Sick Child Question...Please Help...What to Tell The Parents

[WImom]

I have a DCB that was home last week Monday and Tuesday for Gi issues (what mom told me over the phone). Then Wednesday came back and did fine. Thursday came and I sent home after 45 minutes due to two diarrhea diapers. Then see right after he left mom had emailed saying DCB may have rash due to loose bm in the morning .

Stayed home Friday. Dad calls this morning to tell me DCB is staying home today because he threw up and has Diarrhea again this morning. Was on BRAT diet Friday-Yesterday and was fine all weekend. Then last night they gave him chicken and noodles and now his tummy is upset again. DCD wanted to know if he could just send BRAT diet food for him to eat here. (UM...no - he needs to be on regular food - I didn't say they because I wasn't sure what to say. I just said he needed to be symtom free for 24 hours).

What should I tell these parents? Go to the doctor and get a note? He needs to be okay to eat regular foods for 24 hours? Anyone have this issue before?

[daycarediva]

I would ask for a dr's note at this point. If he has been sick for over a week now and isn't improving, then he probably should be seen. I also tell parents (it's in my parent handbook) that the child needs to be symptom free without aid of medication, feeling and acting fine & able to participate fully. So no, I would not allow dcb to come back on a special diet due to illness.

[Blackcat31]

I have a DCB that was home last week Monday and Tuesday for Gi issues (what mom told me over the phone). Then Wednesday came back and did fine. Thursday came and I sent home after 45 minutes due to two diarrhea diapers. Then see right after he left mom had emailed saying DCB may have rash due to loose bm in the morning .

Stayed home Friday. Dad calls this morning to tell me DCB is staying home today because he threw up and has Diarrhea again this morning. Was on BRAT diet Friday-Yesterday and was fine all weekend. Then last night they gave him chicken and noodles and now his tummy is upset again. DCD wanted to know if he could just send BRAT diet food for him to eat here. (UM...no - he needs to be on regular food - I didn't say they because I wasn't sure what to say. I just said he needed to be symtom free for 24 hours).

What should I tell these parents? Go to the doctor and get a note? He needs to be okay to eat regular foods for 24 hours? Anyone have this issue before?

Personally, I don't get too overly concerned about Dr notes and diagnosis of illness unless it is strep or something serious. Diarrhea and upset tummies simply require care I don't provide.

I just focus on the symptom free for a FULL 24 hours rule before they can attend care. If he had ANY episodes of diarrhea and/or vomiting in the last 24 hours, he needs to stay home.

If they say he has been symptom free, then they can send him. If he has another episode while in care, send him home and require he reamin home now for 48 hours before returning.

[Mom&Provider]

If he needs a special diet to keep his bowels under control he isn't well enough to be in care. If he's had diarrhea and vomitting just this morning, he can't come...period. I would just stick to what your rules are, most of us have the same ones, no return to care until he is pooping fine and no vomitting!

It sounds like he has something viral, its' been going around alot lately, so to send him into the Dr's won't really solve anything!

[daycarediva]

I said (and stand by) a dr visit because after a full week of this, I think most pediatricians would recommend it as well. My ped says after 72 hours, still showing symptoms, bring them in.

This happened to my DD. She was sick for a week, we thought she had a virus. I called and they said to bring her in. She ended up with Ecoli 0157 H7, and because I brought her in, and they did a stool spec, she was monitored early. She STILL lost a great deal of kidney function, was on dialysis for 6 months and nearly died.

Diahhrea is some serious business in little people.

[Blackcat31]

I said (and stand by) a dr visit because after a full week of this, I think most pediatricians would recommend it as well. My ped says after 72 hours, still showing symptoms, bring them in.

This happened to my DD. She was sick for a week, we thought she had a virus. I called and they said to bring her in. She ended up with Ecoli 0157 H7, and because I brought her in, and they did a stool spec, she was monitored early. She STILL lost a great deal of kidney function, was on dialysis for 6 months and nearly died.

Diahhrea is some serious business in little people.

While I agree that being sick for over a week is something to be concerned about, it isn't MY concern...kwim?

I just don't allow the child to return until they are symptom free. MOST parents (and I guess I use that term lighty ) would bring their child to see the pediatrician if they are sick for more than a few days but other than suggesting a visit, I can only stop them from coming here.

I can't make them go to the doctor and a Dr's note really does me no good other than being able to name what the child has but still won't change my illness policies. NO care until they are symptom free for a FULL 24 hours.

FWIW~ We have a GI illness going around here (our community) that is lasting up to 10 days. Diarrhea, throwing up and generally just not feeling so hot. It seems to be effecting the school age kids the most but the little ones are getting high fevers with no other symptoms and having that last up to a week too. NOT a fun time of the year I guess.

[countrymom]

hmm, I'm not sure. If they had symptoms on friday and nothing on the weekend, then I would take them back and offer a brat diet. Its not hard to give them toast and crackers all day and some water.

[Scout]

I also think the child needs to be seen by the ped. He could be easily getting dehydrated & with so many things that can cause vomiting and diarrhea I'd want to play it safe.

[MN Mom]

Maybe it's C-dif? My baby cousin was diagnosed with it 2 years ago and his symptoms were almost identical.

[WImom]

Update!

Update:

Parents took him to doctor since they thought maybe a bowel obstruction. But doctor put him on BRAT diet and Probiotics. I guess this can last for 2-4 weeks.

So I'm thinking (a) I need a doctor's note saying he isn't contagious. (b) He still needs to be symptom free of vomiting and diarrhea for 24hours (c) will be sent home if he has any of those symptoms.

Is this what you'd do? They want to know if he can attend or does he have to be out for the whole 2-4 weeks.

[Blackcat31]

Update:

Parents took him to doctor since they thought maybe a bowel obstruction. But doctor put him on BRAT diet and Probiotics. I guess this can last for 2-4 weeks.

So I'm thinking (a) I need a doctor's note saying he isn't contagious. (b) He still needs to be symptom free of vomiting and diarrhea for 24hours (c) will be sent home if he has any of those symptoms.

Is this what you'd do? They want to know if he can attend or does he have to be out for the whole 2-4 weeks.

I would allow him to attend as long as he doesn't have diarrhea and/or any symptoms you normally would exclude for.

I know the virus can last for up to two weeks but as long as he is better and not requiring any care you don't normally provide, I see no reason to keep him out for the whole two weeks.

Symptom free means he can return to care. ANY repeat symptoms and he goes back home until he is again free of any symptoms for a full 24 hours.

[daycare]

I would allow him to attend as long as he doesn't have diarrhea and/or any symptoms you normally would exclude for.

I know the virus can last for up to two weeks but as long as he is better and not requiring any care you don't normally provide, I see no reason to keep him out for the whole two weeks.

Symptom free means he can return to care. ANY repeat symptoms and he goes back home until he is again free of any symptoms for a full 24 hours.

THIS.....this is exactly what I stress on the parents. NO symptoms can be present in order to attend care. they must be able to participate as normal.

If they come and display any symptoms of being ill, I will send home. I don't need a doc note to tell me why they can or cant be here. BOTTOM line, if you are displaying any type of symptoms for any reason, you can NOT be here...

[ninosqueridos]

Doctor's note is nice, but SYMPTOMS trump everything. Good luck!!