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Caringfor you and your baby

Welcome...Caring For You and Your Baby is a practical guide for new mothers with babies from infancythrough to toddler age. It provides information that can help keep you and your baby happyand healthy. This guide was developed by public health experts with a focus on raising healthybabies and protecting them from injury and illness.

Babies and young children have unique needs. For example, they are more likely to getinfectious diseases because their immune systems are still developing and they have not yetlearned about hygiene.

Caring For You and Your Baby covers these basic topics:• A healthy diet and lifestyle, which will help the whole family combat infections and feel

good.• Breastfeeding, which helps babies get the best nutrition and their mothers’ antibodies

while their immune system develops.• Immunizations, which protect your baby from serious and sometimes fatal diseases,

including polio, measles, diphtheria, tetanus, and hepatitis.• Cleaning and hygiene, including diapering, bathing, and laundry, to help prevent the

spread of disease-causing germs.• Household safety, with a focus on your baby’s environment.

Caring For You and Your Baby speaks directly to new moms but there’s a lot of usefulinformation here for your partner and everyone who is helping out during this exciting time.

This guide also includes Internet references and suggestions about where you can get moredetails on certain subjects

...so, please read on!

Acknowledgements

Caring For You and Your Baby is brought to you by the Canadian Public Health Association(CPHA) in partnership with Reckitt Benckiser Inc., the makers of Lysol® products. CaringFor You and Your Baby was originally produced by the Family Health Program,™ apartnership of the U.S. Centers for Disease Control and Prevention, the NationalAssociation of Pediatric Nurse Practitioners (NAPNAP), the Visiting Nurse Associations ofAmerica (VNAA), and Reckitt Benckiser Inc.

The contents of Caring For You and Your Baby are for informational purposes only andshould never replace the advice and care of a health care professional. Neither CPHA norReckitt Benckiser guarantees that the information in this booklet is accurate, complete, ortimely. Neither CPHA nor Reckitt Benckiser will be liable for any direct or indirect loss,damage, or injury caused by the use of this information. By cooperating in the publication ofCaring For You and Your Baby, CPHA does not endorse and shall not in any way be seen asendorsing any products or services that may be referred in this booklet.

The Internet links provided were current at the time of publication.

Photo Credits

Photos on front cover and pages 5 (nutrition and diet), 10, 11, 13, 15, 18, 33, 39, 42. Source:Health Canada website and Media Photo Gallery. Health Canada, http://www.hc-sc.gc.ca.Reproduced with the permission of the Minister of Public Works and Government ServicesCanada, 2009.

Caring For You and Your Baby was funded by an unrestricted educational grant from ReckittBenckiser, the makers of Lysol.®

ISBN 1-894324-41-2

© 2009 Canadian Public Health Association400-1565 Carling Avenue, Ottawa, ON K1Z 8R1Telephone 613-725-3769Fax 613-725-9826E-mail [email protected]

Available online at www.you-and-your-baby.cpha.ca April 2009

2 | Canadian Public Health Association

Table of ContentsA Healthy Mom

Rest and Exercise . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4Nutrition and Diet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5Feelings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8Personal Hygiene and Breast Feeding . . . . . . . . . . . . . . . . . . . . . 11Oral Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13Smoking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Your Healthy BabyBath Time. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15Changing a Diaper . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18Baby’s Laundry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21Feeding Your Baby . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22Introducing Solid Foods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25Food Allergies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27Baby’s Health Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

Your Healthy HomeSetting Up the Nursery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30Safe Sleeping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31Where to Change Diapers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32Safe Toys and Play. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32Germs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34Healthy Food, Clean Kitchen . . . . . . . . . . . . . . . . . . . . . . . . . . . 36In the Bathroom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37Floors and Furniture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38Animals and Insects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

Beyond the HomeCar Safety: Travels With Baby . . . . . . . . . . . . . . . . . . . . . . . . . . . 42Child Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44Child Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46Preparing for Emergencies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48Emergency Contact Numbers . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

Caring for You and Your Baby | 3

A Healthy MomTaking care of your new baby is easiest when you’re feeling your best. It’simportant to take care of your own health and well-being, as well as yourbaby’s. Here are some tips for rest, exercise, and healthy eating.

Rest and ExerciseAll new parents soon learn that babies have different internal clocks than adults. Mostnewborns wake up about every three hours and need to be fed, changed, and comforted.

It is easy for you to become overtired. While a solid eight hours of sleep may not be possiblefor the next few months, here are some ways you can get more rest now.

Tips for Getting More Rest

• In the first few weeks, focus on feeding and caring for the baby and taking care ofyourself. Ask for support from your family and friends—and don’t be shy about tellingthem that you need help.

• Sleep when the baby sleeps. This may be only a fewminutes of rest at a time, but these minutes canadd up during the day.

• Save steps and time. Have your baby’s bednear yours for feedings at night.

• Don’t feel that you must entertain guests.Many new parents enjoy visits from friendsand family, but new mothers should nothave to play hostess. Feel free to excuseyourself for a nap.

• Most mothers find it easy to feed their baby andgo back to sleep at night. The hormones that producebreastmilk also make mothers feel relaxed and sleepy. And oncebreastfeeding is established, it does not take long to feed the baby. You can also expresssome breastmilk during the day and ask your partner to feed your baby for one feedingduring the night to let you get a longer stretch of sleep sometimes. It is okay to introducea bottle after the first two to three weeks.


Continuing to Exercise

• Sleepless nights and changes in your routine dueto the baby will happen, and can make youfeel tired and tearful. In addition to trying toget enough sleep, keeping active can help.

• Try to make time for exercise. Even 10minutes a day will help you feel morerelaxed and able to cope.

• At the same time, don’t do too much toosoon.

• Exercise outdoors if you can. For example, go for awalk with your baby. A breath of fresh air can make youfeel great.

• Begin postpartum exercises, as advised by your health care provider.

Nutrition and DietYour body went through a lot of changes during pregnancy

and childbirth. A healthy diet is one of the best waysto promote your recovery.

The weight gained in pregnancy helps buildenergy reserves for your recovery and forbreastfeeding. After delivery, good nutritionhelps you to stay healthy, active, and feeling your

best. Whether you breastfeed or formula feed,you need to eat a healthy and balanced diet.

Canada’s Food Guide

Canada’s Food Guide explains the amount and types of food you need, as well as theimportance of physical activity in your day. Following Canada’s Food Guide will help you tomake good choices from four food groups:

• vegetables and fruit• grain products• milk and alternatives• meat and alternatives.


The Food Guide’s tips will help you to:• reduce your risk of obesity, type 2 diabetes, heart disease, certain types of cancer, and

osteoporosis• contribute to your overall health and vitality• meet your needs for vitamins, minerals, and other nutrients.

Losing Weight

• Many new mothers want to lose their pregnancy weight quickly, but extreme dieting andrapid weight loss can be hazardous to your health—and to your baby’s health.

• It can take several months to lose the weight you gained during pregnancy. Try cuttingout high-fat snacks and focusing on a diet with plenty of fresh vegetables and fruits,proteins, and whole grains. Use Canada’s Food Guide to help you create a sensible plan.

• Losing 1 to 2 pounds per month for the first 6 months (or until you reach your desiredweight) is safe for both you and baby.

Vitamins and Nutrition after Pregnancy

Some women develop anemia during pregnancy and after childbirth. Anemia is a conditionin which the body does not produce enough healthy red blood cells to carry oxygen aroundthe body to all the tissues and organs. See your health care provider to diagnose and adviseyou about anemia.

• Symptoms of anemia include feeling tired, weak, dizzy, short of breath, or havingheadaches.

• You need to eat foods with iron, protein, and other nutrients if your body is to producehealthy blood.

• You can help prevent anemia by eating more iron-rich foods, such as green leafyvegetables, red meat, nuts, fortified cereals, or by taking iron supplements ifrecommended by your health care provider.

• Vitamin C helps your body to absorb the iron in foods. One way to add vitamin C toyour meals is to drink a glass of orange juice.


Healthy Eating Keeps Mom and BabyHealthy

Your breast milk is nature’s perfect recipe for yourbaby’s growth and development.

• Avoid foods with added fat, sugar, salt, andchemicals.

• Eat when you are hungry and stop whenyou feel full.

• Water, milk, and 100% pure vegetable and100% pure fruit juices are good choices whenyou are thirsty.

• Folate is a vitamin found in dark green vegetables, citrusfruit, and whole grains. Ask your health care provider if you need extra folate whilebreastfeeding.

• Limit the amount of alcohol and caffeine you consume. Caffeine is found in coffee, tea,cola, and chocolate.

• Eat many different kinds of foods.• Stay away from nicotine and other poisons. If you cannot quit smoking, try not to

smoke at least an hour before the next feeding.• Talk to your health care provider if you are taking any medicine. This includes medicines

that you can buy without a prescription.

To Learn More...Public Health Agency Canada: www.phac-aspc.gc.ca

La Leche League Canada: www.lllc.ca


FeelingsAdjusting to life with a new baby can be stressful. Daily routines will change for you, yourpartner, and the rest of the household. This is an important time of social and emotionaladjustment.

Your body also needs time to rest and recover from pregnancy and childbirth. In the first fewweeks after giving birth, you may feel that you are on an emotional roller coaster—happyand elated one minute, anxious, irritable, sad or exhausted the next.

Many things that can affect your emotional well-beingat this time, including:

• lack of sleep• changes in daily routines• changing roles at home and work• changes in your relationship with your

intimate partner• changes in self-image• anxiety about parenting a newborn• changes in your financial situation• hormonal changes.

Many new moms will experience “the baby blues.” This is a temporary condition, which goesaway on its own within a few weeks. It should not be confused with postpartum depression,which is serious and requires prompt medical attention.

Understanding the “Baby Blues”

• New mothers commonly start to feel the “baby blues” within 3 to 5 days after givingbirth. Due in part to hormonal changes, you may experience sleeplessness, sadness,mood swings, crying, headaches, poor concentration, and confusion. These symptomscan come and go for a few weeks and usually disappear on their own.

• Extra support and reassurance from the people around you can help you get through thisperiod. Talking about your feelings with your family, friends, and health professionalsalso helps.


Postpartum Depression

• Postpartum (or post-natal) depression affects about 10% to 20% of mothers. It usuallybegins between 2 weeks and 6 months after giving birth, but in some cases it begins asmuch as a year later.

• Common symptoms of postpartum depression are uncontrollable crying and feelingworthless, guilty, unable to cope, or worried about being able to love the baby.Postpartum depression symptoms occur every day for most or all of the day, and last twoweeks or more. Many women with postpartum depression try to hide their feelings andwithdraw from their family and friends.

• Postpartum depression requires immediate medical attention. If it is not treated, it canhave a serious impact on both the mother and baby.

• If you think you have postpartum depression, talk to your partner, a family member,friend, or a member of your health care team. It is important to get help. Withtreatment, most women recover within a year.

• A family history of depression and emotional or physical stress may increase the risk ofpostpartum depression.

Symptoms of postpartum depression may include:• feeling restless or irritable• feeling sad, hopeless, and overwhelmed• crying a lot• having no energy• eating too little or too much• sleeping too little or too much• having trouble focusing, remembering, or making decisions• feeling worthless and guilty• losing interest and pleasure in things you used to enjoy• withdrawing from friends and family• having headaches, chest pains, a racing heartbeat, or fast, shallow breathing• feeling like you don’t care about the baby• wanting to hurt the baby or yourself.

Treatment for Postpartum DepressionPostpartum depression requires treatment from a health professional. This usually involves:

• medication (many antidepressants are safe to take while breastfeeding)• talk therapy with a doctor, nurse, or social worker.

Postpartum depression is not the same as “baby blues.” It needs to be treated by a healthprofessional.


Coping with Changes and Challenges

Ask for Help• Friends and family members often want to help with new

babies. Ask for help with housekeeping and cooking.• Many people feel honoured to be asked to care for the

baby for short periods of time. Let adults you trustrock or walk the baby, or change a diaper. Don’t feelyou have to do it all yourself.

• Talk to your public health nurse about other ideas onhow you can get help and support from others.

Physical Activity• Exercising as little as 10 minutes a day can make you feel better. Try

to make exercise part of your daily routine. It can be as simple as taking the baby for awalk. Ask your health care provider about the type of exercise that’s best for you.

Stress Management• Stress can make depression worse. Can you remove any sources of stress in your life, even

for a little while?• Give yourself a break! Don’t put pressure on yourself by trying to keep everything

“perfect.” Do what you can and leave the rest.• Avoid alcohol and caffeine.• Try to go to bed and get up around the same time every day and develop relaxing

bedtime rituals, such as reading or having a warm bath.• Choose healthy foods and a well-balanced diet. Eating regular meals can help reduce

depression.• Spend time with people. Don’t isolate yourself. Talk to other mothers and consider

joining a support group.• Make time for yourself and for activities you enjoy, even if you don’t feel like making the

effort.

To Learn More...Canadian Mental Health Association: www.cmha.ca


Your Personal Hygiene and Breast FeedingThere is no need to change your personal hygiene when breastfeeding. Here are some thingsthat help to prevent soreness and infections of the nipples:

• Rub a small amount of breastmilk into your nipples after feeding. • Keep your nipples clean and dry. • If you use breast pad, change them when wet and do not use pads with plastic on the back. • Expose your nipples to the air as much as possible. In addition, try to wear clothing that

allows air to circulate and moisture to evaporate.• If your nipples become painful, ask your health care provider for advice.

Hand Washing

Proper hand washing is one of the best ways to keepfrom getting sick and spreading diseases, such ascolds, the flu, and some stomach problems.Washing your hands helps get rid of germs thatyou come in contact with during your day.These germs can come from things you touch,including other people, unclean surfaces, food,and animals. Even though it is simple to do,hand washing is often overlooked.

There are two key aspects to proper hand cleaning: whento wash and how to wash.

When to Wash

• before eating• before, during, and after you handle food• before dressing a wound, giving medicine, or inserting contact lenses• before picking up an infant• before and after changing a diaper• after contact with blood or other body fluids (like vomit, mucus, or saliva)• after you use the toilet• after handling animals or their food, toys, leashes, or waste

after touching anything that might be soiled (such as trash cans, used cleaning cloths,sinks, drains, soil, etc.)

• more often when someone in your home is sick• whenever your hands look dirty.


How to Wash

• Remove all rings and wet your hands with warm running water.• Apply soap and rub your hands together vigorously to make a lather.• Continue to wash for at least 20 seconds (as long as it takes to sing your ABCs). Make

sure to scrub between your fingers, under the nails, the back of hands, and your wrists.Wash your hands longer, as needed, to get rid of all dirt you can see on your hands.

• Rinse your hands well under running water and use a clean towel or your sleeve to turnoff the taps.

• Dry your hands completely with a paper towel, hand dryer or clean towel. Replace handtowels with clean ones often.

When Soap and Water Are NotAvailable…

• Alcohol-based hand sanitizers (gels or wipes)are an excellent choice when soap and waterare not available.

• Use the gel or wipes as directed on theproduct label.

• Alcohol-based hand sanitizers work well,unless you have a lot of dirt or grease onyour hands.

• Alcohol-based hand sanitizers can be usedby children over one-year-old while youcarefully supervise. Do not allow children toswallow the sanitizer or to touch theirmouth, eyes, or nose before the alcohol hasevaporated from their hands.

More Hand Washing Tips

• Hand lotion can help prevent chapped skin. When using lotions, avoid touching thespout of the container, as this can spread germs to the lotion inside the container.

• Consider giving everyone in your home their own hand towel to use during cold and fluseason.

• To help a young child with hand washing, hold the baby so that his or her hands canhang freely under the warm running water. When you finish helping the child, washyour own hands.


Your Personal CareAffects Your BabyClean hands help prevent germs

from passing between you and your

baby. Always clean your hands

before and after handling the baby—

but especially at these times:

• before nursing/feeding

• before holding or rocking

• before dressing

• after diapering

To Learn More…Lysol Canada: www.lysol.ca

Canadian Public Health Association: www.cpha.ca

Oral CareGood oral care is essential to your overall health.Follow these guidelines to keep your teeth andgums healthy.

Why Oral Care Matters

• Any infection in your mouth, includingcavities and gum disease, affects the health ofyour whole body.

• The more unfilled cavities you have, the more cavity-causing germs you have.

• Cavity-causing germs can be passed to your baby by daily contact, such as sharing foodor letting your baby put his or her fingers in your mouth.

• Consult your doctor or dentist to learn more about how oral care for you and your babycan help improve your health.

Steps for Healthy Teeth and Gums

• Brush at least twice a day with fluoride toothpaste.• Floss daily.• Limit the number of times you eat sweet or starchy snacks.• See your dentist regularly.

To Learn More…Canadian Dental Association: www.cda-adc.ca


SmokingThe harmful effects of tobacco are not limited to the personwho smokes. Using tobacco during pregnancy increases therisk of problems such as low birth weight, still births,spontaneous abortion, premature birth, and sudden infantdeath syndrome (SIDS). Low-birth-weight babies are at riskfor developmental delays and learning problems at school, andserious health problems throughout their lives.

However, even if you cannot stop smoking, breastfeeding is still the best choice for yourbaby. Try not to smoke an hour or two before nursing. And never expose your baby tosecond-hand smoke.

Second-hand Smoke

• Second-hand smoke (also known as “environmental tobacco smoke” or ETS) is a toxicmixture of over 4,000 chemical compounds, 50 of which are associated with or knownto cause cancer.

• Second-hand smoke has harmful effects on everyone but especially babies and children.They are more vulnerable than adults because their lungs and immune systems are stilldeveloping and they have a faster breathing rate. Be aware, too, that babies and childrencannot usually move away from people who are smoking around them.

• Tobacco smoke can trigger colds, asthma, bronchitis, allergies, pneumonia, andbreathing problems in babies and children. Babies exposed to second-hand smoke candevelop painful ear infections and some even die from Sudden Infant Death Syndrome(SIDS).

• If you or others in your household cannot stop smoking, restrict your smoking to theoutdoors. Opening a window, smoking in another room, or smoking in the house whenchildren are not present will not eliminate the risks.

• Some provinces have banned smoking in a car or truck where children are present.

To Learn More…Health Canada: www.GoSmokefree.ca

Or call 1 800 O-Canada (1 800 622-6232)

TTY/TDD: 1 800 465-7735


Your Healthy Baby

Bath Time• Bath time can be fun for both you and your baby.

It’s a great opportunity to bond and interactwith each other. Your baby will enjoy yourgentle touch and a chance to splash andplay.

• A little planning can simplify bath time foryou. Getting everything you need ready andin one place before you get your baby inplace is a good way to start.

• If you give your baby a bath before (rather thanafter) feeding, this can help prevent spitting up duringthe bath.

• Babies do not need to be bathed every day. Bathing too often can cause your baby’s skinto dry out. In between baths, clean your baby’s face after each feeding, and clean thediaper area after every changing.

Getting Ready for the Bath

• Make sure the room is warm (about 24° C or 75° F). Babies lose heat from their bodiesvery quickly.

• NEVER leave the baby alone in the bath or on a changing table. If you’ve forgottensomething, take the baby with you to get it!

• Check the temperature of the water before putting the baby in the bath. The watershould feel warm but not hot on the inside of your wrist or elbow.

• Be sure to clean and disinfect the tub after each bath.

Sponge Baths

• You can give your baby a sponge bath in the first week or two, until you have gottenmore comfortable handling your baby.

• Give a sponge bath to baby boys who have a circumcision that has not yet healed.

Sponge baths can be less stressful for parents than a tub bath, because it is easier to hold thebaby without worrying about slippery bathwater. Here are some tips for giving a sponge bath:

• Keep your baby wrapped in a towel, and uncover one area at a time to sponge it.• Start from the top and work down, cleaning the diaper area last.


• Holding the baby’s head, use a fresh cotton ball or square moistened with water for eacheye. Wipe gently from the inside corner of the eye out.

• Be careful with the soft spot on the baby’s head, but don’t be afraid to touch it.• Use a soft washcloth and plain, warm water to gently wipe your baby’s entire face. Pay

attention to the skin behind the ears and tocreases in the neck, which can easily beoverlooked.

• Clean the outside of the baby’s nostrils andears by gently wiping with a dampwashcloth. Be careful not to drip water intothe baby’s nose or ears and do not usecotton swabs. Gently pat dry with a softtowel before moving on.

• Unwrap and remove the baby’s diaper. Usea mild, moisturizing soap only if your baby issmelly or dirty. Be sure to rinse well.

• Wet your hand or a washcloth and wash the rest of your baby’s body• To clean the genital area, always wipe from front to back to avoid spreading bacteria

from the bowel.• Rinse and gently pat dry. The best way to avoid rashes is to gently dry the folds of your

baby’s skin with a soft towel after cleaning.• Cotton swabs, powders, and lotions are not recommended.

Shampooing

• In general, shampoo your baby’s hair once or twice a week. If giving a tub bath, washyour baby’s hair last. A wet head loses body heat quickly.

• Hold your baby at your side in a towel, supporting the head with your hand. With thebaby’s head over a basin, use your free hand to wet the baby’s hair, and then lather with avery small amount of mild soap or shampoo. Rinse completely and rub dry.

Cradle Cap

• Waxy scales or greasy skin with flaky white or yellow scales on a baby’s scalp are calledcradle cap. This is a common condition in newborns. Cradle cap is not harmful and itusually goes away on its own in a few months.

• If your baby has cradle cap, you can shampoo more often. Rub a small amount of non-perfumed oil, such as mineral oil, into the baby’s scalp before shampooing. Rub gently toloosen the scales, then shampoo as described above.


Pay special attention to the stump of

the umbilical cord as it heals.

• Keep the skin around the cord

clean and dry.

• Keep the diaper folded under

the cord to allow it to dry.

• Clean the cord area with water if

it becomes soiled.

Tub Baths: When Is Baby Ready?

• Sponge-bathe your baby until the stump of the umbilical cord and the circumcision havehealed.

• When baby is ready, you can use a plastic tub or basin in the sink or bathtub, or line aclean kitchen or bathroom sink with a towel or rubber mat.

• Babies are not ready for the big bathtub until they are able to hold their heads up andkeep their backs straight.

Bath-Time Safety

• Gather all your supplies, including a clean towel, diaper, and fresh clothes.• Fill the tub or basin with a few inches of warm water. Always test the water temperature

yourself before putting the baby in.• Carefully watch babies and young children in the bath at all times. Always keep them

within arm’s reach. And if the phone rings during bath time—ignore it!• Put a non-slip rubber mat on the bottom of the tub.• Health Canada recommends that you NOT use baby bath seats. Because they give adults

a false sense of security, bath seats can lead to drowning.• Cover the bathroom floor with non-slip rugs.• For older children, never fill the bath more than waist-high (in the sitting position).• Take care with the taps to prevent bumps and burns.• Clean and disinfect the tub after every bath.

Bath-time Supplies

• mild soap• clean washcloths• diaper and diapering supplies• large soft towels• cotton balls• a change of clothing• a pad or cloth diaper to lay the baby on after the bath.

For More Information...Invest In Kids: www.beststart.org/invest_in_kids/index.html


Changing a DiaperAs a new mother, feeding and changing can seem totake up most of your time. It’s not yourimagination: babies may use as many as 10diapers a day. Changing a diaper may seemcomplicated at first, but all you need is a littlepractice, and you’ll be getting plenty of that!

General Guidelines

Before you begin, gather your supplies within easy reach:• a clean diaper• fasteners (if needed)• cotton balls (for newborns or babies with sensitive skin)• a clean washcloth or diaper wipes (for older babies who aren’t sensitive to wipes)• an extra washcloth for patting baby dry after wiping• diaper ointment (if needed for rashes)• changing pad or a spare cloth diaper to place under your baby.

Optional supplies:• a spare diaper to place over your little boy’s penis• sanitizing wipes or a disinfectant spray to clean and sanitize the changing surface after

each use.

Babies should never be left alone when you are changing a diaper, even for a second.

Since a baby who has something to focus on will wiggle and squirm less, give the babysomething to look at while being changed—such as an unbreakable mirror or a colourfulpicture. Later on, when baby is able to grasp objects, keep favourite toys close at hand.

Once you are ready, unfasten the soiled diaper and hold your baby’s legs up by grasping bothankles with one hand. Remove the soiled diaper and set it aside, out of baby’s reach.

Clean the baby completely. (See Tips for Proper Wiping, below.) For boys, it’s a good idea toplace a clean diaper over the penis while you change the diaper. Exposure to air often causesbaby boys to pee—on you, the walls, or anything else within range. When you have cleanedthe baby, place the penis in a downward position before fastening the clean diaper. This willhelp prevent leaks at the waistline.


If your baby’s umbilical cord stump has not fallen off yet, fold down the waistline of thediaper to keep that area dry.

Tips for Proper Wiping

• Using cotton balls, a wet washcloth, or baby wipes, gently wipe your baby clean from thefront to the back. Never wipe from back to front, especially on girls, or you could spreadbacteria and cause a urinary tract infection.

• You may want to lift the baby’s legs so you can see and reach all areas. Don’t forget thecreases in the thighs and buttocks.

• Once you’ve finished wiping, pat your baby dry with a clean, dry washcloth.• Apply lotions or creams only on buttocks or upper thighs and not on the genitals, unless

your health care provider has told you it is okay to do so.• If you find any marks around your baby’s legs or waist, the diaper was too tight.• Disposable wipes, disposable diapers, laundry soap, bleach, and fabric softener that you

use to launder cloth diapers can irritate your baby’s skin.• Completely clean and disinfect the changing surface with a sanitizing wipe or

disinfectant spray.• Always wash your hands well after changing your baby’s diaper to prevent the spread of

germs.

Odour Control Tip

To neutralize odours from used diapers, sprinkle baking soda on them in the diaper pail.

Disposable Diapers

• Open the diaper and slide it under your baby while gently lifting the legs and feet. Pullthe diaper up between baby’s legs, making sure it’s on straight, so it will wrap evenlyaround baby’s hips. The back part with the adhesive strips should be about level with thebaby’s belly button.

• Raise the front part of the diaper the rest of the way up between your baby’s legs, andonto his or her belly.

• Next, open the adhesive tabs, place them over the front of the diaper, and press themfirmly in place. Be careful not to let the tape stick to your baby’s skin.– For a snug fit, fasten the side closest to you first. Then roll your baby gently toward

you to tighten and fasten the other side.– Try to keep the overlap of front and back as neat as possible, so the diaper will hug

baby’s waist comfortably.


• Dispose of stool in the toilet, and then throw the diaper in the trash.• Empty the garbage regularly (about once a day). This reduces smell and also prevents the

growth of bacteria.

Cloth Diapers

• There are many kinds of cloth diapers, including all-in-ones (which include the cover),pre-folded, fitted, or flat—with or without fasteners, Velcro, or snaps.

• New diapers and covers need to be laundered at least once before using them. Follow themanufacturer’s directions.

• Cloth diapers are less expensive than disposables in the long-run, especially if youlaunder them yourself.

• If you hire a diaper service to pick up your dirty diapers and drop off clean ones once aweek, this becomes much less expensive per child when you have two or more in diapers.

• If the cloth diapers you use do not have snaps or Velcro fasteners attached, you can usediaper tape or oversized safety pins with plastic heads. If you decide to use pins, keepyour hand between the pin and your baby’s skin to prevent pricking.

• Wet diapers can be tossed right into the diaper pail, but soiled diapers should be emptiedinto the toilet first.

• Sprinkle the diapers in the pail with baking soda for odour control and keep the pailcovered.

Cleaning Cloth Diapers

• Always wash diapers separately from other laundry.• Pre-soak heavily soiled cloth diapers and use hot water to launder them. Use a mild

detergent and do not use fabric softeners or dryer sheets.

To Learn More…Baby Center: www.babycenter.ca


Baby’s LaundryWhen babies arrive, they bring joy—and lots oflaundry, too! Always check the care label on babyclothes. Here are some other suggestions forkeeping baby’s clothes clean.

Laundry Products

• Use a detergent that is colour and fragrancefree.

• Wash cloth diapers separately.• Avoid fabric softeners and dryer sheets. These may

irritate baby’s skin and can lessen the flame-retardant qualities of pyjamas and otherclothing.

• Pre-soak stains.

Stubborn Stains

Follow these guidelines unless the care label says otherwise.• Scrape off as much of the dirt or food as you can, and soak the stain in cold water as

soon as possible.• Fill the washer with cold water and allow the clothing to “agitate” while the stain is fresh.• Never soak stains in hot water. This can set the stain into the fabric, making it more

difficult to remove. Don’t put clothing in the dryer before you are sure the stain is gone. .• If needed, soak the stained fabric in cold water with detergent for 30 minutes or longer.

If the stain has dried, soak the item in coldwater and detergent for several hours.

• Wash in warm water and rinse. If thestain remains, soak another 30 minutesand rewash.

• If you need to use bleach, be sure torewash, since bleach may irritate ababy’s skin.

• Remember: don’t put the item in thedryer until the stain is completely gone.


Tip: Safe Clothing forBabiesAvoid cords and strings, loose

buttons, zipper pulls, and ponchos.

These can cause choking or

strangulation.

Feeding Your Baby

Nutrition and Your Baby

• Consult with your health care provider before giving your baby vitamin and nutritionalsupplements.

Breastfed Babies• Breast feeding is the normal way to feed your baby. For you and

your baby it may be a skill you both have to learn. Youwill have a lot of practice very quickly as yourbaby will breast feed 8 to 12 times every 24hours during the first month or so. Breastmilk has the right blend of nutrients thatnourishes your baby and provides a uniquebalance of fats, vitamins, minerals, sugars,and proteins. The breast milk you producehelps your baby to fight infection anddisease. These benefits last your child's lifetime

• Health Canada recommends that babies who arebreastfed receive a daily supplement of 400 IU ofvitamin D until 1 year of age or until you stop breastfeeding.After 1 year, all children should consume 200 IU of vitamin D daily through their diets.

Alternatives to Breast Milk• Health Canada advises that commercial formulas are the most acceptable alternative to

breast milk until 9 to 12 months of age. The formula should be cow’s milk-based andiron fortified.

• Pasteurized whole cow's milk can be introduced to your baby's mixed diet after 9months of age. For infants unable to take cow's milk products, speak to your doctorabout alternatives.

To Learn More…Eat Right Ontario: www.eatrightontario.ca


Feeding and Food Safety for Baby

You’ve probably heard a lot about food borne illness and keeping food safe. Food borne illnessis spread through the food you eat. Infants and young children are particularly vulnerable,because their immune systems are not developed enough to fight off the disease-causing germs.

It’s important to be very careful when you are feeding your baby. In addition to basic foodsafety, keep the following tips in mind.

Storing Breast Milk Safely

Breast Milk: Heating and Handling It Safely• When heating baby’s milk, always shake the liquid to even out the temperature, and test

it on your wrist before feeding. Milk that’s “baby-ready” should feel lukewarm.• Heating breast milk in the microwave is not recommended. Microwaves heat milk and

food unevenly. This causes “hot spots” that can scald a baby’s mouth and throat.

Heating in Hot Water:• Method 1: Place the bottle under hot, running tap water until the desired temperature is

reached. This should take one to two minutes.• Method 2: Heat water in a pan. Remove the pan from the heat and set the filled bottle in

it until it’s warm.


Guidelines for Storing Breast Milk in the Refrigerator or Freezer at HomeLocation How long can I keep breast milk here?

Unrefrigerated breast milk(room temperature) 6 to 8 hours

Refrigerated 5 days

In a freezer section within a refrigerator Up to 2 weeks

In a freezer section separated from the main refrigerator where the freezer maintains a temperature of at least -18º C (0º F) Up to 3 to 6 months

In a deep freezer which maintains a temperature of at least -28º C (-18º F) Up to 6 to 12 months

Drinking Water

• Once your baby is 6 months old you may give them water to drink.• Let the cold water tap run for 2 minutes to flush the pipes every day before using the

water for drinking.

Transporting Baby’s Food

• Transport bottles and food in an insulated cooler when travelling with the baby. Coldtemperatures (4°C or 40 ºF and below) keep most harmful bacteria from multiplying.Throw away any perishable food (except for fresh breast milk) left at room temperaturefor more than 2 hours.

• Use frozen gel packs to keep food or bottles cold on long outings.

Bottles, Jars, and Utensils

• Follow the manufacturer’s recommendations for cleaning bottles before you fill themwith milk.

• Make sure that the safety button on the lid of commercial baby food jars “pops” whenyou first open the jar.

• Throw away jars with chipped glass or rusty lids.• Use detergent and hot water to wash blenders, food

processors, and any utensils (including the can opener)that come in contact with a baby’s foods. Rinse wellwith hot water after washing.

• Don’t put a bottle back in the refrigerator if yourbaby does not finish it. Bacteria from the baby’smouth can get into the bottle during feeding, thengrow and multiply—even after refrigeration.

• Don’t feed your baby directly from a jar and thenrefrigerate the jar. Why? Because bacteria can be transferredfrom the spoon to the jar. Instead, put one serving in a dish with a clean spoon, andrefrigerate the rest of the food in the jar. Throw away any food that may be left in theserving dish.

• Don’t place dirty diapers in the same bag with bottles or food. Harmful bacteria from adirty diaper can spread to baby’s food.


Plastic Baby Bottles

The Government of Canada is moving to ban the sale of plastic baby bottles containingBisphenol A because of concerns about long-term exposure to this chemical.

Bisphenol A (BPA) is used to make a hard, clear plastic known as polycarbonate. It is alsoused in a protective lining on the inside of metal-based food and beverage cans, includingbaby formula. The government is working with manufacturers to come up with alternativesto BPA while ensuring that infant formula contains the lowest levels possible.

• Bisphenol A can move from polycarbonate baby bottles into the liquid inside the bottlewhen boiling water is added, or when the bottle is heated in a microwave.

Introducing Solid FoodsAt 6 months of age, your baby is ready to start tryingsome solid foods. Breast milk should continue to be animportant part of your baby’s nutrition until 2 years andbeyond.

The shift to solid foods is a whole new stage of feeding.Your baby is ready to experience new textures and new ways ofeating. The tips below will help you prepare for this exciting time,but talk to your health care provider before you begin.

• Remember to introduce all solid foods, including infant cereal, with a spoon. Babies canchoke on solid foods in a bottle.

• Babies may eat less than half a teaspoon at first. Spoon a small amount into a bowl oronto a plate with a clean spoon.

• Do not feed your baby directly from the jar. The bacteria from your baby’s saliva willmake the unused food deteriorate, even when refrigerated.

• Introduce only one new food at a time to your baby, waiting 3 to 5 days before tryinganother. This helps you determine if the new food agrees with your baby.

• Start with nutrient rich foods containing iron. In Canada, most babies have an iron-fortified infant cereal as their first solid food. Iron-fortified cereals can be mixed withbreast milk, formula, or water.

• Meat and alternatives can also be introduced at this stage. This includes cooked meats,fish, and poultry; tofu, cooked egg yolks; and well-cooked peas and beans. Iron frommeat sources is better absorbed than iron from non-meat sources.

• Vegetables and fruits are usually added to baby’s diet next, followed by milk productssuch as cottage cheese, other cheeses, and yogurt.


Avoid Choking Hazards

Foods that are more likely to cause choking are:

Small and slippery, such as...• grapes • raisins• hot dogs • hard candy

Hard to chew, such as...• popcorn • chips• raw carrots • nuts• chunks of meat

Sticky, such as... or...• peanut butter • any food that is the size of baby’s little finger.

In addition, bottles should never be “propped up” for feeding.

Risky Foods For Young Children

For Babies Under 1 Year Old• Honey is not safe for children under 1 year old. It may contain a germ that can cause

serious illness or death.• Egg yolks should be fully cooked and any foods containing raw eggs should be avoided.• Avoid citrus fruits and juices (orange, grapefruit, lemon, and lime) until 1 year of age

because they can cause a painful diaper rash.• Cow’s milk is usually offered around 1 year of age as part of a mixed diet.

For Older Children• Children and infants are especially vulnerable to the food borne illnesses linked with raw

(unpasteurized) milk and juice. The sale of raw milk is illegal in Canada. Unpasteurizedjuices and ciders may be sold at some farmer’s markets, roadside stands, orchards, andgrocery stores. Most producers voluntarily label unpasteurized juice or cider but if youhave any doubts, boil it first or don’t give it to children or infants.


Food AllergiesYour baby is more likely to have an allergy if one or both parents or brothers or sisters haveallergies, asthma or eczema. If there is an immediate family history (mother, father, sister,brother) of allergies, speak to your health care provider. You may need to wait to start somefoods until your baby is older.

Watch for allergic reactions when you offer new foods. Follow the steps on how to start solidfoods on page 21 this booklet.

If you see anything unusual after introducing your baby to a new food, call your health careprofessional immediately. A reaction will often occur within 24 hours of eating a new food.

Look for these signs:• difficulty in breathing• constipation• diarrhea• vomiting• skin rash• watery eyes• coughing• runny nose• a lot of bloating or gas• unusual crying or being very cranky during the daytime.

To Learn More…Canadian Partnership for Consumer Food Safety Education:

www.canfightbac.org

Health Canada: www.hc-sc.gc.ca

Canadian Paediatric Society: www.caringforkids.cps.ca


Baby’s Health Care

Oral Care

• Good oral care is important for your baby right fromthe beginning. Oral health is a key aspect of overallhealth and you can begin good oral habits whenyour baby is an infant. Follow these guidelines tohelp your baby have a bright smile!

Age 0-6 months• Clean your baby’s gums daily.• Don’t put your baby to bed with milk in a bottle. Sugars in milk or formula can cause

decay on teeth that have not appeared yet. Water is the best way to quench a thirst.• Plaque grows in a baby’s mouth even before they have teeth. The bacteria found in

plaque can cause early childhood tooth decay, whether your baby feeds from the breastor from a bottle. This painful disease can lead to an early loss of baby teeth, affectingnutrition, speech development, and how the permanent teeth come in.

Age 6-18 months• Clean your baby’s teeth daily.• Avoid letting your toddler walk around with a bottle or sippy cup, which allows sugars to

“pool” in the toddler’s mouth.• Serve juice and milk in a sippy cup, not a bottle.• Visit the dentist for a check-up.

How To Clean Your Baby’s Mouth

• Wrap a damp cloth or piece of gauze around your finger• Gently wipe the gums from back to front, removing any leftover milk or formula.• As soon as teeth begin to appear in your child’s mouth, use a small, soft, and wet

toothbrush to clean them.

To Learn More…Canadian Dental Association: www.cda-adc.ca


Immunization

Babies are highly vulnerable to infectious diseases because their immune systems are stilldeveloping. That is why it’s important to boost your baby’s immune system with timelyimmunizations.

Mothers pass their immunity to their babies during the lastfew weeks of pregnancy, but this begins to fade within afew weeks of birth. If you are immune to a certaindisease, your baby will benefit from this for a short time.In addition, breastfeeding provides some generalimmunity, so your baby will have fewer colds forexample. But breastfeeding does not protect your babyfrom specific illnesses such as whooping cough or diphtheria.

What Are Vaccines and Immunization?

Vaccines are made from weak or “dead” versions of viruses or bacteria. Vaccines may be givenas injections (also known as “needles” or “shots”) or as liquid drops that the baby willswallow. Vaccines stimulate the body to produce antibodies that protect us from diseases. Aswith adults, babies get vaccinated so that they will develop antibodies to protect them fromspecific diseases.

A hundred years ago, infectious diseases were the leading cause of death worldwide. InCanada, they now cause less than 5% of all deaths—thanks to immunization programsacross the country. Today, it is rare for a Canadian child to get polio, diphtheria, tetanus,mumps, or measles. Whooping cough and rubella (German measles) are also becoming lesscommon as more and more children are immunized against these diseases.

The vaccines used in Canada are very safe. They are developed using the highest standardsand are continually monitored to make sure they are safe and effective.

Your health care provider can answer any questions you might have about vaccine safety.

To Learn More…Canadian Public Health Association: immunize.ca


Your Healthy Home

Setting Up the NurseryTo ensure your baby’s safety, you must choose the correct kinds of equipment, supplies, andtoys. Follow these suggestions for a safe and well-equipped room for the baby.

The Crib

• All cribs made before 1986 are unsafe. Check thedate on the crib’s label. Do not use a crib thatdoes not have a label, is homemade, or wasmade before 1986.

• The space between crib bars should be nomore than 6 centimetres (2 3/8 inches).

• The part of the crib that supports themattress should be attached permanently tothe crib frame.

• The crib should not have any corner posts thatcould catch on clothing and no design cut-outs inthe headboard or footboard.

• It is important to make sure the crib does not have any loose, missing, or broken parts.• The crib mattress should be firm and free of any plastic covering. Make sure it fits tightly

within the crib and is no more than 15 centimetres (6 inches) thick.• Lower the mattress level as your baby grows, with the mattress at its lowest level by the

time your baby can sit up.

Crib Safety

• Lock the sides into place after putting your baby in the crib.• Babies should sleep on their backs; never face down.• Do not let the baby wear a necklace or a soother on a cord.• Place the crib away from windows, curtains, cords, lamps, electrical plugs, and extension

cords.• Do not put soft mattresses, pillows, comforters, stuffed toys, or bumper pads in cribs.• Supervise babies when toys are also in the crib.• Remove mobiles and activity gyms by 5 months of age. Children who can lift themselves

onto their hands and knees can strangle on these items.


Safe Sleeping• The safest place for your baby to sleep is alone

in a crib. The crib should be beside an adult’sbed until 6 months of age.

• A cradle is also a safe place to sleep until 6months of age or until your baby can sit up.

• The risk of suffocation rises when babiessleep in a place other than a crib or a cradle.

• Provide a smoke-free environment both beforeand after birth

• Always place your baby on his or hers back to sleep– night time and nap time. An infant should never beplaced on their stomach to sleep.

Bed Sharing

• Bed sharing (sometimes called “co-sharing” or “co-sleeping”) is when an adult or anotherchild sleeps on the same surface as an infant. Health Canada advises that a baby shouldnever be placed to sleep on the same sleep surface as an adult or another child.

• There is no proof that bed sharing reduces the risk of Sudden Infant Death Syndrome(SIDS). Research shows that the risk of SIDS is higher if the person sharing a bed withan infant is a smoker, very tired, or under the influence of drugs or alcohol.

• Adult beds are not designed for infant safety. Babies can die if they get trapped betweenthe bed and the wall or other surfaces, or if a parent lies on them.

• Infants can suffocate in soft bedding materials, such as pillows or comforters.

To Learn More...Health Canada: www.hc-sc.gc.ca

Public Health Agency of Canada: www.phac-aspc.gc.ca


Where to Change DiapersYou don’t have to buy a diaper changing station. You can use any sturdy surface—such as atable or chest of drawers—and add a waterproof changing mat. No matter what surface youchoose to use, keep these safety guidelines in mind:

• If you place your baby on any raised surface, always keep one hand on the baby.• The best place to change a diaper is on the floor, on a waterproof changing mat, or on a

clean towel.• Clean and disinfect the changing mat after each use by wiping it with hot water and

detergent and then using a sanitizing wipe or disinfectant spray.• Have diaper supplies handy, but out of your child’s reach.

Safe Toys and PlayToys and play are important to your child’s development, and safety is essential. In Canada,responsibility for toy safety is shared among governments, the toy industry, safetyassociations, parents, and caregivers.

Toy makers must ensure that their toys meet Health Canada’s product safety regulations. Althoughstores are regularly checked for unsafe toys, such toys can still make their way into your home.

Toy Safety: What You Should Know

• Children under 3 years of age tend to put things in their mouths.• Keep small toys, small balls, or small loose toy parts away from children under 3 and

from older children who still put toys in their mouth.• If the toy or any piece of it can fit inside a toilet paper tube, it could cause a child to choke.• Keep all toys, especially fabric and soft toys, away from heat sources, such as stoves,

fireplaces, and heaters.• Avoid toys with cords.• Loud toys can damage a child’s hearing.• Supervise children at play and teach them how to use their toys safely.• Regularly inspect your baby’s toys to make sure they are not broken. Look for sharp edges.• Check the eyes and noses of stuffed animals. Broken seams in stuffed toys may reveal

small removable parts, such as squeakers in squeeze toys. Discard toys that are not safe.

Balloons• Balloons can make children choke.• Always keep balloons and pieces of broken balloons out of the reach of young children.• Supervise children when they are around balloons.


Toy Storage• If the toy box has a lid, it should be lightweight, with hinges that

can hold the lid open and holes that allow air inside. Heavy lidsfalling on children’s heads and necks can cause death.

• Children should not have access to airtight storage bins, trunks, orboxes. These could cause suffocation if a child climbs inside.

Ride-On Toys• Toys that children ride on must match the child’s size and ability. Make sure the toy will

not tip when your child is on it.• Children on ride-on toys can move very quickly. Do not permit a ride-on toy near stairs,

traffic, swimming pools, or any other dangerous area.• Clear the area of lamps, cords, and anything that could be knocked over or pulled down

onto the child.

How to Buy Safe Toys

• Read labels to make sure the toy is right for your child’s age.– Even if your child seems mature for his or her age, remember that the age level for a

toy is based on safety.• Check for safety features.

– Toys made of fabric should be labeled as flame resistant or flame retardant.– Stuffed toys should be washable.– All toys should be painted with lead-free paint, and art materials (including crayons)

should say “non-toxic” somewhere on the package.• Look for toys that are sturdy and well constructed.

– Young children like to pull and twist toys, and often try to put them in their mouths.– Make sure that eyes, noses, buttons, and other small parts of toys are securely attached.– Check toy cars to make sure the wheels are on tight.

• Don’t buy toys with cords or long strings for babies or toddlers. Never hang anything arounda toddler’s neck and never hang toys with long strings or ribbons in a crib or playpen.

• Throw away the plastic wrapping around a toy as soon as it is open. A child can chokeon this wrapping.

To Learn More…Health Canada: www.hc-sc.gc.ca

The Hospital for Sick Children: www.sickkids.ca


Germs

What They Mean for You and Your Family

Germs are everywhere. Most germs are actually good butsome are bad. As a mother, you will want to protect yourchildren from the harmful germs as much as possible.

A safe, clean, and healthy home is important to your baby and the whole family. Here aresome simple guidelines.

Where Germs Grow in Your Home

The main sources of germs in your home are usually people, pets, food, and water. Somegerms—especially bacteria—like to live in warm, moist places. They can grow and multiplyquickly in places where water and waste collect, such as in sinks, toilets, wet towels, and thecloths and mops you use for cleaning.

Did you know that bacteria can grow and divide every 20 minutes? One single germ cell canbecome more than 8 million cells in less than 24 hours.

Bad Germs

Germs that can cause illness are called pathogens. They include the following:• Bacteria—such as salmonella or E. coli, which cause food borne illness.• Fungi—such as Candida albicans, which causes yeast infections; or some moulds, such as

Cladosporium, which can cause nasal stuffiness, eye irritation, wheezing, or skin irritation.• Viruses—such as rotavirus, which can cause severe diarrhea in babies; or rhinovirus,

which causes the common cold.

How Germs Are Spread

Germs can be spread by direct contact, indirect contact, or through the air.• Direct contact is skin-to-skin contact with infected people or animals, or contact with

blood or other body fluids. This is why hand washing is so important for everyone whocomes in contact with your baby!

• Indirect contact occurs when germs that are present in raw food or water, in soil, and onanimals are picked up on your hands and transferred to the mouth, eyes, or nose.Common contact points include:1) Contaminated surfaces, such as dirty diapers, cutting boards, and items used to clean

these surfaces, such as cloths and sponges.2) Pets and other animals3) Insects, like mosquitoes, fleas, ticks, and spiders


• Through the air. Germs are carried on dust that your skin sheds or in tiny droplets thatleave our bodies when we are coughing, sneezing, or talking. Your baby could pick up thesegerms by breathing them in. Germs that can be transferred this way include childhooddiseases like measles, mumps, and rubella, and other contagious diseases like tuberculosis.

Toothbrushes can carry germs too. Replace all toothbrushes every 3 months and after anyupper respiratory, oral, or skin infection, including colds, sinus infections, and strep throat.

Controlling Germs: Cleaning and DisinfectingCleaning and disinfecting are not the same thing. Cleaning removes germs from surfaces;disinfecting actually destroys germs.

• Cleaning with soap and water to remove dirt and germs is usually good enough.However, it’s important to routinely clean and disinfect surfaces.

• While surfaces may look clean, many infectious germs may still be lurking. In somecases, germs can live on surfaces for hours—and even days.

To Clean or To Disinfect?When you clean, you are physically reducing dirt and the number of germs on the surfaceyou are cleaning. Cleaning requires soap (or detergent) and water, or a good cleaningsolution, and strong scrubbing.

When you disinfect, you are killing germs. As a general rule, disinfect those areas where largenumbers of dangerous germs may be and where there is a possibility that these germs couldbe spread to others. When you disinfect with a sanitizing wipe or disinfectant spray, you areactually killing most of the germs present on the surface you are wiping or spraying, givingeven better protection. Disinfectants are regulated by Health Canada’s Health Canada’sTherapeutic Products Directorate and should be clearly labeled.

Tip: Prevent Germs by Keeping Surfaces DryMost germs cannot live long on a clean, dry surface. But just a few germs on a wet surfacecan survive . . . and will quickly multiply. You can help prevent the growth of germs bykeeping surfaces, baby’s toys, and clothing clean and dry.

To Learn More…Lysol Canada: www.lysol.ca

Canadian Public Health Association: www.cpha.ca


Healthy Food, Clean KitchenThe Canadian Partnership for Consumer Food Safety Education recommends four simplesteps to reduce the risk of food borne illness.

CLEAN: Wash hands and surfaces often• Wash your hands with warm, soapy water for 20 seconds before

and after handling food. Washing hands is one of the best thingsparents can do to prevent food borne illness.

• In addition, wash your cutting boards, dishes, and other surfaceswith hot, soapy water after preparing each food item and beforegoing on to the next food.

• Wash fruits and vegetables with cold water before using.

SEPARATE: Don’t cross-contaminate• Separate raw, cooked, and ready-to-eat foods while shopping,

preparing, and storing.• Never place cooked food on a plate that previously held raw meat,

poultry, or seafood.

COOK: Cook food to proper temperatures• Use a food thermometer to be sure you cook food to safe minimum

temperatures, which are listed at www.canfightbac.org.

CHILL: Refrigerate Promptly• Refrigerate or freeze perishables, prepared foods, and leftovers

within 2 hours or sooner.


Preventing Food Borne Illness—Kitchen Tips

• In addition to washing cutting boards, dishes, utensils, and countertops with hot, soapywater after preparing each food item and before going on to the next, try using separatecutting boards. Have one cutting board for fruit and vegetables, and one for raw meats,poultry, and seafood.

• If you use paper towels to clean kitchen surfaces, you can then throw the germs away! Ifyou use cloth towels, wash them often, using hot water.

• Periodically disinfect the kitchen countertops, following the directions on product labelsfor effective use.

• Clean your refrigerator regularly. Wipe up spills immediately and clean the inside wallsand shelves with hot water and a mild liquid dishwashing detergent, then rinse. Usesanitizing wipes to clean up spills.

• Once a week, check all the food in the fridge and throw out any that has expired. Beaware that the “best before” date only tells you how long the unopened product willretain its freshness and high quality. Once it’s opened, the “best before” date no longerapplies and the product’s storage life is now the same as if it were a fresh product.

To Learn More…Canadian Partnership for Consumer Food Safety Education:

www.canfightbac.org

Canadian Public Health Associatoin:

www.foodsafety.cpha.ca

In the BathroomToilet bowls likely contain germs, but the greatest riskof infection actually comes from surfaces that arewe touch often—like the toilet flush handle,toilet seat, taps, and door handles.

You should regularly clean and disinfect surfacesusing these guidelines:

• Clean and disinfect the toilet bowl as often asnecessary to prevent the build-up of dirt andscum that can cause odours and give germs a placeto live. If you use a toilet brush, make sure it is storedclean and dry after you use it.


• Clean up spills immediately and disinfect surfaces if any body fluids are involved.• Rinse baths, sinks, and showers after each use and clean them regularly to remove all the

lime scale and soap scum where germs can grow.• Store toothbrushes and other personal items where germs are not likely to splash onto

them. Rinse them after each use and store them dry. Do not share personal items.• Launder and replace towels often.• Keep the bathroom clean and well ventilated to prevent the growth of moulds.• Wash your hands completely after using the toilet and after cleaning the bathroom.• For added protection, spray surfaces with a disinfectant spray.

Floors and FurnitureFloors and furniture are usually a low risk forspreading germs. Follow these guidelines.

• Vacuum carpets and soft furnishings to pickup dust, dust mites, and other debris.

• Hard surfaces, such as tile, linoleum, orlaminates are better options than carpetingin the bathroom and kitchen. Hard surfacesare easier to clean and do not collect debrisin the same way that carpets can.

• Hard surface floorings only requiredisinfecting if body fluids have spilled ontothem. Use disposable paper towels toremove body fluids before cleaning anddisinfecting the surface.

• If you use a mop and bucket, disinfect themafter each use and store them dry, with themop head upwards instead of resting on thefloor.

• Dust with a damp cloth to minimize dustand dirt.

• To prevent the growth of moulds and fungi,clean and disinfect tiled walls and other hardsurfaces where moisture is likely to collect.

• Do not use bleach on carpets, woodensurfaces, or in confined areas where aircannot circulate. Never mix bleach withother cleaners.


Clean Floors for BabyDisinfecting floors, furniture, walls,

and other surfaces should only be

necessary when body fluids, such as

vomit or feces, have spilled.

However, keep in mind that when

young children and babies crawl on

the floor, there is a higher risk of

infection. This risk increases if you

also have pets.

• Before putting your baby on the

floor, check that the area has been

recently vacuumed or washed, and

disinfected if necessary. It may be

easier to cover the floor with a

play mat that you can disinfect or

launder when it gets dirty.

• Make sure there are no small,

loose objects that your baby could

choke on, or any other hazards,

like open heat sources or exposed

electrical cords.

• If possible, do not wait until floors

or carpets are visibly dirty to clean

them. The more often you clean

them, the easier the chore will be.

Animals and Insects

Household Pets

Pets are valued members of many households.However, animals can also pass germs anddiseases to humans. The chance that healthydogs and cats will make you sick is small, butreptiles, such as turtles, snakes, and lizards, caneasily transmit bacteria to their owners.

You can reduce the risks by practising good personalhygiene, keeping pet areas clean, and keeping pets’ vaccinescurrent. The following tips will help you enjoy a happy and healthy relationship with yourpets.

Pets and Cleanliness• Wash your hands often, especially after touching animals or their treats, toys, leashes,

bedding, etc.• Avoid raw animal-based pet treats (beef, pork, chicken, fish, or seafood), which carry the

risk of Salmonella bacteria.• Make sure pets have their own feeding dishes and utensils that you clean separately from

other household items.• Immediately clean and disinfect any surface contaminated with animal saliva, mucus,

feces, urine, or blood.• Regularly clean and disinfect floors, feeding areas, and the sinks and tubs you use to

wash pets.• Never allow pets onto counters or tables where you prepare food.• Don’t clean pet cages and tanks in your kitchen. Use a bucket and go outside if possible.• Do not let your pet share your plate or lick your—or your baby’s—face.• Keep all exotic pets—especially ferrets—away from your baby.• Never allow turtles, snakes, lizards, and iguanas or their cages near your baby. Reptiles

can transmit Salmonella bacteria.


Be Ready For Baby: Your Pet’s Health• Check with your veterinarian to make sure your dog and cat are fully immunized and

regularly treated for fleas, ticks, intestinal worms, and other parasites, includingroundworm, hookworm, whipworm, tapeworm, and heartworm.

• Check pets regularly for signs of ill health and take them to a vet immediately ifanything is wrong.

• Keep their claws trimmed to reduce the risk of scratches.• Train your pets not to jump on people.

Introducing Your Pet to Your Baby• Ask the veterinarian for tips before your baby arrives.• In the first few weeks, you will probably have a lot of visitors and the focus will be on

you and the baby, so this could be a stressful time for your cat or dog.• Give your pet time to adjust and make the introduction to your baby a positive one for

the pet.• Never leave small children and animals alone together.

Safety Tip for Pets and Toddlers• Don’t let toddlers use pets as a guide for walking.• Teach your children how to handle pets, for their safety and for the animal’s safety.• Supervise children less than 5 years of age when they are around animals.• Watch for warning signs from the pet, such as guarding its food and toys, etc.• Contact your health care provider if your child is bitten or scratched by any animal.


Household Pests: Insects and Rodents

In Canada, household pests range from very small insects and spiders to mice, rats, bats,squirrels, pigeons, and raccoons.

Pests enter our homes in order to get food, water, or shelter. They can be attracted by light,warmth, moisture, food, or smells. Prevention is the best approach. Even when pests do getinto the house, you will rarely need to use pesticides. Simply removing their food supply andbreeding sites is the most effective way to control them.

• Never leave sources of food or water (including garbage) exposed.• Clean up spills immediately.• Do not leave pets’ water and food out 24 hours a day.• Keep food in tightly sealed plastic or glass containers.• Regularly clean dark and/or humid places in your house.• Clear away small branches, grass, and debris that may be around the outside of the house.• Seal any entrance holes you discover on the inside or outside of your home.

Mice, rats, and other rodents can carry disease, some of which are spread by their urine anddroppings. Breathing in the dust from droppings can cause illness so follow these safety tips.

Safe Clean-up Tips• Never sweep or vacuum dry droppings.• Wet the droppings and debris with a bleach and water solution before wiping up.• Wear rubber gloves and a dust mask.• Wash your hands completely after you finish cleaning up.• Change your clothing after cleanup and launder those clothes in hot water.• Wear gloves to dispose of dead rodents.

Make sure that children and pets cannot reach poisons and traps. Follow the directions whenusing pest control treatments.

Check yourself, other family members, and pets after spending time outdoors where ticks reside.• Ticks should be removed immediately with tweezers by applying gentle, steady pressure

until they release their bite.

To Learn More…Health Canada: www.hc-sc.gc.ca


Beyond the Home

Car Safety: Travels With BabyCar safety is very important. Because babies haveweak muscles in their necks and backs, they needextra support when travelling in a vehicle.

For Infants

• A rear-facing infant seat will support yourbaby’s head and neck in a sudden stop or acrash. A rear-facing car seat installed in the backseat is needed for baby’s very first car ride, and anyother time the baby travels—even the shortest distance—for the first year or more.

• Make sure the seat fits your baby’s weight and height The rear-facing car seat should beused until your baby is at least one-year-old, weighs at least 10 kilograms (22 pounds),and can walk.

• An infant wearing bulky clothing may not stay snugly in a car seat. Put your baby in thecar seat in normal clothing, and add blankets on top, if needed.

• A rear-facing infant car seat can be used to carry your baby but don’t use it instead of acrib in your home.

• When using an infant car seat outside the car, never place it on top of furniture orcounters. Babies can rock the car seat over the edge or get knocked off, so place the seaton the floor.

• The car seat should be firmly fastened in the back seat and should not slide from side toside. Be sure to read and follow the manufacturer’s instructions.

• Ask your health care provider about using car seats for premature or special needsinfants.

For Toddlers

• When your baby outgrows the rear-facing seat, the new car seat should be installed in theback seat, just as with a rear-facing infant seat.

• Children should not use a car booster seat until they weigh at least 18 kilograms (40pounds), which is generally between 4 and 5 years old. Children can be hurt during asudden stop or a crash if they are using a booster seat when they are too small.

• Find out about and obey the laws on booster seats in your province or territory.


For All Ages

• Keep the car seat’s straps over your baby’s shoulders. Adjust the harness so that you canonly fit one finger underneath the straps at your baby’s chest. The chest clip should beeven with the baby’s armpits.

• Never leave a baby alone in a car and buckle the child into the car seat.• All car seats sold in Canada must be tested to meet Transport Canada safety standards.• Seats that were in a car crash need to be replaced, even if they look okay. Do not buy a

used car seat. Why? You cannot be sure it was never in a crash.• Fill in and mail the registration card that comes with the new seat. Then, if there is a

problem and the seat needs to be fixed or replaced, the company will know how tocontact you.

• Read the instructions about safety seats in your car owner’s manual as well as those fromthe car seat manufacturer.

Install the Car Seat Correctly

• As many as 70% of car seats in Canada are not used correctly. Common problemsinclude seats that are not tightly secured to the car, loose harnesses, and chest clips in thewrong place.

• Ask your local public health unit or health care provider where you can go for a free carseat inspection. This service is offered in many communities by hospitals and firedepartments.

To Learn More…Transport Canada: www.tc.gc.ca

Canadian Paediatric Society: www.caringforkids.cps.ca


Child DevelopmentYour baby’s growth is more than just physical.Children grow, develop, and learn throughouttheir lives.

From birth to 5 years, your baby will developnew skills that include playing, learning, andspeaking. Smiling for the first time, making eyecontact, and pointing are a few of the milestonesalong the way.

Because children usually develop in a certain way withincertain periods of time, you can predict when your baby will start to do new things.However, all babies develop at their own pace, so there is no exact timetable for learning askill. For example, babies learn to walk between 9 and 15 months, so don’t worry if yourbaby is not walking by 12 months.

Developmental milestones are just some of the things you should be looking for as your childgrows. Use the list below† as a guide, and if you have any concerns, talk with your child’shealth care provider.

By the end of 3 months, many children are able to:• smile back at another person• mimic some movements and facial expressions• grasp and shake small toys• follow moving objects.

By the end of 7 months, many children are able to:• turn their head when their name is called• respond to sound with their own sounds• play peek-a-boo or other social games• babble chains of sounds.

By the end of 12 months, many children are able to:• use simple gestures (waving “bye-bye”)• make sounds such as “ma” and “da”• mimic actions when they are playing (clap when you clap)• respond when told “no.”


By the end of 18 months, many children are able to:• do simple pretend play (“talk” on a toy phone)• point to interesting objects• look at an object when you point and tell them to “look!”‡• use several single words unprompted.

To Learn More…Public Health Agency of Canada: www.phac-aspc.gc.ca


Questions to Ask Your Child’s Health Care Provider• What should I do if I’m worried about my child’s progress?

• Where can I get more information?

It’s normal to measure your child’s growth in terms of height and weight. But don’t

forget to look at all the other ways your child is growing, too.

From birth to 5 years, there are milestones your child should reach in terms of how he

or she plays, learns, speaks and acts. A delay in any of these areas may signal a

developmental problem or autism. The good news is that the earlier it’s recognized, the

more you can do to help your child reach his or her full potential. Talk with your child’s

health care provider about overall development.

† From Caring for Your Baby and Young Child: Birth to Age 5 by Steven Shelov, Robert E. Hannermann, (c) 1991,1993, 1998, 2004 by the American Academy of Pediatrics. Used by permission of Bantam Books, a division ofRandom House, Inc.

‡ Baird, G., Charman, T., Baron-Cohen, S., Cox, A., Swettenham, J., Wheelwright, S., and Drew, A. (2000), AScreening Instrument for Autism at 18 Months of Age: A 6-Year Follow-up Study. J. Am. Acad. Child Adolesc.Psychiatry, 39:694-702.

Child CareInfants and toddlers often spend at least some oftheir time being cared for by people other thantheir parents. Whether with relatives, friends, orin a child care setting, all children need a placewhere they will be safe and healthy… and wherethey will thrive.

Choosing the best child care can be a difficultdecision for parents because there are so many factorsto consider.

• Do you prefer a child care centre or a home-based setting?Is licensed child care important to you?

• Do you want child care to be close to your home or workplace?• How can you learn about the options that exist close to where you live?

Finding Child Care

Ask your local public health department for information about safe and reliable child careand how to find out if you qualify for a child care subsidy.

Once you know what you want and how much you can afford, doing some research will helpyou to choose the child care that best meets your needs and those of your child.

Research the Child Care ChoicesOnce you have a list of child care options, begin with telephone interviews. Write down thequestions you want to ask. If you are satisfied with the answers you receive, make a plan tovisit the centres and homes in person. According the Canadian Child Care Federation,quality child care settings have several things in common:

• clean, safe, and secure• a caring, learning environment• a small number of children with each adult• space for quiet and active times, indoor and outdoor play• a balance of interesting activities• flexible, yet predictable daily routine• a variety of toys and equipment• nutritious meals and snacks


Don’t rely on first impressions. A nice provider is not always a quality provider. Ask abouthours, fees, discipline, policies on sickness, vacations, and how parents can be involved. Whatare their rules about early or late pick-up or drop-off?

Your relationship with the caregiver is also very important. Does the caregiver agree with youon discipline? Weaning? Toilet training? Feeding?

After visiting the different child care sites, you will probably be able to narrow your list downto just a few choices. You might want to drop in unexpectedly to see how you are greeted.

Check references before you make a final decision and make sure the child care agreement isin writing. This can prevent misunderstandings later on.

Finally, find out if all the adults who will work with your child have had a criminalbackground check.

Questions to Ask about Activities and the Site:• Are activities and schedules explained to your child?• Are toys and materials well organized so your child can choose what interests him or her?• What program (curriculum) is used for children of different ages?• Can the caregiver and the environment accommodate any special needs?• Is the site appealing, with good lighting and an acceptable noise level?• Can a parent visit at any time?• Will your child feel good about coming here?

To Learn More…Canadian Child Care Federation: www.cccf-fcsge.ca


Preparing for Emergencies

First Aid

Babies and young children are extremely vulnerable to accidents. They are too young toassess safety risks… they lack coordination and balance… and they need to explore and learnabout the world around them. The main causes of injuries in the home are falls, burns, andpoisoning.

It’s a fact of life that emergencies happen. However, you can be prepared so that you—orsomeone else—can act quickly, rather than having to search for information or supplies whenaction is needed.

First Aid KitsA family First Aid kit is your first defence whenaccidents occur. Be ready for emergencies bypreparing First Aid kits in advance. That way, if anemergency happens, you will have everythingyou need at hand.• Keep a First Aid kit in your home and one

in each car. Keep them out of reach ofchildren.

• Bring a First Aid kit on family outings andextra prescription medication on vacations.

• Check your kits every spring.• Replace any used or expired items promptly.• Read the First Aid manual and review it with the whole family before there’s an

emergency.

What Goes in a First Aid Kit?Medications

• antiseptic (wipes or solution such as hydrogen peroxide)• antibiotic ointment• antihistamine• anti-diarrhea medication• calamine lotion• pain reliever (ibuprofen or acetaminophen—never give Aspirin to children).


Supplies• bandages (many different kinds and sizes)• instant cold packs• First Aid manual• sterile gauze (pads and roll)• disposable gloves• mouthpiece for giving CPR (available from the Red Cross)• safety pins• scissors, tweezers, and a needle• soap or hand sanitizer• thermometer.

Cardio-Pulmonary Resuscitation (CPR)

• Every parent should know how and when to administer CPR (cardio-pulmonaryresuscitation). CPR can save a baby’s life by restoring breathing and circulation untilemergency medical help arrives on the scene.

• CPR classes are offered at many hospitals, fire stations, and parenting classes. Check withthe Red Cross for locations.

Poisoning

• Medication causes an estimated 67% of poisonings in children. Even small amounts ofadult medication can be fatal to a child.

• Household cleaners and personal care products (mouthwash, nail polish) and otherhousehold products can also poison children.

If you think your child may have swallowed something harmful, call the poison informationcentre or dial 911.

Emergency Contact Numbers

• Fill out the Emergency Contact sheet at the back of this guide.• Put a copy by every phone in your house and inside your First Aid kits.• Give a Copy to anyone who may be caring for your child.

To Learn More…Canadian Red Cross: www.redcross.org

The Hospital for Sick Children: www.sickkids.ca


Emergency Contacts

Your family name:

Home telephone number:

Home address:

Nearest cross street:

Emergency Numbers

Emergency services: 911

Poison control:

Ambulance:

Fire:

Police:

Hospital emergency department:

Family doctor:

Phone number:

Dentist:

Phone number:

Pharmacy:

Phone number:

Health Insurance

Government information:

Other health insurance:

Insured’s name:

Policy number:


Family Members

Mother’s full name:

Mother’s phone numbers:

Father’s full name:

Father’s phone numbers:

Child’s full name:

Date of birth:

Blood type:

Allergies or medical conditions:


Date of birth:

Blood type:



Date of birth:

Blood type:


Emergency Contact’s Full Name

Relationship to you:

Phone number:


Notes


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