Rourke Baby Record continues to evolve
Improving children’s health is a never-ending story
For nearly four decades, parents and their doctors have been able to formulate a plan to care for children from coast to coast to coast.
The means that has made this possible is the Rourke Baby Record, a system that many Canadian doctors and other health care professionals use for well-baby and well-child visits for infants and children from one week to five years of age.
Developed by doctors Leslie and James Rourke, both former family physicians in St. John’s and educators of family medicine, the Rourke Baby Record was introduced in 1979 as an evidence-based health supervision guide for primary health care practitioners of children in the first five years of life.
“With the explosion in new literature and evidence for recommendations for care of children, it is increasingly difficult for the individual doctor to stay current in all areas,” Leslie Rourke said.
“The Rourke Baby Record (RBR) organizes a vast amount of information to help doctors and those caring for children keep up to date, and through its parent resources, helps provide reliable information for parents about common health issues for their young children. This is a key to its popularity and widespread use.”
Jurisdictions such as Ontario, Nova Scotia, Nunavut and the Northwest Territories have recently adopted the use of the RBR.
“With our permission, the national version of the RBR has been modified by several provinces, territories and regions for their unique populations,” she said.
A recent list of modifications was released and appears on the RBR website (http:// www.rourkebabyrecord.ca/ updates).
Rourke said changes occur about every three years and this year’s derivations include areas such as the introduction of solid foods and allergenic foods to a child’s diet.
She said introducing these allergenic foods to babies in the first six months of life provides a greater chance of an infant developing antibodies that will reduce allergies.
A second change of major significance has to do with studying social detminants of health and poverty. This allows health professionals to make inquiries to families to see if they are making ends meet or feeding their families, and how poverty is tied to health.
The Rourke Baby Record revolutionized well-baby visits, creating a record system that included nutrition, development and family issues, among other factors. At a time when well-baby visits consisted of little more than a vaccination, the Rourkes recognized a gap and acted, creating the Rourke Baby Record. The record is a tool that simplifies evidence-based wellbaby/child care from ages 0-5. The Rourke Baby Record has been used extensively by physicians for more than 35 years, and has seen numerous updates and revisions as new evidence has emerged.
It has been updated jointly several times since its first iteration. In 1998, the tool was revised with Dr. Jacqui Wakefield to include recommendations from the 1994 Canadian Task Force on Periodic Health Examination. Since 1999, the Rourkes have continued to update the tool in collaboration with Dr. Denis Leduc, past-president of the Canadian Pediatric Society, who is now a co-author of the record.
“The RBR is increasingly being incorporated into electronic medical records (EMRS) used by doctors and other health care professionals. The goal is the same: to spread best practice in order to improve the health of infants and young children,” she said.
The RBR system uses forms (Guides I to V) for charting the well-baby visits, and resources pages one to three that summarize current information and provide links to supporting resources for health care professionals.
The RBR contains guidelines and information for comprehensive well-baby/child care, including growth and nutrition monitoring, developmental surveillance, physical examination parameters, immunizations and anticipatory guidance on safety, family, behaviour and health promotion issues.
The Memorial University faculty of medicine has been one of the organizations that have provided significant support for the RBR — in addition to the Government of Ontario, Canadian Paediatric Society, College of Family Physicians of Canada and Dietitians of Canada.
Rourke retired from medical practice and from being a full professor at MUN in 2016, but her work on the RBR has served as a major retirement project.
“It has been my passion throughout my career,” Rourke said.
“We do not take any money ourselves for this, and the RBR is freely available.”
Both the College of Family Physicians of Canada (CFPC) and the Canadian Pediatric Society endorse the RBR. Leslie Rourke was awarded the Dr. Wallace J. Ingram Award in 2006 for new faculty at Memorial University, which was used to fund the development of the Rourke Baby Record website (www.rourkebabyrecord.ca), making the free resource even more accessible for physicians worldwide.