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Immunization: for Adults

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By staying up to date with your immunizations you are protecting yourself, your family and your community. 

Immunizations: 

  • are safe and effective 
  • protect against diseases caused by germs such as bacteria or viruses 
  • are also known as a shot, needle, booster, vaccine or vaccination 

Why do adults need immunizations? 

  • Adults who did not receive all their immunizations as children may be at risk of getting diseases such measles, mumps or pertussis (whooping cough). 
  • Some immunizations, such as tetanus (lockjaw) and diphtheria, need booster (helper) shots. 
  • If you are not up to date with your immunizations and have a newborn who is not fully immunized, you can infect your baby with diseases. 

What adult immunizations do I need? 

See Routine Immunization Schedules – Province of Manitoba for the most up-to-date information.

For a full list of all adult immunizations see Immunize.ca 

All people in Manitoba who are six months old and older are encouraged to get their free flu vaccine and keep up with all recommended shots. You can get the flu vaccine at the same time as other vaccines, including the COVID-19 vaccine. This vaccine is especially important for people who are at higher risk of getting COVID-19 or becoming very sick, as well as their caregivers and close friends and family. 

Even if you’re not at higher risk, you can still get the COVID-19 vaccine.  

 For COVID-19 immunization information visit: Province of Manitoba – COVID-19 and Protect Our People MB

How do I get a copy of my immunization record?  

You can get your immunization record by submitting a request via the e-form: Immunization Update Request Form 

You may also be able to get a copy by: 

  1. contacting your local public health office 
  2. checking if your local medical clinic or doctor’s office can provide them to you
  3. asking at a local nursing station or health centre 

References

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Immunization: In Pregnancy

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Why should I get immunized? 

Immunization is one of the best ways to protect you, your family and your community. Pregnancy is a great time to ask your health-care provider if you are up to date with all your immunizations (also called vaccines). By staying up to date with your immunizations you are protecting yourself and passing on the protection to your unborn baby. This also protects your newborn baby for the first few months of life. Your baby will start receiving immunizations at two months of age.  

Immunizations: 

  • are safe and effective 
  • protect against diseases caused by germs such as bacteria or viruses 
  • are also known as a shot, needle, booster, vaccine, or vaccination 

Safety Tip 

It’s important for all members of your household to have up-to-date routine vaccinations, including pertussis, to protect your baby. Newborns can catch infections easily and get very sick, especially in their first months. 

When is the best time to update my vaccines? 

Vaccines best given before or during pregnancy: 

  • COVID-19
    • Evidence shows that the mRNA COVID-19 vaccines are safe to get during pregnancy and will not harm your unborn baby. COVID- 19 vaccines:
      • are recommended at any stage in pregnancy. 
      • are very effective at reducing the risk of severe illness, hospitalization and death. 
      • can help prevent pregnancy complications for parent and baby. 
      • decrease the risk that you will develop COVID-19 and expose your baby. 
  • Influenza (Flu) 
    • Immunization against influenza (flu) during pregnancy is recommended for all pregnant people, especially during flu season (November to April). 
    • Flu is more likely to cause severe illness in pregnant people than in people who are not pregnant. 
  • Tetanus, diphtheria and pertussis (Tdap)  
    • Pregnant people should be immunized with the Tdap vaccine in EVERY pregnancy 
    • You should get the vaccine between 27 to 32 weeks of pregnancy, although it can be given at any time during pregnancy. 
    • This protects your newborn baby for the first few months of life. 

Vaccines best given before you get pregnant or after you deliver: 

Where can I get immunized? 

  • your regular health-care provider; if you do not have one, you can use the Family Doctor Finder
  • at a walk-in/same day clinic
  • nursing station or health centre  

What if I’m traveling out of the country? 

If you are planning a trip, talk to your immunization provider or visit your local travel health clinic at least six weeks prior to your expected departure to see what vaccines may be recommended. Vaccines for travel purposes are not publicly funded by Manitoba Health. For more information about travel vaccines, advice and advisories, visit: 

Did you know?

You can request a copy of your immunization record at Your Immunization Record Matters 

See what’s next:

Baby’s First Year of Immunizations  

For more information: 

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A Parent’s Guide to your Child’s First Words

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As with all stages of child development, there is a range during which children develop their skills. So, if your child is not doing everything at every stage, it is not necessarily cause for concern. However, a wait-and-see approach is not necessarily the best either, especially when early intervention can make a difference.

Lisa Fehr, a speech-language pathologist with the Winnipeg Regional Health Authority, often tells parents that a child’s language development can be compared to climbing a set of stairs, with a child at the bottom and moving up one step at a time. 

Babies start reacting to sound right at birth. At around four to six months, they will start cooing or “talking,” followed by babbling at around six to 12 months. 

You will usually hear your baby’s first words at around 12 to 18 months. As your child continues up the steps, you should be seeing them using around 50 single words by 18 to 24 months. By 24 months, children start to use some two-word phrases, such as “Ahdah mama” (“All done mama”) or “Wawa peas” (“Water please”). 

The words and sounds of a two-year-old are not necessarily spoken clearly, but this is normal. From two to three years of age, you should be seeing a rapid change in speech and language development, with an increasing vocabulary and use of language. At this stage, you should be wondering, “Where did our child even learn certain words?”

By three years of age, you should understand your child’s speech 75 per cent of the time, and they should be telling you short stories, and using three-and four-word phrases (“Me goed to the pawk (park)”, “Her is awdone (all done) now”). Their speech may not be completely perfect yet, but that is still okay. 

From four to five years of age, children are gaining more and more words, ideas and concepts, and should be able to express themselves with longer sentences and in a smooth, clear way. They should understand your questions and directions and their speech should be understood almost all the time by an unfamiliar listener. That is a lot of stairs, in a short time.

Here are a few tips to help your child’s speech and language development:

  1. Limit screen time according to the Canadian Pediatric Society’s recommendations. That means no screen time (TV/tablet/phone) for children up to two years of age and limited screen time (less than one hour per day) for children between two to five years of age.
    We don’t talk much when we look at a screen and the same goes for your child. This is a tough one in this day and age, but children learn how to communicate through active play and engagement with the people and things in their world.
  2. Provide lots of verbal input to your child. Talk to them all the time about what you’re doing, what they’re doing, what you’re seeing and hearing and where you’re going. Talk throughout your day. Talk to them in the language you are most comfortable. When you talk to your child, wait for them to do or say something in response. Mealtime, bathtime, playtime, driving, walking, shopping are all opportunities for your child to learn words.
  3. Use books right from birth with your child. Use them to snuggle up and enjoy some time together. Aim to read at least one book every day. Use the library. Don’t feel you have to read the entire book. Look at the pictures and name the items on the page. Even if your child is only interested in one page, that is still a great start and a great way to learn words and ideas.
    The stories and books you share in the early years shape your child’s: 
    • understanding of the world 
    • sense of humour, compassion and interests

Sharing your own traditional stories, songs and poems in your home language helps your children understand your culture and family values.

Did you know?

If at any point your child’s speech and language seems to be “stuck” on a stair or moves down a stair (regresses), or if you have concerns, it is likely time to talk to a professional.

Talk with your health-care provider to find out about speech-language pathologists/clinical services in your region.

Lisa Fehr is a speech-language pathologist/clinical service leader with the Winnipeg Regional Health Authority’s ACCESS Downtown. This column was originally published in the Winnipeg Free Press on Friday, December 4, 2018.

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Why Give Vitamin D?

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All babies need vitamin D to help their bones and teeth grow and develop. Babies who do not get enough vitamin D can get a painful disease called rickets, where the bones become soft and can bend and break easily. 

How much vitamin D does my baby need?

  • All breastfed/chestfed and formula fed babies need 400 IU of vitamin D a day. 
  • Your health care provider may recommend up to 800 IU every day. Giving more than this amount may not be safe for your baby. 

How do I give vitamin D?

Vitamin D for babies comes in different forms. Directions on how to give each form are different. 

Dropper form (400 IU per 1 ml):  

  1. Remove the dropper from the bottle. Only use the dropper that came with the vitamin D bottle.  
  2. Squeeze the top of the dropper and put it inside the bottle.  
  3. Slowly let go of the dropper until the liquid is up to the line recommended on the dropper. This is 400 IU of vitamin D.  
  4. Gently squirt the liquid into your baby’s mouth.  
  5. Rinse the dropper before putting it back in the bottle.  
  6. Do not give more than two droppers (2 ml) per day 
An amber vitamin d bottle and a dropper

D drop form (400 IU per drop):  

  1. Remove the lid.  
  2. Turn the bottle upside down. In a few seconds, a drop will fall out by itself. Do not shake the bottle.  
  3. Put 1 drop (400 IU) onto mother’s nipple or a clean finger. Allow your baby to suck for at least 30 seconds.  
  4. Do not give more than 2 drops per day 
vitamin d drops
vitamin d drops

Store vitamin D drops upright and at room temperature. 

Keep vitamin D out of your children’s reach. 

For more information see this handout on how to give babies vitamin D drops. 

If you have a nutrition or food question, call Dial-a-Dietitian Manitoba at 204-788-8248 in Winnipeg or 1-877-830-2892. 

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Vitamin K for Newborns

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What is vitamin K? 

Our bodies need vitamin K to form clots and to stop bleeding. We get vitamin K from the foods we eat, such as green leafy vegetables, fish, meat, and eggs. 

Why does my newborn need vitamin K? 

Babies are born with a very small amount of vitamin K. Not having enough can cause bleeding that doesn’t stop because there isn’t enough vitamin K to form a clot. The bleeding can happen inside or outside of the body – including the brain – at any time up to six months of age. 

How is vitamin K given to babies? 

There are two ways newborns can receive vitamin K: 

  • A single injection in the thigh within 6 hours of birth, or 
  • three doses by mouth—one at baby’s first feeding, another at two to four weeks of age, and another at six to eight weeks of age. Your baby must receive all three doses. 

The Canadian Paediatric Society recommends that doctors and healthcare providers give newborns vitamin K by injection. Giving vitamin K by mouth is not as effective as by injection. Vitamin K is not absorbed as well when given by mouth and does not last as long. Babies who get vitamin K by mouth have a higher risk of later developing vitamin K deficiency. This can cause bleeding, which can happen between two weeks and six months of age. 

Is the vitamin K injection safe? 

Yes, the vitamin K shot is very safe. There are no side effects. There may be some redness, swelling, or pain at the injection site. 

Can’t my baby get vitamin K from my breast milk/chest milk? 

Breast milk/chest milk contains very low amounts of vitamin K, so babies who only breastfeed/chestfeed will not get enough. Even formula-fed babies have very low levels of vitamin K for several days. 

What about the injection pain? My baby is so little! 

To reduce pain from the injection, hold your baby during the vitamin K shot. You can also try breastfeeding/chestfeeding at the same time to comfort your baby. For more tips on reducing the pain see Pain Management During Immunizations for Children.

More information from the Canadian Paediatric Society 

Guidelines for vitamin K prophylaxis in newborns 

Resources 

Reviewed by the Canadian Paediatricians Society’s Fetus and Newborn Committee 

Reprinted with permission from the Canadian Paediatric Society 

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How Does Gender Identity Develop in Children?

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Reprinted with permission from the Canadian Paediatric Society

Gender identity refers to the deep and intimate feeling a person has of themselves. Children begin to understand and express their gender identity early in life.  

This article discusses how gender identity typically develops and how parents and caregivers can promote healthy development of gender identity and expression in children. It’s important to remember that each child is unique and may develop at a different pace. 

What we mean by gender: Some useful definitions 

Sex at birth: When children are born, sex is assigned based on external genitalia. A child who has a penis is said to be male. A child who has a vulva is said to be female. A child who is born with reproductive or sexual anatomy that does not fit the description of “female” or “male” is referred to as an intersex child. 

Gender identity: Gender identity is “who you know yourself to be.” It is important to know that gender identity exists on a spectrum. A person’s gender identity can be masculine, feminine, non-binary (neither entirely male nor entirely female) or other. 

Gender expression: This is how you portray your gender to others, whether through behaviour, clothing, hairstyle, the name you choose to go by, etc. Gender expression may or may not reflect gender identity.   

Sexual orientation: This refers to sexual or emotional attraction that one feels for another person. 

Transgender:  When a person’s gender identity is not the same as the assigned sex at birth, the umbrella term “transgender” (often shortened to “trans”) is used. For example, a child born with female genitalia may identify as a boy. A child may also say that they are not a boy or a girl, but just “themselves” because they don’t want their sexual characteristics to define who they are. 

Two-Spirit: Some cultures and Indigenous people use the term “Two-Spirit” to represent a person who identifies as having both a masculine and a feminine spirit. Two-Spiritedness can include cultural, spiritual, sexual and/or gender identity. 

Gender dysphoria: Describes the level of discomfort or distress that can exist when there is a mismatch between a person’s experienced gender and their assigned sex at birth. Some transgender and gender-diverse children experience no distress about their bodies, while others may express significant discomfort. This distress may increase as puberty begins and the body starts to change. 

Younger children may express their gender very clearly. For example, they may say “I am a she, not a he!”, “I am not your daughter, I am your son.”  

Children may also express their gender through their: 

  • Clothing or hairstyle 
  • Choice of toys, games, and sports 
  • Social relationships, including the gender of friends 
  • Preferred name or nickname 

Remember: Gender expression is different from gender identity. You can’t assume a child’s gender identity based on their gender expression (for example, their choice of toys, clothing, or friends)

Here is what you can typically expect at different ages: 

  • 2 to 3 years old:
    • At around 2 years old, children are aware of differences between boys and girls. 
    • By age 3, most children can identify themselves as a “boy” or “girl.” This term may or may not match their assigned sex at birth. 
  • 3 to 5 years old:
    • Some children’s self-identified gender remains stable, while others may alternate between presenting themselves as a “boy” or a “girl” at different times (sometimes even in the same day). This exploration is normal and healthy. 
    • Children become more aware of gender expectations or stereotypes as they grow older. For example, they may think that certain toys are only for girls or boys. 
    • Some children may express their gender very strongly. For example, a child might go through a stage of insisting on wearing a dress every day or refusing to wear a dress even on special occasions. 
    • While many children at this age have a stable gender identity, gender identity may change later in life. 
  • 6 to 7 years old:
    • Many children begin to reduce outward expressions of gender as they feel more confident that others recognize their gender. For example, a girl may not feel that she has to wear a dress every day because she knows that others see her as a girl no matter what she wears. 
    • Children who feel their gender identity is different from the assigned sex at birth may experience increased social anxiety because they want to be like their peers but realize they do not feel the same way. 
  • 8 years old and up:
    • Most children will continue to have a gender identify that matches the assigned sex at birth. 
    • Pre-teens and teens continue to develop their gender identity through personal reflection and with input from their social environment, like peers, family and friends. 
    • Some gender-stereotyped behaviours may appear. You may notice your teen or pre-teen making efforts to “play up” or “downplay” some of their body’s physical changes. 
    • As puberty begins, some youth may realize that their gender identity is different from their assigned sex at birth. 
    • Because some children’s gender identification may change, especially around puberty, families are encouraged to keep options open for their child. 

Some children go through a period of resisting society’s gender expectations. Remember that gender expression and gender identity are two different things. The way you express yourself does not necessarily define your gender. 

Children do best when their parents or caregivers show them that they are loved and accepted for who they are.  Discouraging your child from expressing a gender can make them feel ashamed. Give them unconditional support. In doing so, you are not framing a gender, but simply accepting who they are and how they are feeling. 

For many children, this is part of normal exploration of gender identity. No one can tell you whether your child’s gender identity or expression will change over time. What children need to know most is that you will love and accept them as they figure out their place in the world. In older children, you can also gently help prepare them for potential negative reactions from other children, for example, by role-playing how best to confidently respond to teasing. 

Gender-diverse children express their gender differently from what society may expect. For example, a boy who wants to wear dresses might be considered gender-diverse. Society’s expectations for gender constantly change and vary in different cultures and at different times in history. 

Parent support is key!

  • Love your child for who they are.
  • Talk with your child about gender identity. As soon as your child is able to say words like “girl” and “boy,” they are beginning to understand gender.
  • Ask questions! This is a great way to hear your child’s ideas about gender.
  • Read books with your child that talk about many different ways to be a boy, a girl, or having another gender identity.
  • Don’t pressure your child to change who they are.
  • Find opportunities to show your child that gender-diverse and transgender people exist and belong to many communities who appreciate and love them.
  • Ask your child’s teachers how they support gender expression and what they teach about gender identity at school.
  • Be aware that a child who is worrying about gender may show signs of depression, anxiety and poor concentration. They may not want to go to school.
  • Be aware of potentially negative issues that your child may face. Let your child know that you want to hear about any bullying or intimidation towards them.
  • If you are concerned about your child’s emotional health, talk to your child’s family doctor, paediatrician, mental health provider or other professionals that specialize in the care of gender-diverse and transgender children.
  • Some parents have a hard time accepting that their child’s gender identity is different from the assigned sex at birth. If you are having difficulties, please seek additional help through websites, printed resources, support groups or mental health providers. See below for additional resources.

Gender diversity is not a result of illness or parenting style. It is not caused by letting your child play with dolls or trucks. 

If your child is gender-diverse, they can live a happy and healthy life. Get support from other parents of gender-diverse children or talk to a mental health professional who specializes in the care of gender-diverse and transgender children (if available in your community). Indigenous families can talk to a Two-Spirit elder or leader. See additional resources listed below.  

References: 

Resources 

Books for Parents: 

  • The Transgender Child: A Handbook for Parents and Professionals Supporting Transgender and Nonbinary Children (updated 2022) by Stephanie Brill & Rachel Pepper 
  • Transitions of the Heart: Stories of Love, Struggle and Acceptance by Mothers of Transgender and Gender Variant Children (2012) Edited by Rachel Pepper 
  • Parenting Trans and Non-Binary Children: Exploring Practices of Love, Support and Everyday Advocacy (2022) by Mikulak Magdalena 

Manitoba Family Resources: 

Rainbow Resource Centre 

Online Resources: 

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Formula Feeding Your Baby

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Deciding how to feed your baby may come with a lot of questions. You may feel overwhelmed with the amount of information there is. If you are trying to decide and want more information on breastfeeding/chestfeeding see our article, Breastfeeding/Chestfeeding – Good for Baby, Good for You.

If formula feeding is part of your plan for your healthy, full-term baby, this information is for you. Ask your health-care provider about what type of formula is best if your baby: 

  • is premature 
  • is ill 
  • had a low birth weight 
  • has special needs

How to choose an infant formula 

  • There are many types and brands of formula on the market. Choose what works best for your situation unless your health care provider says your baby needs a special formula. Do not choose a formula based on advertising or the brand they gave you in the hospital. 
  • All formulas must meet safety standards set by Health Canada. The law requires that all brands of regular formula have the same basic ingredients. 
  • For most babies, a cow’s milk-based, store-bought infant formula with iron is best. Always check the label for the type of infant formula you are buying for your baby. 
  • Formula with prebiotics, probiotics or DHA and ARA fats added are available. However, the research is mixed about whether these types of formulas are beneficial for all babies. 
  • Organic formula is not necessary. Parents may choose it for personal reasons. 
  • Formula with “partially broken down” proteins is not needed by most infants but may be recommended by a health-care provider for some medical conditions. 
  • When buying formula, check the expiry date on the package. Do not use formula that is expired. 
  • Never buy formula if the container is damaged, dented, unlabelled or bulging. 
  • Formula-fed babies need to stay on infant formula until they are nine to 12 months of age. “Follow-up” formula is not needed. 

Did you know?

 All breastfed/chestfed and formula-fed babies need a vitamin D supplement. 

Do not use… 

  • homemade formula 
  • cow’s milk or goat’s milk 
  • plant-based beverages made from almonds, cashews, soy, rice or other plants

Note: Soy-based infant formulas are recommended for babies with some medical conditions, and some parents may decide to use soy formulas for personal, cultural or religious reasons. Discuss this with your health-care provider. 

There are three types of infant formula 

  • Ready-to-use – It really is ready to use. You do not need to add anything to it. This type is generally the most expensive. 
  • Concentrated liquid – You need to add sterile water according to the directions on the package. This type is also more expensive. 
  • Powder – This is the least expensive type of formula. Unlike the others, powdered formula is not sterile. It is not recommended for babies who:
    • are born premature (less than 37 weeks gestation) and are under two months of age 
    • are born with a low birth weight (under 2.5 kilograms) and are under two months of age 
    • have a weakened immune system 

If you’re unsure, talk to your health-care provider before giving powdered formula to your baby. 

Formula Comparison Chart

Formula

Preparation

Cost

How to store container after opening

How long open container can be stored

Powder *Powdered infant formula is not sterile

Boil water for two minutes Add powder to water while it is still over 70°C and follow mixing instructions that come with your powdered formula

Least expensive

Covered in a cool dark place

Less than 30 days

Liquid concentrate

Boil water for two minutes Let water cool Mix equal amounts of water and liquid concentrate

More expensive

Covered in fridge

Between 24 to 48 hours. Check the formula container for the different formula recommendations.

Ready-to-use

Use as is

Most expensive

Covered in fridge

Between 24 to 48 hours. Check the formula container for the different formula recommendations.

Do not mix different types or forms (such as powdered and concentrate) of formula together when preparing bottles unless directed by your health-care provider.

More things you need to know about formula feeding 

Feeding your baby is more than providing nourishment. It’s also a time to learn about your baby and connect with each other. This helps your baby grow and develop. Skin-to-skin contact during feeding has many benefits, including calming your baby and helping them feel safe and secure. 

two adults smiling and holding their baby

References

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Thinking About Getting Pregnant? Take Folic Acid

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Did you know that taking a folic acid supplement at least three months before pregnancy can help prevent a serious health condition called neural tube defect in your baby? A neural tube defect (NTD) is a serious health condition that affects your baby’s brain and spinal cord. Taking a folic acid supplement can help prevent NTDs in your baby. Most NTDs happen in the first four weeks of pregnancy, often before you know you are pregnant. This is why people who could become pregnant (adults and teens) should consider taking a daily multivitamin containing 0.4 mg of folic acid. 

What is folic acid? 

Folic acid (also known as folate or folacin) is a B vitamin. Foods rich in folic acid include some grains, green vegetables (spinach, broccoli), meats (liver) and legumes (lentils and kidney beans). Although it’s found in these foods, it can be hard to get enough folic acid from diet alone. Folate is essential to the normal development of your baby’s spine, brain and skull, especially during the first four weeks of your pregnancy. It helps your baby’s neural tube develop properly during pregnancy and protects against neural tube defects (NTDs). It may also lower the risk of other problems, such as cleft lip and palate or heart and urinary tract defects. 

What is a neural tube? 

A baby’s central nervous system starts to develop early in pregnancy. When that happens, a neural plate forms, which eventually folds in on itself and becomes the neural tube. One end of the neural tube forms the brain, and the rest forms the spinal cord. By week six of a pregnancy, the openings in the neural tube usually close. 

What is a neural tube defect? 

Neural tube defects happen when one of the openings in the spinal cord does not close properly during early pregnancy. This leads to spina bifida or anencephaly. Spina bifida results when the spine does not develop normally. Anencephaly happens when the skull and brain don’t form normally. NTDs happen in three to four of every 10,000 babies born in Canada. 

When do neural tube defects happen? 

NTDs happen 25 to 29 days after conception, before you may even realize they are pregnant. That’s why it’s important to start taking folic acid supplements at least three months before becoming pregnant. 

How much folic acid should I take? 

Most healthy women should supplement their diet with 0.4 mg (400 micrograms) of folic acid daily. You can usually find it in a daily multivitamin. You may need a higher daily supplement if you have: 

  • an NTD yourself or in your partner 
  • a family history of NTDs (sibling, parent, cousin) 
  • diabetes, epilepsy, advanced liver disease or inflammatory bowel disease
  • had gastric by-pass surgery
  • a history of over-use of alcohol
  • had a previous liveborn or stillborn infant with an NTD

If you are not certain which dose you need, talk to your health care provider. 

If you are already pregnant, it is a good idea to keep taking a multivitamin with folic acid or a prenatal vitamin throughout your pregnancy. 

Can you test for neural tube defects in your baby? 

There are two tests available for the detection of NTDs in the second trimester of pregnancy: 

  • A blood test that measures the level of a protein called “alpha fetoprotein” or AFP in the mother’s blood. This test is usually performed between 16 and 18 weeks of pregnancy. 
  • A detailed ultrasound examination of the baby’s head and spine. This is usually done between 17 and 20 weeks of pregnancy. 

These tests are not harmful to the baby and will detect the majority of babies with NTDs. 

Reprinted with permission from Caring for kids (cps.ca) 

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Prenatal Care: Why It’s Important and What to Expect

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Prenatal care is a good way to make sure that you and your unborn baby are healthy. Regular prenatal care: 

  • helps keep you and your unborn baby healthy. 
  • identifies and helps you address health concerns. 
  • lets you learn more about your growing baby and your changing body. 
  • gives you a chance to ask questions. You may find it helpful to come with your list of questions. 
  • helps you bond with your unborn baby. 
  • connects you with community services. 

In Manitoba, health care is insured (paid for) through our medical system. A family physician, obstetrician or midwife can provide your prenatal care. Family physicians and midwives can provide care to you and your baby after birth. For more information see our page on finding a health care provider. 

Your first visit – what to expect 

You should have your first prenatal appointment between 10 and 14 weeks of pregnancy. 

At this visit, your health care provider will:  

  • Ask you about your health and any medical conditions. 
  • Offer you a physical examination including checking your weight and blood pressure and Pap test if needed. 
  • Give you a form for lab tests. You will have a urine test to check for bacteria and a blood test to check for:
    • anemia (low hemoglobin or iron levels, which can make you feel tired and weak) 
    • sexually transmitted infections including syphilis and HIV 
    • antibody levels for chickenpox, measles, mumps and rubella, hepatitis B 
    • blood type and Rh factor 
    • thyroid levels 

How often will I have prenatal appointments? 

  • one a month until you are about 28 weeks pregnant
  • then every two weeks between 28- 36 weeks of pregnanc 
  • then every week until you give birth

What to expect at all my prenatal appointments? 

For every visit, you can expect to:

  • have your blood pressure and weight taken. 
  • hear your baby’s heartbeat. 
  • have your belly measured to check that your baby is growing well. 

What are other tests I should expect during my prenatal appointments? 

Between 15-20 weeks of pregnancy: 

  • You will have another blood test (Maternal Serum Screening in Manitoba)  which tests for Down’s syndrome, Trisomy 18, Trisomy 13 and open neural tube defects. 
  • You will have an ultrasound when you are 20 weeks pregnant to:
    • check how your baby is growing and developing 
    • identify if there any problems 
    • check your amniotic fluid and placenta 
    • determine if you are carrying more than one baby  
    • confirm how many weeks pregnant you are (your due date may change based on this) 
    • check how active your baby is 
    • try to determine the sex of your unborn baby if you want to know. If you want to know the sex, they will write it in the report and your health care provider will tell you at your next appointment.

For more information check out Routine Tests – The Society of Obstetricians and Genecology 

Healthcare professional performing an ultrasound on a pregnant patient, pointing to the monitor displaying the fetus

How to prepare for your ultrasound: 

  • wear loose fitting clothes 
  • do not pee before your ultrasound (you need a full bladder) 

Note: A keepsake ultrasound may seem exciting and provide an opportunity see your unborn baby however, they are not recommended. The Society of Obstetricians and Gynaecologists of Canada, Health Canada and the Food and Drug Administration in the U.S., all recommend against the use of ultrasound to take pictures of your unborn baby for non-medical reasons. To read more about why it is not recommended click here. 

At 24-28 weeks of pregnancy: 

Pregnancy tip: be prepared to be at this appointment for a couple of hours 

A smiling pregnant person holding a glass filled with orange liquid.

You will be offered a “glucose challenge test” which checks for diabetes in pregnancy (gestational diabetes).  

This involves: 

  1. consuming a high-sugar drink
  2. waiting for an hour 
  3. having a blood test to see how your body responds to sugar

During the blood test they will also re-check for anemia, Rh status and sexually transmitted infections. 

At 28-37 weeks of pregnancy: 

You may need follow up care if your tests results show you have Rh negative blood and do not have antibodies for Rh factor. Your provider may give you an injection of RhoGAM at 28 weeks of pregnancy. This prevents a serious blood condition from developing in your baby. 

  • You will also receive a vaginal/anal swab to test for Group B Streptococcus (GBS) around 35 to 37 weeks.
    • GBS is bacteria that are commonly found in the vagina and anus. It is not harmful to you but can be transferred to your baby during delivery and cause a serious infection. If you test positive for GBS, you will receive an intravenous antibiotic during labour. 
  • You will be tested again for sexually transmitted infections. 

From 37 weeks until you deliver, you will see your health care provider weekly. For more prenatal information see: Babies Best Chance- 7th Edition Parents’ Handbook of Pregnancy and Baby Care. 

What vaccines are recommended for pregnant people?  

With each pregnancy, you should be immunized with Tdap (tetanus, diphtheria, pertussis) vaccine between 27 and 32 weeks. This protects your newborn baby particularly against pertussis (whooping cough) for the first few months of life. 

COVID-19 and flu vaccines are also recommended at any stage in pregnancy. They are effective at reducing the risk of severe illness, hospitalization and death due to flu and COVID-19. The vaccines will also protect your baby once they are born. Visit Vaccine Finder – Government of Manitoba  to find out where you can get your vaccine. 

References

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