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Parents often wonder about their child’s health, leading to the frequently asked question: “Is my baby healthy and growing normally?”

These information sheets outline normal and healthy growth and developmental milestones, and common health topics for your baby.

Due to space constraints, some messages are repeated at several ages while others appear once only. Read the complete set of sheets to obtain the entire information.

The Rourke Baby Record (RBR) is a guide that many Canadian doctors and other healthcare professionals utilize for well baby and child visits for babies and children from 1 week to 5 years of age.

photo of a babies hand touching an adults hand

1 Month

Feeding & Growth

  • Breastfeeding helps protect against sudden infant death syndrome (SIDS) and may lower the risk of infections in babies. Feed your baby on-cue at least 8 times per day.
  • Other foods are not needed until your baby is ready for solids, a few weeks before to just after 6 months old.
  • If your baby is taking breastmilk, give him Vitamin D drops (400 IU/day or 800 IU/day in Northern communities). You should also take a standard multivitamin containing Vitamin D (400 IU/day) yourself while breastfeeding
  • You know your baby is getting enough milk if she has 6 to 8 wet diapers each day.
  • Breast milk can be stored for 3 - 4 hours at room temp less than 29oC (85o F), 3-5 days in your fridge, 3-6 months in a freezer with a separate door, and 6 to 12 months in a chest-type freezer below -20o C (-4o F).
  • When breastmilk is not available, give commercial, not homemade, formula, when your baby seems hungry. At this age, your baby will likely drink about 450 to 750 mL (15 to 25 oz) formula per day

Vaccinations

  • Vaccinations prevent infectious diseases that in earlier years killed many children or left them disabled for life. Each Canadian province/territory has its own schedule of funded vaccines, guided by the National Advisory Committee on Immunizations. Discuss vaccines with your healthcare professional.

Keeping Baby Safe

  • Safe sleeping: Your baby should sleep on his back, in a crib, cradle or bassinette that meets Canadian regulations, with no other items such as blankets, toys, or bumper pads. Babies should NOT share a bed with their parents or siblings, as this is linked with a higher rate of SIDS. Having the crib in your room for the first 6 months lowers the risk of SIDS.
  • Never shake your baby. This can cause serious brain damage or death. If your baby will not stop crying, and you feel like you are losing control after trying to comfort her, lay your baby in her crib and take a moment to collect yourself before trying to soothe her again.
  • To prevent falls, never leave your baby alone on her change table or other high surface.
  • To prevent burns, install smoke detectors on every level of the home. Adjust the temperature setting on your hot water tank to no higher than 49oC (120oF).
  • Carbon monoxide detectors are important if you have a car in an attached garage, or have oil, gas or wood heating, stove, or fireplace.

Development

  • At 1 month, your baby should:
    • Focus her eyes on an object.
    • Startle to loud noises.
    • Calm when she is comforted.
    • Suck well on the nipple.
  • You and your baby are getting to know each other. Cuddle, smile, talk, read and sing to him. Massage his tummy, back, arms and legs.
  • Report any concerns about your baby’s development, including her hearing and vision, to her physician or other healthcare professional.

Other Advice

  • Do not use over the counter cough/cold medications and consult your physician if your baby under 3 months old has a temperature that is 38oC or higher.
  • Using a pacifier (soother) may help soothe your baby and is associated with a lower risk of SIDS. Offer your baby the pacifier once breastfeeding is established.
  • Give your baby supervised “tummy time” for 10-15 minutes several times a day to prevent a flat head and to strengthen his neck muscles.
  • Make sure your baby is not exposed to cigarette smoke. Second-hand smoke predisposes him to childhood illnesses like coughs, colds, ear infections, pneumonia, and asthma, and increases his risk for SIDS. Ask your healthcare provider for help to quit smoking.
  • Colic occurs in up to 20% of babies. Babies with colic are healthy but have episodes of crying for no apparent reason at least 3 hours/day for at least 3 days/week for more than 1 week. It often occurs from 3 to 8 weeks of age and ends by 3-4 months. Colic has no lasting effect on your baby but can be very upsetting for you. Try cuddling, swaddling, massaging, low lights, soft music, motion (gentle rocking or car ride), pacifier, warm bath, etc. Discuss other options with your healthcare professional. Remember that colic is not your fault.
  • If you have other children, they too are adjusting to your new baby. Changes in their behaviour are common and usually normal. However, loss of their previously attained developmental milestones (e.g. speech) may be abnormal. Discuss with your healthcare professional.
  • It is normal to feel tired and sometimes sad or uncertain with a new baby. If these feelings worsen or become overwhelming, tell your family, friends, and healthcare professional.

Resources

For more information on your baby’s health, the top 5 websites cited by the RBR Parent Resources are:

  1. Canadian Pediatrics Society – Caring for Kids (www.caringforkids.cps.ca)
  2. Hospital for Sick Children – About Kids Health (www.aboutkidshealth.ca)
  3. Parachute - formerly Safe Kids Canada (www.parachutecanada.org)
  4. Dietitians of Canada (www.dietitians.ca)
  5. Health Canada (www.hc-sc.gc.ca)

Support and Acknowledgements

The RBR Parent Resources website and this series of information sheets were created by then Memorial University of Newfoundland (MUN) medical student, Dr. Laura Butler, and the RBR authors (Drs. L. Rourke, D. Leduc and J. Rourke). Two MUN Summer Undergraduate Research Awards and MUN Faculty of Medicine Office of Professional Development supported these projects. Evaluation project by Dr Aimee Holla, MUN FM Resident. 2020 brochure revisions by Dr. Anne Rowan-Legg.

Support for the RBR includes the Government of Ontario and MUN's Dr. W. Ingram Award. Licensing contributions for RBR electronic medical record use go to the MUN RBR Development Fund.

As evidence-based information is constantly changing, the Rourke Baby Record and these recommendations should be used as a guide only.

May 2020