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Old 03-03-2014, 08:46 AM
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Default Dope and Drop for Teething

The other dope and drop thread and my experience with DCB this morning got me thinking about this.

I am curious what your policy is regarding dope and drop when they claim it is for teething. DCM has done this a few times in the past few weeks. She keeps saying he is cranky because he is getting his molars so I gave him some tylenol.

How do you handle this?
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Old 03-03-2014, 08:48 AM
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The other dope and drop thread and my experience with DCB this morning got me thinking about this.

I am curious what your policy is regarding dope and drop when they claim it is for teething. DCM has done this a few times in the past few weeks. She keeps saying he is cranky because he is getting his molars so I gave him some tylenol.

How do you handle this?
If a child needs meds for ANY reason, they are not allowed to be here.

How does DCM KNOW it's teething?
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Old 03-03-2014, 09:16 AM
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If a child needs meds for ANY reason, they are not allowed to be here.

How does DCM KNOW it's teething?


This is what I do too. I say that a fever over 100 is grounds for exclusion, no matter what the reason ... even teething. I also exclude if a child is under any OTC medication whatsoever. If a child is in so much pain or has a fever of 100 or more and needs pain/fever reducer then the child is not well enough to attend. If an infant is teething and is in so much pain/discomfort and grouchy/crying that he needs to be medicated then really that child should stay home.
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Old 03-03-2014, 09:33 AM
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I roll my eyes when they shut the door and go about my day. I don't have a no meds policy. I only exclude when they puke, run a fever that is obviously not teething, or have more than one bout of diarrhea. Usually the littles are so distracted here that teething is not problematic for me. I tell parents that they usually don't need meds here, but if they give them in a.m. just to let me know, and I can give meds here if need be. It has come back to bite me in the rear a time or two, but I don't expect DCPs to keep kids home every time they are cranky in the morning - they'd get fired! They are happy and playing once they get to my house. Sorry they have to be such turds for mom and dad! It's just the way I do things.
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Old 03-03-2014, 12:34 PM
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I don't have a no med policy and if meds are used to cover up a fever and illness then I view that differently then treating pain from teething. Using teething as am excuse is crappy though. If baby is truly teething and miserable (which I can usually tell the difference) then I don't mind giving a dose of Motrin. I think it's incredibly cruel to not treat your child's pain because they're not able to tell you exactly why. Some babies teethe with no problem, a tooth just pops up one day. Other babies have a hard time sleeping, eating, run low grade fevers, diarrhea, etc. and it's hard to tell and I would probably exclude if a child was that miserable. I also appreciate parents telling me when they've given Motrin or Tylenol for teething. If they tell me it was for teething and then after 4-6hrs they get a moderate fever then obviously they doped & dropped. I had one mom who did that but she's gone now. She never voluntarily kept her child home in the 14 mos he was here. The other mom I have tells me when she gives him meds and why. If he's sick she's kept him home, a whole week (paid) more than once in the year he's been here. The new DCG I have came once with Motrin in her bag "in case she got fussy" but never did. I've only treated with meds a couple times.
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Old 03-04-2014, 08:04 AM
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I don't have a no med policy and if meds are used to cover up a fever and illness then I view that differently then treating pain from teething. Using teething as am excuse is crappy though. If baby is truly teething and miserable (which I can usually tell the difference) then I don't mind giving a dose of Motrin. I think it's incredibly cruel to not treat your child's pain because they're not able to tell you exactly why. Some babies teethe with no problem, a tooth just pops up one day. Other babies have a hard time sleeping, eating, run low grade fevers, diarrhea, etc. and it's hard to tell and I would probably exclude if a child was that miserable. I also appreciate parents telling me when they've given Motrin or Tylenol for teething. If they tell me it was for teething and then after 4-6hrs they get a moderate fever then obviously they doped & dropped. I had one mom who did that but she's gone now. She never voluntarily kept her child home in the 14 mos he was here. The other mom I have tells me when she gives him meds and why. If he's sick she's kept him home, a whole week (paid) more than once in the year he's been here. The new DCG I have came once with Motrin in her bag "in case she got fussy" but never did. I've only treated with meds a couple times.
Sounds like we have similar experiences in this dept. That's what I meant about it biting me in the rear-there has been just a half dozen times in 12 years where it ended up not to be teething, but a "dope/drug n drop." But, I have had parents thank me so many times that they don't get called for pick-ups unless it is an actual full-blown-no-question-if-the-kid-is-in-fact-sick-illness like some of their friends or family complain about at their daycares.
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Old 03-04-2014, 01:35 PM
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Originally Posted by TwinKristi View Post
I don't have a no med policy and if meds are used to cover up a fever and illness then I view that differently then treating pain from teething. Using teething as am excuse is crappy though. If baby is truly teething and miserable (which I can usually tell the difference) then I don't mind giving a dose of Motrin. I think it's incredibly cruel to not treat your child's pain because they're not able to tell you exactly why. Some babies teethe with no problem, a tooth just pops up one day. Other babies have a hard time sleeping, eating, run low grade fevers, diarrhea, etc. and it's hard to tell and I would probably exclude if a child was that miserable. I also appreciate parents telling me when they've given Motrin or Tylenol for teething. If they tell me it was for teething and then after 4-6hrs they get a moderate fever then obviously they doped & dropped. I had one mom who did that but she's gone now. She never voluntarily kept her child home in the 14 mos he was here. The other mom I have tells me when she gives him meds and why. If he's sick she's kept him home, a whole week (paid) more than once in the year he's been here. The new DCG I have came once with Motrin in her bag "in case she got fussy" but never did. I've only treated with meds a couple times.
totally agree. My daughter had bad teething pain. She didn't cut he first one until she was 9 months but they had been red and swollen and just horrible for MONTHS.

My son, I swear he just kept waking up with teeth just WHAMMO. Never red, never cried, nothing.

I have no problem with medicating for teething although I'd rather do topical than oral but it is what it is.

I only ask that parents tell me what and when they gave whatever it was. Lots of asthma and allergies down here and it's very common for kids to be on allergy meds, decongestants, breathing treatments heck you name it.

But I do understand that everyone has to do what works best for them though.
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Old 03-04-2014, 02:03 PM
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But I do understand that everyone has to do what works best for them though.
And this is it right here. It's whatever philosophy that works best for you (general you).

its my personal philosophy that children dont need OTC meds for minor illness or ailment.I can get by just fine with a teething baby without giving them Motrin or Tylenol. I dont use OTC meds for my children much less for my daycare children. I want the children meds free so I can keep an eye out for an actual fever. Teething fevers are typically low grade and under 100 degrees which is fine with me. A fussy teething infant is no problem for me, I can sooth them with frozen/chilled fruit in a net teether, gum massage, cool damp washcloths, cool teething toys etc.

IMO if an infant NEEDS OTC medication it better be for a good reason, as in the child is really sick, and come with DRs orders because I wouldn't give any type of meds to a child under 2 years without a doctors note to put in the childs file. There is no medication out there that does not say "ask physician". I've seen too many stories of infants ending up with kidney failure because parents used too much for "fussy" babies that were teething or even toddlers and older children and one too many children that are "teething" and are on pain/fever reducer and then the following week an bunch of my DCKs are suddenly teething too, even my preschoolers and school agers apparently catch the teething bug because they all get the same symptoms as my "teething" infant lol.

Just kind of where I'm coming from on the whole meds thing. Its not that I don't want to deal with a fussy teething baby, I'd just rather have no children on meds so I can keep an eye out for a real fever so I can keep my household and daycare kids as illness free as possible and so I dont have to worry about liability issues.
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Old 03-04-2014, 06:00 PM
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I've seen too many stories of infants ending up with kidney failure because parents used too much for "fussy" babies that were teething or even toddlers and older children
I'm curious about this... I talked to 2 different drs about this because I was concerned when they would recommend double-dosing my own children with Tylenol & Motrin for high fevers. I was told that it was rarely found and typically found in dehydrated children. The dehydration makes their kidneys work harder and then the Tylenol or Motrin makes it worse leading to kidney failure. Children given steady doses of Motrin with flu-like symptoms or when vomiting/diarrhea is present are more likely to have kidney failure but treating a child for pain on an occasional basis isn't leading to kidney failure. I also read that you shouldn't treat fevers but treat pain/discomfort. The fever is there for a reason and actually makes you sicker longer when you take fever-reducers. People who died from influenza were treating their fever with Tylenol/Motrin and not resting, taking time off work.

I definitely understand the concept and why people wouldn't allow meds at their DC. I don't want sick kids at my DC and don't want illnesses spread. There's really a small window in which teething can be used as an excuse. Once they hit 18-24mos you're kinda phased out of that. Well... MOST, not all. My DS is 2y3m and still working on 4 incisors! Late teether! If teething is REALLY the issue your solutions are great with distraction, frozen fruit, wash clothes, teething toys, etc. and does open the door for the "teething" excuse everyone else ends up getting. It just happened here 2wks ago. DCG very well may be teething but she also had a cold that she passed on to me! LOL
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Old 03-04-2014, 06:02 PM
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Originally Posted by TwinKristi View Post
I'm curious about this... I talked to 2 different drs about this because I was concerned when they would recommend double-dosing my own children with Tylenol & Motrin for high fevers. I was told that it was rarely found and typically found in dehydrated children. The dehydration makes their kidneys work harder and then the Tylenol or Motrin makes it worse leading to kidney failure. Children given steady doses of Motrin with flu-like symptoms or when vomiting/diarrhea is present are more likely to have kidney failure but treating a child for pain on an occasional basis isn't leading to kidney failure. I also read that you shouldn't treat fevers but treat pain/discomfort. The fever is there for a reason and actually makes you sicker longer when you take fever-reducers. People who died from influenza were treating their fever with Tylenol/Motrin and not resting, taking time off work.

I definitely understand the concept and why people wouldn't allow meds at their DC. I don't want sick kids at my DC and don't want illnesses spread. There's really a small window in which teething can be used as an excuse. Once they hit 18-24mos you're kinda phased out of that. Well... MOST, not all. My DS is 2y3m and still working on 4 incisors! Late teether! If teething is REALLY the issue your solutions are great with distraction, frozen fruit, wash clothes, teething toys, etc. and does open the door for the "teething" excuse everyone else ends up getting. It just happened here 2wks ago. DCG very well may be teething but she also had a cold that she passed on to me! LOL
Agreed that the incidences of kidney failure are high with children who are dehydrated. And no, the occasional dose isn't going to hurt anything.

But yes on the rest.
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Old 03-04-2014, 11:28 PM
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Smile No drugs here

I have many reasons I do not medicate for teething:
1. The difference between dose and overdose for an infant is a few drops. Since I don't trust parents to be honest about amount given or the time elapsed I don't want that child in my care when they crash.
2. The only person who knows when a child is teething is the tooth fairy. There is no way for even a doctor to diagnose teething, so it is a guess. I am not willing to risk my children's and the other children's health on a guess that your child's fever is from teething. A child with a fever needs to be home where they can rest and be monitored by a parent who can make decisions about when to medicate and when to seek medical attention.
3. There are dozens of ways to comfort a teething child. Teething tabs made of chamomile, cold cloths or teethers, frozen infant feeders, massaging gums etc..
4. Even the Tylenol website warns that use for more than 72 hours is damaging to the liver. Imagine what weeks on end would do?

In addition, I have a policy which states that if a parent is caught medicating their child before care without calling to ask me about coming it is grounds for immediate termination, and they will lose their 2 week deposit and their childcare THAT DAY!
If my child needs medication they need to be with me. The same goes for theirs.
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Old 03-05-2014, 09:52 AM
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Agreed that the incidences of kidney failure are high with children who are dehydrated. And no, the occasional dose isn't going to hurt anything.

But yes on the rest.
No, occasional isn't going to hurt but because I do not personally know for sure how often a child is given pain/fever reducer I dont want to give more or have a child here that's on it.

There was an incident a few years ago with a provider that was always told that a DCG was teething and to give pain reducer. DCM would always say this but provider didn't feel right doing this and refused so DCM left to another provider and that provider did as asked. The mom would regularly say DCG has so and so, give Tylenol and began to get excessive. DCG was always getting sick and DCM was always saying giver her Tylenol. Well the little girl ended up getting liver failure and as it turns out any time that the little girl would fuss or cry the mom would give her Tylenol and sometimes Benadril I think it was. Provider had no idea. CPS got involved and they involved Licensing. Provider got shut down for the investigation and felt terrible for participating. She was eventually cleared but she decided to give up her licensean anyway. I'm not sure what ever happened after this but I remember talking to a provider that knows her directly and she said the provider really had no idea that so much was being given at home. She saw no signs.

DCP lie all of the time, about different things for different reasons. I don't know why they do it but it happens. I just want to protect myself from something like that happening to me KWIM. And my licensing analyst says its pretty common to get reports from providers that get visits from CPS and overmedicating at home is a part of it. For me I guess its pretty real so I just want to keep myself safe.
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Old 03-05-2014, 11:00 AM
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I have parents sign a med form for every med given, even OTC if it's regularly taken, it's kept in their file and on their emergency cards. For prescription, I require a drs note (even a photocopy of a prescription stating med, dose, time to be administered)

Under my contract and handbook, not telling me of ANY medication administered is grounds for IMMEDIATE termination.
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