Keeping Your Child Safe In Daycare |
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This is an article I wrote last year which outlines general tips for parents who are thinking about enrolling their children in daycare. I've also written a detailed account of my family's personal experience with daycares in Halifax. Click here to go there directly.
General tips for parents of allergic children who are new to daycare
The first thing you must do to ensure your child's safety is to visit the daycare without your child. Inspect the facility and pay special attention to the kitchen and fridge particularly if that daycare has a No Foods Policy and will be providing food for all children, including your child. That said, I would strongly urge you to reconsider daycares who are not flexible on that policy. I recommend that you provide ALL meals and snacks for your child. This will go a great deal towards making him/her safe. We do the things that no one else thinks about. Who would think to wash a knife after using it to cut a cheese sandwich. Most people think a good wipe is okay and move on to the next sandwich. As parents of allergic children, we are more experienced in minimizing cross contamination because we are more motivated to keep our child safe and because we have all seen, heard, or sadly, experienced anaphylaxis.
Provide the daycare staff with all of the allergy information and facts relating to anaphylaxis, the specific allergies of your child, EpiPen instructions, and information about cross contamination. In our case we provided each member of the staff (including the director, assistant director, and cook) with a package constituting the following:
Make sure that the entire staff operates as one team to ensure the safety of your child. That means teachers have to cooperate together to keep the child safe. Even though your child attends one class, the teachers in the other classes must be vigilant when it comes to washing hands and face with the other children. All the children in the daycare should wash their face and hands after food to avoid cross contamination. Make sure to specify when talking to daycare staff that hands and face need to be washed after food consumption every time. I've spoken to a number of daycares that confirmed they wash hands and face after lunch but neglected to tell parents that they DO NOT wash hands after snack time.
It is paramount that you have a separate and uninterrupted conversation with the kitchen staff about your child's allergies and the dangers of cross contamination, as well as instructions on how to read labels properly. Many people have no idea that cream contains milk protein and is usually made from milk. Just because you are sending food from home, does not mean that the staff can be lax about label reading.
Make sure you are available for the first week to go to daycare with your child and remain there for the entire day to observe the staff and guide them through the process. It will give you an opportunity to point out the danger zones or practices that may make it unsafe for your child.
Make sure that in the event that your child has an allergic reaction, that you have a consistent point of contact, especially when 911 is called.
Make sure that in the event of an allergic reaction, that the staff promptly writes down the details of the incident before they forget. In our case we provided them with the Allergic Reaction Review Form available on this web site. Explain to them how important it is that the information be as accurate as possible because it is vital for your child's proper assessment by the allergist.
Make it absolutely clear that toys have to be cleaned before your child comes in contact with any of them, especially if the class or other classrooms have had unsafe foods recently. Allergen residue on toys is one of the main reasons for cross contamination in any daycare. Explain that a simple disinfectant for example, is not going to fully remove peanut butter residue or smears of margarine. The toy would have to be washed with soap and water in order to be safe.
Make sure that the staff maintains a clear path of communication with you and each other as well. In the event that your child develops a new allergy for example, the staff needs to be updated by someone who is in a position of authority, not just from you. It is best if you approach the director of the daycare with that type of information, as it is his/her responsibility to make sure that the entire staff is updated and on board with the new protocols you have set in place.
Set up a peer review system for label reading. One person reading the labels is unacceptable, especially if they are new to the allergy label reading rules. An extra pair of eyes will help ensure that your child does not accidentally ingest something that is contaminated with allergens. If none of the staff are available for that task, then you may have to be the extra pair of eyes. Make sure that they all understand that you need the kitchen staff's undivided attention first thing in the morning, and that you inspect all the ingredients that are going into all the meals for the entire day.
Inquire about who substitutes for the cook and the teacher in case they are sick. Ask about the protocols in situations like that and make sure they meet your child's needs. Make sure you know who is responsible for relaying the information about your child's allergies to the new cook or teacher. Speak to the new cook to make sure he/she understands the dangers of cross contamination and how to read a label properly.
Find out who provides the food for the daycare, and where they buy all their food supplies. Be firm about vague labels. Explain how important it is that your child not consume anything that is in an unlabeled package. Also make sure that all the food your child eats is produced, packaged, and inspected in Canada. Food inspection and labelling laws are different in every country. Canada is among the strictest, and yet there are still mishaps. If the origin of the food is questionable then it must be avoided for your child's safety. That means that items without a label are completely off limits for your child.
The staff must also be aware that over the counter drugs like Reactine or Benadryl will not stop anaphylaxis so that they do not rely on the premise that such drugs may counteract the effects of cross contamination. Make sure to explain to them that in case of an allergic reaction that epinephrine is the only thing that will temporarily stop anaphylaxis from progressing any further. Make sure the staff understands that epinephrine is only useful early on and not to wait too long after the child has had a reaction to administer the EpiPen.
Print out or purchase labels that are dishwasher safe to stick on cups, dishes, and utensils for your child. Make sure that those items are to be used only by your child and that no unsafe food is allowed to be in them, even if your child is not in daycare that day. Those items should be dedicated to the allergic child only. The label should include the child's name and what they are allergic to. Professionally done allergy labels are widely available and convenient as they are UV, dishwasher and microwave safe. Some of the really good ones I've purchased are allergy labels made by Mabel's Labels where you can list up to 6 allergies.
Be polite but firm when it comes to talking about allergy information. After the initial session of information, it is advisable to have another session perhaps a couple of months later, which includes all the staff. That session would be a summarized version of the first session but its purpose is to remind the staff of the allergies and the dangers of cross contamination. As human beings, we get complacent especially when things are going well, so a refresher course about allergies will not hurt.
Make it clear that your child is just like any other child and you expect them to be treated as such. This means that teachers do not have the right to exclude your child from regular daycare activities or celebrations. Be generous and offer a helping a hand to try to come up with a solution that will work for everyone while maintaining the safety of your child. If they are having a celebration that will involve food, offer to help by giving them recipes that are safe for your child.
Make sure that your contact info and other emergency contacts are clearly visible and available on hand quickly when they need it. Offer to help and explain that you are flexible or that you can make schedule changes if need be to keep your child safe. In general, you want to remain approachable and never scold or get upset if the staff administers the Epipen needlessly. It is always better to be safe than sorry.
Listen to your gut feeling; it's your instinct. If you feel uneasy, or if there is something bothering you or making you feel uncomfortable, pull your child out of that daycare, until the issues are addressed and resolved. Do not compromise the safety of your child. If the issues are not resolved, then that daycare is unsuitable.
Finally, download whatever documents you need from this web site and use them to help you work with the daycare. If you need any more information or assistance, please contact me. I might be able to help you.
Good luck, and stay safe in your search.
General tips for parents of allergic children who are new to daycare
The first thing you must do to ensure your child's safety is to visit the daycare without your child. Inspect the facility and pay special attention to the kitchen and fridge particularly if that daycare has a No Foods Policy and will be providing food for all children, including your child. That said, I would strongly urge you to reconsider daycares who are not flexible on that policy. I recommend that you provide ALL meals and snacks for your child. This will go a great deal towards making him/her safe. We do the things that no one else thinks about. Who would think to wash a knife after using it to cut a cheese sandwich. Most people think a good wipe is okay and move on to the next sandwich. As parents of allergic children, we are more experienced in minimizing cross contamination because we are more motivated to keep our child safe and because we have all seen, heard, or sadly, experienced anaphylaxis.
Provide the daycare staff with all of the allergy information and facts relating to anaphylaxis, the specific allergies of your child, EpiPen instructions, and information about cross contamination. In our case we provided each member of the staff (including the director, assistant director, and cook) with a package constituting the following:
- Information about allergies in general that summarizes the myths and misconceptions associated with allergies and how severe allergies can be, such as chapters from the book Food Allergies For Dummies
- A dedicated write up and detailed chapter about the dangers of cross contamination and how to prevent it
- A printed list of the allergen names and their derivatives, as well as fridge magnets and small cheat sheets that encompass the same information for the cook and the person responsible for doing the grocery shopping
- Recipe versions that are comparable to the daycare recipes, only without the allergens your child is allergic to
- A copy of Food Allergies For Dummies which we thought was suitable because it's an easily digestible version of allergy information for someone who does not live with allergies and so would be coming in with a lot of myths and erroneous misconceptions about allergies, such as the common confusion between a milk protein allergy and a lactose intolerance
Make sure that the entire staff operates as one team to ensure the safety of your child. That means teachers have to cooperate together to keep the child safe. Even though your child attends one class, the teachers in the other classes must be vigilant when it comes to washing hands and face with the other children. All the children in the daycare should wash their face and hands after food to avoid cross contamination. Make sure to specify when talking to daycare staff that hands and face need to be washed after food consumption every time. I've spoken to a number of daycares that confirmed they wash hands and face after lunch but neglected to tell parents that they DO NOT wash hands after snack time.
It is paramount that you have a separate and uninterrupted conversation with the kitchen staff about your child's allergies and the dangers of cross contamination, as well as instructions on how to read labels properly. Many people have no idea that cream contains milk protein and is usually made from milk. Just because you are sending food from home, does not mean that the staff can be lax about label reading.
Make sure you are available for the first week to go to daycare with your child and remain there for the entire day to observe the staff and guide them through the process. It will give you an opportunity to point out the danger zones or practices that may make it unsafe for your child.
Make sure that in the event that your child has an allergic reaction, that you have a consistent point of contact, especially when 911 is called.
Make sure that in the event of an allergic reaction, that the staff promptly writes down the details of the incident before they forget. In our case we provided them with the Allergic Reaction Review Form available on this web site. Explain to them how important it is that the information be as accurate as possible because it is vital for your child's proper assessment by the allergist.
Make it absolutely clear that toys have to be cleaned before your child comes in contact with any of them, especially if the class or other classrooms have had unsafe foods recently. Allergen residue on toys is one of the main reasons for cross contamination in any daycare. Explain that a simple disinfectant for example, is not going to fully remove peanut butter residue or smears of margarine. The toy would have to be washed with soap and water in order to be safe.
Make sure that the staff maintains a clear path of communication with you and each other as well. In the event that your child develops a new allergy for example, the staff needs to be updated by someone who is in a position of authority, not just from you. It is best if you approach the director of the daycare with that type of information, as it is his/her responsibility to make sure that the entire staff is updated and on board with the new protocols you have set in place.
Set up a peer review system for label reading. One person reading the labels is unacceptable, especially if they are new to the allergy label reading rules. An extra pair of eyes will help ensure that your child does not accidentally ingest something that is contaminated with allergens. If none of the staff are available for that task, then you may have to be the extra pair of eyes. Make sure that they all understand that you need the kitchen staff's undivided attention first thing in the morning, and that you inspect all the ingredients that are going into all the meals for the entire day.
Inquire about who substitutes for the cook and the teacher in case they are sick. Ask about the protocols in situations like that and make sure they meet your child's needs. Make sure you know who is responsible for relaying the information about your child's allergies to the new cook or teacher. Speak to the new cook to make sure he/she understands the dangers of cross contamination and how to read a label properly.
Find out who provides the food for the daycare, and where they buy all their food supplies. Be firm about vague labels. Explain how important it is that your child not consume anything that is in an unlabeled package. Also make sure that all the food your child eats is produced, packaged, and inspected in Canada. Food inspection and labelling laws are different in every country. Canada is among the strictest, and yet there are still mishaps. If the origin of the food is questionable then it must be avoided for your child's safety. That means that items without a label are completely off limits for your child.
The staff must also be aware that over the counter drugs like Reactine or Benadryl will not stop anaphylaxis so that they do not rely on the premise that such drugs may counteract the effects of cross contamination. Make sure to explain to them that in case of an allergic reaction that epinephrine is the only thing that will temporarily stop anaphylaxis from progressing any further. Make sure the staff understands that epinephrine is only useful early on and not to wait too long after the child has had a reaction to administer the EpiPen.
Print out or purchase labels that are dishwasher safe to stick on cups, dishes, and utensils for your child. Make sure that those items are to be used only by your child and that no unsafe food is allowed to be in them, even if your child is not in daycare that day. Those items should be dedicated to the allergic child only. The label should include the child's name and what they are allergic to. Professionally done allergy labels are widely available and convenient as they are UV, dishwasher and microwave safe. Some of the really good ones I've purchased are allergy labels made by Mabel's Labels where you can list up to 6 allergies.
Be polite but firm when it comes to talking about allergy information. After the initial session of information, it is advisable to have another session perhaps a couple of months later, which includes all the staff. That session would be a summarized version of the first session but its purpose is to remind the staff of the allergies and the dangers of cross contamination. As human beings, we get complacent especially when things are going well, so a refresher course about allergies will not hurt.
Make it clear that your child is just like any other child and you expect them to be treated as such. This means that teachers do not have the right to exclude your child from regular daycare activities or celebrations. Be generous and offer a helping a hand to try to come up with a solution that will work for everyone while maintaining the safety of your child. If they are having a celebration that will involve food, offer to help by giving them recipes that are safe for your child.
Make sure that your contact info and other emergency contacts are clearly visible and available on hand quickly when they need it. Offer to help and explain that you are flexible or that you can make schedule changes if need be to keep your child safe. In general, you want to remain approachable and never scold or get upset if the staff administers the Epipen needlessly. It is always better to be safe than sorry.
Listen to your gut feeling; it's your instinct. If you feel uneasy, or if there is something bothering you or making you feel uncomfortable, pull your child out of that daycare, until the issues are addressed and resolved. Do not compromise the safety of your child. If the issues are not resolved, then that daycare is unsuitable.
Finally, download whatever documents you need from this web site and use them to help you work with the daycare. If you need any more information or assistance, please contact me. I might be able to help you.
Good luck, and stay safe in your search.