The health of your family is important. The HKPR District Health Unit offers a variety of programs, services, support and resources to help babies and children grow up healthy.

For more information, call us toll-free at 1-866-888-4577.

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.

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.

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

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

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.

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.

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:

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.


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.

Pregnancy & Childcare

Is cannabis safe to use while pregnant or breastfeeding?

There is NO known safe amount of cannabis use while pregnant or breastfeeding regardless of how it is used (smoked, vaped, eaten, taken as a pill, applied as a cream).

The chemical THC in cannabis is passed on to your baby during pregnancy and when breastfeeding.

The safest option for you and your baby is to NOT use cannabis while pregnant or breastfeeding.

Using cannabis can have harmful effects on your own health, as well as your relationships, and your child’s health and development.

While more research is needed, studies have shown that cannabis use during pregnancy poses risks to babies and children and may have long-term effects on teens and young adults. Some of these risks include:

Risks to Babies:

  • lower birth weight,
  • increased risk of Neonatal Intensive Care Unit (NICU) admission ,
  • increased startles and tremors (e.g., shaking), and
  • changes in sleep patterns.

Risks to Children:

  • poorer attention (e.g., easily distracted),
  • poorer memory,
  • behaviour issues,
  • difficulties in school, and
  • mental health concerns (e.g., symptoms of depression).

Risks to Teens and Young Adults:

  • increased risk of behavioural problems,
  • poorer school performance, and
  • more likely to start trying and using cannabis or other substances (e.g., tobacco, alcohol) at an earlier age.

Read More:

  • Information for Pregnant or Breastfeeding Mothers
  • Best Start – Risks of Cannabis on Fertility, Pregnancy, Breastfeeding and Parenting
  • The Society of Obstetricians and Gynaecologists of Canada

How does cannabis affect fertility?

Cannabis use may affect the ability to become pregnant because heavy cannabis use can change menstrual cycles for women, and lower sperm count and cause poor sperm quality in men.

If I use cannabis while breastfeeding, can I just pump and dump?

The chemical “THC” in cannabis can stay in your body for weeks. This chemical can be passed on to your baby through breast milk. The safest option for you and your baby is to not use cannabis when breastfeeding

Can second-hand cannabis smoke harm my baby or child?

Like tobacco smoke, secondhand cannabis smoke is harmful, especially for babies and children. Smoke or vape away from your children and not inside your home or car.

How can cannabis affect my ability to care for my child?

The THC in Cannabis can make you feel sleepy, affect your focus, ability to remember and react quickly. This may affect your ability to respond to your child’s needs (e.g., hunger cue) and safety. Remember, the effects of cannabis can last for a few hours

Cannabis use can cause confusion, affect mood and the ability to make decisions.

Help for Parents & Caregivers

Talking to your child or teen about marijuana can be challenging, but talking openly with your child, letting them know they can talk to you about cannabis, and being non-judgmental will go a long way.

What are the health risks to my teen for using cannabis?

Youth and young adults under the age of 25 who use cannabis are at higher risk of harmful effects on brain development and function that may become permanent. This is because the brain continues to develop until the age of 25, and the THC in cannabis affects the parts of the brain that direct brain development.

Young people who use cannabis are at higher risk of:

  • mental illness (depression, anxiety, schizophrenia or other psychosis),
  • addiction to cannabis (Cannabis Use Disorder),
  • problems with memory, thinking, learning, problem-solving skills,
  • behavioural issues,
  • difficulties with relationships at home, school or work, and
  • lung and respiratory problems from smoking cannabis.

Young people who use cannabis may also use it with other substances such as alcohol, which intensifies the effects and can lead to more health risks and worsening judgment leading to reckless behavior (such as driving while impaired, having unprotected sex, or other risk-taking behaviors).

For more information: Cannabis: What Parents/Guardians and Caregivers

Need to Know

What are some reasons my teen may use cannabis?

Teens have given the following reasons for why they have used cannabis:

  • it’s acceptable in friend and family circles,
  • to fit in with friends or family,
  • because it’s available and accessible to them,
  • the perception that cannabis is less harmful than alcohol and other substances, and
  • to cope with stress.

How do I talk to my child or teen about cannabis?

Talking with your child about drugs and alcohol can be tough, but there are ways to engage your teen that promote open and positive communication. Overall, talking with your child openly and regularly, and being actively involved in their life is most important.

Setting the stage for a conversation with your teen about substance use:

  • Keep an open mind (try not to judge or condemn).
  • Put yourself in your teen’s shoes to understand how they feel.
  • Be clear about your goals for the conversation.
  • Be calm and relaxed.
  • Be positive.
  • Don’t lecture or shame.
  • Find a comfortable setting.
  • Be aware of body language (avoid finger-pointing or crossing your arms).

What are some signs that my child may have a problem with cannabis use or other substances?

Signs that your child may have a substance use problem:

  • ignoring responsibilities at work, school, or home,
  • giving up activities that they used to find important or enjoyable,
  • changes in mood (e.g., feeling irritable and paranoid),
  • changing friends,
  • having difficulties with family members,
  • being secretive or dishonest,
  • changing sleep habits, appetite, or other behaviors, or
  • borrowing money, stealing money, or having more money than usual.

It may be hard to detect a cannabis use problem because some signs can look like typical youth behaviour. It’s best to talk to your child and find out if there’s a problem.

Tips on how to talk to your teen about cannabis: Cannabis Talk Kit – Drug Free Kids Canada

For more help, see Get Help With Drug, Alcohol & Other Addictions

Where can I get help for my child or teen for cannabis use or other addictions?

See Get Help page

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.

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

Immunization of School Pupils Act (ISPA)

The Health Unit is required under the Immunization of School Pupils Act to collect and maintain up-to-date immunization records for every student registered in our jurisdiction. The law states that parents must provide the Health Unit with proof of completed immunizations for:

  • diphtheria
  • tetanus
  • polio
  • measles
  • mumps
  • rubella
  • whooping cough (pertussis)
  • chickenpox (only applies to students born on or after 2010)
  • meningococcal

The Health Unit will contact parents/guardians of local students who are overdue or missing certain immunizations required under the ISPA. Families who receive these notices are asked to immediately contact the Health Unit toll-free at 1-866-888-4577, ext. 1507 or email us.

Under the ISPA, students can be suspended from school if their immunization records are not up-to-date with the Health Unit.

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