Early child development and experiences, both positive and negative, affect not only future learning but also physical, mental, and emotional health throughout life. Preventive care and health supervision for infants and children in the first few years of life are thus increasingly important, especially with respect to healthy child development and future health outcomes.

The Rourke Baby Record (RBR) is an evidence-based health supervision guide for physicians and other health care providers who provide care for children in their first five years of life.

The 2020 version of the RBR includes important updates such as:

• graphic design changes to enhance legibility, readability, and navigation
• guides to the early introduction of allergenic foods to high-risk infants
• advice to screen for iron-deficiency anemia in high-risk infants and toddlers
• counsel on limiting consumption of foods and beverages high in sugar as well as highly processed foods high in dietary sodium
• recommendations on injury prevention
• counsel that swaddling is contraindicated once a baby shows signs of attempting to roll
• counsel on the removal or safe storage of firearms and cannabis edibles
• effects of climate change on children, including increased air pollution; the physical and mental effects of natural hazards and extreme weather events; and infection risks associated with insects such as ticks
• updated recommendations for diagnosis and management of Autism Spectrum Disorder
• new Canadian Caries Risk Assessment Tool to help promote oral health
• physical examination recommendations to detect early signs of cerebral palsy.

A complete list of updates and supporting evidence can be found on the Rourke Baby Record website. You can download your own copy of the RBR for use in your practice in various formats here. Be sure that your EHR has the most up-to-date version.

The latest 2020 RBR revision was developed by myself and Dr. James Rourke, as well as family physicians Drs. Bruce Kwok and Imaan Bayoumi, and pediatricians Drs. Denis Leduc, Patricia Li, and Anne Rowan-Legg. Our team was assisted in the evidence review process by the McMaster Evidence Review and Synthesis Team. The RBR is endorsed by the College of Family Physicians of Canada, Dieticians of Canada, and the Canadian Pediatric Society and is supported by the Government of Ontario.

If you practice in Ontario, the RBR plays an essential role in Ontario’s Enhanced 18-Month Well-Baby Visit. Machealth offers two free, certified courses and other important resources to provide everything you need to organize an effective visit in your practice. These courses have been updated, providing you with everything you need to implement the enhanced visit in your practice, including a hands-on introduction to the use of the Looksee Checklist and the Ontario version of the Rourke Baby Record with interactive patient case examples. Both courses are available in English and French.

At your 15-month visit, encourage parents to check out the 18-Month Well-Baby Visit Planner, a quick 5-10 minute guide that helps parents consider and prioritize potential concerns they may have, making them fully prepared for their next visit with you.

To further support child development, you can refer parents to Play&Learn, another free resource that hosts 70+ expert-reviewed games and play-based activities. These games are designed to help children practice and develop their skills at home across four developmental domains: thinking and learning, social and emotional, language and movement.