Vol. 27#3
Fall 2015
For all people interested in the health of preschoolers
What a record-breaking summer! Hot and dry. Were you
able to play in the shade? Did you remember to apply
and reapply sunscreen? Hope so. Sunburn can lead to
skin cancer later in life. In keeping with preventing
injuries, do not throw out the sunscreen. Keep using
sunscreen on exposed skin through the fall and winter
months. Sunshine reflects off water and snow
increasing the risk of sunburn. Wear sunglasses with
SPF protection all year round.
As we move from fall to winter, caregivers need to
remember to manage the risks of injuries. With every
activity, there is a risk of injury. It is important to be
aware, look first, wear the gear and buckle up.
General safety tips to be aware of:

Check weather forecasts to anticipate the clothing
needs throughout the day.

Choose play areas with shelters

Dress in layers. Outer layer should be windproof
and waterproof. Wear mitts instead of gloves and
wear waterproof boots.

Wear a hat that protects the ears if there is a cool
wind.

Choose a neck warmer instead of a scarf.

Remove drawstrings from all clothing.

Watch children at play. That means no cell phone!

Teach children the rules of outdoor play.

Wear the gear. Insist helmets be worn for skating,
sledding, and bike riding.
Join the Dietitian! – Child Care Workshop Series:
A four-part nutrition session to learn more about
planning, preparing, and navigating mealtimes in child
care. Starting this September, topics will include menu
planning, allergies, and more on healthy eating for
preschoolers. For more information, contact your Public
Health Nurse.
Inside this Issue
Letters to the Health Centre .............................. Page 2
Speech & Language: Exploring with Stories ......... Page 3
Dental Health: Teething ................................... Page 4
Nutrition: Learning About Food Allergies ............ Page 5
Environmental Health: Cleaning at the
Child Care Centre ............................................. 6 and 7
Tips for Choosing Health Recipes ........................ Page 8
Recipe Page: Barley Spinach Bake ...................... Page 9
Resource Page ................................................ Page 10
Contact is a publication of Public Health – Edmonton Zone, Alberta
Health Services. Information in this newsletter can be freely
reproduced for educational non-profit purposes by any child care
centre in Edmonton area.
Contact is edited by Pam Todd. Phone: 780-342-1284
Fax: 780-484-9156
The information provided in this resource is not to be used for
consultation during an emergency, to make or confirm a diagnosis or
to treat people, as a substitute for obtaining medical advice or for
seeking treatment from a qualified doctor.
www.albertahealthservices.ca
Letters to the Health Centre
Dear Health Centre
Can you tell me about 811?
Claire
Dear Claire,
Getting accurate and trusted health advice around the
clock just got simpler. 811 is the new, easy to remember
phone number for Health Link. 811 replaces the numbers
for Health Link throughout Alberta.
One simple, easy to remember phone number connects all
Albertans to the same trusted health advice.
The goal of Health Link is to support Albertans in
managing their own health. The result is a more
knowledgeable public, fewer hospital visits, and healthier
communities.
Health Link provides 24 hour, 7 day a week access to
trusted advice provided by experienced Registered Nurses
and other health-care professionals.
Why should I call Health Link?

Need health advice for a specific person?

Do you have a general health question about
something such as head lice, ringworm or Fifth’s
Disease?

Looking for information about a health program or
service?
Call Health Link for answers to all your health questions.
Registered Nurses will be able to help you to determine
your best options.
Anyone in Alberta can call 8 1 1
On-line health information available at
MyHealth.Alberta.ca
Your Public Health Nurse
AHS Edmonton Zone Public Health, Child Care Initiative Newsletter. Volume 27 #3
2
Exploring with Stories
Help For a Child Who Stutters
Toddlers are starting to share stories. You encourage this
experience when you:

Share books, stories, and songs.

Talk about what you did during the day and what
will happen tomorrow or in the future.

Share family pictures and stories about special
occasions that have already happened.

Encourage her to act out or tell grandpa her
favourite story.

Act out a story about a new experience so she knows
what to expect. For example, the first day of
preschool or a visit to the dentist.
Be creative.
Toddlers are starting to use their hands and minds to
build and create. They learn different things from
different objects and activities. The act of creating is
more important than what your child creates. Let your
child tell you about what she has made.
You can encourage a child to be creative.

Have fun. Pretend you are different animals. Move
like they move. Dance freely to music.

Go outside to play. Go on a nature walk. Make a
sandcastle or snowman. Pour water into dirt and
make mud pies.

Explore objects. Bring out the paper, glue, crayons,
blocks and yarn. Let the child make her own
creation. Get her to tell you about it.

Dress up. Put together a box of old jackets, purses,
skirts, and hats. Enjoy the fun.
Screen time
The Canadian Pediatric Society suggests that parents
limit the amount of screen time for children. Screen time
is any time spent in front of screens such as TVs,
computers, phones or tablets. There is no educational
program that replaces hands-on learning!
The Canadian Pediatric Society suggests the following
screen time limits.
Children under 2 years
No screen time
Children 2 – 4 years
Less than 1 hour
Older preschool children
Less than 2 hours
Screen time affects a child’s health and development.
Limit screen time and engage your child in active
activities. While allowing your child to be more physically
active, these activities also help her develop social skills
and improve her behavior, attention, and language skills.
Studies have shown that screen time negatively affects
the number of words children know by Grade one.
Be a role model. Children watch and copy their
significant others. Limit the time you spend on the
phone, on the computer, watching TV or using other
electronic devices.
Healthy Parents Health Children: The Early Years
AHS Edmonton Zone Public Health, Child Care Initiative Newsletter. Volume 27 #3
3
Dental Health

Tooth Eruption - “Teething”
Teething is a natural and temporary process. It usually
starts when your infant is about 6 months of age and
continues off and on until your child is about 3 years old.
Every infant grows and develops at their own pace. Some
infants may begin teething earlier and some later. There
are tooth development charts that can help parents learn
about when to expect more teeth. Most toddlers have all
20 baby (primary) teeth by the time they are 3 years of
age.

Benzocaine containing gels. Benzocaine numbs the
gums, throat, and is a potential choking hazard.
Some infants may develop an adverse reaction to the
numbing agent.

Teething necklaces. Amber beads are not safe.
Health Canada strongly advises that children
younger than 3 years of age have nothing around
their neck. Health Canada’s website has additional
information about Teething products that have
been recalled: www.hc-sc.gc.ca
Signs of teething can be:

Fussy, restless and irritable behaviour.
Keep your child’s new teeth healthy:

Producing more saliva and drooling.


Chewing and sucking on fingers and other objects.
Brush teeth with a child-sized toothbrush twice
daily.

Red or warm cheeks.

Use a rice-sized amount of fluoride toothpaste.

Red, swollen gums.


Take your child for their first dental check up by 1
year of age.
Possible loose stool and diaper rash.

Temporary change in eating habits.
Comfort measures during teething:

Offer lots of love and extra comfort.

Rub gum pads with clean finger or cold wet
washcloth.

Offer a clean, damp, cold washcloth to chew on.

Offer pain relief medication on the advice of a
healthcare professional.

Offer cold fluids to help decrease swelling of the gum
pads.
Nina Kennaugh, Registered Dental Hygienist
AHS Dental Program
Things to avoid during teething:

Teething biscuits.

Liquid or gel-filled teething rings.

Frozen teethers or frozen food.
Teething does not cause diarrhea,
fever or vomiting. These are signs
that your infant is sick, not that she
is teething.
From: Healthy Parents Healthy Children: The Early Years,
Page 127
AHS Edmonton Zone Public Health, Child Care Initiative Newsletter. Volume 27 #3
4
Learning About Food Allergies
Did you know?
Milk Allergy
An allergic reaction happens when our immune system
reacts abnormally to proteins in certain foods. An allergic
reaction can be mild or severe. The best way to prevent a
reaction is not to eat the food that causes a reaction.
When preparing food for a preschooler with a milk allergy,
read food labels to check the ingredient list for “milk” or
“milk ingredients”, or for a caution note that says,
“contains milk”.
You may have some children in your care that have food
allergies. This can be stressful. Keep reading to learn
about two common food allergies. Learn what you can do
to prevent or deal with reactions.
Some sources of milk are:

Butter and buttermilk

Cheese
Wheat Allergy

Ice cream and cream
Wheat is a common grain. It is in many foods. Here are
some examples:

Kefir (yogurt-like drink)

Sour cream

Breads and baked goods

Yogurt

Flour, prepared mixes and
powders (for example, in
cake, pancake, or gravy
mixes)
NOTE: “Milk Allergy” and “Lactose Intolerance” are
different.

Battered foods (such as
fish sticks or chicken
fingers)

Chicken and beef broth

Pie fillings and puddings

Sauces (soy sauce) and seasonings

A milk allergy is a reaction to milk by the immune
system.

Lactose intolerance is when the body cannot break
down lactose, a sugar in milk and milk products.
Preschoolers with lactose intolerance can often eat
small amounts of milk products like cheese or
yogurt.

Always ask the parent if the child has a milk allergy
or is lactose intolerant.
To identify prepared food products that may contain
wheat:
For more information on allergies

Use the food label on the food item to look for the
word “wheat” in the ingredient list.

Visit Healthy Eating Starts Here
www.healthyeatingstartshere.ca

Look for a caution note that says “may contain
wheat” or “may contain traces of wheat.”

Click on Healthy Eating at Child Care Centres and
follow links to learn more on common allergies and
allergy safety.
NOTE: “Wheat Allergy” and “Celiac Disease” are different.

Wheat allergy is a reaction to wheat by the immune
system.

In Celiac Disease, the body does not react to wheat;
it reacts to “gluten”. Gluten is a protein found in
wheat, barley, and rye grains. Gluten can hurt the
intestines.

Always ask the parent if the child has a “wheat
allergy” or “Celiac Disease”.
AHS Edmonton Zone Public Health, Child Care Initiative Newsletter. Volume 27 #3
5
Cleaning at the Child Care Centre
Cleaning at the Child Care Centre
It is important to keep children’s toys clean. Babies and young children are constantly touching things and putting their
hands and objects in their mouths. They pick up germs and get sick easily. To help reduce the chance of getting sick, clean
and sanitize your child’s toys often.
Cleaning Versus Sanitizing
Process
Step One
Clean
Step Two
Sanitize
Recommended Solution
Outcome
ALWAYS CLEAN BEFORE SANITIZING
Scrub, wash, and rinse surface. Dirt
can prevent sanitizers/
disinfectants from working
effectively.
Mild detergent and water.
Removal of visible dirt soil, and
debris from surface.
Cover the cleaned area with
sanitizing solution. Leave the
solution to air dry or follow the
manufacturer’s recommendation
before wiping off.
The Canadian Pediatric Society
recommends a bleach solution
of 500ppm (5ml household
bleach to 500ml of water).
Reduction of the number of
bacterial contaminants
to an acceptable level.
Alberta Health Services, the Canadian Pediatric Society and many health organizations recommend bleach and water
solution as a sanitizer for the public and for child care programs. Bleach and water are recommended because:

It is readily available/not expensive.

Bleach is easy to use.

If used correctly, a low concentration of bleach reliably sanitizes and disinfects non-porous surfaces of common and
harmful bacteria.

A properly diluted solution is non-toxic and safe for children’s equipment.

Has a short killing time. Less likely to exert prolonged antimicrobial pressure.

No rinsing needed. Bleach breaks down quickly into harmless components.

Scientifically proven to be effective against Norovirus.
Other sanitizers can be used and have benefits as well as limitations. As with
bleach, proper cleaning of equipment and surfaces with soap before applying
the sanitizer is required.

Quaternary ammonia (quat) product, a longer contact time is required.

Some products need to be rinsed off.

Some products, if not used properly, can lead to resistant bacteria.
AHS Edmonton Zone Public Health, Child Care Initiative Newsletter. Volume 27 #3
6
Cleaning at the Child Care Centre Con’t
Examples of how to clean and sanitize toys.
The method used to clean and sanitize toys will depend on the size, material and the type of toy.
Small plastic toys with no batteries or electrical components.



Clean and sanitize in a dishwasher if the machine has a sanitizing cycle.
Wash in a sink with soap and water. Rinse and then soak in a sink with a sanitizing solution for two minutes.
Let items air dry.
Toys with batteries or components that cannot be submerged in
water.


Clean the outside with a cloth with soap and water.
Wipe with a cloth with a sanitizing solution. Air-dry.
Larger plastic, metal or wooden toys and equipment.



Clean the surface with soap and water.
Wipe with the diluted bleach solution.
Air-dry.
Fabric toys and equipment.

Wash in the laundry with laundry soap and hot water.
When should toys and equipment be cleaned or sanitized?
Do not drive yourself crazy cleaning and sanitizing baby toys and equipment every moment. It is good to clean and sanitize
toys and equipment at certain times, such as:





When you notice they are soiled. For example, after food spills on the table.
When recovering from an illness such as diarrhea or a cold.
After a play date.
When other children have put your baby's toys in their mouth.
Regularly. For example, clean and sanitize at the end of every month.
Meaghen Allen
Coordinator, Child Care Facilities
Safe Built Environment
AHS Edmonton Zone Public Health, Child Care Initiative Newsletter. Volume 27 #3
7
Tips for Choosing Healthy Recipes
Look for a recipe that:
Great Recipe Ideas

Uses healthy cooking methods like grilling, baking,
broiling, poaching, and steaming.


Includes “Choose Most Often” foods.
Visit the Healthy U website at
www.healthyalberta.com to find a variety of
delicious and healthy recipes.

Has lots of vegetables and fruits.


Uses whole grains such as whole grain flour, brown
rice or whole-wheat pasta.
Analyze your favourite recipes with Dietitians of
Canada. Use the Recipe Analyzer at
www.dietitians.ca

Uses lower fat milk alternatives (20% MF cheese,
plain 2% MF yogurt).


Has lean meats or meat alternatives such as lentils,
beans, and chickpeas.
My Amazing Little Cookbook provides recipes that
children can help make. Ask for one at your local
Community/Public Health Centre or visit
www.healthyalberta.com.

Includes small amounts of healthy fats like nonhydrogenated margarines or vegetable oils instead
of lard, hard margarine, butter or cream.

Uses herbs and spices instead of salt for seasoning.

Limits the amount of added sugar.
Children have small appetites.
Remember this when looking at how much the recipe
makes. Think about healthy, child-friendly portion sizes
and the recipe might actually make double the number of
servings it suggests.
Healthy Eating Starts Here: Child Care Centre
Resource
This Alberta Health Services website will help you
organize, plan, prepare and deliver safe and nutritious
food choices to the children in your care.
www.albertahealthservices.ca/8941.asp has the
following headings to help you get started Menu Planning

Recipes

Food Allergies

Staff Training

Child Care Policy

Healthy Eating Resource
AHS Edmonton Zone Public Health, Child Care Initiative Newsletter. Volume 27 #3
8
Recipe Page
Barley Spinach Bake
Serves 6
Ingredients:
Metric
Imperial
Olive oil
10 mL
2 tsp.
Onion, finely chopped
1
1
Garlic cloves, minced
4
4
Pearl barley
250 mL
1 cup
Water
875 mL
3½ cups
Tomato paste, low sodium
60 mL
¼ cup
Chili powder
5 mL
1 tsp.
Spinach, shredded
3L
12 cups
Raisins
125 mL
½ cup
Slivered almonds, toasted
75 mL
1/3 cup
Method
1. Preheat over to 350˚F (180˚C).
2. In non-stick dutch oven or flameproof casserole, heat oil on low.
3. Add onion and garlic. Cook, stirring frequently until onion is tender.
4. Stir in barley. Cook one minute. Stirring to coat.
5. Add water, tomato paste, chili powder, and bring to a boil. Cover.
6. Bake for 35 minutes.
7. Stir in spinach and raisins. Return pan to oven. Recover and cook 10 to15 minutes or
until barley is tender.
8. Stir in almonds and serve.
Recipe from Healthy Eating Starts Here, http://www.albertahealthservices.ca/8941.asp.
For more recipe ideas, visit the “AHS Healthy Eating Starts Here” website:
http://www.albertahealthservices.ca/8941.asp
AHS Edmonton Zone Public Health, Child Care Initiative Newsletter. Volume 27 #3
9
Resource Page
Focus on… The “Outbreak Pager” (AHS - Edmonton Zone)
Identifying and Reporting Suspect Outbreaks in Edmonton Area Child Care Facilities
Child care workers have an important role in helping control the spread of illness in their child care
facility. Carefully watching the children for signs of an illness is called “disease surveillance” and is the
first step in illness management. Symptoms to watch for are:
● Diarrhea
● Cough
● Vomiting
● Rash illness
● Fever
● Other clusters of unusual symptoms
Recording illness on a log sheet helps identify patterns or clusters of similar symptoms of illness at the
child care facility. These occurrences should be reported to Public Health for further assessment and
follow up as appropriate.
What is an “outbreak” of illness?
An outbreak may be suspected in a child care facility when there are 2 or more children with the
same category of symptoms that started within 48 hours of one another.
If an outbreak is suspected (as defined above), it must be immediately reported to the Office
of the Medical Officer of Health, Edmonton Zone, Alberta Health Services (AHS):
Monday to Friday (between 8:30 a.m. and 5:00 p.m.)
(780) 445-7226 pager
After hours or weekends (including statutory holidays)
(780) 433-3940
Each fall, the Office of the Medical Officer of Health, Edmonton Zone, mails an
information package to all licensed child care programs in the Edmonton area
that reviews outbreak processes in more detail. Watch for it in your mailbox!
Important Contacts for Child Care Providers
Do you want information about
community services? Call 211
Government of Alberta Child Care Orientation Course
HealthLink – Available 24 hours a day
to answer your questions. Call 811
AHS Environmental Public Health has some excellent
resources for Child Care Agencies:
Healthy Parents Healthy Children
online
* Environmental Public Health Education Courses
http://www.healthyparentshealthychildren.ca/
* Health & Safety Guidelines for Child Care Facilities
To looks up health information online:
MyHealth.Alberta.ca
Government of Alberta Family Day
Home Standards Manual for Alberta
http://humanservices.alberta.ca/documents/famil
y-day-home-standards-manual.pdf
http://childcare.basecorp.com/home
http://www.albertahealthservices.ca/3151.asp
http://www.albertahealthservices.ca/EnvironmentalHealth/wf-eh-healthsafety-guidlines-child-care-facilities.pdf
Outbreak Pager – Report an outbreak or ask questions
* 780-445-7226
Monday to Friday (between 8:30 a.m. and 5:00 p.m.)
* 780-433-3940
After hours or weekends (including statutory holidays)
For ideas on creating a healthy eating environment, visit “AHS Child Care Healthy Eating Starts
Here” website: http://www.albertahealthservices.ca/8941.asp
AHS Edmonton Zone Public Health, Child Care Initiative Newsletter. Volume 27 #3
10