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    1. National Version RBR
    2. Ontario Version RBR
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    4. WHO Canadian Growth Charts
      1. Explore The RBR
        1. RBR Guide 1
        2. RBR Guide 2
        3. RBR Guide 3
        4. RBR Guide 4
        5. RBR Guide 5
        6. Resources 1
        7. Resources 2
        8. Resources 3
  4. Frequently Asked Questions
  5. Parent Resources
  6. In Depth Information
    1. Current Evidence Summary
    2. Updates / Changes
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    4. Publications on the RBR
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Download RBR and Growth Charts

The Rourke Baby Record (RBR) consists of: 4 guides for charting well baby/child visits up to five years of age; an immunization chart; and 3 Resources pages.  It should be accompanied by Canadian WHO growth charts for monitoring growth.

  • Guide I: visits at up to one week, two weeks, and one month of age;
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  • Guide II: visits at two, four, and six months of age;
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  • Guide III: visits at nine, 12, and 15 months of age;
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  • Guide IV: visits at 18 months, two to three years, and four to five years of age.
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Guide V is a table for charting immunizations.

There are three sheets of Resources that accompany the RBR:

  • Resources 1: dealing with growth monitoring, nutrition, physical examination, and education and advice issues excluding those on development, behaviour, immunization and infectious diseases.
  • Resources 2: dealing with development, behaviour, and parenting resources.
  • Resources 3: dealing with immunization and infectious diseases.

 

Fonts used in the Rourke Baby Record
Three fonts are used in the Rourke Baby Record to reflect the strength of recommendation based on literature review using the classification system of the Canadian Task Force on Preventative Health Care.:

  • Good (bold type); 
  • Fair (italic type); 
  • Consensus (plain type).

 

National Version 2011 RBR
This is the generic version without province-specific modifications. For example, the national version of the RBR contains the immunization schedule as recommended by NACI (National Advisory Committee on Immunization).

 

Ontario Version 2011 RBR

The Ontario version retains the NACI immunization schedule. It differs from the national version in two places: 

  • The 18-month visit development section contains a space to record which items on the Nipissing District Development Screen™ (NDDS™) have not yet been achieved. The NDDS is freely available to Ontario healthcare providers.
  • The Early Child Development and Parenting Resource System found on the Ontario version of Resources 2 is Ontario specific.
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Download WHO Growth Charts for Canada

Canadian WHO Growth Charts are provided with the permission of the Dietitians of Canada

The release of the WHO (World Health Organization) Growth Standards and Growth References has prompted a re-evaluation of which growth charts are appropriate for monitoring and assessing the growth of Canadian children. Promoting Optimal Monitoring of Child Growth in Canada: Using the New WHO Growth Charts, a practice guideline for health professionals, was developed collaboratively by Dietitians of Canada, Canadian Paediatric Society, The College of Family Physicians of Canada and Community Health Nurses of Canada. The project includes the full report, executive summary, health professionals’ guide, questions and answers for health professionals and for parents, and set of WHO Growth Charts adapted for the primary health setting for Canada.

The WHO Child Growth Standards were released in April 2006 and were developed using data collected in the WHO Multicentre Growth Reference Study.http://www.who.int/childgrowth/en/ This study followed more than 8,000 children from six countries (Brazil, Ghana, India, Norway, Oman, USA) who were raised under optimal health conditions (exclusive or predominantly breastfed for more than four months, complementary foods by six months, continuation of breastfeeding until at least 12 months, immunized, receiving healthcare, nonsmoking environment). Under these optimal conditions there were only 3% intersite differences, and thus the WHO Child Growth Charts may be used in children of different racial backgrounds. As these WHO growth charts are based on optimal health conditions, they are called growth standards.

In versions of the RBR prior to 2009, the growth charts used were from the United States Centers for Disease Control and Prevention (CDC). http://www.cdc.gov/nchs/about/major/nhanes/growthcharts/clinical_charts.htmThese CDC growth charts are based on the growth of American children without controlling for optimal health conditions and are better called growth references rather than growth standards.

Use of the WHO growth charts results in different prevalence of underweight, overweight and obesity:

  • 0 - 6 months: WHO charts reflect a heavier sample - due to faster initial rate of weight gain in breastfed compared to formula fed infants, and thus one might expect to see:
    • Higher rates of under-nutrition
    • Lower rates of overweight and obesity
  • Over 6 months: WHO charts reflect a taller lighter sample- due to slower rate of weight gain in breastfed and ideally nourished children, and thus one might expect to see:
    • Lower rates of under-nutrition
    • Higher rates of overweight and obesity

 

 

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© Leslie Rourke, Denis Leduc, and James Rourke, 2011.