1. Home
  2. Background
    1. Authors
    2. Support & Acknowledgements
  3. Download RBR & Growth Charts
    1. National Version RBR
    2. Ontario Version RBR
    3. WHO Canadian Growth Charts
  4. 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
  5. Frequently Asked Questions
  6. Parent Resources
  7. In Depth Information
    1. Current Evidence Summary
    2. Updates / Changes
    3. Literature Review for the RBR
    4. Publications on the RBR
  8. Questionnaire on RBR and website
  9. Contact Information
  10. Disclaimer
  11. Fair Use Authorization
Home | RBR Downloads | Explore The RBR | In Depth Information

Changes in the Rourke Baby Record

Highlights of Changes in the 2011 Rourke Baby Record

A version of the 2011 national English RBR highlighting all the changes from the previous edition can be downloaded for viewing here. Changes in content in the 2011 RBR are shown in magenta (pink) print and new web links in the 2011 RBR are in green print.

Growth

  1. Growth monitoring: the strength of the evidence has improved from fair to good with use of the WHO growth charts.
  2. "Regains birth weight between 1 and 3 wks" has been added to the 2 week visit.

Nutrition

  1. Change from bottle to cup discussion occurs earlier at 9 months.
  2. Vegetarian diets: new topic and resources.  
  3. Breastfeeding mothers are advised to continue vitamin D supplements for the duration of breastfeeding.
  4. New resources on:
    - infant formulas,
    - medications during breastfeeding,
    - mercury in fish.

Education and Advice

  1. Safe sleep wording expanded to include:
    - advice against using sleep positioners,
    - stronger advice against bed sharing,
    - cradle and bassinette safety statement.
  2. Lead screening risk factors and resources expanded.
  3. Children entering foster care: new topic and resources.
  4. Updated resources on:
    - health and the environment,
    - shaken baby syndrome,
    - fetal alcohol spectrum disorder.

Physical Examination

  1. Fontanelle examination and closure wording has been clarified.
  2. Hip exam recommended until at least one year of age, or until the child can walk.
  3. Obstructive sleep apnea wording includes the presence of snoring.

Investigations/Screening

  1.  Premature infants: included in the at-risk group for anemia screening.
  2.  Universal newborn hearing screening: included with good strength of evidence.


Immunization/Infectious diseases

  1. Immunization pain reduction strategies and resources: included with good strength of evidence.
  2. Immunization info web links for parents and physicians have been expanded.
  3. Rotavirus vaccine has been added to the RBR Immunization chart (Guide V) along with resources.
  4. Varicella vaccine schedule has been updated on the RBR Immunization chart (Guide V).
  5. Statements have been updated for:
    - varicella vaccine,
    - pneumococcal conjugate vaccine,
    - meningococcal conjugate vaccine.

Miscellaneous

  1. One month visit is no longer optional: to insure adequate growth, nutrition and parent adjustment.

Changes in the 2009 Rourke Baby Record 

Rourke L, Leduc D, Constantin E, Carsley S, Rourke J. Update on well-baby and well-child care from 0 to 5 years: What’s new in the Rourke Baby Record? Canadian Family Physician 2010; 56: 1285-90.

 

Rourke Baby Record: 2009 edition - Summary of major changes from the 2006 RBR

General

  1. No major format changes.
  2. Same endorsement by the CFPC and CPS as for the 2000 and 2006 editions of the RBR.
  3. Web links updated.
  4. Paper hard copies are no longer being distributed by McNeil Consumer Healthcare. The 2009 edition of the RBR may be downloaded from the Rourke Baby Record website (www.rourkebabyrecord.ca) and from various organization websites such as the CFPC and CPS.
  5. See the Rourke Baby Record website (www.rourkebabyrecord.ca) for pending updates including proposed new section for literature review with levels of evidence and new section for parent resources.

Growth

  1. Change from the CDC 2000 growth charts to the WHO 2006 growth standards.
  2. Update in recommendations for correction of growth measurement for premature infants.

Nutrition

  1. Addition of suggested daily volumes of milk intake as an approximate guide at different ages.
  2. Update re vitamin D supplementation.
  3. Change in the recommended fat content in milk given to 2 to 5 year olds.
  4. New recommendations on the indications for using soy-based formula.

Education & Advice - Anticipatory Guidance

Injury prevention issues

  1. Update in information/evidence regarding transportation in motor vehicles, bicycle helmets, hazards re choking and falls, aspects of water safety.
  2. Clarification of safe sleeping terminology.

Behaviour/Family/Development issues

  1. New guidelines for screening for autism spectrum disorder including use of the MCHAT.
  2. Update in information/evidence regarding non-parental childcare, facilitating literacy, and crying and the risk of shaken baby syndrome.
  3. The inclusion of recommendations for infant swaddling and on parenting programs.

Other issues

  1. Update in information/evidence regarding pacifiers, antipyretics, insect repellents, and dental care/oral health statements.
  2. New evidence and recommendations on OTC cough/cold medications and on serum lead levels

Development Milestones

  1. External reviews of levels of evidence for various developmental milestone items with subsequent revision of some items.
  2. Update in recommendations for correction of developmental milestones for premature infants.

Physical Examination

  1. Revision in level of evidence for vision screening and for screening for developmental dysplasia of the hips.
  2. New evidence and statements on hearing screening including universal newborn hearing screening.
  3. Clarification of the expected norms for fontanelle examination.

Immunization

  1. Update of immunizations as per NACI recommendations.
  2. New evidence and statements on rotavirus vaccine.
  3. Updated schedule for meningococcal vaccine.
  4. New resources for parents regarding immunizations.

2009 Rourke Baby Record: National and Ontario versions
As in the 2006 edition, the only differences between the Ontario and National versions of the 2009 edition of the RBR are found on Guide IV and its reverse (Healthy Child Development Selected Guidelines/Resources)

  1. On the Ontario version, the 128 month visit development section includes the following statements not on the national version:
    "Enhanced inquiry after Nipissing Developmental Screen™ (NDDS™)**
    List NDDS™ items not yet attained: _______________"
  2. 2. The 2009 Early Child Development and Parenting Resource System found on the reverse of Guide IV (Healthy Child Development Selected Guidelines/Resources) are either national or Ontario specific.

Changes in the 2006 Rourke Baby Record

The major changes to the September 2000 version found in the May 2006 version of the Rourke Baby Record are as follows:  

  • Expansion of visits from 3 guides to 4 to allow more writing space, with an optional 15-month visit to accommodate some immunization preferences/schedules.
  • Major emphasis on the 18-month visit as a critical time for assessing development.
  • Use of the Centers for Disease Control’s full-page growth charts.
  • Creation of an immunization chart to more easily document immunization.
  • Reorganization of the Education & Advice section to avoid omitting issues if a visit is missed.
  • Incorporation of selected evidence-based environmental, literacy, and healthy active living issues.
  • More detail on child development, including new evidence-based information on the reverse of Guide 4.
  • Incorporation of web-based resources for further information.

Disclaimer | Fair Use Authorization

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