Sickness -How Would You Handle It?

[Diana1234321]

Hello everyone. .. I'm looking for input and advice for how to handle this:
I have my neighbors 1hr old under my care, his parents are nice people but are really young. The baby is with me for 10 to 12 hours a day even when the parents are home. In the morning, they wake him up just to bring him over and they go back to hang out at their house, they both only work part time, but while they do pay me for a full time slot, I can't really complain about what they do with their free time, unless it's one of those 3 days a week when they pick him up late . Although I have to admit, I do judge them... when I was working full time out of the house, and my kids had to be in daycare, as soon as I got out of work I couldn't wait to pick them up... but maybe that's just me.
Anyways. . . My real issue now is that, in 2016 the baby has been sick multiple times. Severe cough, severe colds, fevers and now hands foot and mouth disease! !! While there's no reason for him to get that since he's here most of the time and just goes to sleep at his parent's, we still have the weekend to account for... apparently the baby spends weekends at his grandma's house which is 2 hours away (yes, parents are still home), cousin's were infected and he came in contact with them last weekend. Monday came and they sent the baby over to me...
I noticed he had a little bit of a diaper rash, but that has been another common thing that happens every time he comes back from the weekend, which I thought was his parents fault, but apparently it's grandma's. He also didn't eat as well as he usually does for a couple of days, while I did talk to his mom about this, there where no other signs so far of sickness. The weekends came and I got a call from.the mom explaining everything that had happened last weekend and that the baby was now getting the blisters and while he hasn't seen the doctor, the mom's RN cousin confirmed that he had hands foot and mouth disease.
I am sooooooo mad at them! I now it's a relatively common disease, buthe I feel like I could've been prevented. Now my kids are going to get sick, my 3 yr old wasn't feeling too good last night and I now my 2 yr old is next. While seeing them in pain is the worse, I still have to deal the fact that I will basically be out of business for about 2 weeks, and the hat the other parents are.going to be pissed at me, and might not want to bring their kids back as well as the fact that my reputation will be on the floor. My husband days I should terminate them, but as a professional it doesn't seem right, I feel.like kids get sick and even if I let them go, we are still exposed to sicknesses and diseases along the way, it just comes with the territory, but he feels that because they are not responsible parents, the baby will keep getting sick and bringing God knows what over to us all the time.
What do you guys think?

[mamamanda]

That is frustrating, but hand foot and mouth is something that is very, very common and you often don't realize you have it until several days after symptoms start. Do you have a sick policy in your contract? I would be very firm with this family on excluding for sickness, but I wouldn't term over this. Anyone of your families could have brought it in with them. You could pick it up yourself just going to the grocery store. I exclude for hand foot and mouth if the symptoms fall under my exclusion policy. If they are running a fever, vomiting or diarrhea, too tired/irritable to participate in group care, etc. Other than that, they can attend. Hand foot and mouth can be contagious through stool and saliva for weeks after symptoms are gone. There is no way to legitimately exclude that whole time. Also, I don't see why you would need to close for two weeks over this. If your own kids are running a fever, sure. But I've had many kids with hf&m and they rarely miss more than a couple days.

The other thing to consider is that although it is super frustrating to have parents like this, you can't make a parent be a parent. You sell a service. If they are paying for that service and following your policies, then what they do on their own time is their own choice, kwim? That doesn't mean it is any easier to swallow your frustration, but ultimately you don't know how responsible any of your families are. I'm guessing you only know so much about this one b/c they are neighbors. Try not to let it bother you as it is eating you up inside, but not affecting them at all.

[Diana1234321]

Yes. I agree!
Thank you!
I am fairly new to the daycare world, and never really been around hf&m, and for what I read, it said 10 days so I thought I would have to be closed to not spread the disease
Thank you for your help

[MunchkinWrangler]

Here's the thing, they knew about the exposure. They should have told you. Young or not, they have a responsibility to let you know of things like that. I don't know, I would probably term, especially because you have to shut down and lose business. But, I would include in your contract that if you have to close for things like that, people should still pay you. And you should mark in your illness policies that they are responsible for notifying you and consequences will happen.

[Thriftylady]

My only two pieces of advice are to have and enforce a sick policy and to have an enforce late fees.

I also do only contracted hours, so if you are using 10 or 12 hours a day, you are paying for it! For me anything over 9 hours a day is a much higher rate. I let parents choose when they enroll, I tell them that they can use 10 hours but it costs extra.

[mommyneedsadayoff]

I would terminate care. I know it can be hard, but I have learned that I can't make a parent be a good parent, but I CAN choose not to work with parents who don't even want to make an attempt to parent.

[Blackcat31]

When you choose to open your home up to others, you are opening your home up to all sorts of viruses and illnesses.

Sometimes feeling as if we "know" exactly where an illness came from builds resentment but in reality you don't KNOW where it came from as ALL children and adults are carriers of pretty much every thing they come in contact with.

All you can do is control those things you have the right to control.

Have a good solid illness policy in place and stick with it.

Illnesses are more common in certain times of the year and sometimes no matter what you do, you can't avoid it.

I hope your own kids don't catch it but if they do, remember that kids in child care (including the providers own children) ARE sick more often and more frequently than those kids that do not attend child care but the good news is that those same kids build up an pretty strong immune system for the remainder of their lives.

[Ariana]

Stress can cause a lot of illnesses to take hold so try not to stess about where a virus came from. Just think positively that you won't get it. My kids are rarely sick. My child was 5 before she had antibiotics and a fever which shocked the pharmacist! Illnesses come into my home every day and my kids don't get it.

Some kids experience a lot of stress, especially a baby in your care or grandma's care for 12 hours a day. Daycare is a stressful thing for most children and research has shown that kids in daycare have higher cortisol levels. The longer they are in care the higher those numbers. So just because a child gets sick in your care does not mean you will get it. So far this year I have had kids out with fevers, colds, flu, diarrhea, vommiting and my kids and I got mild colds so far, that's it. My eldest daughter is in school with 20 other kids, who are also in daycare, and has only had a mild cold once.

Try and keep positive about this. Eat healthy, drink lots of water etc.

[renodeb]

I have had hf&m. 2 out of 3 kids got it. One was out of dc for 8 days, the other was out 5 days. I had them both stay out until there sores where 100% healed over. I spent 2 days cleaning and sanitizing everything. That should break the chain so to speak. I'm not sure I understand the issue. Who is to say how and where kids get sick. Kids get sick but if they are trying to come while sick then that's an issue. Stick to your sick policy.
Deb

[MunchkinWrangler]

The OP did state that the cousins had it and was in contact the week before. In this particular case, the evidence shows where and when the exposure came from. I'm not saying that a provider has control over exposure. You wouldn't think your cold came from a grocery cart handle when you've been in direct contact with someone who had a cold, would you?

[Play Care]

The beauty of this job is that we can choose who we want to do business with.

The late picks ups, the constant diaper rash, the possibility of them doing the "dope and ditch" etc. would be deal breakers for me. Those things ARE your business, KWIM?

I think it's time to send them on their way.

[Blackcat31]

The OP did state that the cousins had it and was in contact the week before. In this particular case, the evidence shows where and when the exposure came from. I'm not saying that a provider has control over exposure. You wouldn't think your cold came from a grocery cart handle when you've been in direct contact with someone who had a cold, would you?

I would/might.

Because I know from experience how it does and doesn't work.

Just because the kid(s) were exposed to someone that had HFM doesnt mean it's them that gave it to them.

Incubation periods discredit that theory for me.

My own children rarely if ever got the same illnesses so I know being in contact with someone who does have something doesn't automatically mean they're the one "guilty" of spreading it.

Like I said, incubation periods for me mean ANYONE can carry and spread something and it's not guaranteed to be the kid that actually has the illness. In part because once someone actually has symptoms they aren't always contagious anymore.

http://www.hennepin.us/~/media/hennepinus/residents/health-medical/infectious-diseases/hand-foot-mouth-disease-provider.pdf?la=en

[MunchkinWrangler]

BC, sometimes I don't think people do enough to prevent the spread of illness. I do think it's up to the provider to make that call, I'm sure you agree....maybe.

Plus, what's to say that child either mouths things like crazy(I still have a problem with my DS who is 2, SMH), what if they have a blow out,etc. I personally don't think once the fever fades when it comes to HFM, is enough time to exclude, age dependent also.

I don't know, I just vent about this because so many people hide illness and are out in public when they need to keep themselves at home to prevent spreading their germs around to everyone else. I just finished my illness policy(thanks for your PM, it was really helpful in writing up my own) and it's pretty strict but not overboard. My DCP's are big on "kids get sick, etc" but I have to be clear that I'm not a nurse and I don't care for sick children and if I get sick I'm closing out of sheer POness. Sorry for hijacking the thread

[Blackcat31]

BC, sometimes I don't think people do enough to prevent the spread of illness. I do think it's up to the provider to make that call, I'm sure you agree....maybe.

Plus, what's to say that child either mouths things like crazy(I still have a problem with my DS who is 2, SMH), what if they have a blow out,etc. I personally don't think once the fever fades when it comes to HFM, is enough time to exclude, age dependent also.

I don't know, I just vent about this because so many people hide illness and are out in public when they need to keep themselves at home to prevent spreading their germs around to everyone else. I just finished my illness policy(thanks for your PM, it was really helpful in writing up my own) and it's pretty strict but not overboard. My DCP's are big on "kids get sick, etc" but I have to be clear that I'm not a nurse and I don't care for sick children and if I get sick I'm closing out of sheer POness. Sorry for hijacking the thread

AMEN!!

I agree that not enough preventative measures are taken.
Rarely are kids given the foundational wellness they really need to not be sick every time they come in contact with something.

I am willing to bet that only 1 in 5 kids now days get really good sleep, really good nutritional meals and gets good outdoor/exercise on a regular basis.....Most kids eat in the car, nap in the car and are rarely home enough to even realize it's their home. kwim?

I also agree 100% that providers should be the one making the call as they are the ones providing care and integrating that child into the group they have. No one else understands that dynamic other than the provider that deals with it day in and day out.

I have a very strict illness policy and I enforce it every single time. Even in times when I am pretty sure "it's probably teething" and I have lured parents to my program because of my strict policies and on the same note I've lost parents over it as as well but bottom line is, it's MY business and I do what I need to do and what I believe is best for my group.

I have been doing this a long time now and (knock on wood) have had very little illness go through my care. I've never had a child with HFM so I have no experience with it.

I guess my point was that it's pointless to try and pin point who or where an illness started and rather than focus any energy into that, I prefer to just manage what I can.

I exclude for symptoms, send home when symptoms appear in daycare, require Dr visits when necessary (for MY comfort) and enforce my exclusion policy every single time.

So far that has worked very well.

[MunchkinWrangler]

I've been lucky myself so far this year, and nothing serious has gone through my daycare. I have had 4 exclusions and 3 send homes just within the last week and a half.

I agree, it is hard to pinpoint where an illness comes from. The cold everyone got last week, everyone got sick on the same day, but I still excluded some for popping fevers, or being too unwell for care. I heard some comments about everyone having it but stood my ground when it came to excluding for their child's sake. Everyone has been really good with it, especially with letting them know that it's a noisy, busy enviornment and I can't do one on one.

Now I'm sick with this lovely cold, I'm sure after a week of wiping runny noses, and cuddling sick babies and my own sick son, it's conceivable to believe that is how I got it.

I, personally, am so strict with bedtimes and naptimes for my own son because I believe adequate rest is important for kids and adults. I'm strict with nap for daycare. I try my best with healthy food, sometimes after cooking/ preparing meals all day gets taxing and I take the easy way out for dinner.