Riverin Bruno, Li Patricia, Rourke Leslie, Leduc Denis, Rourke James
Doctoral candidate in the Department of Epidemiology, Biostatistics, and Occupational Health at McGill University in Montreal, Que.
Assistant Professor of Pediatrics in the Faculty of Medicine at the McGill University Health Centre in Montreal.
Can Fam Physician. 2015 Nov;61(11):949-55.
To update the 2011 edition of the Rourke Baby Record (RBR) by reviewing current best evidence on health supervision of infants and children from birth to 5 years of age.
The quality of evidence was rated with the former (until 2006) Canadian Task Force on Preventive Health Care classification system and GRADE (grading of recommendations, assessment, development, and evaluation) approach.
New evidence has been incorporated into the 2014 RBR recommendations related to growth monitoring, nutrition, education and advice, development, physical examination, and immunization. Growth is monitored with the World Health Organization growth charts that were revised in 2014. Infants' introduction to solid foods should be based on infant readiness and include iron-containing food products. Delaying introduction to common food allergens is not currently recommended to prevent food allergies. At 12 months of age, use of an open cup instead of a sippy cup should be promoted. The education and advice section counsels on injuries from unstable furniture and on the use of rear-facing car seats until age 2, and also includes information on healthy sleep habits, prevention of child maltreatment, family healthy active living and sedentary behaviour, and oral health. The education and advice section has also added a new environmental health category to account for the effects of environmental hazards on child health. The RBR uses broad developmental surveillance to recognize children who might be at risk of developmental delays. Verifying tongue mobility and patency of the anus is included in the physical examination during the first well-baby visit. The 2014 RBR also provides updates regarding the measles-mumps-rubella, live attenuated influenza, and human papillomavirus vaccines.
The 2014 RBR is the most recent update of a longstanding evidence-based, practical knowledge translation tool with related Web-based resources to be used by both health care professionals and parents for preventive health care during early childhood. The 2014 RBR is endorsed by the Canadian Paediatric Society, the College of Family Physicians of Canada, and the Dietitians of Canada. National and Ontario versions of the RBR are available in English and French.
通过回顾目前关于从出生到5岁婴幼儿健康监护的最佳证据，更新2011年版的鲁尔克婴儿记录（RBR）。
证据质量采用前一个（2006年以前）加拿大预防性医疗保健特别工作组分类系统和GRADE（推荐分级、评估、制定和评价）方法进行评级。
新证据已纳入2014年RBR建议中，涉及生长监测、营养、教育与建议、发育、体格检查和免疫接种。生长情况采用2014年修订的世界卫生组织生长曲线图进行监测。婴儿开始添加固体食物应基于其准备情况，并包括含铁食品。目前不建议推迟引入常见食物过敏原以预防食物过敏。在12月龄时，应提倡使用敞口杯而非鸭嘴杯。教育与建议部分就不稳定家具导致的伤害以及2岁前使用后向式儿童安全座椅提供了指导，还包括关于健康睡眠习惯、预防儿童虐待、家庭健康积极生活方式和久坐行为以及口腔健康的信息。教育与建议部分还新增了一个环境卫生类别，以说明环境危害对儿童健康的影响。RBR采用广泛的发育监测来识别可能有发育迟缓风险的儿童。在首次健康婴儿访视的体格检查中包括检查舌活动度和肛门通畅情况。2014年RBR还提供了关于麻疹 - 腮腺炎 - 风疹、减毒活流感和人乳头瘤病毒疫苗的更新内容。
2014年RBR是一个长期基于证据的实用知识转化工具的最新版本，有相关的网络资源，供医疗保健专业人员和家长在幼儿期用于预防性医疗保健。2014年RBR得到了加拿大儿科学会、加拿大家庭医生学院和加拿大营养师协会的认可。RBR有国家版和安大略版，提供英语和法语版本。
