Immunization Requirements for Daycare

Within a daycare environment, infectious diseases can spread easily from child to child, or between children and staff. Immunization is an extremely effective way to prevent children and staff from become ill from diseases and suffering further complications that could arise.

Parents and/or guardians are required to provide their child’s immunization record or valid exemption to the daycare during registration.

The local Medical Officer of Health requires children attending daycare to be immunized against measles, mumps, rubella, Haemophilus influeunza b (Hib), diphtheria, tetanus, pertussis, polio, meningococcal disease and varicella (Chickenpox), according to the Ontario schedule.

The Health Unit works in partnership with day nursery operators to ensure all children and staff in their facilities are protected from vaccine preventable diseases. Effective assessment of immunization status and management of outbreaks requires ongoing monitoring.

To learn more about immunization requirements, contact the Health Unit at 1-866-888-4577, ext. 1507.

Breastfeeding After the First Six Months

Breastfeeding babies up to two years of age and beyond, with the addition of appropriate complementary foods, is recommended by Health Canada.

There are a number of benefits of breastfeeding baby beyond six months of age, including:

  • supports ongoing growth and development of your baby’s brain, gut, and other organs
  • continues to reduce childhood illness and infections, as children are commonly exposed to illnesses through other children and at daycare
  • promotes ongoing attachment between mother and baby
  • helps children become more independent and secure
  • reduces the risk of obesity and diabetes
  • decreases mother’s risk of breast and ovarian cancer
  • saves the family money

Breast Changes After Six Months

After breastfeeding for six months, a mother’s breasts may feel and appear softer, smaller and less full – this is normal! Mothers will continue to produce enough milk for their baby. As well, breastfeeding intervals may become shorter – this means that baby has learned to take the amount of milk needed in a short period of time.

Infant Teething While Breastfeeding

Just because baby is teething, doesn’t mean it is time to wean. When baby is breastfeeding correctly, it will not be painful for the mother. If mothers have questions or concerns about baby biting while breastfeeding, they can contact the Health Unit to speak with a Family Health Nurse.

Nursing Strike

A nursing strike happens when a baby or toddler who has been breastfeeding well suddenly refuses to breastfed. This is not the same as weaning, as weaning typically happens over a gradual period of weeks or months. Nursing strikes can happen for a variety of reasons, including a mother changing her deodorant, soap, or perfume, a mother being under stress, or a baby has an illness or injury that makes breastfeeding uncomfortable (ear infection, stuffy nose, thrush). Other reasons may be a recent change to the breastfeeding pattern, baby has sore gums from teething, or mother frightened the baby when she reacted strongly to being bitten while breastfeeding.

How to Get Baby Back to the Breast

  • be patient and remember that the baby is not rejecting the mother
  • get extra help with household chores and older children
  • relax and concentrate on making breastfeeding a pleasant experience
  • comfort the baby by cuddling, stroking, and providing skin-to-skin contact
  • offer the breast when baby is sleepy or asleep
  • breastfeed in a quiet room with the lights dimmed
  • try rocking or walking while breastfeeding
  • expressing breastmilk to keep your milk supply up
  • stimulate the let-down reflex and get milk flowing before offering the breast
  • feed baby expressed milk with a cup, eye-dropper, syringe or spoon
  • seek medical attention if an illness or injury seems to have caused the strike
  • get help – Family Health nurses at the Health Unit can answer questions about feeding baby

Skin-to-Skin

Skin-to-Skin… Important for ALL Babies

The first hours of snuggling skin-to-skin help you and your baby bond and get to know each other. Hold your baby belly-down on your chest or tummy immediately after birth. Keep cuddling skin-to-skin as often as possible in the months after birth. The benefits for bonding and breastfeeding continue long after that. Safe skin-to-skin is also better for babies born prematurely or by Caesarean birth.

Safe skin-to-skin is easy. Here’s how:

  • Take off your baby’s blankets and clothing. Leave diaper on
  • Move clothing away from your chest and tummy
  • Choose a safe sleeping or resting area where you can sit in a semi reclined position
  • Hold your baby, facing you, against your chest and/or tummy
  • Make sure your baby can easily breathe by nose and mouth and can easily lift their head and turn from side to side
  • Make sure baby’s arms are not curled under his/her body
  • You can put a blanket over you and your baby
  • Enjoy the closeness and bonding with your baby

If you haven’t held your baby skin-to-skin yet, start now! It’s not too late.

Benefits of Holding your Baby Skin-to-Skin

Babies:

  • Breastfeed better
  • Cry less and are calmer
  • Stay warmer
  • Enjoy more comfort from you
  • Have better blood sugar levels
  • Are protected by some of your good bacteria

Mothers:

  • Breastfeed more easily
  • Learn when your baby is getting hungry
  • Bond more with your baby
  • Gain confidence and satisfaction caring for your baby

Breastfeeding:

  • Your baby is more likely to have a successful first breastfeed
  • Your baby may breastfeed sooner and longer
  • You will make more breast milk
  • Helps your baby breastfeed when sleepy

Families and Skin-to-skin: Your family members can also spend skin-to-skin time with your baby. If you have a partner, plan safe skin-to-skin time together with your baby. It’s a great way for you and your partner to spend time together and bond with your baby.

To learn more, call the Health Unit at 1-866-888-4577 and speak with a Healthy Families nurse.

Cue-Based Feeding

Cue-based feeding means watching your baby to know when they are hungry and when they have had enough food. It’s important to follow your baby’s lead and watch for early signs (cues) that your baby is hungry. Remember to be flexible – it is normal for feeding patterns to change from day-to-day. Every baby is unique and you should not compare your baby’s feeding schedule to others or base it on the clock.

Knowing When Your Baby is Hungry

Babies show early signs of being hungry. Some early signs your baby is ready to eat:

  • rapid eye movement during light sleep
  • turning head side-to-side
  • wiggling, moving arms and legs
  • hand to mouth movements
  • sucking sounds and movements
  • soft cooing or sighing sounds

Crying is a late hunger sign and it is best to recognize the cues and feed your baby before they start to cry.

Signs Your Baby May Be Full
  • sucking actions slow down
  • losing interest or letting go of nipple
  • rooting will stop
  • turning head away

To learn more about cue-based feeding, call the Health Unit toll-free at 1-866-888-4577 and speak with a Family Health Nurse.

Additional Resources:

Baby Feeding Cues – Queensland Government

Getting Off to a Good Start with Breastfeeding

Breastfeeding is a learning experience for both baby and mother. It takes patience and practice, but it’s worth it!

Helping Your Baby to Breastfeed

Additional Resources:

Ten Valuable Tips for Successful Breastfeeding – Health Canada

To learn more about breastfeeding, call the Health Unit toll-free at 1-866-888-4577 and speak with a Family Health Nurse.

Making an Informed Decision: How to Feed Your Baby

This is one of the most important decisions you will make as a parent. The information on this website will help you make an informed decision. It is important to start breastfeeding shortly after birth as it may be challenging if you decide to start later. Also, if you stop breastfeeding at any time, it may be difficult to restart.

Importance of Breastfeeding

Breast milk, or human milk, is naturally made for babies. It is all that a baby needs for the first six months and continues to be important for up to two years and beyond. Babies can start foods at approximately six months of age.

Birth Control and Breastfeeding

Resources:

10 Great Reasons to Breastfeed Your Baby – Public Health Agency of Canada

For more information about feeding your baby, contact a Family Health Nurse at the Health Unit toll-free at 1-866-888-4577.

Immunizations – A little pain but a lot of gain

Let’s be honest – no one likes to watch their children get immunized. The needle can sometimes cause babies and children some anxiety and pain and that’s tough for parents to watch. But as parents or caregivers, we need to do what’s best for our little ones and that means making sure they are immunized again serious diseases. So, what’s a parent to do when their little one is due to be immunized?

Give one of the following tips a try to see if you can lessen the pain of the needle:

Check your state of mind:

  • Try to stay calm, use your normal speaking voice and be positive before, during and after the vaccination. This will help your baby to stay calm.
  • Children see and feel what their parents are doing and often do the same. If you are nervous, you can take a few slow deep breaths to calm yourself. Breathe so your belly expands, not your chest. You can do this while holding your child.

Distract your child:

  • Taking your child’s focus away from the needle can reduce their pain.
  • Hold your child close and distract them with singing or talking. For babies, breastfeeding is an ideal way to comfort them and keep them busy. If you are not breastfeeding, try giving them a soother. Allow baby to suck (breastfeeding or soother) before, during and after the vaccination.
  • Add rocking your child back and forth after the vaccination.You may choose to distract an older child with toys such as bubbles, pop-up books rattles, or smartphones. If toys do not work, hold your child close and distract with singing or talking. Add rocking your child back and forth after the vaccination.

Will these tips eliminate the pain? Probably not but helping your child through the experience will make both you and your child feel better.

Soothers and Pacifiers

It’s important to know all the facts so you can make an informed decision about giving your infant a soother. Know the facts about soothers.

Still have questions? Call the Health Unit at 1-866-888-4577, ext. 5003 to speak with a Family Health Nurse.

Risks of Using a Soother:

  • Soothers can interfere with successful breastfeeding. It can decrease the time a baby spends sucking at the breast, which can affect mom’s milk supply.
  • A soother is not nutritious and can impact a baby’s growth if it is used to replace breastfeeding.
  • A baby could develop a preference to the soother and refuse to breastfeed, making exclusive breastfeeding more difficult.
  • Using a soother can interfere with exclusive breastfeeding, it can make the Lactation Amenorrhea Method (LAM) an ineffective choice of contraception.
  • If not cleaned properly, soothers can carry germs.
  • If not used properly, soothers can be a choking hazard.
  • Ear infections and dental problems are more common with soother use and can be related to abnormal oral muscle function.
  • Overusing a soother can affect your child’s ability to learn to talk and can Lead to teeth problems.

If you have made an informed decision to use a soother, here are some tips to consider:

  • Wait until your baby is breastfeeding well and your milk supply is established (around four to six weeks) before offering a soother. If you feel you need to introduce a soother at an earlier stage, talk to your health care provider.
  • Always make sure your baby is not hungry, tired, or cold before giving a soother.
  • Avoid using a soother to delay you baby’s feedings. Always follow your baby’s feeding cues.
  • Sterilize the soother by boiling it in water for two minutes before the first use. Allow it to completely cool down before giving it to your baby. After each use, wash it with hot, soapy water. Don’t “clean” the soother by sucking on it yourself as it can spread germs from you to your child, including bacteria that can lead to tooth decay.
  • Always make sure the soother is not damaged and is free of cracks. Throw it out if it is damaged. Soothers should be replaced every two months.
  • Never let your baby or child chew on a soother. It could become damaged and cause choking and death.
  • Do not tie anything around your baby’s neck, this can cause strangulation and death. Clips with short ribbons attached to them are safe to use and are available where you buy soothers.
  • Don’t make your own soother out of bottle nipples, caps, or other materials. This can cause choking and death.
  • Children should not crawl or walk with a soother in their mouth.
  • Soothers should never be dipped in anything sweet. This can lead to tooth decay. Also, using honey can lead to botulism, which is a type of food poisoning.
  • Sometimes premature or sick babies like to suck for comfort. Talk with your health care provider or lactation consultant for help.

Managing Your Child’s Pain During Immunization

Immunizations protect your child from serious disease, but they can also cause discomfort. This can cause stress and anxiety for some children and their parents, who may then delay or avoid vaccinations. This then means that those children are not protected from serious diseases.

Parents play an important role in supporting their children during immunizations. Below are some tips you can use to help reduce the stress, anxiety and pain when it comes to immunizations in children under the age of three years.

What you can do:

Breastfeed your child

  • If you are breastfeeding your baby, start to breastfeed your baby before vaccination. Make sure you have a good latch. Then continue breastfeeding during and after the vaccination.
  • Breastfeeding during vaccination is safe for babies, even newborns. There is no evidence that babies will choke or associate their mother with pain.

Hold your child

  • Position your child upright and hold your child close before, during and after the needle. This helps your child to feel secure and to stay still.
What you can give

Topical anesthetic

  • In Canada, you can buy topical anesthetics to reduce the pain from vaccination without a prescription: EMLATM (lidocaine-prilocaine), AmetopTM (tetracaine), or MaxileneTM (lidocaine).
  • They are safe for babies, even newborns.
  • Apply them at home or at the clinic before vaccination. For more information about numbing creams and patches for immunizations. Click Here for More Information

For more tips on reducing the pain of immunization for children, call the Health Unit at 1-866-888-4577, ext. 5003 and speak with one of our Healthy Families nurses.

Babies and Sleep

Sleep is important for your baby’s growth and development, especially for their rapidly developing brain. Each baby’s sleep pattern will be different, depending on their personality and temperament.

In general, you can expect to see some of the following changes during the first year of life:

Babies less than three months of age:

  • normally sleep between 14 to 17 hours during a 24-hour period,
  • usually wake every two to three hours to feed,
  • have irregular sleep patterns and may sleep at any time of the day or night, and
  • spend a lot of time in active sleep and may move, grunt and twitch during sleep. This may cause a baby to wake up not long after they fall asleep, just before moving into quiet sleep.

Babies three to six months:

  • normally sleep 12 to 16 hours during a 24-hour period, including naps,
  • continue to wake frequently to feed,
  • may have a more regular sleep pattern, with more time spent in quiet sleep, and
  • may begin to stay awake longer during the day and sleep for longer stretches at night.

Babies six to 12 months:

  • normally sleep 12 to 16 hours during a 24-hour period, including naps,
  • may still wake during the night to feed,
  • may develop a more regular sleep routine, and
  • may transition from many short naps to fewer, longer naps.

Infants have shorter sleep cycles than adults (about 60 minutes), and they may wake up as they move from one sleep cycle to the next.

Still have questions about your baby’s sleep? Call one of our Healthy Families nurses at 1-866-888-4577, ext. 5003.

Sudden Infant Death Syndrome

Sudden Infant Death Syndrome (SIDS) is the death of an otherwise healthy baby under one year of age, with no identified cause after autopsy. An infant’s sleep environment can impact their risk for death or injury. When the sleep environment is a contributing factor (e.g. such as with suffocation), it is called sudden unexpected death in infancy (SUDI). Babies can be injured if left unsupervised in an unsafe place, or if infant products are not used as intended.

Help prevent Sudden Infant Death Syndrome (SIDS):

  • Place your baby on their back for every sleep.
  • Place your baby to sleep alone in a crib, cradle, or bassinet that meets Health Canada’s safety regulations.
  • Ensure a smoke-free environment for your baby, before and after birth. This means preventing first, second and third-hand smoke exposure.
  • Breastfeed your baby.
  • Ensure the mattress is firm with a tight fitted sheet and no loose bedding, bumper pads, or toys.
  • Keep your baby in the same room with you during the first six months of life.
  • Ensure your baby is not covered in any way.
  • Dress your baby in a fitted one-piece sleeper.
  • Keep the room at a comfortable temperature.
  • Do not swaddle your baby.

Healthy Babies Healthy Children Program

The Healthy Babies Healthy Children (HBHC) Program is a free, confidential and voluntary program for pregnant women and families with children up to age six.

The Healthy Babies Healthy Children Program provides you with advice and support at various stages to help you give your children the best start in life.

When your baby arrives

A Public Health Nurse will phone within a few days after your hospital discharge to see how you are doing. Home visits are provided if you need support to make a healthy adjustment in the first few weeks after having your baby.

You can receive information and support about:

  • Feeding your baby
  • Staying physically and emotionally healthy
  • Dealing with occasional feelings of sadness
  • Being a parent
  • Encouraging your baby’s growth and development
  • Keeping your baby safe
  • Finding community resources you may need

A Public Health Nurse and a Family Home Visitor will provide home visiting to those families that would benefit from learning more about growth and development, positive parenting and community resources.

To learn more about the Healthy Babies Healthy Children program, call the Health Unit at 1-866-888-4577

Additional Resources:

Healthy Babies Healthy Children – Ministry of Children, Community and Social Services

Folate Before Pregnancy

Women who could become pregnant need to eat folate-rich foods and have a daily multivitamin with 0.4 mg of folic acid.

Did you know that half of all pregnancies in Canada are unplanned? Having 0.6 mg of folate daily will help prevent you from having a baby with a neural tube defect (NTD). The defect occurs before most women know that they are pregnant. NTDs are serious birth defects, such as spina bifida. Tissues that normally surround the brain and spine do not fully develop. You need 0.6 mg folate daily for at least one month before pregnancy and during the first 10 to 12 weeks of pregnancy.

What about supplements?

Folic acid is the name for the form of the vitamin found in supplements and fortified foods. To get the recommended 0.6 mg of folate daily, you must take 0.4 mg of folic acid from a multivitamin supplement. Your pharmacist can show you the best kind.

Folic acid should not be taken in a dose higher than 1 mg daily because it can hide signs of vitamin B12 deficiency. Only take one multivitamin daily because taking more than 10,000 IU (3,300 RE) of vitamin A puts you at risk to have a baby with a birth defect.

Have more questions about folate?

Talk to your health care provider, pharmacist or call one of our Healthy Families nurses at 1-866-888-4577.

Smoke-Free Pregnancy

Whether you are a woman, man, infant or child, smoking is harmful for your health. It’s especially important to remain smoke-free if you are planning a pregnancy or are already pregnant.

Keeping your environment smoke-free is best for you and your developing baby. If you smoke, it is best to quit. Remember, when you smoke or others smoke around you, your baby smokes too!

Additional Resources:

Postpartum Mood Disorder (PPMD) or Postpartum Depression

Postpartum Mood Disorder (PPMD) affects one in five new mothers. PPMD is a serious medical condition and is the number one complication after birth. It can start at anytime between pregnancy up until the baby is one year old. Researchers are unsure of the cause but believe it could be related to the following risk factors: hormonal changes, history of depression, history of PPMD with previous pregnancies, past or present physical, sexual and/or emotional abuse.

**Men can suffer from PPMD too. Up to 10 per cent of new fathers develop depression after a baby is born.

Resources:

Crisis Lines

  • Four County Crisis Community Mental Health Crisis response Program (24 Hour)
    • 705-745-6484 or 1-866-9933
  • Telehealth Ontario (24 Hour)
    • 1-866-797-0000

Web Sites

Local resources

  • Lakeshore Counselling (Cobourg)
    • 905-377-9891
  • Northumberland Community Counselling Centre
    • 905-372-6318 or 905-372-6425
  • Women’s Health County – Point in Time Centre for Children, Youth and Parents
    • Haliburton 705-457-5345 or Minden 705-286-2191
  • Ross Memorial Community Counselling (CMHA) Lindsay and surrounding area
    • 705-878-8900
  • Haliburton Highlands Mental Health Services
    • 705-286-4575
  • Women’s Health Centre (Peterborough regional Health Centre)
    • 1-800-419-3111

Speech and Language

Speech and Language

Communication Counts!

By the time most children are four years of age, they can speak and communicate well with others. However, some children have difficulty developing their speech and language skills. This puts them at risk for failure in school, which could lead to further problems later in life. As parents, we all want the best for our children.

Make sure your baby, toddler or preschooler’s speech skills are on track by calling the Health Unit toll-free at 1-866-888-4577 and having your child’s speech skills checked over the phone. For more information, call your local health unit, a partner in the District Preschool Speech and Language Program.

Shaken Baby Syndrome

Shaken Baby Syndrome is a condition that occurs when a baby is shaken violently. Shaking is a potentially fatal form of child abuse.
If a baby is shaken with force, it can lead to a lifetime of problems:

  • Shaking can damage a child’s brain
  • Shaking can cause permanent disabilities like blindness or paralysis
  • Shaking can even cause death

Never, never shake a baby! No child, at any age, should ever be shaken.

Sleeping

Helping your baby sleep

It takes time for infants to develop a circadian rhythm cycle (having more awake time during the day and sleeping more at night). However, parents and caregivers can help their baby develop healthy sleep habits right from birth. Try these tips when putting your baby to sleep:

  • Allow natural sunlight into the home during the day and keep the lights low at night. This will help your baby learn the difference between day and night.
  • Start a calming bedtime routine with your baby, including things such as reading a story, bath time, baby massage, singing or rocking. Stay consistent and over time babies may learn that the routine and their crib mean it is time for sleep.
  • Some babies may need more help than others to fall asleep. Try feeding, rocking, singing, shushing or patting to help soothe your baby.

Helping your baby nap

Napping helps a baby to sleep better at night. Keeping your baby awake during the day will not help your baby sleep longer at night. Some babies nap as little as 20 minutes, while others may nap for 3 or more hours. Both are normal. Try these tips to help your baby nap:

  • It may be helpful to use a shorter version of your baby’s bedtime routine before a nap, for example, a short story and cuddle.
  • Whenever possible, place your baby to sleep in the same place for daytime napping and night-time sleeping.

Prenatal Program eClass

Pregnant or planning for a baby?

Our free online Prenatal Program is for you!

Get access to reliable, accurate information on pregnancy, labour and birth, and caring for your newborn – all in a web-based, mobile-friendly format. We use InJoy eClasses* to provide you access to: resources, videos, fun quizzes, learning activities, helpful web links (including local support services), downloadable information sheets and a parents’ toolbox loaded with interactive features.

Get access to reliable, accurate information on pregnancy, labour and birth, and caring for your newborn – all in a web-based, mobile-friendly format. We use InJoy eClasses* to provide you access to: resources, videos, fun quizzes, learning activities, helpful web links (including local support services), downloadable information sheets and a parents’ toolbox loaded with interactive features.

It’s trusted education… your way!

How to Access the Site:

  1. Visit InJoy Online.
  2. Click on Create Account.
  3. Fill out your Name, Email and Password.
  4. Enter redemption code: hkprbaby
  5. Click Validate.
  6. Accept the Terms and Conditions.
  7. Click Complete.
  8. Log in to your Dashboard to view the eClass content.

Let’s stay in-touch! Via email, we’ll confirm your registration and send reminders about the online course.

Need more help? Email us (healthyfamilies@hkpr.on.ca) or call 1-866-888-4577, ext. 5003.

**InJoy eClasses are hosted by a third-party vendor in the United States of America that collects and maintains your first/last name, email and password for 13 months. InJoy’s privacy policy is available in the Terms and Conditions on the registration website.

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