as jumping, skipping and bike riding.

SIT LESS: It is important for children to get up and move often, and to sit for only short periods of time. Young children (up to 4 years of age) should not sit for more than 1 hour at a time when awake. Follow recommendations for screen time on page 40. Older children (5-17 years of age), in a 24-hour period, should: • SWEAT for at least 60 minutes doing moderate to vigorous physical activity. • STEP for several hours doing a variety of structured and unstructured light intensity physical activity. • SLEEP uninterrupted for 9-11 hours if they are 5-13 years of age. • SIT for no more than 2 hours a day doing recreational activities in front of a screen and limit any sitting for extended periods of time.

BE ACTIVE & HAVE FUN WITH YOUR CHILD EVERYDAY! They will be more likely to be active & live healthy, happy lives. Find ideas for being active with your child at:

www.caringforkids.cps.ca Search ‘active kids, healthy kids’ For physical activity guidelines, go to: www.csep.ca/guidelines parentguide.ca

|

37

YOUR CHILD’S DEVELOPMENT As children grow, they will learn new things for their age and stage of development; these are called developmental milestones. The NDDS is an easy-to-use checklist that can be used to track your child’s development starting as early as one month of age and up to age six. Call Region of Waterloo at 519-575-4400 if you have questions about your child’s development or how you can receive the NDDS. You can register for the online version at www.endds.ca. Community Programs Parenting programs are a great place for your child to learn age-appropriate skills and to play with other children. Your local Ontario Early Years Centre (OEYC) offers programs and supports for children from birth to six years of age and their parents and caregivers. Visit: www.earlyyearsinfo.ca for more information. See the directory in this Guide for a list of community resources that can help support your child to meet their optimal potential.

How is your child developing? Register your child today at endds.ca and you’ll get...

• • •

A checklist that captures a snapshot of your child’s development Email reminders when it’s time to do the next checklist Tips and activities to encourage your child’s development

For Practical Tips on How To Help Your Child’s Development Visit: • www.children.gov.on.ca (click on Early Childhood link) • www.developingchild.harvard.edu and search for the following activity guide: Enhancing and Practicing Executive Function Skills with Children from Infancy to Adolescence • www.zerotothree.org/resources/221-getting-ready-for-school-begins-at-birth#downloads

IS YOUR CHILD 18 MONTHS OLD? Now is an important time to book an appointment with a health care provider to check your child’s development. Your health care provider will give your child a more detailed medical check-up and any immunizations needed. Most importantly they will talk to you about your child’s development and answer any questions or concerns you may have. If concerns are identified they will link you with community resources to get started on helping your child reach their full developmental potential. DOES YOUR 18 MONTH OLD • Identify pictures in a book (“Show me the dog”)? • Use gestures (waving, pushing, reaching up)? • Show affection towards people, pets, toys (hug, kiss)? • Say 20 or more words (in any language)? Visit www.ndds.ca for more information 38

|

NEW PARENT RESOURCE GUIDE 2017

DON’T WAIT AND SEE

?

If there are concerns abut your child’s development at any age speak to your health care provider. Don’t wait and see if they will ‘catch-up’ to other children their age. The earlier a child receives support, the more likely they are to reach their poten al. Community agencies who can help support you and your child are listed below. Mental Health & Behavioural Concerns

Developmental/Physical Concerns/Special Needs

Front Door (operated in partnership between Carizon and Lutherwood) offers access to children’s mental health services for children experiencing social, emo onal, and/or behavioural issues. Walk-in counseling is available 4 days per week. For more Informa on visit www.frontdoormentalhealth.ca

Call Region of Waterloo Public Health (519) 575-4400 for intake in to the Infant and Child Development Program (for children with developmental delays).

SPEECH, LANGUAGE & HEARING KidsAbility (www.kidsability.ca) provides preschool speech and language services.

DENTAL

Contact a Dentist. For information about financial assistance call Region of Waterloo Public Health at 519-575-4400

Special Needs Access Point (SNAP) for children aged 0-6 years with developmental concerns who are attending /planning to attend licenced child care in the Region of Waterloo. KidsAbility (www.kidsability.ca) provides therapy for children from birth to age 18 for children with special needs, including children with Au sm.

VISION Children need to have their eyes examined at six months of age and then once a year. Eye exams are free for children under 18 years of age if you have OHIP. Find an optometrist at http://bit.ly/1Phjo7N

NUTRITION Nutri-eSTEP (www.nutri onscreen.ca) is a good tool to use to check the ea ng habits of children 18 months to 5 years of age to see if there are any concerns. EatRight Ontario (www.eatrightontario.ca) 1-877-510-510-2 Registered Die ans offer advice and ps on healthy ea ng and can answer your ques ons about Nutri-eSTEP. PARENTING SUPPORTS

The Ontario Early Years Centre (www.earlyyearsinfo.ca) offers paren ng resources, informa on and programs. See the Special Needs Directory (page 112) for contact informa on and a list of other agencies that can provide support for you and your child.

parentguide.ca

|

39

SPEND TIME WITH YOUR CHILD MAKE STORY TIME A PART OF EVERY DAY It is never too early to read with your child – the sooner, the better! Reading with your child helps develop their speech, language, math skills, hearing, vision and memory. When you read with your child: • Talk about the pictures. You don’t always need to read all of the words. Use your home language or the language you are most comfortable using • Ask questions and make connections between the story or pictures and your child’s life: “There’s a picture of an apple. It’s a big, red apple. It looks like the apple we ate for lunch today” • Be enthusiastic when you read. Make noises, laugh and sing. Have fun together • Sit close together when you can; it helps your child to pay attention and feel loved. • Words and numbers are everywhere! Find them on the bus, at a store, and on the street IT’S NEVER TOO EARLY TO START READING TO YOUR BABY. COME TO ANY LIBRARY LOCATION AND GET YOUR BABY A FREE LIBRARY CARD.

WHAT ABOUT SCREEN TIME? Set limits on how and when you and your child use technology. Technology can be helpful, but it can also interfere with the important interactions between parent and child. Your child’s brain learns best when your child can move and interact face-to-face with real people, not screens. GUIDELINES FOR SCREEN TIME (including phones, TV, computer and video games): • Children from birth to 2 years of age should have NO screen time • Children from 2 to 4 years of age should have less than 1 hour a day; less is better • Children and youth 5 to 17 years of age should have 2 hours or less a day OTHER HEALTHY MEDIA HABITS INCLUDE: • Keeping electronics out of your child’s bedroom so that they will not interfere with your child’s sleep • Putting electronics away at meal times and turning them off when not in use • Previewing all media to make sure it is okay for your child’s age and offers some form of learning • Being aware of your own media habits and changing them if necessary. As your child grows, they learn many of their values and ideas from you. Save your screen time for when your child is napping For more information on how to support healthy media habits go to www.caringforkids.cps.ca 40

|

NEW PARENT RESOURCE GUIDE 2017

COMFORT, PLAY, TEACH

COMFORT You can provide comfort to your child through your words, physical presence, and touch. When you comfort your child, they feel feel secure, loved, and valued. • Pay attention to your child and what they are telling you by their cries, words, and actions. Make your child feel secure by responding to their needs. Listen to your child and try to understand how they are feeling • Use positive words and actions to encourage your child

TEACH Teaching is an important part of parenting. You are your child’s first teacher and know your child best. Use practical every day activities to teach your child, such as preparing a meal together or setting a table.

PLAY Play is the ‘work’ of children. It is important for parents to play and have fun with their child every day. Play allows children to: explore, create, imagine, and figure things out; learn basic math, science and language skills; and it prepares them for school. Try to include different types of indoor and outdoor play in your child’s routine every day: • Unstructured/free play: Your child chooses what to play with and how to play. Support and encourage play by having a variety of things to play with and allow them to lead you in play. You don’t need expensive toys; use what is around you! • Structured play: Organized activities/games with or without rules, including sports. Be careful not to overschedule your child with too many activities and too many rules • Active play: Physical activity is important for children to learn basic movement skills and for good health

IMPORTANT TIPS: Create safe places for play both inside and outside the home. Watch your child at playtime to make sure they do not put small or sharp objects in their mouth. For toy recalls see www. healthcanada.gc.ca WATCH FOR SIGNS YOUR CHILD IS READY TO LEARN Children learn best when they are calm and alert. When children are taught new things in a positive way, they learn more. Helpful steps you can take to teach your child include: • ALERTING - get your child’s attention • INSTRUCTION - show or tell your child what you would like them to do • PERFORMANCE - give your child lots of time to try the activity • FEEDBACK - show how you feel by smiling, nodding or clapping; they will want to try again

parentguide.ca

|

41

HEALTHY EMOTIONS TEACHING YOUR CHILD HOW TO DEAL WITH STRESSFUL FEELINGS As children develop, they need to learn ways of soothing or calming themselves if they are feeling stressed; this is called “self-regulation.” Self-regulation is a set of skills that children learn beginning at birth and continuing on into early adulthood. Parents have the most important role in helping their children learn how to calm themselves. BABIES (BIRTH TO 1 YEAR) need caring adults who respond to their cries by feeding, changing or holding them. By doing this babies learn to trust that their needs will be met. This trust allows them to calm themselves down when they are upset. When this happens again and again, children learn to control their emotions. TODDLERS (1 TO 2 YEAR OLDS) need a lot of help from parents and caregivers to deal with their emotions (e.g. calm themselves down). Encourage your toddler to express their feelings through language and gestures. PRESCHOOLERS (2 TO 5 YEAR OLDS) need reminders from adults to take turns, share, wait, be friendly, calm down and focus on tasks. Parents and caregivers need to role model how to stay calm, pay attention and act in the way they would want their child to act. Help your children name their feelings (glad, sad, mad, scared, etc.). Point out that other people have these feelings too. (Adapted from Best Start, Building Resilience in Young Children Booklet) When a child gets help from an adult to self-regulate, they will be able to: • Follow directions more easily • Communicate their needs more appropriately • Solve problems and complete tasks more easily • Use information from previous experiences • Get along well with others For more information and examples visit www.aboutkidshealth.org search “self-regulation” and view the “Executive Function six-part series” or see the resource Learning to Play and Playing to Learn: What Families Can Do from www.beststart.org (click on For parents - Do you have young children?). DID YOU KNOW? Each child handles stress and stimulation differently. You can reduce stress and overstimulation by: having regular meal and snack times, having quiet time during the day and turning off the TV during meal times.

42

|

NEW PARENT RESOURCE GUIDE 2017

TEMPER TANTRUMS Temper tantrums are a normal part of child development and occur while young children are learning to express their emotions and control their behaviours (see page 42). Tantrums often happen when children are: • • • •

Over-tired, excited or hungry Not able to do something they want to do Asked to do something they do not want to do Frustrated when they cannot communicate their feelings, desires or needs

The following suggestions may not work for every child. Find what works best for your child. TO PREVENT TEMPER TANTRUMS • Recognize good behaviour and encourage it • Reduce triggers such as being hungry or over tired • Set rules, be consistent and stick to your child’s routine (meals, naps) • Be active with your child everyday, play outside as much as possible • Put things that are not safe for your child to have out of your child’s reach • Give limited and realistic choices so your child feels they have some control • Distract your child and redirect their attention • Give your child words to help them express their emotions. For example, “Are you feeling sad/mad?” DURING A TEMPER TANTRUM • Stay calm • Ignore the behaviour • Keep your child safe. Move furniture, toys and other children away • Hold your child if you think they may hurt themselves or others • Never spank your child or use physical discipline AFTER A TEMPER TANTRUM • Encourage your child to express their feelings in a positive way • Give lots of hugs; comfort your child and tell them you love them • Provide quiet play with your child • Do not punish your child

BE A ROLE MODEL. KNOW YOUR OWN TOLERANCE AND TRIGGERS; DO NOT HAVE TEMPER TANTRUMS OF YOUR OWN BECAUSE CHILDREN LEARN WHAT THEY SEE. For more information visit: Children See Children Learn at www.childrenseechildrenlearn.ca or Canadian Pediatric Society at careforkids.cps.ca (follow behaviour and parenting link). parentguide.ca

|

43

POSITIVE PARENTING POSITIVE PARENTING: As a parent, you are your child’s first teacher. You know your child best. Interacting with your child in a positive way during everyday activities helps to strengthen your relationship with your child. As you learn to parent and to set limits for your child, think about: • Connecting with your child; understanding your child’s personality • Helping your child find words for their emotions, understand their own personality & make good choices HOW TO DISCIPLINE YOUR CHILD IN A POSITIVE WAY Your child learns from you and your actions. Research shows that punishments such as slapping, spanking and shaming do not work. There are more positive ways to teach your child what to do

AGE

STRATEGIES FOR PREVENTING NEGATIVE BEHAVIOUR

STRATEGIES FOR DISCIPLINING YOUR CHILD

Infants (0-12 months)

• Respond to your baby’s needs • Once your baby has a routine, try to stick to it • Baby proof your home (see page 30 for information on baby proofing) • Play with and enjoy your baby

• Use a nurturing touch and/or simple words or gestures to redirect your baby • If your baby is playing with something dangerous, take it away and interest her in a safer toy

Toddlers (1-2 years old)

• Set up a safe environment • Establish a routine with reasonable bedtimes, naps, snacks and mealtimes • Notice when your toddler does something well and praise them! • Be realistic about your expectations • Try to understand your toddler’s behaviour

• Distract your toddler with a different activity or toy • Show and talk with your toddler about what they should be doing • See page 43 for information on temper tantrums

Preschoolers (3-5 year olds)

• Set clear limits & be consistent • Plan ahead and talk to your child about good behaviour • Spend time playing with your child; let your child take the lead • Talk about what your child does well • Communicate using short and clear instructions • Offer choices if you can • Model good behaviour

• Stop the negative behaviour and then talk with your child; review the rules and tell them what they can do instead • If the behaviour continues explain the consequences such as removing the toy; follow through on consequences if the behaviour continues • If your child uses bad language stay calm; ignore the behaviour or talk with your child about why you don’t use that language

Your infant is too young to know right from wrong; it is your job to comfort, teach & guide them

The key to disciplining your toddler involves understanding & quick thinking

You will need a lot of patience and creativity as you guide & teach your pre-schooler to follow rules and get along with others

For more information visit www.regionofwaterloo.ca/positiveparenting or www.childrenseechildrenlearn.ca

44

|

NEW PARENT RESOURCE GUIDE 2017

PARTNER SUPPORT INVOLVED ADULTS As fathers, partners, families and friends, you have an important role in welcoming a new baby and raising a child. When you take care of a child they learn to feel safe and trust others. Being a part of a child’s life shows them that they are important and loved!

I tell my life story and we make new memories together.

I learn values by watching you be my role model. You teach me to respect myself and others.

I know about my child’s health immunizations, doctor and dentist visits.

I share child care & concerns about my child’s growth & safety.

I show love and affection to children. Play and read with me everyday!

See more at: www.dadcentral.ca for tips and resources, including: renovating your relationship www.newdadmanual.ca for tips and video clips on new baby www.regionofwaterloo.ca/breastfeeding for information on partners supporting breastfeeding www.beststart.org/resources for these and other helpful resources: • Welcoming and Celebrating Sexual Orientation and Gender Diversity in Families • Building Resilience in Young Children • Daddy & me on the move www.beststart.org/resources/hlthy_chld_dev/BSRC_Daddy_and_Me_EN.pdf parentguide.ca

|

45

TALK FOR TOTS

“thE talk” for tots A parents’ guide to sexual health and well-being during infancy and early childhood.

Talking with your child about healthy relationships and sexual development builds trust between you and your child, helps your child with decision making, and supports their safety and well-being. It is never too soon or too late to find teachable moments and share your values and beliefs. Here are some age appropriate topics to get you started…

What Can i do dUrinG… infanCy (0 to 2 years of age)

What to ExpECt… Between 0 and 2, your child may:

· provide opportunities for play with other children · teach correct names of body parts

· explore their own body parts including genitals · benefit from hugs

Early Childhood (3 to 5 years of age)

Between 3 and 5, your child may:

· · · ·

teach the basics of reproduction (e.g., need an egg, sperm, and a uterus) teach basic rules around privacy (e.g., touching one’s own genitals is done in private) teach child “your body belongs to you” and teach your child to say “no” or “stop” to behaviours that make them uncomfortable start conversations about what a healthy relationship is (e.g., sharing, being kind to others)

middlE Childhood (6 to 8 years of age)

· · · · · · ·

teach your child the similarities and differences between boys’ and girls’ bodies provide a basic understanding of how babies are made (i.e., sperm fertilizes an egg), sexual intercourse, and pregnancy begin talking about the physical changes with puberty (e.g., periods, wet dreams, hair growth) teach that there are a variety of sexual orientations value who your child is and let them be who they are reinforce that “your body belongs to you” and it’s okay to say “no” or “stop” to behaviours that make them uncomfortable talk about what makes a good friend

to be naked · like bathroom humour (e.g., pee, poo, fart) · enjoy or rub their own genitals · touch to close their bedroom/bathroom · choose door for privacy · be curious about other people’s bodies

Between 6 and 8, your child may: to show early signs of puberty · begin their own interests · explore language to shock, tease, joke, · use and impress friends to be curious about their own body · continue and sexuality (e.g., be naked, “playing doctor”, “acting or dressing like the same or opposite sex”)

For a list of web resources for parents, including the complete guide “thE talk” from tots to tEEns, visit: www.regionofwaterloo.ca/sexualhealth For more information call: 519-575-4400 (TTY 519-575-4608) This information was developed as part of the Waterloo Region Sexual Health Youth Strategy. 46

|

NEW PARENT RESOURCE GUIDE 2017

TEETHING WHAT CAN I EXPECT? Teething is a natural process. Your baby is born with a set of 20 teeth hidden beneath the gums. Teething is the process of these teeth working their way through the gums. The first teeth usually appear between 6 to 10 months of age, with the rest following over the next 2 to 3 years. However, each child is different. It is important that these first teeth are kept healthy as they each keep a place for the adult teeth, which usually erupt between the ages of 6 to 12 years. COMMON SIGNS OF TEETHING Your baby may: • drool • be more cranky and irritable • have red cheeks, and red, swollen gums • show a need to chew on things

HOW CAN I HELP MY BABY DURING TEETHING? Directly massage irritated gums with your finger or a clean, wet, refrigerated cloth. Give your baby a teething ring or a chilled wet cloth to chew on.

Don’t confuse teething with illness. Fever, stuffiness, runny nose, and diarrhea are not caused by teething. You should see your doctor if these symptoms occur.

Avoid giving your baby hard foods like raw carrots that could cause choking. Do not give “teething biscuits” as they contain sugar and could also be a choking hazard. OVER-THE-COUNTER GELS FOR TEETHING SHOULD NOT BE USED.

parentguide.ca

|

47

DENTAL CARE YOU CAN PREVENT EARLY CHILDHOOD TOOTH DECAY “Early Childhood Tooth Decay” (ECTD) is a pattern of tooth decay, or cavities that occur in very young children. It is caused by a combination of too much sugar in the diet and poor brushing habits, or not brushing at all. It can be prevented by starting good brushing habits early in life and eating healthy foods. THE ABCs OF CHILDREN’S DENTAL CARE

Always hold your baby while feeding. NEVER put your baby to bed with a bottle.* Begin cleaning baby’s teeth as soon as they appear in the mouth. A clean baby washcloth works well until 4-6 teeth have come in. Children should be seen by a dentist or dental hygienist by their first birthday. *Breast milk is the only natural food for infants

BIRTH TO THREE YEARS Use this check list to help you keep your child’s teeth healthy. Follow the dental care tips to help you care for your child’s teeth. If you answer “no” to three or more questions, please talk to your dental care provider about your child’s dental health. YES

NO

QUESTION

DENTAL CARE TIP

o

o

Are your child’s teeth cleaned by an adult twice each day?

Use a clean baby washcloth to wipe your newborn’s gums after each feeding. As soon as teeth appear, brush them twice daily using a soft baby toothbrush and water - no toothpaste. The most important time to brush is just before your baby goes to sleep at night.

o

o

Are your child’s teeth white and shiny?

Even babies and toddlers can get tooth decay. Check your child’s teeth at least once a month. Lift the upper lip to see the teeth right up to the gum line. If they look chalky, have white or brown spots or are chipped, take your child to a dental professional.

o

o

Does your child usually drink from a cup without a lid?

By 12 months, children should drink mostly from an open cup at mealtimes in their highchair. Do not let a child walk around all day with a “sippy” cup.

o

o

Does your child fall asleep with anything in his/her mouth?

Milk left pooling around the teeth may cause Early Childhood Tooth Decay. Clean your child’s teeth before bedtime. Stop breastfeeding when your child has fallen asleep. Never put your child to bed with a bottle.

o

Does your child have set times during the day for meals and snacks?

Your child should have no more than 5-6 set meal and snack times during the day. Frequent snacks, especially if sticky or sweet, may cause cavities. Examples of healthy choices are cheese, yogurt, fresh fruits, vegetables and milk. Avoid offering fruit juice or limit to 125 mL (1/2 cup) a day, even those labelled 100% fruit juice. Offer in an open cup.

o

Adapted with permission from the Community Dental Health Services Research Unit, one of the Ontario Government’s Health Systems Linked Research Units.

48

|

NEW PARENT RESOURCE GUIDE 2017

DENTAL CARE THREE TO FIVE YEARS At three years of age and if your child can spit on command, begin to brush with a children’s toothpaste that has fluoride. Be patient, and make it fun! Your child will soon learn that brushing is part of routine care, like washing their hair and bathing, and needs to be done whether it’s easy or not. Be sure to rinse toothpaste from your child’s mouth and do not let them swallow or eat it. Children should be encouraged to learn how to brush, but they cannot do a good job until they are eight or nine years of age. Until then, you will have to brush for them. ARE BABY TEETH REALLY THAT IMPORTANT? AREN’T THEY JUST GOING TO ALL FALL OUT ANYWAY? Baby teeth ARE important! Baby teeth allow your child to eat, drink and speak properly. They also help in forming the pathway for the adult teeth when they come in. Your child’s last baby teeth will not get loose and fall out until they are 11 or 12 years old. Call Region of Waterloo Public Health at 519-575-4400 to get information about financial assistance programs for dental treatment for children. READ MORE ON THIS TOPIC:

Ontario Dental Association www.oda.on.ca

parentguide.ca

|

49

HEALTH AND WELLBEING SIX STEPS TO HELP KEEP YOU HEALTHY

1. Wash your hands often using soap and water or an alcohol-based hand rub. Ensure hands are washed: • After coughing, sneezing or blowing your nose         • After using the washroom • Before touching your eyes, mouth, or putting in contacts • Before eating or preparing food 2. Avoid touching your face as much as possible 3. Cough and sneeze into a tissue or your elbow. Throw out used tissues right away and wash your hands 4. Do not share objects that have been in other people’s mouths, e.g. toothbrushes, drinks, water bottles, unwashed utensils, cigarettes, lip products, mouthpieces and musical instruments 5. Stay home if you are sick. This will help prevent spread of infections to co-workers and others 6. Frequently clean common surfaces such as keyboards, doorknobs, counter tops, etc.

VIRUS OR BACTERIA – DIFFERENT OR THE SAME?

• Both viruses and bacteria can cause infections and are easily spread in similar ways: » coughing or sneezing infected droplets to others directly, or » touching surfaces or objects that have been infected with viruses or bacteria and then  touching your mouth, nose or eyes without washing your hands • Most respiratory infections are caused by a virus (e.g. common cold, flu) • Viral infections can get better in four to five days, but some may last longer • Some viruses can be treated with antiviral medication • Antibiotics only work against bacteria; your doctor may not be able to give you antibiotics for your illness

ANTIBIOTIC RESISTANCE IS A PROBLEM!

What is antibiotic resistance? • Antibiotic resistance means that a drug is no longer effective in killing a certain bacteria • Antibiotics are only effective against bacterial infections, not colds or the flu, caused by viruses. Increased improper use of antibiotics can lead to resistance. Your doctor may not always prescribe medications for your illness • Antibiotics are only effective if taken and finished as prescribed by your doctor. Do not stop taking antibiotic medications part way through your treatment, even if you are feeling better

YOU CAN MAKE A DIFFERENCE!

• Do not share prescription drugs or take drugs prescribed for someone else • See your doctor or medical practitioner for further assessment if your illness becomes more serious. Your doctor may be able to prescribe a medication or treatment • Make sure you and your family get your flu shots each year and that other vaccinations are up to date For more information contact Region of Waterloo Public Health at 519-575-4400.

CHECK TO SEE IF YOUR WELL WATER IS SAFE TO DRINK….

Unsafe drinking water can cause serious illness, especially in pregnant women and babies. Private well owners should test their water at least three times per year (Spring, Summer, Fall), for bacteria such as E. coli and Coliforms, and once per year for nitrates and fluoride. To find out more check out our fact sheets at:

http://chd.region.waterloo.on.ca/en/healthyLivingHealthProtection/resources/Nitrates.pdf http://chd.region.waterloo.on.ca/en/healthyLivingHealthProtection/resources/FluorideDrinkingWater_fs.pdf http://chd.region.waterloo.on.ca/en/healthyLivingHealthProtection/Private-Wells.asp

50

|

NEW PARENT RESOURCE GUIDE 2017

FEVER AND SICKNESS When your child is sick they may have a fever. If you think your child has a fever, use a thermometer to check their temperature. Your child has a fever if their temperature is above the number listed below:

METHOD TEMPERATURE

Rectum Mouth

38°C (100.4°F) 37.5°C (99.5°F)



Armpit

37.3°C (99.1°F)



Ear

38°C (100.4°F)

Source: Canadian Paediatric Society (2014) www.caringforkids.cps.ca

NEED A FAMILY DOCTOR?

Call Health Care Connect to register: 1-800-445-1822

Use one thermometer for rectal and a separate one for taking oral temperatures. Do not use glass or mercury thermometers, use digital or plastic thermometers instead. Forehead thermometers are not as accurate as other methods for taking temperatures. For information on how to correctly take a temperature, visit www.caringforkids.cps.ca.

WHAT YOU CAN DO IF YOUR CHILD HAS A FEVER: • • • • • • •

Babies younger than six months old should see a doctor when they have a fever If your child is older than six months, then give more to drink (such as breast milk or water) Take off extra clothing and blankets, leave enough to avoid shivering Check your child’s temperature often Do not give medication unless recommended by your health care provider A child or teenager with a fever should not be given Aspirin or Acetylsalicylic Acid (ASA) Call your health care provider if the fever does not go away after 72 hours (three days), if your child has other signs of sickness or if you are concerned

Alcohol rubs or baths and sponging with water are NOT recommended.

OTHER SIGNS YOUR CHILD MAY BE SICK: • Acting differently (tired, weak, sleepy, loss of appetite, fussy or a lot of crying) • A runny nose • Coughing • Vomiting • Rash • Difficulty breathing • Diarrhea • Change in skin colour (pale or looks yellow) To talk to a Registered Nurse, call Telehealth Ontario 1-866-797-0000 (TTY: 1-866-797-0007); available 24 hours a day, 7 days a week. In an emergency situation call 911.

WHAT IS RESPIRATORY SYNCYTIAL VIRUS (RSV)? RSV is a common virus in infancy and early childhood. Almost all children will be infected with RSV by 2-3 years of age. Premature babies and children under two years of age with lung or heart conditions are at greater risk of getting very sick from RSV. RSV may look like a cold at first (fever, runny nose). If RSV gets into the lungs, symptoms can include a deep and frequent cough, difficulty breathing, wheezing, blue lips/fingernails, dehydration and difficulty feeding.

STEPS YOU CAN TAKE TO REDUCE THE RISK OF RSV INFECTION: • Wash hands before touching your baby • If you have a cold or fever, gently hug instead of kissing your baby • Keep anyone with a cold or fever away from your baby • Do not smoke around your baby; keep your home smoke-free For more information about RSV visit www.caringforkids.cps.ca parentguide.ca

|

51

HEALTH AND THE ENVIRONMENT MAKE YOUR HOME SAFE FROM HARMFUL SUBSTANCES Chemicals in the home can have long-term effects on the health of a developing fetus and children. Small amounts of harmful substances add up; you can reduce the amount by following these tips:

1. BUST THAT DUST Clean floors often with a damp mop or vacuum; use a damp cloth to dust. Take off    shoes at the door.

2. GO GREEN WHEN YOU CLEAN

Choose fragrance-free laundry and cleaning products. Scrub sinks/tubs with baking soda. Mix vinegar   and water to mop floors, wipe counters and wash windows. Avoid air “fresheners”.

3. RENOVATE RIGHT

Pregnant women and young children should stay away from areas being renovated. Paint used in older homes may contain lead. Cover old painted surfaces with new paint instead of sanding or scraping.

4. GET DRASTIC WITH PLASTIC

Avoid using plastic in the microwave, even if the label says “microwave safe”. Most cans have BPA plastic inside, choose fresh or frozen foods when possible. Use glass, ceramic or stainless steel for hot food or drinks.

5. DISH SAFER FISH

 Choose low-mercury fish, especially when pregnant. If you eat canned tuna, choose “light” over “white" (albacore). See fish guide on page (57).

6. CHOOSE FRAGRANCE FREE

Avoid products with “fragrance” in the ingredient list, such as body care products and candles.

7. DETECT SMOKE AND CARBON MONOXIDE

Have a smoke detector and carbon monoxide (CO) detector on every level of your home, test monthly and change the   batteries every year.

8. REDUCE RADON

Measure the radon level in your home by using a radon test kit (radon is a harmful gas). For more information, visit www.healthyenvironmentforkids.ca Resources available in many languages.

AVOID SECOND AND THIRD-HAND SMOKE Second and third-hand smoke is harmful to your health and your children’s health. For tips on how to avoid it go online http://www.beststart.org/resources/tobacco/pdf/tobacco_handout_eng_FINAL.pdf

SMOKING IS BANNED IN MANY INDOOR AND OUTDOOR PLACES. For more information or to make a complaint contact Region of Waterloo (519) 575-4400 http://chd.region.waterloo.on.ca/en/healthyLivingHealthProtection/Smoking-Legislation.asp

52

|

NEW PARENT RESOURCE GUIDE 2017

HEALTH AND THE ENVIRONMENT SUN SAFETY

Too much sun can be harmful. Babies and young children have thin skin that can be damaged easily by ultraviolet radiation from the sun. This damage builds up over time and can lead to skin cancer. We want children to be outside for their physical, social, mental and emotional development, but, it is also important that children enjoy the sun safely when outside. Follow these sun safety tips when the UV Index is 3 or higher (which is usually between April and September from 11am to 3pm) • Cover up by wearing long sleeve shirts, pants, a wide brimmed hat, & sunglasses. • Use sunscreen and lip balm that is labelled as broad spectrum and water resistant with a minimum of 30 SPF. Reapply as directed. • Seek shade under trees, umbrellas, or other structures. Babies need extra protection. Keep them out of the sunlight for their first year by staying in the shade or covering up. Sunscreen is not recommended for babies under six months of age. For more information, visit: http://healthycanadians.gc.ca/healthy-living-vie-saine/environment-environnement/sun-soleil/tips-parent-conseils-eng.php

PROTECTING AGAINST BUG BITES 1. COVER EXPOSED SKIN

When you are outside and mosquitos are active wear light coloured, long-sleeved shirts and long pants, socks and a hat.   2. USE AN INSECT REPELLENT

Before using an insect repellant read and follow manufacturer’s directions carefully. Insect repellants containing DEET and Icaridin have been approved for use in Canada. Icaridin is the repellant of first choice for use on children between the ages of six months to 12 years. When applying sunscreen and insect repellant, first apply sunscreen and let it absorb for 30 minutes, then apply repellant. 3. PROTECT YOUR HOME

Screens on windows and doors should be free of holes, gaps and tears to prevent insect entry. Cleanup outside areas where water accumulates and keep bushes and  tall grasses trimmed to prevent water from ponding and attracting mosquito’s.

AGE GROUP

SUGGESTED % OF DEET

RECOMMENDED NUMBER OF APPLICATIONS PER DAY

Newborn to 6 months

DEET is not recommended for this age group. Use netting or limit time outdoors at dusk and dawn to prevent mosquito bites

6 months to 2 years

10% or less

Not more than one (do not apply to hands or face)

2 years to 12 years

10% or less

Not more than 3

Older than 12 years

Up to 30%

Follow instructions on label

For more information go to: http://chd.region.waterloo.on.ca/en/healthylivinghealthprotection/westnilevirus.asp parentguide.ca

|

53

PREPARING YOUR CHILD FOR CHILD CARE

54

|

NEW PARENT RESOURCE GUIDE 2017

PREPARING YOUR CHILD FOR CHILD CARE

parentguide.ca

|

55

PREPARING FOR YOUR NEXT PREGNANCY THINKING OF HAVING ANOTHER BABY? To prepare for a future pregnancy consider your emotional and physical health, age, events in a previous pregnancy, and the health of your child(ren). Consider talking with your health care provider before you become pregnant about: Your previous pregnancy and birth experience: • Gestational diabetes • Caesarian section • High or low weight gain • Preterm birth (born before 37 weeks gestation) • Birth defect • Low birth weight baby (less than 2500 grams) • Infant/fetal loss • High birth weight baby (more than 4500 grams) • Mental health concerns Your current health and experiences: • Abuse • Mental health concerns • Tobacco, alcohol or street drug use • Medication • Immunizations up to date Talk to your health care provider about these or other issues at your six week post birth visit/check-up or other visit to prepare for a future pregnancy.

WHAT’S YOUR REPRODUCTIVE LIFE PLAN? http://www.beststart.org/ resources/preconception/ AdultReproLifePlan_F18E.pdf Want to know what to bring to the hospital? See page 106.

PREPARING YOUR CHILD FOR A NEW BABY • Let your child know that the baby is coming • Talk about the changes that will happen • Answer their questions • Assure your child that you will love them just the same • Take your child to visit someone else’s new baby • Read children‘s books about new babies to your child • Help your child get used to other caregivers • If your child is going to be moved out of a crib and into a bed, do this long before the new baby arrives. This gives them time to get used to the new bed.

See www.regionofwaterloo.ca/onlineprenatal for a free, 24/7 online prenatal program 56

|

NEW PARENT RESOURCE GUIDE 2017

YOUR HEALTHY PREGNANCY HEALTHY CHOICES START NOW – FROM THE START OF YOUR PREGNANCY • Be active regularly • Take a daily prenatal vitamin with folic acid and iron • Take time for yourself • Eat following Canada’s Food Guide • Have an alcohol free pregnancy • Brush and floss your teeth • Live smoke free • Get prenatal information to prepare for your baby’s birth

• Plan to breastfeed. Take the "Me? Breastfeed?" workshop http://chd.region.waterloo.on.ca/en clinicsClassesFairs/mebreastfeed.asp • See your health care provider regularly Visit www.regionofwaterloo.ca/onlineprenatal a free, 24/7 online prenatal program for more information on these topics and more www.regionofwaterloo.ca/onlineprenatal – this free, 24/7 online prenatal program has links on these topics and more!

EATING FISH Canada’s Food Guide recommends eating two servings of fish, that are high in omega 3 fats and low in mercury, each week. If you could become pregnant, are pregnant or breastfeeding, you should avoid fish that are high in mercury. Unborn babies and infants exposed to high levels of mercury may, in time, have problems with learning, walking and talking. For more information go to www.regionofwaterloo.ca/ph and search “A Guide to Eating Fish”. FOOD SAFETY Listeriosis is rare in Canada, but can be very serious for pregnant women. The Listeria monocytogenes bacteria can be found naturally in soil, water and plants, & eating contaminated food, such as meat, fish, dairy products or produce, can cause a potentially severe infection. Pregnant women should avoid certain foods to reduce their risk of acquiring the disease. For more information see http://chd.region.waterloo.on.ca/en/healthylivinghealthprotection/resources/listeriosis_fs.pdf For other Food Safety tips, see   http://chd.region.waterloo.on.ca/en/healthyLivingHealthProtection/Food-Safety-at-Home.asp

SIGNS AND SYMPTOMS OF PRETERM LABOUR (before 37 weeks of pregnancy) If you experience any of these go to the hospital right away: • Bad cramps or stomach pains that don’t go away   • Lower back pain/pressure or a change in lower backache • A feeling that the baby is pushing down   • Contractions or change in the strength or number of them • An increase in the amount of vaginal discharge • Bleeding, or a trickle or gush of fluid from your vagina WARNING SIGNS DURING PREGNANCY If you experience any of these go to the hospital right away: • A feeling that something is just not right • Blurred vision or spots before your eyes • A significant change in your baby’s movement     • Fever, chills, dizziness, vomiting or bad headaches • Sudden or severe swelling of feet, hands or face       • Bleeding from your vagina

parentguide.ca

|

57

YOUR HEALTHY PREGNANCY SMOKING AND PREGNANCY • Smoking during pregnancy affects your unborn baby • Avoid second-hand smoke, make your home and car smoke-free spaces • Chemicals in tobacco smoke move from the mother's blood to the baby's blood. The baby gets less food and oxygen, and can be smaller in size and less healthy. • If you smoke, consider quitting for you and your baby's health. Smoking can increase your baby’s chances of being born early and/or at a low birth weight • Talk to your health care provider, or someone who is trained to help you to quit • Region of Waterloo Public Health 519-575-4400 www.regionofwaterloo.ca/QuittingSmoking • Smokers’ Helpline 1-877-513-5333 www.smokershelpline.ca DID

YOU

KNOW?

Quitting smoking and keeping a smoke-free home can reduce the risk of Sudden Infant Death Syndrome. More information about these topics can be found at www.pregnets.org and www.beststart.org (translation available in multiple languages)

COPING WITH EMOTIONAL CHANGES IN PREGNANCY Emotional changes in pregnancy are common for women and their partners. Changes occur in relationships, energy levels, lifestyles, hormones and concerns for the future. Learn about these changes and talk with your partner or health care provider about how you are feeling. To cope with these changes: eat well, get enough sleep/rest, and take care of yourself. Sometimes women may have anxiety, depression or other mental health challenges in pregnancy. If you feel that the emotional changes you are having are not normal for you, talk with your health care provider. Many women have mental health challenges during pregnancy that may continue after baby is born (see pages 16,17). ALCOHOL AND SUBSTANCE USE IN PREGNANCY Your baby’s brain develops throughout pregnancy so the safest choice during pregnancy is no alcohol at all. In fact, it is best to stop drinking if you are trying to get pregnant or think you might be pregnant. Choose not to drink any alcohol during your pregnancy. Drinking alcohol in pregnancy can cause Fetal Alcohol Spectrum Disorder (FASD). Children who have FASD have brain damage that lasts a lifetime. They have trouble remembering, thinking things through, getting along with others and they may have physical disabilities. Taking substances in pregnancy is not recommended. Any substance use has the potential to affect a baby. Many pregnancies are unplanned, if you have had some alcohol or substances in pregnancy and need help or have questions call Motherisk at 1-877-327-4636 or Region of Waterloo Public Health at 519-575-4400. The most important thing is to stop drinking alcohol or using substances for the rest of your pregnancy. Need more information about preparing for your birthing experience, for example, a list of what to bring to the birth? See page 81 for hospital contact information and page 96 for midwife contact information. 58

|

NEW PARENT RESOURCE GUIDE 2017

NEED A FAMILY DOCTOR? Call Health Care Connect at 1-800-445-1822 to register. Translation service for 140 languages. Or go to www.ontario.ca/healthcareconnect

YOUR HEALTHY PREGNANCY HEALTHY WEIGHT GAIN DURING PREGNANCY The recommendation for weight gain is based on your body mass index (BMI) before pregnancy. How quickly you gain weight is also important. It is recommended that a small amount of weight be gained in the 1st trimester, with most of your weight gain taking place in the 2nd and 3rd trimesters. Being pregnant with more than one baby will change the recommended range for weight gain. Women who gain a healthy amount of weight may lower their child’s risk of childhood obesity and they may have fewer complications such as: • Caesarean section • Long labour

• Pre-term birth

• Large-for-gestational age baby

PRE-PREGNANCY BMI CATEGORY (KG/M2 )

RATES OF WEIGHT GAIN IN THE 2ND AND 3RD TRIMESTER

RECOMMENDED RANGE OF TOTAL WEIGHT GAIN

Underweight