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daycare 11:37 AM 07-24-2014
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
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Childminder 12:36 PM 07-24-2014
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.
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Solandia 12:48 PM 07-24-2014
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.
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Blackcat31 01:10 PM 07-24-2014
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.
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Blackcat31 01:11 PM 07-24-2014
http://www.ucsfchildcarehealth.org/p...081803_adr.pdf
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sharlan 01:49 PM 07-24-2014
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.
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Blackcat31 01:56 PM 07-24-2014
Originally Posted by 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.
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-PenŽ 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
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sharlan 02:54 PM 07-24-2014
Originally Posted by Blackcat31:
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-PenŽ 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.
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Josiegirl 03:46 PM 07-24-2014
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.
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sharlan 04:55 PM 07-24-2014
Originally Posted by 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.
In CA, home daycares are NOT allowed to give insulin.
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Josiegirl 05:21 PM 07-24-2014
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.
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sharlan 06:27 PM 07-24-2014
Originally Posted by 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.
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.
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Childminder 09:54 PM 07-24-2014
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.
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Wubby 10:21 PM 07-24-2014
Originally Posted by 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.
: 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.
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daycarediva 03:48 AM 07-25-2014
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.
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Blackcat31 05:42 AM 07-25-2014
Originally Posted by 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.
Originally Posted by Wubby:
: 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.
My DH is type 1 diabetic. My nephew is as well (diagnoses under Pre-k age). My DH has lost a brother to diabetes (brother was very young).

I am NOT discriminating against diabetics.

I simply do NOT have the capabilities of caring for a diabetic child.

When things are going well for them and their readings are consistent, there is usually no problems. However, when there are problems....I do NOT have the extra hands or eyes to provide the necessary care and supervision.

The risk of the child going low can happen quickly and without reason.

I've seen the fall out from that.

NOT a risk I am personally willing to take while caring for 10-11 other children.

I believe that children with diabetes really do need an "available" and medically educated caregiver.

Simply counting carbs and entering info into a pump with a few words of precaution from a parent is NOT enough.

I believe the caregivers who do enroll diabetic children should have some additional training. Training provided by a diabetic specialist (NOT the parent) and not just basic training.

If I had a child with diabetes, I would never place them in a child care with multiple children and only one caregiver. I just wouldn't.
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Unregistered 06:07 AM 07-25-2014
I currently have a toddler in care who has recently been diagnosed with type one diabetes. I would not sign on a new child knowing they have type one diabetes. I do not believe group care with a single provider is the best or safest environment for their care. Just my feeling. While I think I have a pretty great set up and provide good care, If I was a parent with a child recently diagnosed with T1D I would not keep them in my type of care environment.
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Unregistered 06:28 AM 07-25-2014
Originally Posted by Blackcat31:
My DH is type 1 diabetic. My nephew is as well (diagnoses under Pre-k age). My DH has lost a brother to diabetes (brother was very young).

I am NOT discriminating against diabetics.

I simply do NOT have the capabilities of caring for a diabetic child.

When things are going well for them and their readings are consistent, there is usually no problems. However, when there are problems....I do NOT have the extra hands or eyes to provide the necessary care and supervision.

The risk of the child going low can happen quickly and without reason.

I've seen the fall out from that.

NOT a risk I am personally willing to take while caring for 10-11 other children.

I believe that children with diabetes really do need an "available" and medically educated caregiver.

Simply counting carbs and entering info into a pump with a few words of precaution from a parent is NOT enough.

I believe the caregivers who do enroll diabetic children should have some additional training. Training provided by a diabetic specialist (NOT the parent) and not just basic training.

If I had a child with diabetes, I would never place them in a child care with multiple children and only one caregiver. I just wouldn't.
Totally agree. It's all good when things are going well. But when it changes, you may need more than two hands on deck. Adults can be tricky and children can be even trickier. It goes downhill SOO fast.
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