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In 6 years as a provider, I've not had to term too many children/families. I can honestly say that my current group is one of the best I have had in my 6 years as a provider. I have one 15mo DCG that still spits up constantly. The DCPs have brought up their concerns with it to their doctor, but nothing helps. My daycare room is carpeted, and smells horribly if the carpets are not cleaned daily. She spits up 5-10 pools of spit up a day...it's not a small amount. I constantly have to redirect the other children so they aren't sitting in a wet spot I freshly cleaned. I hate to sound like a whiner, but the amount of cleaning I am having to do to toys and carpets is really becoming a hassle. I can't afford to have the playroom carpets professionally cleaned weekly, but if I don't the smell is horrible. My spot cleaning only helps temporarily. Has anyone ever termed a child due to reflux?
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Is she still on formula? Is she still on a bottle? What is it that's being spit up?
If she's not on formula then I would consider that vomiting and she'd be sent home the first time it happened every day.
I know many parents switch from formula to full bottles of cow's milk... is that what she's drinking?
IMO, after 12 months of age they should be getting less than a cup of milk at each meal and that's it. Their nutrients should mainly come from food. -
She is on milk, but there are some days she doesn't drink it. I don't think it's related to anything she eats or drinks, it happens everyday no matter what is eatenComment
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What is it that's being spit up? I mean... what's coming out of her as gross as that question is.Comment
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I don't think terming is unreasonable. It's a health concern for the other children. If the parents and doctor can't come up with a plan to take care of it then I would not want to deal with that.
I agree that at that age it isn't spit up, that's vomit. To me spit up is a small amount from an infant. This is not an infant and not a small amount.
Occasionally, maybe. But daily? NoComment
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Ew. No. I would not have put up with this as long as you have, and I have very lenient exclusion rules. I would look into terming if they can't figure out a plan. Something is definitely not right if she is puking that much. I have an adult friend with severe reflux. If she doesn't take her meds, she "spits up" stomach acid. This sounds similar. Imagine what it is doing to her poor insides!Comment
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years ago I had a child with gag, but the child would throw up HUGE amounts of vomit. Like yours, it did not matter what she ate.
I had to implement a rule that if she threw up more than 2 times in one day, she had to go home.
Some days she would vomit 3-4 times and I would spend all day having to clean the house.
DCM also did agree to have my carpets cleaned every other month.
She was sent home at least once a week. But the DCP knew that I was being more than cooperative with the situation.
They had been through several carseats and major upholstery cleanings for their car and home.
I would maybe talk to the dcm and tell her go back to the doc and see if there is anything that they can do to help the child.
I would also set a limit of how many vomits a day you are going to allowed before having to send the child home.
Honestly, if its too much, don't feel bad for terming. I know how you feel and trust me even cleaning 2 vomits a day made me want to term every single timeComment
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Oh yucky! That you've tried working with this for this long is commendable.
My first rule of thumb is in thinking....this is my home first. If daycare interferes beyond the normal daycare hubbub, then a change is necessary.
If the parents didn't help to solve the problem, then I would term.
I'm honest surprised that a doctor would allow this to go on for this long. Just the thought of the possible damage to her esophagus from stomach acid is concerning.
My daughter had extreme gurd/reflux and was put on adult strength Prevacid to help, and later had an endoscope procedure to make sure no holes in her esophagus existed.Comment
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I've dealt with reflux a few times, and my own dd had it terribly, and reading your title I was going to say try to stick it out, most babies outgrow it by 9-12 months but seeing she is 15 months and is still that bad and that its creating such a sanitary issue in your home I would probably term. While their dr. may be dismissing it it is the parent's responsibility to demand further testing, treatment, etc. and I would present it as such when terminating. Her parents are dropping the ball here, it could be an allergy, could just be horrible acid reflux but either way there are treatments that can help it!!!Comment
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Multiple times daily I don't think I could manage long term. I imagine the smell would put off other clients too.
There should be a clear cut definitions with pictures and maybe even videos of "spit up" as compared to "vomit." So when mom drops of slipping out the door saying "Oh she spit up all over her bed this morning." I could say by the definition a TWO YEAR OLD does not spit up ALL OVER, that would be vomit my dear.Comment
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I wouldn't term yet, but I would give parents a time frame to get a diagnosis/ treatment plan from their doctor.
Be tactful and explain it's nothing against the child but it has become a sanitary/ environmental issue affecting other children in your care.
Good luck.Comment
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I would also clearly define with the parents the difference between spit up and vomit.
I would put this back on the parents because as long as you are putting up with it and not making me become responsible/uncomfortable, nothing will change.
In this case, I would follow my illness policy. After one vomit they are sent home? EVERY SINGLE TIME. Doesn't matter WHY. Eventually the parents need to realize this should be THEIR problem. Not YOURS. Your responsibility is to protect ALL of the children and they only have one to worry about.
If after two weeks, nothing is done to improve the situation, I would term. In the meantime, advertise to fill the spot.Comment
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It amazes me that parents assume we are willing to deal with their child's vomit! We deal with it from our own kids because, well, they are our own kids...another kid's vomit is gross! Add to that the fact that other children play in the vomited on area...
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What alarms me the most is that the child is vomiting that often, in large amounts, and the parents aren't demanding answers from the provider for their child or looking for second opinions from someone who will find answers for them. That has to be miserable for the child, not the mention causing serious damage to the child's esophagus...
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I have a similar problem, but DCB is almost 18 months, and it is very small amounts.
However, it's also not daily and I think our issue is related to him eating EXTREME quantities and extremely fast. His parents just let him eat until he stops, which isn't even after an adult quantity of food and he really shovels it in.
We limit him to the correct portions for his age and we only give him a few bites at a time. We do the same with his milk, which is in a sippy, and he gets a short drink and we take it for a few minutes.
This has helped IMMENSELY. He has had all the doctor visits and they can't find anything wrong with him, but as soon as we implemented that feeding plan all the throw up stopped.
Our policy is if he throws up more than once in a week he goes home for the day immediately.
Not sure if any of that is helpful, but I would try to limit or change feeding if possible and see if that helps. If not, I would definitely term.Comment
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