Baby Care - 4-12 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 will I know when my baby is ready for solid foods?

You may be starting to think about introducing your baby to solid foods. Breast milk, or formula, if you are formula feeding, is all your baby needs for the first six months. At about six months, you can start looking for signs that your baby may be showing you that they are ready for solids. These include:

  • Being able to hold their head up consistently
  • Being able to sit up and lean forward
  • Opening their mouth in response to being offered food
  • Being able to let you know when they are full (for example, turning their head away from a spoon)
  • Picking up food with their fingers and trying to put it in their mouth

Each baby is unique and will on their own time show when they are ready. Follow the signs and cues that your baby is giving you, and try not to compare what your baby is doing to other children their age.

For more information on starting solids and food ideas, check out Introducing Solid Foods to Your Baby or watch this video called "Trust me, Trust my Tummy" from Toronto Public Health.

Breastfeeding is beneficial for your baby far beyond when you introduce solids and it is recommended you continue for two years and beyond. It provides nutrients, comfort and immune protection to your baby well beyond their first birthday!

For additional support with breastfeeding/chestfeeding or with questions about introducing solids, contact a public health nurse at (807) 625-8814, or



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.

Postpartum Mood Difficulties

If you are experiencing mood changes after having your baby and aren’t feeling like your usual self, 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.

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 are available to you.

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



What can I expect in terms of my baby’s sleep?

At this stage, you may find that your baby starts to develop a more regular and predictable sleep pattern. Your baby may be asleep for longer stretches between feeds; however, it is still common and normal for your baby to wake at night to feed. Some caregivers find it helpful to implement a consistent “sleep routine” that can cue their baby that it is bedtime. Sleep routines can include reading a story, singing, rocking or a pre-bedtime bath.

Babies’ sleep safest when their sleep surface is in the same room as their parents 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.

You may have considered bed sharing with your baby. There can be risks to this practice. For more information on how to make bed sharing safer, read about the Safe Sleep Seven.

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

If you have questions related to your baby's sleep, contact a public health nurse at (807) 625-8814 or




I think my baby is teething. How can I help?

Your baby’s first teeth usually appear between 6 and 10 months, but symptoms such as drooling, fussiness, reddened cheeks and showing a need to chew on things can be present earlier than 6 months. It is always important to rule out illness, which can look a little like teething. Be sure to check for fever, ear rubbing, a runny nose or diarrhea, which can indicate that your child is ill.

Some tips for relieving pain from teething include giving clean, damp face cloths that are kept in the fridge for your child to chew on, massaging your baby’s gums or offering a teething ring filled with only water.

Even before your child’s first teeth arrive, it is important to be doing oral care. Wipe your baby’s gums with a clean, damp cloth after feedings. After your baby has their first tooth, they are eligible for fluoride varnish. It is a fast, easy and painless process where a protective coating is painted on your baby’s teeth. This coating makes the teeth stronger and protects from cavities. This is a free service offered by the TBDHU for children under 4 years old.

For more information about teething, taking care of your child’s teeth and dental programs offered at TBDHU, visit Oral Health Care for Infants and Toddlers or contact a public health nurse at (807) 625-8814 or



My baby will be on the move soon. How can I make sure they stay safe?

Your child will do plenty of learning and growing over the coming months! Soon, they will start exploring the world around them. This is an exciting time, but it is important to be sure that your space is safe for their exploration.

For resources on how to limit your children’s risk for injury and look after any potential hazards, visit Prevent Child Injury.

Many child caregivers often have questions about car seats: which is the right one for my child? How can I be sure it is installed properly? What can my child safely wear in their car seat? For answers to these questions and more, visit Car Seat Safety.



What immunizations are recommended at this age?

  • Your baby will need to see your doctor or nurse practitioner regularly for well-baby checks and immunizations. Vaccines are recommended at 6 and 12 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?

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. Checklists are available for ages 4, 6, 9 and 12 months. To contact a public health nurse about the checklists or about questions regarding your child’s growth or development call: (807) 625-8814 or email:

Your Child's Mental, Social & Emotional Health

As your child’s caregiver, you play an important role in having a positive impact on your child’s mental well-being and their overall growth and development. Your baby’s brain is growing and developing at a very fast rate and early childhood experiences shape your child’s brain and mental health for their lifetime. Your child depends on you to respond to their needs and to teach and interact with them. For more information on how to promote positive mental health for your child, visit Infant Mental Health Promotion.


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, providing a list of programs available during and after baby arrives.

Babies' Day Out

Babies' Day Out offers a comfortable, fun and inviting atmosphere for parents and their babies up to 12 months of age. At Babies' Day Out, child caregivers have the opportunity to meet guest speakers, Health Unit staff and early childhood educators. We have informal discussions on helpful topics such as infant care, parenting and growth and development that are relevant in the first year with baby. Also, we plan circle time, songs and stories to stimulate baby and child caregiver can meet other families and socialize. So come on and join us!

Visit Babies' Day Out for more information and to view the current calendar.


Your baby will need to see your doctor or nurse practitioner regularly for well-baby checks and immunizations. Your baby’s coming immunizations will be at 4 months, 6 months, 12 months, 15 months and 18 months. It is important that your baby receives their immunizations at the right time.

Review the 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 parents’ 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.

For more information on immunizations, visit our Immunizations page. If you do not have a primary health care provider, you can visit Find a Doctor or Nurse Practitioner to learn more about registering for Health Care Connect and the process for finding a family doctor or nurse practitioner. For health-related questions, you can also contact Telehealth 24 hours a day at toll-free: 1-866-797-0000

Registering for Childcare

If you are planning on returning to work or school and will need childcare for your baby, it is important that you register on a waiting list early to ensure you will have a space. 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.

Your Child’s Vision

The current recommendation is that children have their first exam by an optometrist completed at 6 months of age. It is estimated that one in four school-aged children has an undetected vision problem that affects their learning. An eye exam is painless and quick and looks different from a typical adult eye exam; your baby will not have to recognize any numbers, letters or symbols. For more information on your baby’s vision and where to have it tested, visit our Infant Vision page.


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