New Daycare Baby That Is Constantly Sick

[MunchkinWrangler]

I just had a new enrollment that started last week and I just don't know if it's going to work out.

DCG is 9 months old and since her interview over a month ago has been sick. I'm not sure if she is just getting one cold on top of another but my kids have only had one cold go through here and that was a month ago and she wasn't attending yet. They are all healthy and well. Since the interview she has had croup, an ear infection, croup again(just this week) on her 'off' week and has a bad cough and a very sticky green runny nose. She seems miserable.

Her current enrollment is every other week because of the parents work and school schedule, I needed the income and they pay full time so I figured I'd see how it goes. She was dropped off today for the afternoon and I was told she was into the doctor on Monday for steroids for croup and she checked out on everything else. None of this was told to me before she was dropped off just during drop off when I mentioned that she still seemed sick and I was surprised because last week she was a goobery mess that I thought for sure would be cleared up by now.

I have two interviews next week for a spot that I had held unpaid for 6 months that hired a nanny. Different subject there. I'm considering terming because as I made very clear I don't do sick care. I have a small group and my own son and I do understand that kids get sick at this time of year but this is starting to seem excessive, especially when I'm starting to feel that this is their issue not mine. I shouldn't feel like I have to quarantine a child while they're here to prevent my other DCK's from getting sick also.

I guess my question is should I hold out and see if she gets better and just start calling for pickup when it becomes unmanageable? If both families are interested should I just term and replace? I'd feel bad, she's cute and is great here except for the sick part and her parents are sweet but I just don't know if they understand the extra work with other children in care. She was in a center and I'm getting the feeling that they just took her sick.

[Blackcat31]

I just had a new enrollment that started last week and I just don't know if it's going to work out.

DCG is 9 months old and since her interview over a month ago has been sick. I'm not sure if she is just getting one cold on top of another but my kids have only had one cold go through here and that was a month ago and she wasn't attending yet. They are all healthy and well. Since the interview she has had croup, an ear infection, croup again(just this week) on her 'off' week and has a bad cough and a very sticky green runny nose. She seems miserable.

Her current enrollment is every other week because of the parents work and school schedule, I needed the income and they pay full time so I figured I'd see how it goes. She was dropped off today for the afternoon and I was told she was into the doctor on Monday for steroids for croup and she checked out on everything else. None of this was told to me before she was dropped off just during drop off when I mentioned that she still seemed sick and I was surprised because last week she was a goobery mess that I thought for sure would be cleared up by now.

I have two interviews next week for a spot that I had held unpaid for 6 months that hired a nanny. Different subject there. I'm considering terming because as I made very clear I don't do sick care. I have a small group and my own son and I do understand that kids get sick at this time of year but this is starting to seem excessive, especially when I'm starting to feel that this is their issue not mine. I shouldn't feel like I have to quarantine a child while they're here to prevent my other DCK's from getting sick also.

I guess my question is should I hold out and see if she gets better and just start calling for pickup when it becomes unmanageable? If both families are interested should I just term and replace? I'd feel bad, she's cute and is great here except for the sick part and her parents are sweet but I just don't know if they understand the extra work with other children in care. She was in a center and I'm getting the feeling that they just took her sick.

Beside being that time of the year, she is young and it seems that age is alot sicker than others simply because they are still working on establishing regular sleeping and eating routines. Those two things alone can cause someone to be continuously sick or just not ever really be 100%.

I have a very firm illness policy and enforce it every time. It's difficult for some parents to manage and not so difficult for others but it's my policy and I'm not changing it so they either choose to follow it or find alternate care.

One of the things I do that really helps (thank you Catherder! ) is exclude a child until 24 hours symptom free if the PARENT chooses to keep them home but exclude for 48 hours if I have to send them home from daycare. Essentially it puts the responsibility back on the parent to use their own judgement.

I would clearly outline what symptoms you exclude for and follow it. Sometimes going over your policy after a parent seems to be disregarding it is a great way to "refresh" their memory in regards to what they already agreed upon and signed up for.

[finsup]

A lot of it really is this time of year and well, it stinks. My own child had a stomach bug before Christmas, shortly after a cold. Now croup. Doctor said that after the barky cough was gone she would most likely have cold symptoms for another week or two. It's no fun for anyone

My suggestion would be to follow your sickness policy very strictly and send home anytime dcg is in violation of that. Love the 24/48 hour rule that BC was talking about too. For me, I'd require them home the day following the croup diagnosis. They need to rest and here that's not going to happen. They could return after that when the cough was mild and fever gone. Yucky noses etc, they can come as long as its not excessive. Ear infections, not contagious so no worries there unless it affects her behavior or causes a fever. Any fever over 100.4 gets you sent home here, no exceptions. I can also send home for not being able to participate normally.

Anyways, if you want to replace to for it. If they are a great family otherwise, I'd just be very strict on my sickness policy and hope it improves in a few months when cold/flu season winds down!

[MunchkinWrangler]

Ok, I'm going to go through my sick policy again with them and I think I'll add that 24/48 rule because I believe this will put the responsibility on them instead of me. I have new client syndrome, where I try to show them how great of a provider and bend over backwards and then later I'm regretting my loss of a backbone. I think my main issue is when a client is in front of you, you don't get time to process the information until they leave. I'm still new at this and you're both right I need to just enforce my policies and eventually they'll catch on.

Her symptoms are borderline excludable, no fever, not a constant cough but her age with a gooey nose is hard because if you don't catch it right away it's on their hands clothes and then on all the toys. I have an infant, a toddler, and 2 preschoolers. My own son is annoying with putting things in his mouth and obviously the babies are still in that mouthing stage. So when one gets sick they all do. She also has spurts of feeling well throughout the day, which is typical with being a little under the weather. Plus, I always wonder if she's medicated sometimes and there is really no way to tell. Thanks for the great advice. Backbone engage!!!::

[Blackcat31]

Her symptoms are borderline excludable,

One of the reasons I will exclude a child is when their condition or symptoms require MORE care and attention than I am able to provide without compromising the safety and supervision of the other kids in care.

So excluding a 10 month old with a faucet of a nose would be something I would do after 2-3 days of it where as a 4 yr old with the same problem wouldnt be a big deal since most my 4 yr olds know how to use a tissue.

I also require a Dr's visit if the symptoms that are borderline have not improved within a 5-7 day period. I have a form I use that I send with the parent to have their Dr fill out so that I KNOW the child is not getting worse and that someone took them into the clinic at all.

The form does NOT allow the Dr to do anything other than diagnose and does not allow for the Dr to give permission for the child to be re-admitted to care. That is MY call.

If you are interested in seeing this form as it might be useful in your situation, just let me know

[Ariana]

I don't find this kind of illness to be normal personally. Yes kids get sick but constant sickness means she has a VERY weak immune system and it's probably an underlying allergy or sensitivity to whatever she is eating, my guess is dairy. Is she breastfed or formula fed? something is taxing her immune system.

What is your sickness policy? I would be excluding for everything you have mentioned.

[MunchkinWrangler]

One of the reasons I will exclude a child is when their condition or symptoms require MORE care and attention than I am able to provide without compromising the safety and supervision of the other kids in care.

So excluding a 10 month old with a faucet of a nose would be something I would do after 2-3 days of it where as a 4 yr old with the same problem wouldnt be a big deal since most my 4 yr olds know how to use a tissue.

I also require a Dr's visit if the symptoms that are borderline have not improved within a 5-7 day period. I have a form I use that I send with the parent to have their Dr fill out so that I KNOW the child is not getting worse and that someone took them into the clinic at all.

The form does NOT allow the Dr to do anything other than diagnose and does not allow for the Dr to give permission for the child to be re-admitted to care. That is MY call.

If you are interested in seeing this form as it might be useful in your situation, just let me know

You know, I think that would be awesome. The mother is a physician's assistant but I question whether they really brought her in or not. The mother tried to sign the vaccine form, which I gave her a new one for her daughter's doctor to fill out. My pediatrician for my son has always said when a sickness isn't going away after 10-14 days it's time to question what else is going on or if an infection has developed. He also knows I do daycare so he has given me some really good advice for my home.

I think I'll have to push the issue, I really think there is something else going on and I know I'm only allowed certain medical information but I'm a mother also and have more experience and have a lot of medical people in my family. Personally I feel she needs antibiotics if she isn't on them already.

[MunchkinWrangler]

I don't find this kind of illness to be normal personally. Yes kids get sick but constant sickness means she has a VERY weak immune system and it's probably an underlying allergy or sensitivity to whatever she is eating, my guess is dairy. Is she breastfed or formula fed? something is taxing her immune system.

What is your sickness policy? I would be excluding for everything you have mentioned.

She is on breastmilk and still breastfeeds with mom. She is also very underweight. Her parents mentioned she was losing weight but think she is a chunk. She is not a chubby baby by any means, no rubber bands ankles and wrists, to me she is skin and bones. I know there is medical confidentiality and there are things that if they don't want to let me know there is nothing I can do. I also know she is due for a checkup but she has not had that yet.

I exclude for fever, diarrhea, vomiting, unusual rash, lice, and if a child is lethargic. I'm currently writing out a new illness policy because with having more kids there is less attention I can give an infant and toddler even with a mild illness.

[Ariana]

She is on breastmilk and still breastfeeds with mom. She is also very underweight. Her parents mentioned she was losing weight but think she is a chunk. She is not a chubby baby by any means, no rubber bands ankles and wrists, to me she is skin and bones. I know there is medical confidentiality and there are things that if they don't want to let me know there is nothing I can do. I also know she is due for a checkup but she has not had that yet.

I exclude for fever, diarrhea, vomiting, unusual rash, lice, and if a child is lethargic. I'm currently writing out a new illness policy because with having more kids there is less attention I can give an infant and toddler even with a mild illness.

Yep definitely something going on there. My own two were dairy and soy sensitive during breastfeeding. It might not be dairy but low weight plus constant illness is an indicator something is up. Maybe suggest the mom take her for that check up if she wants her to keep attending.

I exclude for everything except mild cold like symptoms (slight clear runny nose and slight cough).

[Blackcat31]

You know, I think that would be awesome. The mother is a physician's assistant but I question whether they really brought her in or not. The mother tried to sign the vaccine form, which I gave her a new one for her daughter's doctor to fill out. My pediatrician for my son has always said when a sickness isn't going away after 10-14 days it's time to question what else is going on or if an infection has developed. He also knows I do daycare so he has given me some really good advice for my home.

I think I'll have to push the issue, I really think there is something else going on and I know I'm only allowed certain medical information but I'm a mother also and have more experience and have a lot of medical people in my family. Personally I feel she needs antibiotics if she isn't on them already.

I PM'ed you all my illness forms.

You will see that they are pretty CLEAR and covers any common loopholes parents find in regards to not really bringing their kid in, not disclosing symptoms to the Dr, trying to return to care before they are suppose to and all the other little things parents try to pull.

[MunchkinWrangler]

I PM'ed you all my illness forms.

You will see that they are pretty CLEAR and covers any common loopholes parents find in regards to not really bringing their kid in, not disclosing symptoms to the Dr, trying to return to care before they are suppose to and all the other little things parents try to pull.

Thank you so much. I'm going to use your format for my illness policy as it looks more friendly but gets the message across. I'm also adding things that I haven't thought of having on my exclusions to make it clear that I don't do sick care at all. This I'm finding is hard for parents to understand. The old allergy excuse or that they 'just don't know what's going on.' In other words that's telling me that they haven't really invested themselves into whether their child is sick and they leave it up to me to determine, which I don't want as a responsibility. They also think it's okay for me to give Tylenol and such and your form makes it simple, because I believe also that if a child needs medication than they're not well enough to be in daycare. It's a huge help to 'pick your brain and experience.'