Day care sends tots home too quickly...

[deleted account] ( 27 moms have responded )

Child care centers are too prone to send toddlers home for mild illnesses, doctors say.

In a new survey of centers in Milwaukee, Wisconsin, directors said they would exclude kids more than half the time for minor ailments such as pink eye, ringworm or mild fever.

This is medically unnecessary and runs counter to long-standing professional guidelines, the researchers say.

By the time kids have symptoms, they've already been contagious, and "they've already done the damage," Dr. Andrew N. Hashikawa of the Medical College of Wisconsin in Milwaukee told Reuters Health. "It doesn't do any good to send these kids home."

He added that exclusion is "a significant burden for parents," who may be forced to take unpaid sick leave or scramble to find an alternative.

The findings square with earlier surveys from states that don't back the medical guidelines, first issued in 1992 by the American Academy of Pediatrics and the American Public Health Association. But Wisconsin endorsed the guidelines more than a decade ago, the researchers said in the journal Pediatrics.

For their survey, Hashikawa and colleagues interviewed 305 child care center directors. They presented them with five different scenarios in which a toddler had mild illness and asked what action the directors would take.

In each scenario — a kid with a cold, a light fever, pink eye, ringworm, or loose stools — the guideline recommendation was the same: No need to send the toddler home right away.

However, almost one-third of the directors chose to exclude the kid in four or all five of the cases. Overall, they ended up sending 57 percent of kids home unnecessarily.

"There are conditions where you'd obviously send a kid home," said Hashikawa. But, he added, "We found that oftentimes they are sent home when they really don't need to be."

Only a minority of center directors turned out to be familiar with the guidelines. "Directors have a tough job, they are working hard," said Hashikawa, "I think they just need more training."

Calvin Moore, Jr., president of the National Association for Family Child Care, which represents about 8000 centers across the country, agreed.

"We need more training and more technical assistance, and it should be part of the licensing requirements in each state," he said.

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Serene - posted on 04/24/2010

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I work in childcare and i am all for the dierectors sending home a child that has loose bowel movements, pinkeye, fever of 101. rash, hand foot and mouth and puking. These are neccessary precautions to take its all highly contagoius and us as childcare workers should not be obligated to work around it and infect the whole center because they are, "mild illnesses."
As a parent you should know that if your child has any of these symptons then you keep your butt at home and take care of them. We are not doctonrs and we don't get paid enough to bring this," mild illnesses." to our own families just because a parent doesn't want to take care of there child or take them to the doctor. These are the kind of parents i deal with on a daily basis. 40 percent of my parents shouldn't of had kids.

Belinda - posted on 04/21/2010

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"In each scenario — a kid with a cold, a light fever, pink eye, ringworm, or loose stools — the guideline recommendation was the same: No need to send the toddler home right away."

This is what irks me. Pink Eye is sooo contagious. And the kids pass it back and forth. So for kids to "not be sent home right away" is nonsense to me. If I think a child has pink eye, I want proof they have seen a doc, and have taken their 2 doses of drops. We may be reading things differently, but they way I'm reading it, it sounds as though this doc thinks that kids with infectious illnesses LIKE PINK EYE should be left in care, "because the damage has already been done" and we wouldn't want to burden the parents. And that is ridiculous IMO.

Children who have several loose stools in a short time period should be sent home...kids who have a low grade fever WITH another symptom....kids with a high fever....kids who had a low grade fever that spikes 4 or 6 hours later...kids who have a ringworm that the parents won't keep covered...etc.

These might seem minor, until all the kids keep getting it. Then all of a sudden parents are flipping out because their kid keeps getting sick. Well if child A had stayed home when he wasn't "fully recovered", child B might not have caught it and then given it to child C. It's a cycle and by being a little overly cautious, a center director can keep a full blown outbreak from happening. And in my state, if the licensing dept came in, and you had a child with a "red" eye, they wanted to know where that child's release to return to school was.

[deleted account]

Funny because the daycare I used to work at did the opposite. We had a kid who had diarrhea 6 times (SIX) in 8 hours and they wouldn't call his mom. We had a kid that had a fever and they wouldn't call his mom because they said it was from vaccinations. Both parents were very upset when they found this out (these were infants). It shouldn't be the directors call. If she doesn't think they *need* to leave she should still call the parents and let them know what's going on. The poor kid with the fever was miserable all day. My cousin was in Children's for a week because he caught Rotavirus from a child puking in a trash can all day next to him at school. They have a nurses office and why the teacher didn't send this kid there is beyond me.



On the other hand, I student taught and subbed at the preschool that was ran by my University. They were on top of things. They had strict policies regarding illnesses. I liked that much better. We had a parent that wouldn't believe us when we told her her child was sick. Because that center had a policy regarding illness she had to come get him because he had a fever. She took him to the doctor and he had hand, foot and mouth disease. She tried to bring him back the next day, but he was still contagious. You don't want other children in your center catching these things because parents don't want to miss work.



I prefer the better to be safe than sorry plan. None of the centers I worked at would send children home for small things like colds. I'm glad I didn't have to work during the madness of this last flu season.

Charlie - posted on 04/23/2010

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Yep snotty noses are fine otherwise they would all be at home ! LOL

Jenny i bet you would have loved our Reggio based centers , i wouldn't teach anywhere that doesn't follow the Reggio based philosophy because i too hate structure and their intent to crush children 100 languages !

Belinda - posted on 04/21/2010

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And being in debt is no excuse for taking your child to school sick. I used to work full time and my kids always came first...ALWAYS.

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Tracey - posted on 04/26/2010

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I worked at a military daycare and we were strict on illness. if we suspected pink eye, a supervisor would come and take a look just to verify it. we verified fevers one with the classroom thermometer and one from up front. if a child in diapers had diarrhea that came out of the diaper twice they where sent home. i mean from a care givers point of view, i felt with some of the children that we spent more time with them than their parents. we had one child that was always there, even for our give parents a break day. and that child's parents would say that child would be there even if you knew they were on vacation or something. so i thinks its an inconvenience to some, but if want to know whether your child is sick or not. i was once uninformed that the room my daughter was is had something going around, i took her for a little ice cream cuz she was almost 1 yrs old and teething (or so i thought) and i held her and it was projectile vomit she was so sick for days.

Amber - posted on 04/26/2010

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It makes me sad that parents think they shouldn't have to take care of thier kids when they are sick. When my son is even mildly sick, we try to keep him home or send him to a relatives house. I want him to be cuddled and get lots of sleep/rest, not be running around like crazy and spreading more germs. If he's sick he's more likely to pick up more germs because his immune system is down.
Parents need to understand that this is what they signed up for. Daycare does not have a sick room and you should respect the other children and their parents by correctly caring for your own child.

Jessica - posted on 04/25/2010

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When I read this story on my local news website it made me mad. I use to work for a daycare center in the one year old room and seen it all! Our center was worried about making the "parents happy" -- we had kids stay in our class all day with pink eye and LICE! We once had a parent bring in a child who has RSV with a fever of 105..telling us the doctor told her it "wasn't serious". Really? She was a nurse for a doctors office too. I think what parents forget is..you may not be able to "take time off for your sick child" but when we catch whatever they have..we don't get paid for sick time either. My center offered a whole 40 hours of sick time a YEAR. That was four sick days a year for us (we worked 4 - 10 hour days). And most of the time if we tried to call in ill - we were told he HAD to come in because the staff was short (always was!) We had kids with chicken poxs showing up..once had a parent bring in a child an hour after he had tubes put in his ears because dad who wasn't working at the time mind you..need a break. Yea, this is the wonderful stuff you see! I now do in home care and my rules are the ones set by the state. I have my nieces and I even send them home if they get a fever or loose bowels alot (unless it's teething, my youngest has a smell that you KNOW it's teeth LOL).

But personally..if my child was ill..I'd keep him home. Even for a cold! My husband would take him or my grandmother would keep him. No need for him to be in daycare (at the time when he was attending) when he's feeling crappy! I know I didn't want to be there when I felt bad.

Nikki - posted on 04/25/2010

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I am not sure about other countries but in Australia as a Director we have a guide, "staying healthy in childcare" which dictated when to send a child home.

I would say being in that position, I have sent children home who are possibly not really sick or contagious but they are miserable, day care is no place for a child who is unwell, there are not enough carers to provide sufficient care to children who are unwell.

My other way of thinking about it is that these children need rest when they are unwell, they need to repair their little bodies, by being in day care it can prolong the process, they are over stimulated, subjected to further germs, and are unable to properly rest.

So regardless of what a doctor says, the judgement call to send a child home is the Directors decision and me personally I take more into consideration that a runny nose.

[deleted account]

Ha ha a significant burden on parents!!!! Yep thats parenthood for you if you cant take a day off when your kids are sick then dont have any kids simple as that. Does my head in when people send their kids to school when they are ill and then my kids catch it.

Jenny - posted on 04/23/2010

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I don't like centres, too structured for my taste. My kids have always been in homecare situations with just a couple of other kids. I'll send them there with a snotty nose but any concerning lethargy, fever or certainly puking and I'll keep them home.

Charlie - posted on 04/23/2010

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My center always sent home children with those contagious illness it was not only policy BUT it is advised by the department of health .

I believe the centers have every right to call and send the kids home for a couple of reasons , the child needs to be at home being cared for in a comfortable , isolated environment and because the health of all the other kids are at risk by them simply being there , im not a doctor but i was a teacher and they may say " they've already been contagious, and they've already done the damage," but i can guarantee you that the risk is GREATLY minimized when these precautionary steps are taken .

As for the "a significant burden for parents," comment , well sorry but that's part of parenting .
We are paid to teach your children not to mention provide the highest level of supervision which cannot be done effectively when there are thirty kids outside and not enough to supervise because one is sick inside and needs a teacher with them at all times when this happens other jobs needing to be done by the teachers get put behind until we are the ones who end up staying late behind at work catching up as if we dont have lives to get on with outside of school like picking our own kids up , feeding our kids and the paperwork we have to do anyway when we get home .

Laurel - posted on 04/23/2010

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In my day home I usually only call mom or dad if the child is "really" ill.....or if they are in distress and just want mom or dad. If the child is generally happy and content I won't call, but as soon as I see warning signs..( you get to know them :) ) I call asap.. My parents usually tell me at drop off if there is something wrong. I texted updates through the day when I have time. LOL when kids have chicken pox, I beg them to bring the kids, so I can get it over with as well as the seasonal flu's!!!!

[deleted account]

As Kimberley said, day carers are not nurses. They don't get paid enough for what they are supposed to do, let alone all the extra work that comes with caring for toddlers with "minor ailments." All these ailments like contagious and keep getting passed back and forth. Send them home as soon as there's any health issue.

[deleted account]

I agree Belinda.

After reading this, I'm so glad that I'm in New Zealand, where the MINISTRY OF HEALTH recommends that pink eye and diarrhoea and other such "minor ailments" must be sent home from a daycare centre.

And Jackie, I can see your point about people who have financial difficulty... I have a friend who is exactly the same with money... but if it came down to her child's health, she would, without a doubt, put her son first.

And also, keep in mind that childcare teachers/directors are not doctors or nurses! How are they supposed to know if something is contagious or not - hell, half the time doctors and nurses don't even seem to know if something is contagious! I've taken my son to the doctor with a rash and they usually say "it's probably just a virus" - well if it's a virus then it's probably contagious so I'll keep him home. And no, I'm not a stay-at-home mother, I do have a job to go to (and no paid sick leave yet because I'm only relatively new at that job), but I just always put my son first.

[deleted account]

We had a Dad drop off his daughter who had been sick to the University preschool. He slipped and told us student teachers that she threw up last night, but hadn't since then. When the teacher asked for an update we told her what he said. It's a policy that kids have to go 24 hours vomit free before returning. Boy was he mad when they made him come get her. He was in a meeting with the President of the university. He had to stay at home with her because his wife was sick with the same thing and couldn't care for her.

Heather, I got sick a lot too when I worked in daycares. It doesn't matter how many times you wash your hands. The kids just want to love all over you :).

Jackie - posted on 04/21/2010

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And yes private "center" laws vary by state...if they register as a daycare center. There's headcounts on that....in my state you can watch up to a certain # of kids without being a "business"...so ya, those people can do what they want (in terms of all these regulations).

Jackie - posted on 04/21/2010

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Like I said, my post was premised with the point at which AFTER a doctor has said they are not contagious. And on the vaccination thing that is a totally different story, I def. have a big problem with that not being mandatory in any situation where groups of kids are together. The center we use they make you update the kids vaccination history like every 6 mos...and the kids are not allowed to be there without being up to date on everything.

Belinda - posted on 04/21/2010

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I get that some illnesses are past the "incubation" period. But that is up to a doctor to decide. And , No, private Centers can't do as they please. They are required by state laws to follow certain guidelines as well. Depends on the state.

And I have seen MANY children who are dropped off at daycare not feeling well and it is expected that the other children and the staff should "suck it up because Mom and Dad HAVE to work". One such child had a slight fever, and was just acting really really cranky. Very unusual for this child. Mom didn't want to come and get him, because she had an "important meeting at work". Yeah...turns out he had meningitis. Nice for all those other kids...

You cannot afford to miss work? Not my problem...I ran a large center and if a child had pink eye (one of those illnesses listed as not too serious) it was awful. The kids scratch their eyes and touch toys, spreading the germs no matter how often you clean the toys. And the parents would say "Oh, it;'s just allergies, or just a cold." and "I can't afford to lose a day of work". Still, as a provider I have the obligation to keep the best interests of the majority of the children in mind, and that is NOT to allow children with a potentially contagious illness to stay in my center without a doctors note. It might suck for those parents that wouldn't do that, but better safe than sorry.

C. - posted on 04/21/2010

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I don't know.. I think the first sign of anything, they should let the parents know and if it continues throughout the day, the parents should have to come and get their child. My neighbor's daughter is in school, but they have a lot of illegal immigrants that go there that haven't gotten their vaccinations or anything, so a lot of kids are getting sick and passing it on (and I'm not being racist, I am actually stating a fact. This school is known for that) Anyway, for like 3 days her daughter had diarrhea at school and NOBODY bothered to call her about! She found out the third day only b/c there was a stain in her daughter's undergarments (her daughter is only 4). Anyway, like I said.. The parents should be notified at the first signs and if it lasts, they should HAVE to pick their child up.. There are other children in those places, so it's only courteous to take your child home when they are ill so no one else catches it.

Jackie - posted on 04/21/2010

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I have not taken any posts to say that a child who is STILL contagious should be in daycare. If you understand alot of the ailments that babies get then you know once the symptoms are showing (i.e. the rash shows up, etc) they are no longer contagious...that is what people are saying. Yes they might have a rash, but it is no longer "catchy". My daughter had Roseola and was able to go to daycare b/c once the rash appears, the incubation period is OVER, it's not a matter of "oh it already happened, another few days wont matter"....there is no more "few days", the virus spreads before you know its there, then the rash shows up and its NOT spreading anymore, so there is no harm in her being there.

And obviously private day cares do what they want and make their own rules which is why I wouldn't use one, but certified daycare centers in my state have to abide by certain rules...those being if a child has a fever or diarrhea they have to go home until they are better or have a doctors note, no exceptions. So you can't just bring a sick kid that's puking all day and leave them there.

Of course we all want to be with our kids when they are sick, hell i'd love to be with my daughter 100% of the time, but that's not possible. My husband and I both have to work, I don't and never will have the luxury of being a SAHM. Yes if my daughter is miserable of course one of us stays home with her, because I have the luxury of being able to do that, but I know for some parents that's not an option. I have friends who cant' afford to miss a day of work or they can't pay their rent. As for "you should reconsider your financial situation"....they aren't in that situation b/c they WANT to be...for many people they are doing the best they can...at least they are working and not sucking off the system IMO.

Belinda - posted on 04/21/2010

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That doc can suck a toe. Has he ever had to change 10 kids with diarrhea? Doubt it. And when AN ADULT Doesn't feel well...where do they want to be? HOME!!! If you can't afford to take a day off to care for your child, you should reconsider your financial situation.

And is it fair to keep those sick kids around the healthy ones even longer just because "well, they were already contagious. What's the big deal about a few extra days?" Yeah..awesome for all those other parents.

Amy - posted on 04/21/2010

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I don't think if the child is sick they should be there at daycare anyway. They should be home getting better. I know it takes a toll on the paycheck of mom/dad, but... Then again some of the cases the kid may be fine and then all of a sudden not doing well. I'd hope they'd call me. But I keep thinking of being a daycare worker when you have all these other kids to take care of too, but a sick one is always more demanding and takes up more attention. A common cold is a common cold, but if the kid is miserable, please call the parents. I've never used daycare, so I don't know too much about it, but you'd think in today's sue-happy society, they are just safer on their end to send kids home to parents so they don't get in trouble for not doing so.

Heather - posted on 04/21/2010

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I dont get why people send their sick kids to daycare either...I used to work for head start before becoming a nurse, and we had sick kids all the time, I mean really sick contagious kids with high fevers and strep, or even chicken pox. I was sick wayyy more often during those few years of working in pre school than I have ever been in my 10+ years in nursing. Sure, kids get sick all the time, they have runny noses and little coughs and sneezes, thats fine, But if your child had green snot, a cough, and a high fever, or they are puking and having diarrhea...keep them home so everyone else dosent get it, and continue to pass it around.

[deleted account]

If a baby is sick, of course they should be sent home! I know that when my son is sick, all he wants is to relax at home with mummy, daycare is too stimulating for a sick baby!!! I don't get parents who would send a sick child to daycare. Sorry if you're one of those parents, but if you send your sick baby to daycare then they are infecting other children and not being given the chance to recover themselves! Raaaaa, this is my pet hate.

Jackie - posted on 04/20/2010

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I think the center should ABSOLUTELY inform the parents no matter what, especially with infants. I do very much agree that with the damage is done statement in most illnesses. I know with my daycare if you go to the dr and they write a note that the child is no longer contagious they can go back. It can be annoying wiht some of the rules though. I know someone whose daughter throws up VERY easily when she coughs alot, and she was preemie when born, so has resp. issues....i.e. she coughs alot. But isn't sick...will be perfectly fine 5 min. later. My friend had to leave work and pick her daughter up b/c she threw up, even though by the time she arrived 15 min. later her daughter was eating a snack and juice and playing with the other kids again. SO she had to miss work and lose pay, and still has to pay for the day at daycare...all b/c her daughter had a coughing fit basically.

In some instances I can udnerstand why a kid shouldn't be there...but if they have something that is known to no longer be contagious, there's really no reason.

Lady - posted on 04/20/2010

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When I was a child minder it was certainley the rule (and when I worked in day care, I think it was the same) that our insurance was void if the child had any illness, so it was necessary to send them home right away because if anything happened to that child the insurance would not cover it. Personally I would rather my child was sent home, I don't take them into nursery if they are ill I think they're better off at home. Of course I don't have angry bosses or unsympathetic co workers to deal with.

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