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I just let dcm know her 5mo son's temp was 99.3 & he has been really fussy the last two days... this morning especially. He had a cold last week & pulled on his ears, which I have already told dcm about. He's also not eating too well. All signs of ear infection, to me at least. DCM wants me to give him tylenol. Well I told her I would give tylenol if fever reached 100, otherwise I felt like we would be covering up his potential fever and warning signs of an ear infection. Well, she has called his Dr. and convinced them he is teething, so they would write me a note stating to give him tylenol for teething. I"m thinking that I need to add this to my contract to avoid future conflicts. Do any of you have a policy against giving tylenol fora low grade fever, and how do you word this?
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If she gives you a doctor's note, I would give the tylenol.
I don't have a policy about low-grade fevers, but if the child is not feeling well or cannot participate in normal activities, then my policy is that they have to stay home. My handbook says something like, "when children are not feeling well, they are mcuh more comfortable at home with mom or dad, not at child care...."
My own daughter is teething right now and she had a fever of 100.6 and has been fussy and just seems to feel yucky. And I know it's teething (well, I'm pretty sure), so it would suck to not be able to put her in care for today, but for her comfort, it would be the right thing to do.
I hope that helps, good luck! -
I wouldnt take the doctors note unless the child was actually SEEN by the doctor. I had a child that was teething and had a low grade fever - so I kept her in care well the next day her temp was 102 - her low grade fever wasnt teething..it was Roseola. I don't give tylenol unless it is for pain only, I do not allow children to be dropped off with tyelnol in their systems either.
I also have in my contract/sick policy that if a child is extra fussy and cannot participate in normal activities and requires more one on one attention that they may need to be at home where they are more comfortable.Comment
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Yes, I did give him tylenol. I was forced to with the dr. note. I realize he could be teething, but we won't know now b/c the tylenol is keeping his fever down. He's been teething for about a month now, but all of a sudden after a cold virus he gets irritable/low fever/etc...? To me, they are all signs of ear infection. I hope mom ends up getting it checked out just to be sure.Comment
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That's a great way to word it. Thanks! I'd still like to have something about NOT giving tylenol for low grade fever; but don't know to word that one so that they can't blame everything on teething and make me give tylenol to hide the real symptoms.Originally posted by Heather View PostComment
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I don't have anything in my contract about Tylenol for low grade fevers or teething. Perhaps you could word it like this: I will not administer Tylenol or Motrin for low grade fevers (98.6-100 degrees). Low grade fevers are considered beneficial to the system and the child should not be uncomfortable from just a low fever.
Teething is such a gray area though and it seems like a convenient excuse for a lot of parents and can be an easy way to cover up a real fever. I guess I've been fortunate that my own kids never had fevers or much pain with teething. Personally, my kids don't get Tylenol unless they absolutely need it for pain or have a temp of 102. I think some parents over medicate and just give Tylenol when the kids don't need it, but I do know that some kids do benefit from the pain relief. To address the Tylenol issue with teething, perhaps you can put in: Tylenol for teething will only be administered if I receive written permission from the parent and the child is uncomfortable while in my care. Tylenol will only be administered once per day. If you must give your child Tylenol before attending care or if it must be administered more than once per day, then your child should not attend care for the day.
I think the teething one comes off really strict, but it's just an idea. Like I said, I don't have anything in my contract for it, so I just made that up. If you think your parents (even if it's only one) give Tylenol to mask a real fever, then I'd go with a strict policy.Comment
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I explain in my contract that even though a child doesn't necessarily have a fever over 100 it doesn't always mean they feel great and want to participate in daycare! I said mothers always know best and you know when your child isn't feeling 100% and when you feel this way it is a day you need to stay home and give the added attention to your child in which they deserve!! If they cannot participate in an entire day of daycare because they are not feeling well they cannot be here no matter if they have a fever or not! I always get the teething excuses, it is always the first thing out of a parents mouth when a child starts running a fever!! I just say well maybe it is, but I don't know for sure because I am not a doctor! But I do know that they are not feeling well and that they are not having fun here today and they need to be picked up!! Teething is a tough thing because it can come and go and it can last a long time, but aren't fussy every day of teething so stay home with them and give them the comfort they deserve when it is a fussy not feeling good day!! : )Comment
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I will not give Tylenol/Motrin for teething because I have had too many parents try to hide other things by saying their child is teething. Instead I use teething tablets, oral gel, cold teething rings, cold wash rags, etc.
My policy is if their temp goes above 99.5 I call a parent and inform them, especially if the child is fussy. If it gets higher than 100.2 then a parent is called and they must stay out of childcare for at least 24 hours. I then keep an eye on the child to see if they get that mysterious fever that occurs after they have been in childcare for 4-6 hours. I find it amazing fevers start then and that is the same amount of time pain relievers last! Crazy isn't it?
Last week I had a parent take 2 sick days and bring her child to child care. Okay, that is fine, she is paying me and she doesn't feel well. But then this week her child is sick and trying to get her to stay at home with him or take him in to the doctor is like pulling teeth! I don't understand these people some days.
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I don't have a policy for low grade fevers. I will not give Tylenol for teething - I use the cold teethers, rags, tablets, orajel........I do think some dcps over-medicate with tylenol and they wouldn't even know if their child had a "real" fever in the first place. UGH!
Funny how the 3+ year old dck's (and even a couple of 2's) will tell me that Mommy gave them yucky red medicine at home in the morning. I LOVE watching the dcp's faces get all red when I tell them that at pick up.
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Originally posted by caitlin View PostI will not give Tylenol/Motrin for teething because I have had too many parents try to hide other things by saying their child is teething. Instead I use teething tablets, oral gel, cold teething rings, cold wash rags, etc.
My policy is if their temp goes above 99.5 I call a parent and inform them, especially if the child is fussy. If it gets higher than 100.2 then a parent is called and they must stay out of childcare for at least 24 hours. I then keep an eye on the child to see if they get that mysterious fever that occurs after they have been in childcare for 4-6 hours. I find it amazing fevers start then and that is the same amount of time pain relievers last! Crazy isn't it?
Last week I had a parent take 2 sick days and bring her child to child care. Okay, that is fine, she is paying me and she doesn't feel well. But then this week her child is sick and trying to get her to stay at home with him or take him in to the doctor is like pulling teeth! I don't understand these people some days.
LOL I call right around lunch time "Witch Hour", you know right when the tylenol/motrin wears off after being given it right before daycare and all of a sudden a fever pops up!!Comment
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We had to make our own separate illness policy for the parents to read and sign. It was outlined: fevers, diarrhea, vomiting, and misc.
TX law requires regardless of the cause once a child reaches a temp of 100.4 they must be removed from the center. We said that we would take in account that true that a child may be teething but if the child exhibits other symptoms IE fussiness, they MUST be picked up and fever free 24 hours. We would not give Tylenol unless we had a dr's note to RETURN to daycare. We would have a note on file that we could administer Tylenol/Advil, however the parent still must be pick up the child.
Diarrhea: after 2 diarrhea's the child must be removed from the center. We stated however stated we wait until the 3rd diarrhea only because in case a child isnt done :
: Plus we would take in account: antibiotics, teething etc.
Vomiting: after 2nd episode, must be picked up.
Misc: in this section we just basically told the parents that if a child is crying, irritable, cranky, blah blah blah, would they like their child next to this child?
As for this particular parent: if she was at my former center: I would tell her that I would not be giving tylenol. If the temp reaches 100.4 (or whatever) he is to be picked up. He may return 24 hours later. If again after 24 hours he has another fever, he can only return with a dr's note stating he is not contagious. Should he indeed have an ear infection, he needs to be on the medicine for 24 hours or 3 doses.Comment
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it works both ways.
providers are skeptical about parents giving medication and using teething as an excuse - and parents are skeptical about providers using a low grade/teething fever as an excuse to get rid of a kid and have an easier day. that def. DOES happen. i knew one provider that would check temps of every kid, every day - so if a kid happened to have one (even if they felt/acted fine) the ratio would be lower if a kid had to leave - and she could go home early.
i know that it does happen, but there are very, very few parents who would leave their infant in daycare to suffer if they were truly ill and needed to see a doctor. babies DO get fevers when they're teething - along with diarreah. so, if a baby is teething and the parent says the LOW GRADE fever and/or diarreah is a result of the teething, then it probably IS.Comment
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Our policy at the center I work at is 100.5 and then they go home. I don't "warn" the parent's that their child has a low grade fever. I just wait for it to go up past 100.5 and send them home which garuntees they won't be back the next day.
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Thanks everyone for your responses. Well, here's an update: his dad ended up taking him to the Dr. yesterday & he did not have an ear infection. For that I am happy; I truly just wanted him to get checked by the Dr. b/c he is NEVER fussy like that unless something is wrong.
However, I did send him home today. He woke up from his first nap with bright green discharge caked all over his nose and lip. Mom's response when I called her was "But the dr. said he was fine yesterday!" I explained " I know it's frustrating, but he didn't have bright green discharge yesterday. I have been in your shoes before & I understand where you're coming from; but I have to stick by my sick policy for the benefit of the other kids and yours."
She picked him up- one hour and 40 minutes later. I was not happy. Then, she calls me later & says she called and spoke to the nurse. She says "he just has an upper respiratory infection, no need for antibiotics, not contagious, & could have this discharge for two weeks. Kids are just snotty!"
So I told her if the dr. (not the nurse) wrote me a note stating he is not contagious in his current state of green discharge & upper resp. inf.; then I will watch him next week. Haven't heard back from her.
This mom seems to challenge EVERY policy I have; from bringing kids outside to play, to putting her baby on HER schedule (not mine), to giving him tylenol for low grade fevers, to having green discharge in the nose.Comment
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