dr. nutter's list of suggested resources - by topic:

Food allergy prevention (last updated February 2022)

Food allergy vs intolerance

Allergy Check app is an assessment tool re: likelihood child has a food allergy

Anaphylaxis Emergency Action Plan (includes photos/instructions on how to use an Epipen)

Insect sting allergy: resources

Allergic rhinitis (hay fever)

Anxiety Canada "MindShift" app (download here)

Create a My Anxiety Plan & try these Everyday Activities to Ease Anxiety and other calming tools

Psychoeducation, resources from Anxiety Canada & BC Children's

How to manage stress, coping strategies

Why is sleep so important? Track your child's sleep habits using this sleep diary

Physical activity: regular exercise & time outside in nature helps decrease anxiety: physical activity tips

BC Children's SSRI medication factsheet
Find a Psychologist in BC-search by city 

A note about MINDFULLNESS:

Mindfulness is the art of being present & aware of what's happening right here & now in a non-judgmental way. There are many different ways to be mindful including meditation, breathing exercises, going for a walk in nature, etc. The best way to teach mindfulness is to practice it yourself and to talk about it with your child. Stress, worries or feelings of anxiety can get in the way of doing what you want/need to do and mindfulness can help a child be more aware of their feelings so they learn to act on them in socially appropriate ways (ie. stop & become more aware of the feelings of others , interact with empathy & respect).

Mindfulness 101 and relaxation exercises 

Cognitive Behavioral Therapy: link between thoughts. feelings & behaviors, thinking traps

Smiling Mind app (download here) is a great resource for children struggling with anxiety; promotes mindfulness through breathing exercises, guided imaging and other practices to relax the body and mind (which helps reduce stress & anxiety). BCCH also offers a free Breathr app (download here)

Kelowna Family Y: YMCA offers meditation classes, Teen Mindfulness Group: 7-week program: 13–18yo

Confident Parents, Thriving Kids telephone-based parent coaching program (requires a referral)

Asthma Canada & Sick Kids Asthma Hub

Guide for families/caregivers from BC Children's; handout (Child Health BC)

Asthma Action Plan with instructions on how to use an MDI/aerochamber

Smoking increases your kids (and your) risk of upper respiratory infections AND it also makes it harder to heal after infections when they (you) are sick. Even if you only smoke outside, the smoke particles remain in your clothing and exposure to second-hand smoke can trigger flares.

If you don't want to quit for yourself, quit for your kids! Check out BC's free QuitNow program.

Autism is a social-communication difference ie. a different way of communicating/interacting; some may have have language delays  (but not all) as well as repetitive, restrictive or intense interests, behaviors. 

Every child is different. Every child with autism is different.

Autistic children may struggle to communicate how they're feeling in expected ways (ex. when stressed they can quickly go in "fight or flight" mode ie. get angry, shut down or hide/run away). They may struggle to recognize and/or understand  how they're feelings or recognize / understand other people’s intentions, feelings (they may miss social cues, struggle to interpret tone of voice, facial expressions), poor perspective-taking. Some children have very specific or intense interests, be highly sensitive, rigid (struggle with transitions, unpredictability, change/loss of routine, meeting new people/going to new places, etc.).

NOTE: boys are diagnosed 4x more often than girls; unfortunately girls are often diagnosed years later compared to boys (if they are ever diagnosed) as they often present with more subtle features, mask their social challenges & internalize more (high anxiety), sensory processing challenges, social 'burnout' & fatigue, meltdowns more often at home (no longer has capacity to 'mask' after a full day at school).

Early screening, diagnosis and timely intervention helps improve the development & future outcomes in children with ASD. Early intervention can help autistic children learn how to manage feelings, self-regulate, respond/cope in stressful situations & social skills training can improve social communication skills (an important part of childhood development and future lifelong relationships, job success ex. team work, etc.).

GPs and specialists can refer children for a public ASD assessment (IHCAN); parents can also choose to pay for a private assessment with a qualified professional (often a Child Psychologist with specialized training).

ACT-Autism Community Training provides info about the assessment process, treatment & support in BC. Variety can help families cover the cost of a private autism assessment (check eligibility criteria). 

Autism BC has lots of helpful resources including the "waiting for assessment" workshop, how to prepare before an assessment, next steps after a diagnosis & how to build a support team: see RASP provider list

General information: see Kelty Mental Health's resources & Sick Kids Autism Hub

Evidence-based treatments, webinars: Social Thinking, courses & complementary approaches

Help prepare your child so they know what to expect beforehand (ex. Boston Children's visual stories, or Carol Gray's social stories, or make up your own).

Behavioral Challenges:

Tracking and understanding behavior template

Managing anxiety, irritability, challenging behaviors, anger

PDA (Pathological Demand Avoidance) profile & helpful tips for parents

Autism Speaks Toolkits: visual supports, toilet training guide, challenging behaviors, tips to improve sleep

Regular exercise & time outside in nature helps regulate children: physical activity tips

Sensory Processing Challenges:

Read this comprehensive handout with practical tips re: different sensory needs

Helpful sensory behavior tracking tool

Information on interoception & strategies

Find an Occupational Therapist (search by city)   

Kelly Mom website

Dr. Jack Newman Breastfeeding Centre

Which medications are safe during breastfeeding? 

Children's Oncology Group has reliable information to help guide families starting from the initial diagnosis through to treatment and follow-up care and tips for coping with cancer

BCCH resources: congenital heart disease

What are benign or innocent murmurs?

PURPLE crying (a must read for all new parents)

Parent guide and a guide for adolescents

BC Centre for Ability program & more resources

Use the free "Concussion Ed" app to record symptoms, support recovery

CATT: Concussion Awareness Training Tool  (for youth, coaches, parents/caregivers, teachers)

CHEO's constipation guidelines

Encopresis "The Poo in You" video-GI Kids

Restoralax (PEG3350) stool softener

Drink water and eat a high fibre diet

Depression & suicide prevention factsheet

Cognitive Behavioral Therapy: understanding the link between thoughts, feelings & behaviors

BCCH's Kelty Mental Health resources including how to manage stress, helpful coping strategies

What is mindfulness? See list of mindfulness resource , mindfulness 101 and relaxation exercises 

Cognitive Behavioral Therapy: link between thoughts. feelings & behaviors, common thinking traps 

The Smiling Mind app (download here) - a great resource with exercises that promote mindfulness (breathing exercises, guided imaging and other practices to relax the body & mind to help reduce stress)

Sleep is important for both mental and physical health: keep track with a sleep diary

BCCH antidepressant medication factsheets

Find a Psychologist-search by city

COMMUNITY RESOURCES:

Kids Help Phone (ages 5-20): 1-800-668-6868 to speak with a counsellor 24/7 or 1-800-784-2433

Child & Youth Mental Health: CYMH offers walk-in intake appointments for children of all ages (no referral needed however if <5yo parents must call ahead & book an appointment) 

The Foundry Kelowna offers services for youth aged 12-24 and their caregivers (either by drop-in or you can also schedule virtual counselling appointments, find peer support, access primary care, groups & workshops). Download the Foundry's app & explore suggested apps/tools

Society for Pediatric Dermatology - search by topic

Handouts / tips for common issues in children:

• Diaper rash
• Eczema
• Vulvovaginitis

See handout with expected milestones by age (2 months to age 5); adapted milestones for premature infants

Download the free CDC milestone tracker app here

New community pilot project: Family Connections Centre (FCC): offers individual & group-based prevention, treatment and support services designed to help families with children, youth (0-18yo) with various developmental support needs; they offer a range of supportive therapies (SLP, OT, PT, Behavioral Intervention) and educational workshops, parenting support groups. A diagnosis is not required to access services. Parents can fill out a referral form online, call 778-760-1445 or email fcc@arcprograms.com

Specific tips/resources for children with speech and language delays:

1. Check your child's hearing (parents can self-refer to Public Health or arrange a private hearing test)

2. Consult a Speech Language Pathologist (parents can self-refer to Public Health, FCC, hire private SLP)

3. Follow these speech tips/exercises from Toronto Public Health (can translate using google translate)

BCCH tips: diabetes management

Sick Kids Hospital resources 

Sick Kids ENT resources: ear infections, strep throat, croup, nosebleeds, etc.  

Diagnoses of anorexia nervosa, bulimia nervosa, binge eating disorder and unspecified eating disorders have increased significantly worldwide. Many cases go undetected and untreated which is why it is important for families to be familiar with the signs and symptoms and available supports for these devastating disorders:

NEDA parent toolkit, NEDIC, BCCH's Kelty Eating Disorders

Parent cheat sheet (what to do and what not to do), meal coaching tips (for parents)

Information on body image & eating disorders

Peer support: Looking Glass and Jessie's Legacy

Sick Kids information on coughs, fever, common injuries: sprains, strains & fractures

What to do if your child has a seizure?

What is epilepsy?

Information on febrile seizures & what all parents need to know about fever 

Prenatal alcohol exposure, even at low levels, is known to have the potential to cause physical and neurocognitive deficits long-term. Confirmation of prenatal alcohol exposure for an FASD diagnosis can be challenging; some children may not meet all diagnostic criteria; some children may be diagnosed with Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure. 

Helpful resources: Asante Center, outreach, support for families

Key Worker support and POPFASD

Fever is associated with common viral infections (like the flu) and helps the immune system fight disease. Fever-reducing medications (like Tylenol) are strictly for comfort (won't cure or shorten illness). 

Learn about fever  (38 degrees Celsius or higher) & how to measure your child's temperature: handout

Infants (<3months) with fever MUST get an assessment (even if it's the only symptom) to avoid missing a potentially serious bacterial infection like sepsis/meningitis which requires urgent treatment/antibiotics.

Keep track of pain: Abdominal Pain Journal

Watch these helpful videos (explains procedures such as colonoscopy, endoscopy & GI issues: EoE, GERD, IBD, cyclic vomiting, functional GI problems, Sick Kids hub: GI disorders, Celiac Hub

GERD/reflux with specific tips by age (NASPGHAN handout)

Cow's Milk Protein Allergy (CMPA) or food protein-induced allergic proctocolitis (FPIAP), affects up to 17% of infants, primarily those under 1 year old. It is caused by an immune response to proteins found in cow's milk (sometimes eggs, soy). More common in infants with a family history of eczema or food allergies. 

See McMaster handout: what to eat while breastfeeding when your baby has a cow's milk protein allergy?

Canadian Milk Ladder (milk re-introduction) guideline

Keep track: My Headache Diary

Download the "Migraine Trainer" app here

CHEO's migraine handout, BCCH migraine guideline & more info

National Headache Foundation resources (includes: abdominal migraine, cyclic vomiting)

Helpful resources from Sick Kids & videos

Learning Disability association of BC resources

Psychoeducational assessments help identify areas of strength and need, suggest recommendations & accommodations in the classroom (and at home) and should be repeated every 3-4 years (ie. before Middle School, High School). Recommended if the following is suspected:

• Specific Learning Disability in reading (dyslexia), writing (dysgraphia) and/or math (dyscalculia)
• Intellectual Disability (mild, moderate, severe/profound)
• Giftedness

Current waitlists to get a psyched assessment via the public school system = extremely long. Parents often  arrange a private assessment (no referral needed; private insurance can help cover some of the costs). 

Variety will fully fund cost private assessment up to age 18 (as long as family meets their eligibility criteria).

Info on kidney disease, CKD, cysts, single kidney, kidney stones & high blood pressure

Feeding your child with love and good sense: tips from the Ellyn Satter Institute

Sick Kids Hospital nutrition hub & "Live 5-2-1-0" healthy lifestyle guideline

Generation Health is a FREE program for families with children ages 8-12 years old offered in communities across B.C. The program supports participants to make family changes re: Healthy Eating, Physical Activity, Wellness, Screen Time, and Sleep. At least one parent or caregiver must attend the sessions with the child. The program is offered both Virtually and In-Person in many communities across BC. If your child is not within the age range or if the schedule doesn't work - here's a link to their self-directed online course.

General tips on feeding your baby in the first year

How to improve your child's iron intake

How to calorie boost (1st year) & in children > 1year, teens

What to do when unwanted thoughts, repetitive behaviors take over: NIMH

Tools for parents, Anxiety Canada OCD tips, International OCD Foundation

Sick Kids website: eye conditions, first aid

Vision Therapy? (Canadian Ophthalmological Society)

Acute vs chronic pain

Video that explains chronic pain

Coping; help your child get active again

Effective parenting for children with chronic pain for young children, older children and teens

Teens can download and use the free WebMAP Mobile self-management app (Seattle Children's)

MyCarePath is Pain BC’s free online tool to help youth aged 12-17 who live with chronic pain

Self-care pyramid: parents/children - make sure everyone's basic needs are met first

Video: why we lose control of our emotions (for elementary-aged children)

Parenting tips: managing challenging behaviors using positive discipline and empathy

Child Psychologist Dr. Laura Markham: website & books - positive parenting tips

Mindfulness: list of helpful resources

Triple P & The Incredible Years programs

Consult a Counsellor, Psychologist or Occupational Therapist

Helpful tools for PARENTS:

• Free The Happy Child parenting app
• How to have more positive conversations with your kids
• Mind Masters: activities to improve your child's emotional regulation
• Zones of Regulation (often used in school)

Pharmacy Compass: compares medication costs at different pharmacies; although cost is not always the most important factor in choosing where to fill your prescriptions.

It is important to make sure that you choose a pharmacist that you trust and who helps you to understand your medications and how to take them most effectively.  

Living Without a Diagnosis: roadmap, navigation tools for families

Info on specific rare diseases, NORD's rare diseases database 

Parent & community support

Parachute charity: injury prevention

Prevent unintentional cannabis poisoning

Safety tips: babyproof your home, information on car seats & helmets

Summer safety tips: playing in the sun or water, travelling or exploring nature (ex. burn prevention, poison ivy, insect/tick bites and wildfire smoke tips) and winter safety

Numerous studies have found links between negative mental health effects in teens and an increase in social media use, including depression, anxiety and low self-esteem.   

Technology is changing childhood. Screen use can become addictive; children to resist doing homework or other tasks to stay online. Playing outdoors, spending time with friends, reading books and hanging out with family is happening a lot less often to make room for hours of snap chatting & watching YouTube. 

Screen time recommendations for young children & school-age children, teens

Up to 95% of youth ages 13–17 report using a social media platform, with >1/3 reporting they use social media “almost constantly.”  In the U.S., nearly 40% of children ages 8–12 use social media. Video games, social media and smartphones simultaneously provide both connection & disconnection. Technology is an inescapable — and important — facet of everyday life. 

Dr. Vivek Murthy (U.S. Surgeon General) recently issued a landmark advisory on the impact of social media stating “it can have a profound risk of harm to the mental health and well-being of children and adolescents; in early adolescence, when identities and sense of self-worth are forming, brain development is especially susceptible to social pressures, peer opinions and peer comparison. Children are particularly impacted by too much exposure to apps such as TikTok and Instagram." 

Wait Until 8th pledge empowers parents to delay giving their child a smartphone until at least 8th grade.

Keep your family connected in a digital world

Support healthy screen & videogame use

FBI safe online surfing, NetSmartz, Thorn, safety tips, watch the Childhood 2.0 documentary here  

The transition between youth and adulthood can be overwhelming; young adults face new experiences, challenges & pressures. See: parent guide & red flags to be aware of. Open Mind BC also has helpful info.

Most girls start puberty between 8 to 13 years old. Most boys start puberty between 9 and 14. It can also be normal to start earlier or later. Hormones (chemical messengers) from the brain trigger the start of puberty:

In males: the hormones tell the testicles to make testosterone & sperm

In females: the hormones tell the ovaries to make estrogen & trigger the growth/release of eggs

Other puberty hormones come from the adrenal glands, a pair of glands that sit at the top of the kidneys. These hormones lead to the growth of pubic and underarm hair, body odor, and acne.

MALES:

The physical changes of puberty usually starts with the testicles getting bigger. Dark, coarse, curly hair will sprout just above the penis and on the scrotum. The penis and testes will get larger, and erections happen more often. Ejaculation (the release of sperm-containing semen) also happens. Ejaculation during sleep is called a “wet dream” or nocturnal emission. Later, hair will grow under the arms and in the beard area. And that first crack in the voice is a sign that the voice is changing and will get deeper. Their body shape begins to change as their shoulders broaden and they gain weight & muscle. A growth spurt usually happens between ages 12 and 15. By age 16, most males have stopped growing; their muscles will continue to develop.

FEMALES:

The first physical change of puberty is usually breast development. It starts with small, firm, tender lumps (called buds) under one or both nipples. The breasts will get larger over the next year or two. Dark, coarse, curly hair will appear on the labia (the folds of skin surrounding the vagina). Later, more hair will grow in the pubic area and under the arms. Their body shape begins to change as their hips widen and they gain weight and body fat. Expect the first period (menstruation) about 2 years after breast buds appear, usually sometime between the ages of 9 and 16. Most females have a growth spurt about 1–2 years before their period starts. After they get their period, most females grow about 1–2 more inches before growth stops.

At birth, the ovaries contain all the eggs they will ever have. When the time comes to begin puberty, the pituitary gland in the brain signals the ovaries by releasing two hormones (FSH and LH). Ovaries secrete estrogen and progesterone. Normally, during a monthly menstrual cycle, one egg matures and is released from the ovaries. If the egg is not fertilized, menstruation begins. The cycle then repeats about every 28 days. With each menstrual cycle, the supply of eggs decreases. When most of the eggs are depleted from the ovaries, menopause begins (avg age 51), menstrual cycles eventually stop (ovaries stop releasing hormones).

The emotional changes of puberty can be challenging for kids & their parents. Try to support your child and not take it personally as they go through these changes. Your child may:

• be very focused on the way they look and dress
• care a lot about what their peers think about them
• become moodier
• want more privacy
• focus more on their friends rather than family
• show less affection toward parents

This is also the time when kids feel more peer pressure. Talk to your child about choices they will face about drinking, smoking, drugs, and sex. They might not seem like they’re listening, but your opinions and choices do matter. Watch for signs that your child may need your help. 

Puberty can be a time when things like anxiety, depression, and eating disorders show up. Talk to your child about strong feelings and help them develop ways to deal with stress: 

Mental health resources, info on self-harm, vaping and marijuana (for parents)

Sick Kids Hospital sexual health & puberty HUB and Adolescent Health for preteens & teens

SEXUAL & REPORDUCTIVE HEALTH:

Sexual & reproductive health: info on contraception, sexual orientation, gender identity, etc. 

Resources (for kids and their parents - by age) 

Contraception resources from the Society of Obstetricians & Gynecologists of Canada website; choosing the right birth control can be overwhelming; the "It’s a Plan" tool can help

Discuss your options with your GP or the "At Your Cervix" women's contraceptive clinic offers general contraceptive counselling as well as intrauterine devices (IUD) insertions.

Toddlerhood can be a particularly challenging time: toddlers want to be independent & gain new skills, they're developing rapidly but they're also still dependent on their parents which can lead to tantrums and testing boundaries. See Sick Kids Hospital toddler HUB  (for parents).

Changes in routine and conflict between parents can be confusing and frightening; toddlers are often very sensitive to their parents' feelings so they can become upset when their parents are upset. 

TIP: young children / toddlers (as well as older children & adults!) thrive on routine/following a consistent schedule. Remember: a child is doing their best in that moment; if they're having challenging behaviors they're "not trying to give you a hard time - they're having a hard time" ie. behavior is telling you something; they still need your support to get their needs met (ex. overtired, hungry, overstimulated / need a break). 

Challenging behaviors and positive discipline; see helpful "Zero to Three" resources

Have a PICKY EATER? Around 2 years, most children start eating less (as their growth starts to slow down). If your child is healthy and growing well, you don’t need to worry. As a parent your job is to provide your child with healthy choices at meal and snack times. It’s then up to your child to decide what, how much and (sometimes) whether they will eat. Listening to their bodies—eating when they are hungry and stopping when they are full - will help children develop healthy eating habits for life. 

Every child needs a balanced diet with foods from all 3 food groups—vegetables and fruit, whole grain products, and protein foods - see Canada’s Food Guide.

Meals are important social times in a child’s day. They help children learn about food while connecting with family and friends. Eating in a positive atmosphere helps children develop healthy attitudes about food and themselves. Parents and caregivers play an important role in keeping mealtimes relaxed and enjoyable. 

TOILET TRAINING?

Most children begin to show signs they're ready around age 2-3 (though some may be ready earlier and some may not be ready until later than that). Boys often start later and take longer to learn to use the potty vs girls. 

Do make sure all caregivers (parents, grandparents, and daycare workers) follow the same routine and use the same names for body parts & bathroom acts so your child won't be confused. See toilet training tips.

Praise all attempts to use the toilet, even if nothing happens. Remember that accidents will happen and they're expected/normal.  It can take 3-6 months (can take more or less time for some) to toilet train a child. If you start too soon, the process tends to take longer. It can take months-years to master staying dry at night. 

Info on torticollis & plagiocephaly

Arrange an assessment with a Pediatric Physiotherapist (find a PT / search by city) 

BCCH's Kelty Mental health resources

Tic Helper course (for elementary-aged children)

Rainbow Health Ontario's parent guide

BCCH gender clinic roadmap 

Peer support: The Foundry and Transcare BC

Children can react to trauma in a variety of ways, depending on their age, personality, and the impact of the event on their family. Seek professional help early if you're concerned / child is struggling.

• Reassure them: tell them it's normal to feel scared or angry after something scary happens 
• Listen: let them know they can talk about their feelings whenever they want
• Help them understand: try to explain what happened; but avoid details that might be upsetting 
• Set limits: set reasonable and consistent limits & expectations
• Praise desirable behaviors

 Common reactions after a traumatic experience can include:

• Behavioral changes: children may become clingy, irritable, or aggressive. They may also have trouble concentrating, or regress to earlier/younger behaviors. 
• Emotional responses: children may feel scared, sad, angry, or guilty. They may also blame themselves for what happened. 
• Physical symptoms: children may experience headaches, stomachaches, etc.
• Sleep issues: children may have trouble sleeping or have nightmares. 
• Dissociation: children may feel detached from their bodies, or as if they are watching themselves from a distance. They may also lose memories of the event. 

Effects of childhood trauma on the brain: YouTube video (UK Trauma Council)

Caregivers can help by teaching self-regulation skills & encouraging post traumatic growth/resilience

Foreskin care & issues like phimosis

Sick Kids Urology Hub: bedwetting, toilet training, urinary tract infections, inguinal hernia, undescended testicle and hypospadias

Vaccines teach our immune system how to recognize and fight off specific disease-causing germs. Vaccines can save your child's life. In BC, children and teens are offered free vaccines that protect against 15 diseases. 

Find out what vaccines your child should receive and at what age: BC's vaccine schedule. You can download the free CANimmunize app = an immunization record that helps parents keep track / access vaccine records

7 important reasons to immunize your child

**If you choose not to immunize it's important that parents understand the risks**

Have specific questions about certain vaccines? Read CHOP's vaccine education center

Strategies to help your child, ease the pain associated with needles/bloodwork (tips by age)

CARD toolkit, specific tips: needle phobia