Baby Care - 0-4 Months

Vaccine Protection Against Pertussis

TBDHU recommends adults receive vaccine protection against pertussis (whooping cough) so they do not spread the infection to infants who will not be protected until  they receive their infant vaccine series.

The FREE Tdap vaccine (tetanus, diphtheria, pertussis) is recommended for every pregnant person, regardless of whether they have had one before. Adults who are 19 years and older and are caring for young infants should also get the FREE vaccine if they have never received a Tdap dose as an adult and are eligible for a 10 year booster.


If you have any questions about the information below or would like further support, please do not hesitate to contact a public health nurse at (807) 625-8814 or by email:




How do I know if my baby is getting enough milk?

Although you cannot see how much your baby is drinking, thankfully there are things you can look for that tell you your baby is getting enough. By watching your baby’s cues and feeding them frequently, by looking for signs of a good latch and by watching your baby’s output, you can feel confident your baby is getting what they need to grow and be healthy.

For more information on following your baby’s cues, view this video on Baby Feeding Cues and Behaviours or this PDF on Baby Feeding Cues (signs).

For more information on the frequency of feeds and expected outputs, download this PDF on Guidelines for Nursing Mothers.

Health Canada’s Nutrition for Healthy Term Infants: Recommendations from Birth to 6 Months recommends exclusive breastfeeding/chestfeeding for the first 6 months, and up to 2 years or longer with appropriate complementary feeding. If it is not possible to breastfeed/chestfeed, or if you have chosen not to breastfeed/chestfeed, your baby will require infant formula to make sure they are getting all of the nutrients they need for healthy growth and development.

For a comprehensive guide to formula feeding, take a peek at Best Start’s booklet (PDF). Aussi disponible en français (PDF). For a briefer guide, check out our Tips for Making and Feeding Infant Formula (PDF) handout.



I don’t feel like myself after having my baby. What is normal in the postpartum period?

Did you know that 1 in 5 people experience mood changes after having a baby? Adjusting to life with a new baby is not always what you would expect.

How do I know the difference between the “baby blues” and a postpartum mood disorder?

Baby Blues

The Baby Blues affect up to 80% of individuals that give birth for the first time and may involve feelings of worry, sadness, anger, increases in intensity of emotions and feelings of being overwhelmed. This normal and short-lived experience typically resolves within the first two weeks after giving birth. These feelings can be mild or more intense and are related to physical and hormonal changes that occur after giving birth, as well as a lack of sleep and the adjustment of caring for a new baby.

Postpartum Mood Difficulties

If after two weeks, your symptoms have not gone away, you may be experiencing a postpartum mood disorder. You may be experiencing symptoms such as:

  • feeling low, sad, empty or tearful
  • loss of interest/pleasure in activities previously enjoyed
  • changes in appetite or sleeping
  • difficulty bonding with baby
  • feeling helpless and overwhelmed
  • anxious and feeling worried all the time

And in rare cases:

  • hearing voices
  • thoughts of self-harm or thoughts of harming others

If any of these symptoms sound like you, or someone you are close to, know that you are not alone and that there is help available! You do not have to be afraid or suffer in silence.

If you are experiencing difficulty, you can contact Crisis Response Services, which offers mobile crisis response and 24/7 telephone support services to both youth and adults who are experiencing a mental health crisis. You can reach them by calling: (807) 346-8282.

You can contact a public health nurse by calling (807) 625-8814 to talk about what you are experiencing and to learn about what supports may be available to you.

For more information on Postpartum Mood Difficulties and what you can do, please visit Postpartum Mood Difficulties.



Why is skin-to-skin important for my baby?

Your bare chest is the best place for your baby to adjust to life in the outside world. Holding your baby against your bare chest helps your baby to stay warmer, calmer and it helps your baby to breastfeed/chestfeed more easily. Frequent skin-to-skin contact can also help your body to produce more breastmilk/chestmilk for your baby. Skin-to-skin is important for other caregivers, including partners, as it is also a great way to bond with baby.

For more information on the benefits of skin-to-skin and how to do it safely, visit Skin-to-Skin Contact.



What can you tell me about my baby’s sleep?

Babies develop their own sleep-wake pattern that is special to their biology and developmental stage. You should expect that your baby will have an irregular sleep pattern for the first 1-3 months and will need to wake up regularly to feed (usually every 2-3 hours). Many children will continue to wake at night to feed, even into toddlerhood.

Babies’ sleep safest when their sleep surface is in the same room as their caregivers for the first 6 months in a smoke-free environment. It is also important that babies’ be placed on their backs to sleep, dressed in light clothes and without extra blankets, pillows, stuffed toys or bumper pads. They should also be in a crib, cradle or bassinet that meets Health Canada safety standards.

For more information on sleep patterns and routines and sleep safety, download Infant Sleep: What Parents Want to Know (PDF).



Where can I find information about what to expect in the early days after my baby is born?

Adjusting to life with a new baby brings many new experiences. It can be overwhelming to adjust to the new responsibility of caring for a new baby, while also recovering from the delivery and getting used to waking frequently at night. Parenting in Ottawa has created an excellent video series, which highlights important topics such as: bathing your baby, jaundice in the newborn, postpartum recovery, changing your baby’s diaper, newborn behaviours and postpartum mental health.



What kind of support is available in the community?

Parenting a new baby can be both an exciting and overwhelming experience! There are a number of support services in our community that can help ease this transition. Many community programs give an opportunity for you to connect with other new parents. There are also many health care organizations that can check your child’s growth and development and your physical and emotional health.

For more information about these support services, download our Having a Baby in Thunder Bay (PDF) pamphlet.



What about being a partner? Are there any specific resources for them?

Being a partner is an important role and can come with many stressors. Dad Central is a great place, for partners that have activities, resources and information that can help you adjust to the new world of parenthood.



What immunizations are required at this age?

  • Your baby will need to see your doctor or nurse practitioner regularly for well-baby checks and immunizations. Your baby’s first immunizations will be at 2 months and a second set will be available at 4 months.
  • You can learn more about the vaccines by reviewing Ontario’s Routine Immunization Schedule.
  • Health care providers (including your family doctor) do not automatically inform the TBDHU when vaccines are given, so it is the child's caregiver’s responsibility to let us know of their child's immunizations. The TBDHU will only have a record of any vaccines administered by TBDHU nurses, whether at school or in our Immunization Clinic.
  • To submit the vaccine records, we encourage you to create an account in Ontario’s safe and secure online system called ICON (Immunization Connect ONtario).
  • Once created, you can easily submit vaccines as well as access them if you need the records for other reasons like travel or if you move to another province. You can also submit paper copies. Learn more and access ICON by visiting our vaccine reporting webpage.
    • TBDHU will need access to your child’s vaccine records if they attend licensed child care and when they attend school.
    • TBDHU encourages families to create an ICON account and get into the habit of submitting records once vaccines are received.
  • If you do not have a primary health care provider, you can call a vaccine nurse at (807) 625-5900 or toll-free at 1-888-297-6630 to discuss the options so your child can get the vaccines they need to stay on schedule, so they are protected.



What’s ahead for my baby and me? What are the things to keep in mind over the coming months?

Comforting a Crying Baby

Each baby has a different temperament and personality, and some babies cry more than others do. You may be finding it challenging and exhausting if your baby is difficult to soothe or is crying for long periods. It is important to know that this can be an important and very normal part of your baby’s growth and development. This is sometimes referred to as the “period of purple crying." For more information about your child’s crying and for strategies to soothe your baby and cope with your frustrations, visit The Period of Purple Crying.

You can also contact the Healthy Babies, Healthy Children Program at TBDHU for more information and for tips and strategies for caring for and bonding with your baby at (807) 625-8814 or by email at

Registering for Childcare

If you are planning to return to work or school and will need childcare for your baby, it is important that you register on a waiting list early to have the best chance at securing a spot. To register for licensed childcare spaces in the city of Thunder Bay, you must submit an online application at the District of Thunder Bay Childcare Registry.


You may be thinking about family planning, and it is important to consider what method of birth control you would like to use. As you probably are aware, there are many options available to you. However, it is important to know that some of these methods may have an impact on your milk supply if you are breastfeeding/chestfeeding.

For more information on choosing the right method of birth control for you, please read about Birth Control for New Mothers or call a public health nurse at (807) 625-8814. You may also make an appointment at TBDHU's Sexual Health Clinic.

Your Child’s Developmental Milestones

The Looksee checklists are tools that you can complete to help monitor your child’s development. They also provide tips for you to use that can help your child to grow. You can sign up to receive the checklists and you will receive them by email at regular intervals to track your child’s development over time. The first checklist is for babies that are 1-2 months of age. To contact a public health nurse about the checklists or about questions regarding your child's growth or development, call: (807) 625-8814.



What is Tummy Time?

"Tummy Time” refers to the activity of placing a baby on their stomach while they are awake and supervised. You can start practicing “Tummy Time” with your newborn right after they are born by placing them on your chest while you are lying on your back. Encourage your baby to lift their head and see your face by talking to them and smiling. Babies can be placed awake on their stomachs for short periods of time.  Try starting with 1 to 2 minutes, several times a day as tolerated.  When your baby begins to shows signs of fatigue or starts to fuss, gently help them turn onto their back for a quick rest. You can repeat this cycle a few times in a row or you can break “Tummy Time” up by practicing short periods throughout the day. Try practicing it for a few minutes after diaper changes!  Baby will be able to enjoy longer and longer periods on their tummies as they get stronger. “Tummy Time” promotes healthy development by strengthening neck, back and shoulder muscles that baby will need for sitting up, crawling and eventually walking.  It also helps prevent “flat spots” on your baby’s head. You can make “Tummy Time” more fun for baby by playing with them on the floor or by placing objects of interest in front of them, just out of reach.


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