Clinical Practice Guidelines

The Nova Scotia Hyperbilirubinemia Guideline Implementation Working Group provides a provincial strategy for implementing the Canadian Pediatric Society's (CPS) Position Statement and Guidelines for Detection, Management and Prevention of Hyperbilirubinemia in Term and Late Preterm Newborn Infants. The following tools have been developed and others adapted from the CPS Guidelines to assist the Nova Scotia Health Authority and the IWK with this implementation.

Infants and young children are at particular risk of contracting pertussis.  The best way to prevent mortality and significant morbidity from pertussis is for physicians and other health care providers to:

  • offer one dose of pertussis containing vaccine (Tdap) to pregnant women (≥26 weeks of gestation) who have not been previously vaccinated against pertussis in adulthood;
  • ensure that infants and young children are immunized according to the recommended schedule;
  • recommend that caregivers and close contacts of infants and young children receive a pertussis immunization.

In February of 2014 the National Advisory Committee on Immunization issued an updated statement regarding pertussis vaccination in pregnancy. Please see the attached document for further information and important links.

Routine and accurate growth monitoring is essential for assessing health and nutritional status of infants and children. Growth charts are an important tool for health care providers to understand patterns of growth and identify potential nutrition concerns and/or growth problems. The World Health Organization (WHO) released growth charts for term infants and children that reflect optimal growth. Providers in Nova Scotia are encouraged to use the WHO Growth Charts adapted for Canada for monitoring infant and child growth. These charts are recommended by Health Canada, the Canadian Pediatric Society, the College of Family Physicians of Canada, Community Health Nurses, and Dietitians of Canada; other growth charts such as the CDC charts are no longer supported.

The charts may be downloaded (free) from the Dietitians of Canada website: http://www.dietitians.ca/secondary-pages/public/who-growth-charts.aspx.

CME-Accredited, self-directed learning modules are also available (free): http://www.dietitians.ca/Knowledge-Center/Live-Events/Online-Courses/WHO-Growth-Chart-Training.aspx.

For more information, please refer to the article written by Tina Swinamer, Co-ordinator Early Childhood Nutrition, Department of Health and Wellness, Public Health, in both the RCP newsletter (Fall/Winter 2012-13) and doctorsNS magazine (November 2012 issue).

Palivizumab (Synagis®)

In August 2007, the utilization management of palivizumab was transferred to the IWK Health Centre. For information regarding the guidelines for the use of this product and the request approval process, please go to the palivizumab section of the IWK Health Centre's website or contact:

Karen Chestney, RN
Provincial Palivizumab Monitoring Nurse
IWK Health Centre
470-2723

In January 2002, the Department of Health, Public Health/Health Promotion, asked the Reproductive Care Program of Nova Scotia to "Develop ...Department of Health minimum acceptable standards for initial postpartum contact (0-6 weeks) in Nova Scotia". RCP established a Postpartum Services Review Working Group with representation from hospital and community nursing, nursing education, family practice, public health, obstetrics and pediatrics to assist them with this important task. This report represents the findings of the Postpartum Services Review Working Group and recommends a series of guidelines intended to ensure that postpartum/postnatal services are provided in an informed and consistent way across Nova Scotia.

In 2010, the Nova Scotia Newborn Screening Service, now the Maritime Newborn Screening Program, introduced new guidelines for the timing of newborn screening specimens. Also, in some situations additional information will be required to interpret the screening results. These changes align the newborn screening in Nova Scotia with other screening programs in the country and are based on recent recommendations from the Newborn Screening Service Advisory Committee.

There is an overwhelming body of evidence indicating the supine position for infant sleep significantly reduces the risk of Sudden Infant Death Syndrome (SIDS). In light of this evidence, health care providers are obliged to demonstrate and teach supine infant sleep positioning (Back to Sleep) to new parents and others caring for newborns. Health care providers may meet with resistance to adopting this practice, usually based on a belief that the newborn will choke if placed supine. There is no evidence to support this belief.

The Reproductive Care Program of NS (RCP) strongly endorses the Canadian Pediatric Society (CPS) Joint Statement: Reducing the Risk of SIDS in Canada (Vol 4, No 3, April 1999) and the American Academy of Pediatrics policy statement: Changing Concepts of Sudden Infant Death Syndrome: Implications for Infant Sleeping Environment and Sleep Position (March 2000, RE9946).