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)

Create a My Anxiety Plan & try these Everyday Activities to Ease Anxiety

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

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). 

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; and repetitive, restrictive or intense interests, behaviors; some (not all) children have language delays.

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.).

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.

ACT-Autism Community Training provides info about the assessment process, treatment & support in BC. Variety may cover the cost of a private 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

CHALLENGING BEHAVIORS:

Tips for managing anxiety, irritability, challenging behaviors, anger, PDA (Pathological Demand Avoidance)

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 ISSUES: practical tips for different sensory needs (OT handout)

Helpful sensory behavior tracking tool, info on interoception & strategies

Breastfeeding (or formula) is the only food your baby needs their first 6 months. 

For evidence-based breastfeeding support see: Kelly Mom & Dr. Jack Newman

Young babies feed often - including overnight. If you bring your baby into bed to breastfeed, read about risks during bed sharing. Room sharing is recommended during the first 6 months.

Babies that share a sleep surface with someone else have a higher risk of SIDS

If you bed share (even if you did not plan to) follow these safer sleep recommendations:

• Always put your baby on their back
• Make sure the sleep surface is firm and flat, with no gaps where the baby can get trapped
• Keep soft loose bedding or other objects well away from the baby
• Dress your baby so they do not overheat

The safest place for your baby to sleep or nap is in a crib, cradle or bassinet that meets current Canadian safety regulations. A safe infant sleep surface has:

• A firm, flat mattress with a tightly fitted sheet
• No gaps between the mattress and sides
• No loose, soft items (blankets, pillows, bumper pads, mattress toppers, stuffies/toys)
• Never use a drop-side crib (babies have been killed and injured from being trapped in the gap/space. It is illegal to sell or give away a drop-side crib in Canada).

Playpens themselves are not recommended for unsupervised sleep because they are not made to be as durable and safe as cribs. 

• Sofas or arm chairs, air mattresses and adult beds are not made for babies to sleep on. They increase a baby’s risk of falling or being trapped and suffocated. The risk is even higher if the baby shares the surface with an adult or other child. 

• Bed-side sleepers that attach to an adult bed are not recommended. 

• Baby nests or pods (small, portable pads with soft, padded sides) or nursing pillows are not recommended for sleep as they increase a baby’s risk of suffocation.

• Products with a sleep surface that is not flat, like inclined sleepers, baby hammocks, crib wedges, should not be used – even for babies who spit up a lot.

• High chairs, baby swings, bouncers, strollers and car seats are not safe for sleep. Sleeping in a sitting position can cause your baby's head to fall forward, which can make it harder for them to breathe.
  
• If your baby falls asleep while travelling in a car seat or stroller, move your baby to a crib, cradle or bassinet when you arrive at your destination. Take off your baby’s snowsuit, raincoat, jacket and other outerwear indoors to reduce overheating.

Using baby slings and carriers (babywearing) is popular, and babies often fall asleep while being carried in them. If you use one, be sure to use it safely. 

You should always be able to see your baby’s face & make sure they remain upright

• Your baby is safest when they sleep in simple, fitted sleepwear – like a sleeper. It should keep your baby comfortable at room temperature, so they do not get too hot.
• Keep the room at a comfortable temperature. 
• Babies do not need blankets when they sleep. When babies move their arms and legs, they can make the blanket cover their head / risk of suffocation. 
• Many parents use sleep sacks instead of a blanket. If you use one, get the right size so your baby can still move their hips & legs freely

Swaddling is sometimes used to calm babies. If you swaddle your baby, be sure to do it safely:

• Use a lightweight blanket. Make sure it stays away from their nose and mouth.
• Wrap your baby so they can still move their hips and legs freely and hands free.
• Stop swaddling when your baby can roll. 

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 (must read for all 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 with suggested Restoralax "clean-out" and "maintenance" doses

Encopresis "The Poo in You" video by GI Kids

Ensure your child is drinking enough water and eating a high fiber diet

Depression & suicide prevention factsheet

BCCH's Kelty Mental Health resources,how to manage stress (ex. exercise, time in nature...)

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

Help lines & 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

Expected milestones by age (2 months up to age 5); adapted milestones for premature infants

Kelowna Family Connections Centre (FCC): offers individual & group-based prevention, treatment and support services designed to help families with children, youth (0-18yo) who require developmental therapies (SLP, OT, PT, Behavioral Intervention), educational workshops, parenting support groups. A diagnosis is not required. Parents can fill out a referral form online.

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

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

2. Consult a Speech Language Pathologist (parents can self-refer to IH, FC or hire a private SLP)

3. Follow these speech tips/exercises at home

BCCH tips: diabetes management

Sick Kids Hospital resources 

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

Anorexia nervosa, bulimia nervosa, binge eating disorder and ARFID have increased significantly. Many cases go undetected and untreated which is why it is important for families to be familiar with the signs & symptoms and 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

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 be diagnosed with Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure. 

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 temperature: handout

Infants (<3months) with fever MUST get an assessment (even if fever is 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 12months.

See McMaster handout: what to eat while breastfeeding when your baby has a cow's milk protein allergy and the Canadian Milk Ladder (milk re-introduction) guideline from BC Children's

Keep track: My Headache Diary

CHEO's migraine care plan handout

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 & need, recommendations & accommodations in the classroom (and at home) and may need to be repeated in 3-4 years.

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

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

Variety may cover the cost of a private assessment (if you meet the eligibility criteria)

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

General tips on feeding your baby in the first year

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

Improving your child's iron intake

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.

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

Tools for parents, International OCD Foundation

Sick Kids website: eye conditions, first aid

What about Vision Therapy? (Canadian Ophthalmological Society)

Acute vs chronic pain; helpful video that explains chronic pain

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

Coping; help your child get active again, free WebMAP Mobile self-management app 

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

Triple P & The Incredible Years programs

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 schools)

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

Preventing 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. Screens are addictive; playing outside, spending time with friends/family, reading books, etc. is happening a lot less vs spending hours watching YouTube. 

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) issued an 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 & peer comparison. Children are particularly impacted by too much exposure to apps like TikTok and Instagram." 

Wait Until 8th pledge empowers parents to delay giving 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 doc here 

The transition between youth and adulthood can be overwhelming as youth face new experiences, challenges & pressures. Sick Kids Hospital puberty HUB, Adolescent Health for preteens & teens

Most girls start puberty between 8-13yo. Most boys start puberty between 9-14yo. It can also be normal to start puberty earlier (or later).

MALES:

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. 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 12 and 15. By age 16, most males have stopped growing; their muscles will continue to develop.

FEMALES:

Puberty usually starts with breast development; small, firm, tender buds at first then breasts will get larger over the next 1-2years . Dark, coarse, curly hair will appear on the labia (the folds of skin surrounding the vagina) and under the arms. Their body shape begins to change as their hips widen and they gain weight and body fat. 1st period (menstruation) approx. 2 years after breast buds appear, usually between the ages of 9-15yo. Most girls have a growth spurt 1–2 years before their period starts. After they get their period, growth stops about 2 years later.

The emotional changes of puberty can be challenging for both youth & 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: parent guide & red flags to be aware of. Open Mind BC, info on self-harm, vaping and marijuana use

SEXUAL & REPRODUCTIVE 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 via contraceptive clinic which offers contraceptive counselling and 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 stressful as toddlers are often very sensitive to their parents' feelings so they can become upset when 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). 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 - see Canada’s Food Guide.

Eating in a positive atmosphere helps them develop healthy attitudes about food and themselves; parents play an important role in keeping mealtimes relaxed and enjoyable. 

TOILET TRAINING?

Most begin to show signs they're ready to start toilet training around age 2-3 (though some may be ready earlier and some may not be ready later). 

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 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

Book 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 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: 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
• 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 & post traumatic growth/resilience

Foreskin care & issues: 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: BC's vaccine schedule, 7 important reasons to immunize

**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