Help...Spit up or Throw Up?

[aDCProvider]

At drop off this morning I had a DCD bring almost 1 year old boy in and say nonchalantly "he threw up in the car". I asked if he threw up or spit up (DCB has been known to spit up earlier on due to over feeding but it hasn't happened since the pedi told them to cut down his food). DCD continued to say he threw up, I told him that DCB could not be here if he threw up, then DCD began to argue that what's the difference, I said if it's just liquid from the bottle then it's spit up, if food, then it's vomit. At this point I was holding the baby and smelled his soiled bib and it distinctly smelled like vomit and I told DCD this. He began to argue getting louder that maybe it was just carsickness or eating too fast and said he doesn't look sick and asked me if I thought he looked sick. I told him it didn't matter that I have to exclude for the symptom as per state regs and that he couldn't be here. He left in a huff saying he had a busy day at work I apologized and his response was "ya whatever". My assistant was shocked at how rude he was considering I've always been lenient with this family since we have mutual friends.

To do damage control, I called DCM and left a message saying that he left very upset with me and explained that the state requires me to exclude for vomit, diarrhea and fever. I left a similar message on dads VM but also adding that we've had a good working relationship to this point and I feel bad having him leaving here so seemingly upset with me but that he has to understand why I sent him home.

15 minutes later another DCB has diarrhea overflowing his diaper, so I send a text to every parent saying to let me know if any symptoms show up as I just sent two kids home with diarrhea and vomiting. DCD responds "he is fine" and mom texts back that he's perfectly fine and must be due to eating to fast as usual. Then she said he must have misspoke, I said I asked if he meant spit up and he said no he threw up so I had to exclude at that point as I have to minimize the risk of exposure to the other kids and that I have to stick to state regs or I could get cited for noncompliance. I also apologized for the inconvenience and said I felt bad that DCD was so upset with me.

I'm not so worried about DCD being upset, I know he will get over it. I just don't like how rude he got or that he raised his voice at me while I was holding his baby and my baby and 2 other DCKs witnessed this. I feel like I need to say something when things calm down about how he treated me.

Also, a question for all you providers, when is spit up not an excuse for vomiting? I believe when a child is eating all table foods and throws up that it is "vomit" if spitting up all liquid after a bottle that is "spit up". This baby is going off formula when he turns one in just a couple weeks, after that I don't think they can ever use the term "spit up" again. What do you all think? And how do you treat spit up vs. throw up when it comes to DCKs?

I will be calling my pediatrician and asking, also we have the same pedi as this family, so the answer I get will be the same one they get if they ask him.

[Oss_cc]

I think by that age, spitting up is really rare. I had a baby with very active reflux that still stopped spitting up by about 7 months. It was probably throw up. Who knows if it is illness related, but you have to exclude for symptoms.
You did the right thing!

[llpa]

Wow! Well, to sort it out, first of all you DID give dad the opportunity to say he spit up but he was the one using the words "threw up". Second, if he did throw up, it doesn't matter why! How are you to know whether it's a virus or overeating at breakfast? Third, yelling at you in front if your child dcks and his own child is unacceptable. He needs a written family warning that if it happens again, you will not be willing to deal with him. Last, imho, spitup is watery milky formula or breastmilk. It can smell bad, but usually is a fairly small amt. Vomit smells awful and if the child has more than formula will generally contain food particles. I think if it smelled like it, it probably was. Sorry your day started that way!:hug:

[daycarediva]

I would strongly consider terming for the blatant disrespect. Anyone raising their voice to me would probably be termed. I don't care what their track record is, that's NOT acceptable.

[taylorw1210]

You did the right thing. I made the wrong call in the same situation as this, but with a younger child. He was very well known for spitting up on the regular, was 7 months old, and I just thought maybe he way over ate as he was acting normal, no fever, etc. I ended up having to close for 2 days as myself, my own children, and literally every single daycare kid came down with it.

I would definitely provide the family with a written warning letting them know that the way DCD handled the situation and treated you was completely inappropriate and that you will not stand for that type of treatment.

[Play Care]

It really doesn't matter what it was, he should NOT have been yelling at you.

That's term worthy, IMO.

[KiddieCahoots]

I think by that age, spitting up is really rare. I had a baby with very active reflux that still stopped spitting up by about 7 months. It was probably throw up. Who knows if it is illness related, but you have to exclude for symptoms.
You did the right thing!

At almost 1yr, I'd think it was vomit.
My daughter had reflux that was projectile. At 7 months, completely all gone! Like someone hit the non reflux switch.

Dcd yelling and disrespecting you is totally not acceptable.
Like taylorw1210 said, a written warning.

I'd stop apologizing to them for their child vomiting too.
Sometimes that opens the door for parents to believe they have a right to act inappropriately.

[EntropyControlSpecialist]

Stop apologizing. THEIR child was sick. You politely declined care as you are required to do. You did nothing wrong but are indicating that you did, to them, by continuing to be sorry.

[aDCProvider]

Okay, so we all agree at DCB's age anything coming out of his mouth will be considered vomit. How would you explain this to the parents the next time they try to explain it away as spit up or eating too fast or car sickness? Please help me with the words.

Also, I called the pedi and they couldn't say one way or the other what classifies vomit. At one point they said with the lack of fever or other symptoms it was likely spit up BUT if it was chunky and more than a tiny amount then it was vomit, so really they were no help.

[aDCProvider]

Stop apologizing. THEIR child was sick. You politely declined care as you are required to do. You did nothing wrong but are indicating that you did, to them, by continuing to be sorry.

I only apologized for the inconvenience. I know I did the right thing, I'm only sorry I had to deal with DCD disrespect. I will be talking to both of them very soon.

[nannyde]

I wouldn't allow a parent to talk to me like that. He would have been terminated the minute he walked out the door.

He could be puking his guts out all day and night and they will say he is fine. If he pukes tomorrow or has diarrhea you will know they were lying.

I wouldn't have apologized for anything. Caring for your sick kid is just parenting.

[aDCProvider]

Update

I received a text from DCD this morning saying that he understands that I have rules to follow but he wanted to tell me how he felt..basically he said we all know his child spits up a lot (true, but stopped 2 months ago at least for me when we found out from Pedi that we were all over feeding him) he also said he's frustrated because his kid wasn't sick only carsick and I should've used more common sense in this situation since we all know him and he does this and the pediatrician is not concerned.

My response basically was that at his age now spit up is not common and that the board of health and state are very strict about not caring for kids who have been vomiting, having diarrhea or fever. I said that I haven't had an incident of spit up here since his 9 month appointment when I was notified to cut down his food and that for future reference I cannot care for him if he has vomited and that to avoid this from happening again and to cover me I would need a doctors note from the pedi saying that he is prone to spitting up and that with the absence of other symptoms that he is cleared for daycare.

I know he was rude, both yesterday and in his text but I refuse to get in a text war. I will address it with him in person the next time I see him about how he was disrespectful.

I don't believe the pediatrician will give a blanket note for spitting up at his age, because it's not spitting up now and the doctor will tell him that. The doctor told them at 9 months that all the spit up was caused by eating too much ( so there is a reason), at this point the doctor knows that this is not normal and so do I. They're just trying to excuse the vomit because he used to be a spitter.

[Blackcat31]

You did the right thing.

I also think it's important that DCD understands that you can't just take his word for it (if his child is or isn't ill). Also car sick is still ill.

If it really was no biggie, why did dad mention it to you? Did the child come in covered in vomit? Was he (DCD) expecting you to clean him up?

I think DCD needs to understand GROUP care and that ONE child's situation along with HIS guess (in regards to the reason he threw up) is NOT a reason for you to risk exposing the other kids.

Parents only get upset about this when it is them being told no. If you had reiterated this same scenario to him about another family guessing their child
s diganosis, he would have congratulated you on standing firm...after all he wouldn't want his child getting ill from someone else.

[aDCProvider]

You did the right thing.

I also think it's important that DCD understands that you can't just take his word for it (if his child is or isn't ill). Also car sick is still ill.

If it really was no biggie, why did dad mention it to you? Did the child come in covered in vomit? Was he (DCD) expecting you to clean him up?

I think DCD needs to understand GROUP care and that ONE child's situation along with HIS guess (in regards to the reason he threw up) is NOT a reason for you to risk exposing the other kids.

Parents only get upset about this when it is them being told no. If you had reiterated this same scenario to him about another family guessing their child
s diganosis, he would have congratulated you on standing firm...after all he wouldn't want his child getting ill from someone else.

I don't know why he told me, because his bib had wiped up vomit and I could smell it when he handed him to me. I can bet you they won't tell me the next time he "spits up".

I told him that neither he or I know that he's not sick and I can't risk the other kids health. Boy, was he pissed at me!

[KiddieCahoots]

Had an incident with a family of 3 siblings.

The dcb 1 and a half yrs got sick on the ride over. Mom insisted the baby was fine and it was a case of car sickness, and I stupidly allowed her to stay.

Not even an hour later, guess who was vomiting again. Mom had to come and pick up.

Then to boot....not even 2 hours after that, her sister started vomiting on the floor too.

Mom had to come back and pick up that sibling too, that's when I smartened up and insisted that the third sibling leave as well.

You did the right thing.

Don't allow them to make you feel differently.