What’s Your Rule About Epi-Pens?

[cheerfuldom]

I accepted a child into care and mom did not tell me until their first day that they have a peanut allergy and also an epi pen! Not happy about this.

We discussed the issue and kid is seeing an allergist and has had peanuts recently without an allergy issue. Mom says they have never used the pen and have not had any allergy issues/hives/etc for over a year (kid is 3) but that the doctor insists that they have an epi pen just in case. I have told mom that I do not guarantee a peanut free home and that I do not have any experience with epi pens.

Kid is not scheduled to come on a permanent basis for another week and half (finishing out the time in the current childcare arrangement).

What would you do?

[EchoMom]

I have a 2 year old with a peanut allergy, has been to the allergist, and they gave me epi-pens to keep here at my house. It makes me nervous as no one has been very clear with me as to how bad the allergic reaction is, what happens, how sensitive he is to them, etc. So I just don't give him anything with nuts and hope I never have to use it! Although, using it seems very very easy if an emergency did happen.

[momma2girls]

You will have to make sure and check all labels on everything you pourchase for snacks, etc.... there are many, many, many labels that say made in peanut factories, or lines. You have to be so careful!! It also depends on the severity of the allergy. There are many that are deathly allergic and you can't have anything made on peanut lines in your house, peanut butter, nuts, etc......

[DCMama]

IF it's still a trial period I would explain to them I am unable to serve their child. It's just not safe if you're not confident or comfortable with it gl

[cheerfuldom]

I have already told mom that I will not be altering anything here in order to accommodate a peanut allergy, that is something that does not work for my program and is too much of a liability for me to promise that. I have 5 daycare kids total plus a very active household (family and friends over in the evenings and weekends) and I absolutely would never guarantee that I could keep a peanut free home. Kid eats breakfast and dinner at home, and is sent a sack lunch for daycare so mom provides food in that regard.

She said she understands that and considering the past year (no allergic reactions even when big sibling gave kid peanuts on accident), she is fine with the arrangement in my household.

I will have her sign a medical permission form/release regarding the epi pen use in case of emergency.

anything else I am missing?

[BumbleBee]

I accepted a child into care and mom did not tell me until their first day that they have a peanut allergy and also an epi pen! Not happy about this.

We discussed the issue and kid is seeing an allergist and has had peanuts recently without an allergy issue. Mom says they have never used the pen and have not had any allergy issues/hives/etc for over a year (kid is 3) but that the doctor insists that they have an epi pen just in case. I have told mom that I do not guarantee a peanut free home and that I do not have any experience with epi pens.

Kid is not scheduled to come on a permanent basis for another week and half (finishing out the time in the current childcare arrangement).

What would you do?

I would not give the child any peanuts or tree nut products. Ask mom for a list of foods that the child cannot have.

Honestly, I would insist an epi-pen be at your home. You never know when an allergy will flare up and it's better to be safe than sorry. Epi-pens are pretty straight forward to use. They do have 'trainers' that sometimes come with the epi-pen. If that is the case, ask mom to bring in the trainer and show you how to use it.

If I remember correctly, all epi-pens have the directions written on them in a 1, 2, 3 step manner with pictures.

Additionally, I would have mom talk to the Dr. about having Benadryl on hand. Sometimes, if it's a minor reaction, Benadryl will calm it down before it gets to be full blown anaphylactic shock. Perhaps ask if the child has an inhaler as well. Some children with peanut allergies do and some don't. If the child does, I would insist that you have that too. In a pinch if you cannot access the epi-pen quickly but can access the inhaler you can use to inhaler to keep the air way open for a short period of time until you can access the epi-pen.

[cheerfuldom]

I would not give the child any peanuts or tree nut products. Ask mom for a list of foods that the child cannot have.

Honestly, I would insist an epi-pen be at your home. You never know when an allergy will flare up and it's better to be safe than sorry. Epi-pens are pretty straight forward to use. They do have 'trainers' that sometimes come with the epi-pen. If that is the case, ask mom to bring in the trainer and show you how to use it.

If I remember correctly, all epi-pens have the directions written on them in a 1, 2, 3 step manner with pictures.

Additionally, I would have mom talk to the Dr. about having Benadryl on hand. Sometimes, if it's a minor reaction, Benadryl will calm it down before it gets to be full blown anaphylactic shock. Perhaps ask if the child has an inhaler as well. Some children with peanut allergies do and some don't. If the child does, I would insist that you have that too. In a pinch if you cannot access the epi-pen quickly but can access the inhaler you can use to inhaler to keep the air way open for a short period of time until you can access the epi-pen.

thank you for those thoughts!

[e.j.]

anything else I am missing?

Both of my kids have an EpiPen and I always had to supply their schools with an Allergy Action Plan and an Anaphylaxis Medication Order filled out and signed by their doctors. On the forms, their doctors had to list their allergy triggers (peanuts in your dcg's case), Symptoms to watch for like swelling, flushed face/body, cold clammy skin, difficulty breathing, cramps, diarrhea, etc. and Medication to be used (Epi Pen) and under what circumstances it should be used, any special instructions and any possible side effects to watch for. If I enrolled a child who came with an Epi, I would want all of that info in addition to permission slips signed by the parent allowing me to administer meds.

[e.j.]

Here's a form similar to the one I had to have for my kids. https://www.foodallergy.org/files/FAAP.pdf

[Solandia]

Let me get this right...this mom enrolled her child, then brought the child to your daycare before mentioning a major potential health issue that is your direct responsibility to control?

Oh, HELL NO. I would drop enrollment the child during the probationary period. Nothing to do with the health issue, and EVERYTHING to do with the mom thinking it is not an issue. My last couple CPR/first aid renewal we did epi training & AED...is that not standard across the country? But it is super easy. That isn't the issue, but the mom trying to 'convince' you that it is no big deal. Did mom tell you if you have to use the epipen, you still have to call 911 and the child needs to go to the hospital...or was that not a big deal to mention, either?

Nope, I don't deal with parents like that.

[My3cents]

I would not want this liability. I think the mom knew that if she told you the child had an allergy that you probably would not have taken the child as most daycare homes don't want to have to deal with this.

One of the first ?'s I ask during an interview and on the first phone call, is does your child have any allergies- I probably ask this more then once. One of my favorite foods is peanut butter. Peanuts are used in many products and I don't want to have to admit them from our diet and home. A true peanut allergy can be deathly. If the child has an e pen most likely its not just a minor allergy that benadryl can fix. One thing that both my husband and I are strong on, because it takes a revamp of your whole home, diet, and what comes into your home. I am talking about a true peanut/nut allergy. If it was mild and controllable I would want a doctors note stating the severity. Having this child in my program would not be a good fit for me, and the fact that she didn't mention this to you concerns me too.

[Sunchimes]

I had one with a peanut allergy until recently. The doctor wouldn't give her an epi-pen until she was 2 (next month) at which time she will be re-tested. As far as I know, she has only had 2 attacks in the year I've known her. Both sent her to ER, but neither one happened on my watch. I went radical and totally peanut free. Since PB is the only sandwich I like, it was hard, but it was harder seeing that poor little thing after one of her attacks. Nothing came into my house unless I read the label. It wasn't hard, and we didn't suffer. She left last month, and we had our first PB sandwiches in day care. The other kids weren't impressed, and I probably won't bother again.

[momofboys]

I would require the parents to provide her food. I would require a signed release leaving you blameless if an incident were to occur under your watch. I would think it through some more before you proceed. If you don't want to take the child I think it is fair for you to tell her so - after all she was misleading you by not lettign you know in advance! Not cool!!!

As a mom of a parent with a peanut allergy I would not proceed with a provider who can't accomodate me (or is not willing to ensure a peanut-free environment). A mistake on your part could be deadly for this child. A child can be exposed to a food item & not have any issues - then BOOM one day it is a huge anaphylactic reaction. I am not saying you are wrong for having a nonchalant attitude about it (saying you won't go peanut-free) after all the parent sprung this on you last minute which I think is very wrong. Personally if if were me as the parent I would have went all out to make sure the provider was OK with said allergy & knew all she needed to know. I am surprised the parent still wants to proceed with care with you. If you don't feel comfortable with it I would let her know & void your contract due to her leaving out important information!

[DaisyMamma]

Are you required to be med. certified to administer the epi?
My state requires this. I got certified once and never renewed because I didn't want the liability.

[texascare]

Make sure you have an Epi pen and some Benadryl on hand! I have had several kids with allergies and a pen but for me it isn't a big deal because my son is a Type 1 Diabetic and I could in an emergency use an Epi pen.