Preschool

This is an article explaining and updating a tool used in many Canadian practices that care for babies and their mothers. The actual Baby Record can b downloaded free at https://www.rourkebabyrecord.ca

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Objective: To assist busy primary care providers caring for infants and young children and their families by providing them with the most recent recommendations and supportive evidence included in the 2024 edition of the Rourke Baby Record (RBR).

Quality of evidence: Articles from pediatric preventive care literature (January 2019 to March 2023) were reviewed for relevance and quality of evidence. When available, evidence from systematic reviews, relevant clinical guidelines, and clinical trials were incorporated. In the absence of high-level evidence, observational studies and expert opinion on the topic were included. Primary research studies were reviewed and critically appraised using a modified protocol.

Main message: Notable updates in the 2024 edition of the RBR include the promotion of early relational health for families; identification of targeted support and resources as opposed to labelling of high-risk groups; guidance on culturally safe care; clarification and evidence-based adjustments of the age of achievement of some developmental surveillance milestones; recommendations on plant-based beverages, vegetarian, and vegan diets; screening considerations for iron deficiency; dangers of ingestion of button batteries and cannabis edibles; literacy and socioemotional benefits of reading, singing, and storytelling; the importance of unstructured outdoor play; the environment's effect on children's health; the significance of sentinel injuries; acholic stools; and the normal presence and abnormal persistence of developmental (primitive) reflexes.

Conclusion: Building on its 40-year history, the 2024 RBR provides freely available, evidence-informed recommendations to guide clinicians in providing effective, up-to-date, and comprehensive preventive pediatric care. Despite the challenging and evolving landscape of primary health care delivery, the RBR will continue to support primary care providers.

Author/s:

Anne Rowan-Legg, Patricia Li, Bruce Kwok, Leslie Rourke, Denis Leduc, James Rourke, Imaan Bayoumi

2024 edition of the Rourke Baby Record

Hope Smashey — Sat, 13 Sep 2025 19:21:20 +0000

Date Added:

September 13, 2025

Journal/Publication:

Canadian Family Physician

Publication Date:

September 13, 2025

Issue:

Volume:

Pages:

553-561

URL:

2024 edition of the Rourke Baby Record

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.46747/cfp.7109553

Keywords

child

infant

Baby

PMID (1):

40940145

MeSH

Culturally Competent Care

primary health care

Vegetarians

Eating

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Author/s:

Anne Rowan-Legg, Patricia Li, Bruce Kwok, Leslie Rourke, Denis Leduc, James Rourke, Imaan Bayoumi

Acid Suppression and Antibiotics Administered During Infancy Are Associated with Celiac Disease

Aubrey Delammermore — Sat, 22 Oct 2022 05:00:00 +0000

Date Added:

October 22, 2022

Journal/Publication:

The Journal of Pediatrics

Publisher:

Elsevier

Publication Date:

October 17, 2022

URL:

Acid Suppression and Antibiotics Administered During Infancy Are Associated with Celiac Disease

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1016/j.jpeds.2022.10.013

Keywords

Infancy

Retrospective Studies

children

prescriptions

celiac disease

PMID (1):

36265574

MeSH

celiac disease

International Classification of Diseases

anti-bacterial agents

proton pump inhibitors

child

Preschool

Another reason to exercise care when prescribing acid suppression and antibiotics in young children. James W. Mold, MD, MPH

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Objective
To investigate why certain at-risk individuals develop celiac disease, we examined the association of proton pump inhibitors (PPI), histamine-2 receptor antagonist (H2RA), and antibiotic prescriptions in the first six months of life with an early childhood diagnosis of celiac disease.
Study design
A retrospective cohort study was performed using the Military Healthcare System (MHS) database. Children with a birth record from October 1, 2001- September 30, 2013, were identified. Outpatient prescription records were queried for antibiotic, PPI, and H2RA prescriptions in the first 6 months of life. Cox proportional hazards regression was used to calculate the hazard ratio (HR) of developing CD based on medication exposure. ICD-9 codes identified children with an outpatient visit for celiac disease.
Results
968,524 children met inclusion criteria with 1,704 cases of celiac in this group. Median follow up for the cohort was about 4.5 years. PPI’s (HR, 2.23; 95% CI, 1.76-2.83), H2RA’s (HR, 1.94 95% CI, 1.67-2.26) and antibiotics (HR 1.14 95%CI 1.02-1.28) were all associated with an increased hazard of celiac disease.
Conclusion
There is an increased risk of developing celiac disease if antibiotics, PPI’s and H2RA’s are prescribed in the first 6 months of life. Our study highlights modifiable factors such as medication stewardship that may change the childhood risk of CD.

Author/s:

Boechler, M., Susi, A., Hisle-Gorman, E., Rogers, P. L., Nylund, C. M.

Association of use of cleaning products with respiratory health in a Canadian birth cohort

Brian Desmarais — Tue, 18 Feb 2020 16:35:59 +0000

Date Added:

February 18, 2020

Journal/Publication:

Canadian Medical Association Journal

Publication Date:

February 18, 2020

Issue:

Volume:

192

Pages:

E154-E161

URL:

Association of use of cleaning products with respiratory health in a Canadian birth cohort

Type:

Clinical Research Results

Format:

Article

DOI (1):

https://doi.org/10.1503/cmaj.190819

Keywords

MeSH

Perhaps it is a combination of excessive cleanliness and exposure to the cleaning products that increase the risk of asthma in children. James W. Mold, MD, MPH

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Abstract

BACKGROUND: Comprehensive longitudinal studies are important for understanding the complex risk factors, pathways, exposures and interactions that lead to the development and persistence of asthma. We aimed to examine associations between use of household cleaning products in early life and childhood respiratory and allergic disease using data from the Canadian Healthy Infant Longitudinal Development (CHILD) Cohort Study.

METHODS: We summed responses from parental questionnaires that indicated the frequency of use of 26 household cleaning products in the homes of 2022 children from this birth cohort when they were 3–4 months of age to create a cumulative Frequency of Use Score (FUS). We used multivariable logistic regression models to assess whether frequent compared with less frequent use was associated with recurrent wheeze, atopy or asthma diagnosis, as defined by the questionnaire and clinical assessments at age 3 years. Data were collected between 2008 and 2015.

RESULTS: Children in homes with a higher frequency of use of cleaning products in infancy, as determined by an interquartile range increase, had higher odds of recurrent wheeze (adjusted odds ratio [OR] 1.35, 95% confidence interval [CI] 1.11–1.64), recurrent wheeze with atopy (adjusted OR 1.49, 95% CI 1.02–2.16) and asthma diagnosis (adjusted OR 1.37, 95% CI 1.09–1.70), but no increase in the odds of atopy at age 3 years (adjusted OR 1.14, 95% CI 0.96–1.35). Compared with the lowest tertile of FUS exposure, infants in the highest tertile had higher odds of acquiring asthma. Stratification of the results showed that females had higher ORs than males for all outcomes, although the p values for this sex difference did not reach statistical significance.

INTERPRETATION: Frequent use of household cleaning products in early life was associated with an increased risk for childhood wheeze and asthma but not atopy at age 3 years. Our findings add to the understanding of how early life exposures to cleaning products may be associated with the development of allergic airway disease and help to identify household behaviours as a potential area for intervention.

Author/s:

McCandless, L., Parks, J., Dharma, C., Brook, J., Turvey, S.E., Mandhane, P., Becker, A.B., Kozyrskyj, A.L., Azad, M.B., Moraes, T.J., Lefebvre, D.L., Sears, M.R., Subbarao, P., Scott, J., Takaro, T.K.