Sick Non Contagious Baby

[lvt77]

I have a baby that is 7 months old in my care. He is a very ill child.

He is severely asthmatic, sounds like he struggles to breath daily. He is always sick with something. Ear aches, colds, and etc.

He only comes one day a week with his older brother who comes 3 days. This past week when he was in my care, he was turning blue and shaking. Luckily, my husband was home to look him over, he’s a paramedic. I was in tears because it scared me so bad. I called the mom right away and told her what was going on. She said she was calling the dad to come get him.

When the dad came to pick up, I found out by talking to him that the baby was in and out of the hospital for several weeks over the Christmas Holiday. I was never told this once before this day..

I cannot administer the babies’ inhaler medication and I don’t know what to do. I feel that this child is way too sick to be in care. If you heard the way he breathes, you would probably call 911. But this is how he breaths every day according to mom and dad.
What do you think…..I don’t feel I am qualified or staffed properly to care for this child.????
What would you do?

[Danielle]

I haven't had my coffee yet so maybe I missed something, why can't you give him his inhaler?

[momofboys]

I don't think nebulizer treatments are that difficult to administer, it just means turning on the machine & holding the tube in the child's mouth. . . some have masks that go over the whole child's head so the child could sit in a high chair (if old enough) & you wouldn't have to do much except for monitor them. It does sound though to me like the child's asthma is not under good control if he sounds that bad. It definitely can be a scary situation & I can understand your desire to not have that much responsibility for someone's well-being.

[ammama]

I wouldn't care for him if he was that sick. Or at least tell the parents that they have to provide a detailed doctors note explaining his symptoms and saying it is ok to be in daycare. What if he picks up a flu or something?

[lvt77]

I dont give any medications here, I live in California otherwise known as the sue happy state. I was told by my lawyer not to assume the liability. I will only give homeopathic medication.
I forgot to mention that every time here is here, which is only once a week, he often has some health issue or an unusual occurance related to his health.

[misol]

I haven't had my coffee yet so maybe I missed something, why can't you give him his inhaler?

I don't think nebulizer treatments are that difficult to administer, it just means turning on the machine & holding the tube in the child's mouth. . . some have masks that go over the whole child's head so the child could sit in a high chair (if old enough) & you wouldn't have to do much except for monitor them. It does sound though to me like the child's asthma is not under good control if he sounds that bad. It definitely can be a scary situation & I can understand your desire to not have that much responsibility for someone's well-being.

Just a thought: It's possible that she may know HOW to give the meds but CAN"T because of her state regs. We have to have MAT certification in order to administer ANY meds - even over the counter ones. The only thing we can do is topical, nonprescription things like sunscreen, diaper cream, etc. I have decided at this time not to get certified in medication administration - too much of a liability IMO. So, when I get calls about a sickly child or a child on maintenance medication, etc. I simply tell the parent that I am not certified to administer meds. Any other explanation for not taking a sickly or special needs child can very easily be interpreted as discrimination.

[lvt77]

very true, I was also told by my lawyer that I do have to give the parents the option to come during childcare hours to administer the meds. When I told the parents this they declined

[jen]

It sounds to me as thought this child needs more specialized care. If you aren't willing to provide it (and I do understand why) then I would terminate care. It isn't fair to that baby. Mom and Dad need to take him somewhere that his medical issues can be addressed on a daily basis.

[lvt77]

I feel so bad for this baby and I want to be able to help but I cant do anything to help him.

[laundrymom]

I feel so bad for this baby and I want to be able to help but I cant do anything to help him.

I wold give parents written notice that they either keep him home until not ill or bring in a lengthy dr explaination saying why it's ok for a child, especially a young infant, to be in a daycare setting when they are obviously unable to breathe effectively. Let them know that either they get documentation for his condition or you will notify child protection. That you are a mandated reporter. Someone needs to speak up for this baby and it looks like you are it. Poor kid. I don't see why parents don't think thru their actions. What if he has an emergency while in your care? He already has issues, what if he has an asthma attack? He needs help. Especially being so young. Was he premie or a drug baby?

[Live and Learn]

It sounds to me as thought this child needs more specialized care. If you aren't willing to provide it (and I do understand why) then I would terminate care. It isn't fair to that baby. Mom and Dad need to take him somewhere that his medical issues can be addressed on a daily basis.

Jen is correct. I would be scared to be left alone with and responsible for this lil guy. I don't give meds of any kind here...period! Meds are for sick kids and I am a well child care house.
It was not appropriate for them to leave him in your care without mentioning his recent hospitalizations. That feels like they were afraid that you would say "no"...so they just snuck him back into your care.....that was risking their own child's well being. NOT OK!

Good Luck.

[SilverSabre25]

I don't know much about asthma, but what I do know is enough to say that this kid's asthma is NOT well-controlled and that is DANGEROUS!

[lvt77]

Thanks for all of your feed back. I actually emailed the county health advisor on it
This is what she emailed me back:
An asthmatic child is considered a special needs child and since a child can actualyy die from a severe asthmatic attack the child needs to be placed with a provider that can administer the necessary medications.

Does the child have an asthmatic care plan provided by the pediatrician? I have sent you a sample of what a care plan should look like.

Please feel free to download the above care plans and encourage the parent to take the care plan to their doctor and have the doctor fill it out and if you are uncomfortable giving the medication than you can inform the parent to please seek another provider and at the same time give her the sample care plan so the next provider can have the information as provided by the pediatrician.

The care plans are from ages 0 to 4yrs, 5 to 11yrs and 12 yrs and up. Please give her all three since the child will be growing and ashtma will remain a concern for the school district when he is old enough to go to school.

[LaLa]

Thanks for all of your feed back. I actually emailed the county health advisor on it
This is what she emailed me back:
An asthmatic child is considered a special needs child and since a child can actualyy die from a severe asthmatic attack the child needs to be placed with a provider that can administer the necessary medications.

Does the child have an asthmatic care plan provided by the pediatrician? I have sent you a sample of what a care plan should look like.

Please feel free to download the above care plans and encourage the parent to take the care plan to their doctor and have the doctor fill it out and if you are uncomfortable giving the medication than you can inform the parent to please seek another provider and at the same time give her the sample care plan so the next provider can have the information as provided by the pediatrician.

The care plans are from ages 0 to 4yrs, 5 to 11yrs and 12 yrs and up. Please give her all three since the child will be growing and ashtma will remain a concern for the school district when he is old enough to go to school.

1. The parents are in the wrong for not knowing what is wrong with their child. And if they do know they should let it be known.

2. You cannot even give tylenol?? NOTHING??? Are you serious??? As a parent I would never have a daycare provider that couldn't give anything. Here in MD we have a doctor sign off if it is ok to give something and the parent also signs something.

3. IMO Asthma is not a "special need". If it is then every child has some sort or "special need". There is no perfect child. You do need to let the parent know if you cannot handle this child. Here in MD it is illegal to discriminate.
It is not hard at all to take care of an asthmatic child.

On another note- My 10 month old is a very "loud" breather. He has what's called a "flappy" voice box. This makes is breathing very loud but he has never turned colors.

The parents should have told you about the hospital visits.

I also agree with Jen on this one...

[lvt77]

Well this is information that I got from the RN PHN IIIChild Care Health ConsultantChild Death Review Team Coordinator of my county..
It's not that I dont want to care for the baby, it's that I dont know how to. I know nothing about asthma. The only thing that I can do right now is either call the paretns to pick up the child or call 911. How would you feel if you had to care for a child and you did not know how to care for them.......
Yes I do give tylenol and OTC as long as they sign consent form and it is age appropiate...