Diabetic Children

[daycare]

I have never had a diabetic child in my DC before. But I do have some experience with it since my father is type 1.

I have an interview with a family that their 3 year old child is on a pump type 1.

I told the mother that I am open to it, I would be willing to take some classes.

My question is what do I need to look out for as far as contract goes.

For example if the sugar spikes and I have to give an injection do I send them home. At what point do I call parents and at what point do I send home?

I know very well how to count carbs of all types, that to me is not a concern. I am also on the food program, so that may help some.

What are your policies/guidelines with diabetic children.

Thanks

[Childminder]

I have one currently age 5 that was diagnosed at 2 and had another child in care for three years 6-9yrs. I was trained by the parents and at first gave needle injections doing all the math and counting the carbs, etc... then they went to pump but still figured amount to input. Now they both have a meter that when I test their blood sends BG to the pump and all I add is carbs and it dispenses the correct amount.

Not what you asked but I just have parents fill out the same medical forms as every other child and their doctors give me a care plan for my records. I don't have issue with pump and lancing their little fingers but sometime if the port gets knocked out I have had to use a syringe, since I was originally trained with it I feel comfortable. No biggie. The older child does everything hisself I just visually check his data input.

I did keep the little overnight a few times and most recently for a week. When I changed the port or gave her a bath and had to detach, THAT was a bit stressful for me. She on the other hand is my hero! Never bats an eye.

When I am concerned or if the child spikes or whatever I just call the parent and most of the time they talk me through whatever I have to do by phone.

[Solandia]

I never had an actual policy for kids with additional needs. However, 99% of the kids that have been in my care go to the same pedi/clinic that we do. They have all sorts of classes & support for parents/caregivers for pretty much anything you can think of.

I would do special care with training, not parent provided training. I expect to be compensated for my time for the classes, and travel ;the classes are 15miles away, even though our satellite clinic is a couple miles down the road). I feel that is reasonable expectations. However in the 10+ years of daycare, and the....probably 5-8 interviews with higher health needs kids...I was told that I was unreasonable to be paid for such basic trainings and were super offended that I would not roll with the parent showing me what to do for their kid with special health needs.

Yes, I realize that it isn't rocket science to care for a kid with diabetes, feeding tube, asthma, breathing treatments, or what have you. But parents do forget the small things, because it has become their normal. But my concern is for the care of the child, not coddling the parents feelings. Too bad, because I have no problem with stuff like that, and have had plenty experience in a couple of those areas...which they though meant I would not expect outside training to become up to date/refresh. The parent may a seen it as a lack of confidence on my part, but more likely...the money talks more, it probably felt like -to them-I was charging them "extra" by requiring payment for training.

[Blackcat31]

Personally, I would not have a child with diabetes in care.

Too many things can go wrong and I've seen some bad stuff happen with diabetic kids (especially the ones on pumps).

Older kids with experience may be a different story but a newly diagnosed diabetic or a child under age 5? NO FLIPPING WAY.

[Blackcat31]

http://www.ucsfchildcarehealth.org/pdfs/healthandsafety/diaben081803_adr.pdf

[sharlan]

Check with licensing before you ever meet with the family.

The last I read, we can only check blood levels. We cannot administer insulin via needle or pump.

[Blackcat31]

Check with licensing before you ever meet with the family.

The last I read, we can only check blood levels. We cannot administer insulin via needle or pump.

Injected medication is delivered through a syringe/needle. At this time, child care providers cannot inject medications such as insulin, with the exception of using an Epi-Pen® after receiving training. However, CCL regulations allow child care providers to do a blood test for children with diabetes that involves a finger prick, although very strict training and guidelines from CCL must be followed

Taken from a California publication

http://www.ucsfchildcarehealth.org/pdfs/healthandsafety/medadminEN102004_adr.pdf

[sharlan]

Injected medication is delivered through a syringe/needle. At this time, child care providers cannot inject medications such as insulin, with the exception of using an Epi-Pen® after receiving training. However, CCL regulations allow child care providers to do a blood test for children with diabetes that involves a finger prick, although very strict training and guidelines from CCL must be followed

Taken from a California publication
http://www.ucsfchildcarehealth.org/p...102004_adr.pdf

Thanks, I was too lazy to look it up.

[Josiegirl]

I do as Childminder does. I have a little girl who they diagnosed a month shy of being 4 yos. She's almost 6 now. She also has a pump now but I gave her injections and checked her sugar for quite awhile. I had given them to my dad for a long time so it wasn't totally foreign to me. It was different giving them to a child though. She's always been a trooper about it.
I've made several calls to dcm with questions, concerns, high numbers, etc. She always talks me through it. She had to come and check her ketones once cause her sugar was much higher than normal. Keep communication open with parents, call your lincensor to see exactly what you 'd need to do as far as keeping records and permission statements, etc.
She's old enough now to handle pricking her finger and entering all the numbers, I just oversee and count carbs for her. She can even tell me when she feels low and she's usually right on the money.

[sharlan]

I do as Childminder does. I have a little girl who they diagnosed a month shy of being 4 yos. She's almost 6 now. She also has a pump now but I gave her injections and checked her sugar for quite awhile. I had given them to my dad for a long time so it wasn't totally foreign to me. It was different giving them to a child though. She's always been a trooper about it.
I've made several calls to dcm with questions, concerns, high numbers, etc. She always talks me through it. She had to come and check her ketones once cause her sugar was much higher than normal. Keep communication open with parents, call your lincensor to see exactly what you 'd need to do as far as keeping records and permission statements, etc.
She's old enough now to handle pricking her finger and entering all the numbers, I just oversee and count carbs for her. She can even tell me when she feels low and she's usually right on the money.

In CA, home daycares are NOT allowed to give insulin.

[Josiegirl]

Sharlan, I'm not in Ca. I called my licensor to see what I needed to do and she told me I needed a log book to record it all in plus a doctor's plan, signed. Now whether or not that's all going to change in the near future with our expected new regulations....who knows? That's why I suggested to OP she call her licensing dept. as I'm sure states are all different.

I don't know why all states can't go by the same rules, it sure would be less confusing.

[sharlan]

Sharlan, I'm not in Ca. I called my licensor to see what I needed to do and she told me I needed a log book to record it all in plus a doctor's plan, signed. Now whether or not that's all going to change in the near future with our expected new regulations....who knows? That's why I suggested to OP she call her licensing dept. as I'm sure states are all different.

I don't know why all states can't go by the same rules, it sure would be less confusing.

OP is in CA.

I don't know if this is true or not, but I read on a diabetes forum, CA nurses are pushing the movement to prevent anyone except for a nurse to be allowed to administer insulin at schools and preschools.

[Childminder]

In our school district in MI if the child cannot administer their own insulin by needle then the parents have to go to the school and do it. One nurse that travels to all the schools can't and the teachers/staff won't do it. Bus driver's do not even want to transport. Luckily her driver has a diabetic daughter so she was gracious enough to accept her. The preschooler's mother had to quit work.

It wasn't her choice to be this way. Diabetics should be the same as any other special needs child the schools HAVE to care for. Why are they discriminated against?

Child will be a kindergartner this fall and her elementary teachers/administrators/lunch room personnel/clerical staff/district nutritionist have all volunteered to be educated on her care needs, bless them for stepping up! The hospital (endocrinologist) will be sending a team to the school for this training.

[Wubby]

In our school district in MI if the child cannot administer their own insulin by needle then the parents have to go to the school and do it. One nurse that travels to all the schools can't and the teachers/staff won't do it. Bus driver's do not even want to transport. Luckily her driver has a diabetic daughter so she was gracious enough to accept her. The preschooler's mother had to quit work.

It wasn't her choice to be this way. Diabetics should be the same as any other special needs child the schools HAVE to care for. Why are they discriminated against?

Child will be a kindergartner this fall and her elementary teachers/administrators/lunch room personnel/clerical staff/district nutritionist have all volunteered to be educated on her care needs, bless them for stepping up! The hospital (endocrinologist) will be sending a team to the school for this training.

: I have had a child in care since he was 18 mos., 5 months after he turned 3, he was diagnosed. He is now 11 and still in care. How is his diagnoses any different than a child will oral meds. Wow, I could not imagine not having him in care.

[daycarediva]

I have a pre diabetic child in care. We are monitoring blood sugar levels and adjusting diet to try to gain control before he becomes diabetic. Since Mom isn't on board 100%, I am ready to term over it.

I had her sign a new contract that she has to provide all supplies and replacement meals. He also can't have seconds of most things--- which DOES create issues.

All in all, it's already hard to manage and I wouldn't knowingly go into it.