Hello:

I'm new to forum and a relatively new Dad.
My wife and I needed to place our 1 1/2 year old in day care recently.
THe provider gave him peanut butter and he had an allergic reaction.
He is ok, but we can't reconcile the fact that it happened.

Our pediatrician said to wait until he is 3 yrs old before introducing, so we were following his advice. THe provider didn't call 911 because although his face and lips were swollen he was still breathing ok. We picked him up and took him to ER for treatment.

Being a 1st time parent I sometimes think I'm over reacting?
We are also struggling with whether to finding a new provider or not?

Thanks in advance for any insight, comments or suggestions

Reply

Unless your provider knew he was allergic, they had no way of knowing what would happen. My kids have been eating peanut butter since they could chew and swallow. Also...an allergic reaction rarely happens on the first introduction of the offending allergen. The body needs time to react and produce anti-bodies first. So, more than likely, your son has had peanut butter, or peanut processed food products before.

Unless you had told the provider to NOT give him foods processed with peanut products...they had no idea what would happen to your son. I'd try to work with them on his food needs. If they are unable and unwilling to work with you, that is when I would look for a new provider.

As a first time parent, things like this can be very scary. Just relax, calm down, and try to go with the flow. As much as we'd like to protect our little darlings 100% of the time...it's just not possible. Things will happen, kids get hurt, its part of the learning process for both parent and child! Hang in there! By child number 2, 3, or 4 little things will be less likely to phase you. =)

Good Luck! Keep us posted!

~Rachael

Reply

I agree with MN mom. I wasn't entirely sure by your post, however, whether the provider called to let you know or if you noticed at normal pick up time. If she called you right away, she did alright. If she took no action and just waited for the normal pick up time, I would be concerned about the level of care your child is receiving.

Reply

umm, i think it's INSANE that she gave him peanut butter.

yeah, my kids ate peanut butter before they were supposed to, but they were my kids.

the ONLY way i'd give someone else's kid peanut butter is if the mom/dad told me that they had been eating peanut butter for some time with no reaction.

she should've known better.

Reply

THank you for the replies.
We hadn't mentioned it as a known allergy since he's never had any signs prior. We were thinking since peanut butter is a life threating allergy for some children, why even risk it?
They did call us after they noticed the reaction. We didn't want to over react and called the pediatrician. They didn't seem too concerned, but the ER mentioned internal oragans also get swollen and he should have been seen ASAP. We were scared when we picked him up because his head looked like a balloon and his eyelids where slits.
We think the only exposure he has had would be airborne as we haven't actually given it to him orally.
You make a good point, kids get hurt, stung by bees, etc. and it could have happened sooner or later.

Reply

So, she should have had the foresight needed to KNOW this kid was going to have an allergic reaction? We are supposed to be mind-readers AND have the ability to see into the future too?? Wow...if I had those abilities I would NOT be in the business of childcare.....

Foods processed with peanuts are so common. PB sandwiches are a traditional food served to children for lunch. Its high in protein and complex carbohydrates, which makes it a great food to serve for those who use high amounts of energy (IE; children). I would never give a second thought to serving peanut butter to children UNLESS I was told otherwise by the parents.

For you to say the provider was insane for doing so is a pretty bold statement. If that is true..I, too, must be insane as well as a good chunk of the other providers on this forum.

Reply

Jakenite, sorry, I misread your post. 1 and 1/2 IS too young for a daycare provider to give peanut butter without asking parental permission. I gave my daughter peanut butter the first and second time on days where I was driving down town near the hospital anyway. That way, if she had a reaction, we were already nearby. But I would never make that kind of decision for someone else's 1 and 1/2 year old.

Reply

First of all, I'm glad that your son is okay, and personally, I don't think that you are overreacting at all.

Contrary to what a previous response stated, a child can react to a peanut allergy on their first exposure. Usually the reaction to the first exposure is milder compared to any subsequent exposure to peanuts. So in your child's case, should he be exposed to peanuts again, his reaction is most likely to be much more severe. Hopefully the ER and your pediatrician have explained all of this to you, and you now have knowledge to handle an allergic reaction complete with epi-pens for your son, at home and at your daycare.

Also, regardless to what a provider may give to their own children, giving peanut products to an 18 month old, in my opinion, should never happen. And your pediatrician's advice to wait until 3 years old, seems to be the current standard protocol - and your daycare provider should know this.

My own personal opinion is that I would actively search for new daycare. Your current provider had two serious lapses in judgment - first giving your child peanut butter without checking with you if he had had it before, and then not calling an ambulance (the reaction could have quickly escalated to a breathing emergency-and there is no way that she could have predicted that it wouldn't). Do you trust her judgment in the future?

My best wishes for you and your family,
Pammie
(I have 23 years in the daycare business, and have cared (and currently have in care )for children with allergies including those to peanuts)

Reply

I don't think that the provider was "insane" however, personally, I don't serve peantbutter first, no matter how old a child is. I just ask if they've had it, if not I don't serve it.

I can't say I've ever had a child who hasn't had peanutbutter before the age of 3.

Reply

I'm thinking that looking for a new provider might be the best idea too. If a child had a reaction like this one (swelling up), no matter what the stimulus was (or what I thought it might be), I would call an ambulance. Yes, I live in Canada and don't have to fork out extra money for it, but I don't think that should be a consideration. The provider should have made sure the child was seen by a doctor regardless of what the parents said. Allergic reactions can progress so quickly, it's a gamble I wouldn't want to make. Good grief, my kids have been taught at school how to recognize anaphylactic shock -- it's something everyone should be constantly on guard for.

As well, I've always understood that the general rule is to not introduce nuts or nut products for the first two years of life, and the later the better. I am concerned that this provider was okay with giving peanut butter to a child that isn't even 2 yet.

Reply

no, she shouldn't have to KNOW this kid was going to have an allergic reaction.

but she should have the common sense to KNOW that you don't give kids (especially OTHER people's kids) peanut butter when they're a year and a half old!!

you're not supposed to give it to them until they're 3 or 4 or they could DIE in the NOT SO RARE event that they're allergic to peanut butter. a lot of places don't serve peanut butter at all, ever, just because the reactions are so severe and it's too risky.

and...he didn't say she fed him a food processed with peanut butter. he said peanut butter.

btw...i was talking to the OP in my response. i said i think it's insane that she gave him peanut butter.

Reply

How many daycare providers actually know you're not supposed to give children under 3 yrs peanut butter or peanut products? I sure didn't know that. Have several years experience and trainings and my children are served peanut butter products (unless we have an allergic child). Never have had a problem.
As for this provider not calling an ambulance, she said she called the parents. The parents called their pediatrician, who wasn't too concerned, so the provider thought it was ok. Why would she go against the parents and the pediatrician and call an ambulance? That's asking for trouble also. Basically, it sounds like she would have been in trouble whether or not she called an ambulance. If the parents didn't tell her to, and they must have not been too worried if they waited until pick-up time to even see for themselves if their child was ok. Now, I do think she was in the wrong for not calling the parents back when she noticed just HOW swollen this little child was getting. Head looked like a balloon, and eyelids were slits? I would have been busting my butt to call the parents back and let them know how swollen their child was. But honestly, if the provider was told it wasn't an emergency, and it was ok to wait til pick-up time, why would she call an ambulance without parental permission after they already told her their pediatrician said not to worry?
I think I would be asking the provider if any other children are allergic. If she has some who are and serves peanut butter anyway (even to the ones who are not allergic while the child who is allergic is present), I WOULD switch providers. Have there ever been any oher problems with this provider? At pick-up and drop off, does it look like the children are well cared for? What's the adult-child ratio? Is she on a food program? If she is, isn't she required to post her menus where parents can see? You could check it at the beginning of every month from now on to make sure she never has peanut products listed for any meals/snacks again, since she knows now that your child is allergic. If there have been any other big problems with her in the past, I would take my child out of there fast. If you've always been happy up til now, I'd give it another chance. Another daycare provider may not serve peanut products, but you never know what other problems there might be, no matter where you leave your child. That's the problem with having to trust strangers with your children...

Reply

This is exactly what I do as well. I ask parents first to see if they've had PB and if not, then they don't get it for the first time at my house. TOO much of a liability.

I too do not follow the before 3 y.o. though, that is a seriously good source of protein but I can see where you as the parents are coming from. I'm sorry you had to go through this. As a first time parent, you are definitely going to freak out about more things than this, it's normal. :-) Just be happy that he was all right and chalk it up to a learning experience.

I agree with another PP that said, if you no longer trust your provider then you probably should start looking for a new one.

Reply

NO I would NEVER give an 18 month old peanut butter. I never give nuts first in my home. I talk to parents extensively about any nut allergies in the family and develop a plan for introduction to nuts AFTER the age of two. I don't give a child ANY nuts until the parents have done in many many times at home.

I encourage parents who want to try introducing nuts to give them to their child DURING their well child visits at the Pediatrician. That way they are on site at a place that can quickly manage a child's reaction.

If a parent doesn't okay nuts and clarify that they have given the child the nuts MANY times I do not give them nuts. I feed the kids pure whole foods that do not have traces of nuts. NO processed food containing nut residue.

A nut allergy is VERY serious. I do not keep kids who have a nut allergy. I talk to the parents about this at our first interview. If a child develops a nut allergy they have to make other care arrangements. It's too dangerous to have them in my house and I'm VERY careful.

I would absolutely remove your child from care. Your provider doesn't understand the magnitude of what she has done and what she MUST do from this day forward to protect your child. If she did she wouldn't have done this in the first place.

Also.. peanut butter is a choke food you do NOT give to 18 month olds.

Definitely terminate and find a completely nut free facility or nut free home. It could save your childs life.

Nan

Reply

I do not think you are overreacting at all. Peanut allergies are on the rise & most pediatricians do not recommend trying peanut products until the age of 3. I think it was in very poor judgement for her to give a young child peanut butter without authorization from you, the parent. I care for a two year old & the mom has told me no peanut products until we try them at home to be sure he is not allergic. I think the public in general is not informed about allergies. They can be deadly. I am glad your child was okay. I think the best thing to do is provide your provider with some educational materials about allergies. My son has a peanut allergy (he's 8 1/2) & thankfully we have never had to use an Epipen (found out about the allergy as a result of testing for another food when he was quite young). IF you are happy about your provier aside from this incident I would not look for another. I would just try to educate her about what you now know. Does your child have other allergy issues? If so, your dr needs to write up a plan of action so you & the provider know how to properlty respond. Honestly, your provider should have called EMS if his face was swollen. Breathing difficulties could have come on quickly!

Reply

No, she should not be a mind reader but she should have had the knowledge to know this was life-threatening, especailly if he was swelling up. This child could have easily gone into anaphylactic shock which could have resulted in death. I would re-consider your peanut butter policy if I were you. Most dr. do not recommend it until 3 years of age.

Reply

Wow..I am torn on this subject (for a change )

First yes the provider should have caused 911. You hear all the time about peanut allergies sometimes with devastating results.

On that same note: the provider could have given the 18 month anything with peanuts. Not necessarily peanut butter. I read labels all the time. I have to since I am allergic to certain types of red dye. Believe me..red dye is in EVERYTHING. From shampoo to ice cream. Me and Benadryl are best friends Anyway, labels sometimes say that a product may have been processed on something made with peanuts (or something like that)

That being said and I feel awkward saying this but in all my years in daycare, I have never asked a parent about a peanut allergy. Of course we would ask about general allergies but nothing about peanuts. Then again we would serve pb and j sandwiches, pb crackers etc..to all children once they were on table food. Even hot dogs. Of course we would cut up the food into small pieces but they were served nevertheless.

Long story short: IMO No I don't think they should leave the provider. The woman did not know the child was going to react. She did call the parents and the parents came. If this subject makes them feel uncomfortable then yes they should change. However IMO this was a learning experience. The parents now know the child is allergic to peanuts.

Reply

I agree with you Former Teacher. The kid's reaction to the pb was severe enough to warrant a call to 911.

I always ask parents if the child has any food allergies but I don't specifically ask about nuts either. Since my family like nuts and nut products I would never make my daycare a "nut free" facility. Personally, I just wouldn't take a child with a nut allergy because it's too risky.

For the record, our old pediatrician said pb was OK after age 1 but if the child is high risk (meaning that they are allergic to other foods or have a family history of allergies) then wait until 2. Our current ped says age 2 unless high risk then wait for 3.

The allergic reaction could have just as easily happened at home so there was no way for the provider to have known. If you like everything else about the provider then I would give her another chance. Maybe educate her about nut allergies as someone else mentioned.

If I am not mistaken, when you are on the food program a child goes to the regular menu once they turn a year old. Since pb is an approved food, and the child was over a year old, it's possible that the provider truly thought pb was OK.

Reply

I'd be freaked out as well, but if you truly like his provider in every other way I would probably stay with her (if she is willing to keep him, this has probably freaked her out almost as much as you). You will both need to educate yourselves to keep him safe in the future. Unfortunately this may make finding another provider difficult as well. As many have commented, he may be seen as a liability to many nut-loving homes You know what *I* learned some new things from this too! My ped always said 2 years before peanut butter, now I know that 3 yrs is recommended. I also never thought about all the foods we serve that are processed in nut-product facilities. Even without peanut butter or actual peanuts we still may trigger reactions unknowingly. Oh, and did anyone else know that moms shouldn't eat nuts while pregnant or nursing if anyone in their family has an allergy (even if it's not them)? I'm sure their Dr would tell them, but I had never given it a thought. It makes sense, but it's amazing how little we can know if it has never directly impacted us. I've never known anyone with a peanut allergy, so I haven't researched it in a while. Glad I did!

Here's an article I found that also mentions peanut butter is ok and actually good for 1 yr olds with no family nut allergy risk. Interesting. (I still wouldnt serve it to dcks though!)


http://babyparenting.about.com/od/nu...anutbutter.htm

Reply

This post saved me from typing the same response. I completely agree.

Reply

ditto to above. I always ask about allergies, but once child is on table food, it is cut up and served.

Reply

I agree, if I was in that situation and ambulance would have been called immediately. Then a call to the parents.

The policies on PB vary from doctor to doctor. There needs to be more consistency in information regarding age-groups imho, due to the confusion most people have regarding allergies, specifically peanut allergies. It happened to be PB that caused the reaction, but peanut(s) and oils are used in the processing and preservation of many foods you would not link to peanuts. Check labels next time you go shopping, you'd be surprised. It could have been a cracker, a cookie etc that triggered this too, eventually.

My ped. specified no peanut butter until after 1 year AND only if they could chew and swallow without issue. He never mentioned anything regarding other foods processed with peanuts, it was always PB. I always thought it was due to the high risk of choking with such a sticky food, not because of allergic reactions.

Of course my youngest is now 4 and the standards / recommendations are always changing. It's very hard to keep up!

Reply

I think the reason my ped recommends waiting until 3 is b/c my oldest does have a peanut allergy so she advised that for our younger kids too. So some docs may say it's okay to try it earlier. And I am totally aware of the high incidence of peanut products & cross-contamination that can occur with foods you would not suspect having peanuts in them. Seeing as my child has the allergy we are very careful with what we buy. I guess that is my point, that providers need to be seeking out the info if they have not. Who as a provider would want to have this situation enfold in their home with other kids in their care & not have a clue what to do? I believe providers should ask parents if the child has ever tried anything with peanuts upon enrollment. If they have not, make sure it is tried at home with the parent & not at daycare. Believe me, it is a very scary situation to have an attack & be unprepared.

Reply

This is a toughy. Although I agree that there was no way that a provider can know what a child is allergic to I also agree that I wouldn't want to be the first child care provider to give a child his/her first taste of ANYTHING especially foods like peanuts, eggs, honey and milk.

I always ask the parents for a list of things that a young child is able to eat and has already tried and what they have not tried. You just never know. If I have a child that is newly being intoroduced to solids I always ask the parents not to bring me baby food that they have not tried before and I make a list of my own of the foods that I can give the child. I even wait a while after a parent tells me they have introduced milk, eggs, honey or peanuts to a child because of the fact that an alergic reaction may not be apparent right away. However, I don't feel that in this case it is anyones fault, just an accident that fotunately didn't end too horribly.

I too think that working with the provider would be the best outcome but if the parents feel uneasy or unerved then looking for care elsewhere might be best. There is no need for anyone to feel uncomfortable when it comes to their children.

Reply

I am a center provider, and our lunches come from the local school. Peanut butter sandwiches are provided daily as a supplement for those who won't eat the lunch. Our teachers are required to have a signed permission form in order to serve peanut butter to any child. When the children are moved onto the school lunch program in the infant room, they are informed about the policy and many parents do serve peanutbutter at home at the age of one. My room is ages 16 - 24 months, and I currently have one child out of 10 who cannot have peanutbutter. In food allergies, we request the parent serve the child the questionable item at home before we serve it at the center.

I feel the provider did the right thing in calling the parent first at the onset of the reaction. The parent chose to call a dr. instead of picking up the child and taking him to get checked out. The provider did what she felt was right, and monitored the child. She followed the parents orders.

I wouldn't find a new provider. The parent has to be accountable for the mistake they made in not requesting medical treatment immediately. We don't know much about the providers background. But she has learned something new in regards to food allergies.

Reply

I also agree with Former Teacher, We are told to wait untill they are one and although i ask about allergies i do not get specific, it's the parents job to inform their provider of any issues, an allergic reaction to a food unless the child has been tested is not something that can be forseen, I would have called the parents and asked what they wanted to do, ie: come see the child for themselves or have me call 911, i wouldnt have let them wait untill pick up but the provider did call and say what happened, the parents cant blame her when they werent concerned enough to leave work over it,If she is a good provider why leave?
KiddieCare

Reply

NO WAY SHOULD YOU GIVE A CHILD UNDER TWO PEANUT BUTTER. This is common knowledge, or so I thought! I've even heard 3 years, but it depends on the source. I've read that if you have no family history of peanut allergies, you can try it at 1 year. But that is on your OWN child. Never, ever should a Daycare Provider give peanut (or tree nut) products to a Daycare child who is too young. They don't know the child's history, and frankly, it's not their place to make that decision. I would consider calling the agency that governs Daycare Providers in your state and ask them if there are guidelines as to what age Providers are allowed to feed the kids nut products.

Reply