Immunization (Vaccination)

Protect babies and children from vaccine-preventable illnesses like measles, mumps and rubella.

Ensuring your child follows Ontario’s Publicly Funded Immunization Schedule is important to provide full protection. All publicly-funded vaccines are safe, effective and available at no cost.

School-Based Immunizations

  • The Health Unit will be providing three vaccines (non-COVID-19 ones) to Grades 7 and 8 students during the 2021/22 school year.  Click here for more information.

Immunization of School Pupils Act

Students in schools are required to be immunized against tetanus, diphtheria, polio, measles, mumps and rubella. This is under Ontario’s Immunization of School Pupils Act.

Students or their parents must provide an up-to-date record of immunization or a legal exemption (based on medical, religious or philosophical reasons) to the Health Unit. If this is not provided, students could face suspension from school.

Similarly, children attending Child Care Centres/Daycares are required to have their childhood immunizations up to date.

Additional Resources

Click on the ‘Related Topics’ links for more information.

Pregnancy and COVID-19

The time before your baby is born is crucial to their healthy growth and development. The Health Unit continues to offer its Healthy Families support programs for new and expectant parents during the pandemic.

COVID-19 Vaccination

Pregnant individuals are eligible for COVID vaccine. To get a vaccine, please visit the COVID-19 Vaccination Clinics page to find a clinic near you. Pregnant individuals can also receive a vaccine through their primary health care provider. Please note this specific clinic for those who are pregnant or thinking about getting pregnant:

If you are questioning if COVID-19 is right for you, here is a link to a key resource that walks you through the benefits and risks of getting your COVID-19 vaccine:

The Ministry of Health also offers information and resources on its webpage.

It is important to consult your health care provider or a health care provider familiar with your pregnancy. For additional questions about pregnancy and the COVID-19 vaccine, call 1-866-888-4577, ext. 5003, and speak with a Public Health Nurse.

Healthy Families Intake Line

Questions and support: the toll-free Healthy Families intake line at 1-866-888-4577, ext. 5003, that allows people to speak to a Public Health Nurse and receive support and answers on pregnancy and breastfeeding. Public Health Nurses are now able to provide infant-feeding support to parents via video-conferencing as well.

Prenatal Program

The free online Prenatal Program gives expectant parents accurate and reliable information/resources on pregnancy, labour and birth, and caring for a newborn. The web-based, mobile-friendly format can be done from home.

Connect with us on Facebook

The Healthy Families Facebook page offers an online forum for parents/caregivers and Health Unit staff to exchange information, comments and resources on parenting and family issues.

Healthy Babies Healthy Children Program

This is a free, confidential and voluntary program for eligible pregnant women, new mothers, and families with children up to age six. HBHC provides advice and support immediately after a baby’s birth and at different stages afterwards to ensure children get the best start in life.

Additional Resources:
Online Prenatal Program – More to Expect!
Pregnant or planning for a baby? Our free online Prenatal Program is for you!

A Healthy Pregnancy is in your Hands – Public Health Agency of Canada

24-Hour Cribside Assistance – A Manual for New Dads

18-Month Well Baby Visit

Is your child 18-months of age? If so, it’s time to make an important medical appointment to check on your child’s progress.

The Enhanced 18-Month Well-Baby Visit is available for children in Ontario. Eighteen months marks an important milestone in a child’s development, so it’s good to check in with your health care provider to see how your child is doing.

What is the Enhanced 18-Month Well Baby Visit?
  • An extended medical appointment with a health care provider
  • A chance for children to get their recommended vaccines
  • An opportunity for parents and health care providers to discuss all aspects of a child’s health and wellbeing. Included is a review of a child’s development through the use of the Looksee Checklist. This checklist highlights key skills most children should master by 18-months of age. Completing the checklist can help identify concerns and lead to referrals to more specialized community support services if needed.
Additional Resources
  • Looksee Checklist – Find a series of easy-to-use milestone tools that help monitor a child’s development from one month to six years of age.
  • 18-Month Well-Baby Visit Planner – Get help to prepare for the checkup, including identifying five key areas of healthy child development that can be raised or flagged with a health care provider.
  • Play&Learn – Find free online games and activities to engage young children and help them learn, grow and thrive.
  • HKPR District Health Unit – Find parenting support and resources close to home. Call the Healthy Families intake line at 1-866-888-4577, ext. 5003, search the Health Unit website for resources, or go to the HKPR Healthy Families Facebook Page for an online forum on parenting and family issues.

Feeding your Baby

Your Health Unit is here to support you!

Family Health staff can answer any questions you have about feeding your baby. Watch this video to learn about one-on-one Breastfeeding Support available for breastfeeding women.

Call the Health Unit toll-free at 1-866-888-4577 for more details.

School-Based Immunization Program

Protect your child from vaccine-preventable diseases.

The Health Unit will be providing three vaccines (non-COVID-19 ones) to Grades 7 and 8 students during the 2021/22 school year. Public Health Nurses will be at local schools in late Fall 2021 to provide first doses, and again in Spring 2022 to provide second doses of these vaccines.

The vaccines being offered protect against the following diseases:

  • Meningitis (Men C-ACYW-135) – This vaccine is required to attend school. It is different from Meningitis C vaccine that your child may have received as a baby.
  • Hepatitis B (HB)
  • Human papillomavirus (HPV)

Please complete the Consent Form for School-Based Vaccines and return to your child’s school as soon as possible.

To help your child on clinic day, make sure they eat a good breakfast, bring a lunch, and wear a loose sleeved shirt. Students can also bring something to distract them like music, a book or a game. You can let them know that the needle may feel like a pinch in the upper arm and should only last for a few seconds.

If you have further questions, call the Health Unit at 1-866-888-4577 ext. 1507.

Additional Resources

Exemptions from Immunizations

Parents may complete a Statement of Conscience or Religious Belief Affidavit form for their child if they are religiously or philosophically opposed to immunization.

The Statement of Medical Exemption is a form for children who require an immunization exemption for medical reasons (i.e. prior immunity or medical contraindication). A Physician or Nurse Practitioner must complete the form.

To learn more about getting exemptions, please visit Vaccines for Children at School (Ministry of Health website) for step-by-step instructions. If you have any additional questions, call the Health Unit at 1-866-888-4577, ext. 1507.

Completed exemption forms must be returned to your local Health Unit office.

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.

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 younger 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.
Help an older child prepare (especially if getting a vaccine at school):
  • Ensure they eat a good breakfast, bring a lunch, and wear a loose sleeved shirt.
  • Have students bring something to distract them like music, a book or a game.
  • Assure them that the needle only feels like a pinch in the upper arm and should only last for a few seconds.

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

Report Your Child’s Immunization

Parents are responsible for updating their child’s immunization record or providing a valid exemption form to the Health Unit.

Students without complete records or a valid exemption on file at the Health Unit may be suspended as per the Immunization of School Pupils Act.

Please do NOT provide records of your child’s COVID-19 vaccination.

To report your child’s immunization:

  • Online: Click here
  • By Phone: Call 1-866-888-4577, ext. 1507
  • By Mail or In Person: Send or take a photocopy of your child’s immunization record to:
    • HKPR District Health Unit
    • 200 Rose Glen Road
    • Port Hope, ON L1A 3V6

When updating your child’s record, you will need the following information:

  • child’s first and last name
  • child’s birth date
  • child’s school
  • name of vaccine received and the date it was received

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
  • hold baby skin-to-skin
  • offer baby the breast soon after birth and feed often
  • use baby-led latching (laid-back breastfeeding)
  • follow baby’s cues
  • learn how to hand express
  • avoid using pacifiers or artificial nipples
  • avoid using infant formula
  • room in with your baby after birth
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.

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 influenza 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… 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

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

Additional Resources:

Baby Feeding Cues – Queensland Government

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.

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


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.

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.

Supporting the Breastfeeding Family

The Baby-Friendly Initiative (BFI)

The HKPR District Health Unit supports the World Health Organization’s Baby-Friendly Initiative (BFI) and the International Code of Marketing of Breast Milk Substitutes and Subsequent Resolutions. This is the Health Unit’s promise to protect, promote and support breastfeeding.

BFI is a global strategy to protect, promote and support breastfeeding all around the world. The Health Unit provides a comfortable environment for breastfeeding and provides support to parents to make informed decisions about feeding their children. We are working towards making our communities Baby-Friendly. For more information on BFI, call the Health Unit toll-free at 1-866-888-4577 or visit The Breastfeeding Committee for Canada website.

Additional Resources:

BFI (video) – HKPR District Health Unit

Suspension of Students Under ISPA

Why First Notices of Suspension are Sent
  • Students are considered ‘overdue’ for a vaccine due to a timing issue (E.g. the interval between immunization doses is incorrect; a child received a vaccine prior to the age of eligibility).
  • Students may have received all the required vaccines from their health care provider, but these records have not been provided to the Health Unit.
  • Students are missing one of the required vaccines and need to be immunized (NOTE: Students may be exempted from vaccination for medical reasons, or by giving a sworn affidavit that it is against their conscience or religious belief. Contact the Health Unit for details).
What to Do
  • Immunization protects students from many serious diseases that can easily be spread. Be sure your student is protected. Vaccines are proven to be safe and effective.
  • Check your student’s immunization record to be sure it is up-to-date.
  • If uncertain, contact your health care provider or the Health Unit to ensure your student has all the vaccines needed to attend school. If your student has followed recommendations in Ontario’s Routine Immunization Schedule, no further vaccines will be required at this time.
  • If a vaccine is missing, you will need to make arrangements with your health care provider or the Health Unit to have your student receive the required vaccines. It is the responsibility of parents/caregivers to provide proof of immunization (or a valid exemption) for students to the local Health Unit.

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

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