Newborn in Care and 3-Year-Old with Cough

[SilverSabre25]

Thankfully the newborn isn't here today. But he's 8/9 weeks old and I have a 3 year old here today with a really awful cough. No fever, but the cough is horrendous and his voice is hoarse/mostly gone. I feel like for the baby's sake I need to exclude him until the cough is better or until I get a doctor's note stating that it's not RSV or something else concerning for the baby. Do they test for RSV? It's not something that's ever really come up before (despite my 6 years of experience at this; this is the first winter newborn I've had). Please advise quickly

**adding** btw the main question is, is excluding the 3 year old a good move?

[mamamanda]

If the cough is bad enough to interfere with daily routine I would exclude. I probably wouldn't exclude just b/c I have an infant though. Is the cough interfering with nap time at all? Or meals? If its creating an issue there I would exclude for those reasons. I do feel more nervous about infants and sickness, but I also feel like parents have to understand that if they leave their child in group care they will be exposed to minor illness. Of course, they could be exposed to the same things shopping for groceries. This time of year is just rough. They can test for RSV, but I don't think they do that unless there is something more than just a cough. If the cough is causing wheezing, breathing difficulty, sounds barky like croup, etc.

[SilverSabre25]

He's moody and crankier than normal but it's not quite interfering with activities. It's pretty barky though, noticeably worse since yesterday, and his voice is super hoarse

[SilverSabre25]

I tried the tactic of discussing the cough with mom, she denied any knowledge that he had one.... so either it developed awfully fast or.... something.

Anyway I asked her to keep him home tomorrow and mentioned possibly looking into getting him checked out to make sure is not RSV

[Leigh]

It seems that an awful URI bug is sweeping the nation right now. It's not just where I am, but all over-little colds turning into hospital stays, and LOTS of pneumonia, bronchitis, ear infections, and other secondary infections. I'd insist on a doctor visit-it seems that these kids will seem OK, and the next day, they're in serious condition. To answer the RSV question, in case someone hasn't, they CAN test for RSV.

[SilverSabre25]

NOW the parents are trying to get out of paying for tomorrow because "it's an illness I don't usually exclude for, i.e. no fever."

[MunchkinWrangler]

If it is a barky cough, like that of a seal, that's croup. It can also make you lose your voice and doesn't necessarily present with a fever if it's viral. Having symptoms while awake, which usually it will be worse while sleeping, means it is a worse case, not bad but very uncomfortable and has the potential of closing off the airway, croup causes your larynx to swell, which can make it hard to breathe and swallow. I always exclude for croupy or excessive coughing, and I require a doctors visit for it. I have personal experience, I always had croup as a kid and a few hospital visits because of it, and sometimes get it still. My son is susceptible to it also.

[NeedaVaca]

I wouldn't let her get out of paying simply because if it is croup it's contagious! I would explain to mom that you have to exclude for anything that could be contagious for the well being of everyone in your care including yourself. She should get a Dr's note stating diagnosis and if it's croup he should be excluded for 3-5 days. What exactly does your illness policy say?

[SilverSabre25]

It's several years old and about to undergo a revision, but copy/pasted from my handbook:

A child will not be able to attend daycare if he/she exhibits any of the symptoms for exclusion. Those symptoms include, but are not limited, to:

· Severe sore throat/coughing/colds or strep throat.
· Fever of 100.5°F or above.
· Green or yellow discharge from nose or eyes.
· Ear discharge.
· Head lice, nits or scabies.
· Two or more watery stools within 24 hours.
· Two or more occasions of vomiting within 24 hours.
· Chicken pox.
· Conjunctivitis (pink eye)
· Mumps, measles, influenza, whooping cough, croup, impetigo, tuberculosis, rubella, etc.
· Any type of body rash (if due to allergies then a doctor’s note will be needed).
· Intestinal worms, ringworms, pin worms etc.
· Anything contagious and transmittable.
· Too tired or fussy to participate in normal activities.


Your child may return to daycare after being symptom free without the aid of medication for a FULL 24 hours.

If your child becomes ill while in my care, I will contact the you to come and pick him or her up within one hour. If I cannot reach a parent within fifteen minutes I will begin contacting your emergency contacts. If the ill child is not picked up within one hour from the time of contact, then I will charge $10/hour for sick child care--this covers the extra time it will take to clean and sanitize my home to prevent the spread of illness, as well as any additional cleaning that arises (from vomit, etc).

Please, do NOT bring your child knowing that he or she is sick, or dosed up with Tylenol or any other fever reducer. Sick children want to be at home with their parents, not stuck at daycare, no matter how wonderful a daycare it is!

They didn't come today and my phone conversation with her last night made me mad. I'm still bitter and angry 24 hours later. She claims he didn't cough ONCE after leaving my house. I seriously doubt it.