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lvt77 08:18 PM 01-09-2011
I have a baby that is 7 months old in my care. He is a very ill child.

He is severely asthmatic, sounds like he struggles to breath daily. He is always sick with something. Ear aches, colds, and etc.

He only comes one day a week with his older brother who comes 3 days. This past week when he was in my care, he was turning blue and shaking. Luckily, my husband was home to look him over, he’s a paramedic. I was in tears because it scared me so bad. I called the mom right away and told her what was going on. She said she was calling the dad to come get him.

When the dad came to pick up, I found out by talking to him that the baby was in and out of the hospital for several weeks over the Christmas Holiday. I was never told this once before this day..

I cannot administer the babies’ inhaler medication and I don’t know what to do. I feel that this child is way too sick to be in care. If you heard the way he breathes, you would probably call 911. But this is how he breaths every day according to mom and dad.
What do you think…..I don’t feel I am qualified or staffed properly to care for this child.????
What would you do?
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Danielle 03:49 AM 01-10-2011
I haven't had my coffee yet so maybe I missed something, why can't you give him his inhaler?
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momofboys 04:39 AM 01-10-2011
I don't think nebulizer treatments are that difficult to administer, it just means turning on the machine & holding the tube in the child's mouth. . . some have masks that go over the whole child's head so the child could sit in a high chair (if old enough) & you wouldn't have to do much except for monitor them. It does sound though to me like the child's asthma is not under good control if he sounds that bad. It definitely can be a scary situation & I can understand your desire to not have that much responsibility for someone's well-being.
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ammama 05:41 AM 01-10-2011
I wouldn't care for him if he was that sick. Or at least tell the parents that they have to provide a detailed doctors note explaining his symptoms and saying it is ok to be in daycare. What if he picks up a flu or something?
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lvt77 07:11 AM 01-10-2011
I dont give any medications here, I live in California otherwise known as the sue happy state. I was told by my lawyer not to assume the liability. I will only give homeopathic medication.
I forgot to mention that every time here is here, which is only once a week, he often has some health issue or an unusual occurance related to his health.
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misol 07:13 AM 01-10-2011
Originally Posted by Danielle:
I haven't had my coffee yet so maybe I missed something, why can't you give him his inhaler?
Originally Posted by janarae:
I don't think nebulizer treatments are that difficult to administer, it just means turning on the machine & holding the tube in the child's mouth. . . some have masks that go over the whole child's head so the child could sit in a high chair (if old enough) & you wouldn't have to do much except for monitor them. It does sound though to me like the child's asthma is not under good control if he sounds that bad. It definitely can be a scary situation & I can understand your desire to not have that much responsibility for someone's well-being.

Just a thought: It's possible that she may know HOW to give the meds but CAN"T because of her state regs. We have to have MAT certification in order to administer ANY meds - even over the counter ones. The only thing we can do is topical, nonprescription things like sunscreen, diaper cream, etc. I have decided at this time not to get certified in medication administration - too much of a liability IMO. So, when I get calls about a sickly child or a child on maintenance medication, etc. I simply tell the parent that I am not certified to administer meds. Any other explanation for not taking a sickly or special needs child can very easily be interpreted as discrimination.
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lvt77 07:25 AM 01-10-2011
very true, I was also told by my lawyer that I do have to give the parents the option to come during childcare hours to administer the meds. When I told the parents this they declined
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jen 08:03 AM 01-10-2011
It sounds to me as thought this child needs more specialized care. If you aren't willing to provide it (and I do understand why) then I would terminate care. It isn't fair to that baby. Mom and Dad need to take him somewhere that his medical issues can be addressed on a daily basis.
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lvt77 08:06 AM 01-10-2011
I feel so bad for this baby and I want to be able to help but I cant do anything to help him.
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laundrymom 08:48 AM 01-10-2011
Originally Posted by lvt77:
I feel so bad for this baby and I want to be able to help but I cant do anything to help him.
I wold give parents written notice that they either keep him home until not ill or bring in a lengthy dr explaination saying why it's ok for a child, especially a young infant, to be in a daycare setting when they are obviously unable to breathe effectively. Let them know that either they get documentation for his condition or you will notify child protection. That you are a mandated reporter. Someone needs to speak up for this baby and it looks like you are it. Poor kid. I don't see why parents don't think thru their actions. What if he has an emergency while in your care? He already has issues, what if he has an asthma attack? He needs help. Especially being so young. Was he premie or a drug baby?
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Live and Learn 09:11 AM 01-10-2011
Originally Posted by jen:
It sounds to me as thought this child needs more specialized care. If you aren't willing to provide it (and I do understand why) then I would terminate care. It isn't fair to that baby. Mom and Dad need to take him somewhere that his medical issues can be addressed on a daily basis.
Jen is correct. I would be scared to be left alone with and responsible for this lil guy. I don't give meds of any kind here...period! Meds are for sick kids and I am a well child care house.
It was not appropriate for them to leave him in your care without mentioning his recent hospitalizations. That feels like they were afraid that you would say "no"...so they just snuck him back into your care.....that was risking their own child's well being. NOT OK!

Good Luck.
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SilverSabre25 09:15 AM 01-10-2011
I don't know much about asthma, but what I do know is enough to say that this kid's asthma is NOT well-controlled and that is DANGEROUS!
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lvt77 12:27 PM 01-10-2011
Thanks for all of your feed back. I actually emailed the county health advisor on it
This is what she emailed me back:
An asthmatic child is considered a special needs child and since a child can actualyy die from a severe asthmatic attack the child needs to be placed with a provider that can administer the necessary medications.

Does the child have an asthmatic care plan provided by the pediatrician? I have sent you a sample of what a care plan should look like.

Please feel free to download the above care plans and encourage the parent to take the care plan to their doctor and have the doctor fill it out and if you are uncomfortable giving the medication than you can inform the parent to please seek another provider and at the same time give her the sample care plan so the next provider can have the information as provided by the pediatrician.

The care plans are from ages 0 to 4yrs, 5 to 11yrs and 12 yrs and up. Please give her all three since the child will be growing and ashtma will remain a concern for the school district when he is old enough to go to school.
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LaLa 05:08 PM 01-10-2011
Originally Posted by lvt77:
Thanks for all of your feed back. I actually emailed the county health advisor on it
This is what she emailed me back:
An asthmatic child is considered a special needs child and since a child can actualyy die from a severe asthmatic attack the child needs to be placed with a provider that can administer the necessary medications.

Does the child have an asthmatic care plan provided by the pediatrician? I have sent you a sample of what a care plan should look like.

Please feel free to download the above care plans and encourage the parent to take the care plan to their doctor and have the doctor fill it out and if you are uncomfortable giving the medication than you can inform the parent to please seek another provider and at the same time give her the sample care plan so the next provider can have the information as provided by the pediatrician.

The care plans are from ages 0 to 4yrs, 5 to 11yrs and 12 yrs and up. Please give her all three since the child will be growing and ashtma will remain a concern for the school district when he is old enough to go to school.


1. The parents are in the wrong for not knowing what is wrong with their child. And if they do know they should let it be known.

2. You cannot even give tylenol?? NOTHING??? Are you serious??? As a parent I would never have a daycare provider that couldn't give anything. Here in MD we have a doctor sign off if it is ok to give something and the parent also signs something.

3. IMO Asthma is not a "special need". If it is then every child has some sort or "special need". There is no perfect child. You do need to let the parent know if you cannot handle this child. Here in MD it is illegal to discriminate.
It is not hard at all to take care of an asthmatic child.

On another note- My 10 month old is a very "loud" breather. He has what's called a "flappy" voice box. This makes is breathing very loud but he has never turned colors.

The parents should have told you about the hospital visits.

I also agree with Jen on this one...
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lvt77 05:47 PM 01-10-2011
Well this is information that I got from the RN PHN IIIChild Care Health ConsultantChild Death Review Team Coordinator of my county..
It's not that I dont want to care for the baby, it's that I dont know how to. I know nothing about asthma. The only thing that I can do right now is either call the paretns to pick up the child or call 911. How would you feel if you had to care for a child and you did not know how to care for them.......
Yes I do give tylenol and OTC as long as they sign consent form and it is age appropiate...
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nikia 06:32 PM 01-10-2011
"How would you feel if you had to care for a child and you did not know how to care for them......."


I do not know anything about asthma either. It doesnt make you a bad provider at all. If you want to continue caring for the child the parents should be teaching you everything about it. When my daughter was born her pulmonary artery didnt open all the way and there were possible things that could happen to her even though it was a very slim chance. As she grew the artery opened all the way but I still gave my daycare provider a copy of all the information I received from her doctor and told her everything the doctor told me. I think that is what parents should do. Always inform the person taking care of your child of everything that is going on with them. If the parents cannot do that for you then you should let them go. Again in no way does this make less of a provider. Everyone has limitations, screaming babies, lice, and many more.
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laundrymom 10:55 AM 01-11-2011
Any update on this baby?
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lvt77 11:10 AM 01-11-2011
Yes, he actutally went into the hospital on this day of the event...Of course I just found out yesterday when older brother came. I am so worried for the lil guy...

I told them that I need a baby care plan from the doctor. Something that would tell me warring signs, how to care for this child and etc. I told the parents that we share interest in the well being of their child and that if they dont start co-parenting on this issue with me, then they are going to have to find another daycare. I told them how can they expect me to help their child, after I told them I know nothing about his issue and then they don't do anyting to inform me...
hopefully the lil guy is fine and will be able to return to care..
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laundrymom 11:12 AM 01-11-2011
sorry you are getting nothing from them but so glad he was seen by doc. Hope he gets stronger soon, seems like his parents dont really care if he does.
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lvt77 11:32 AM 01-11-2011
I am so angry right now its not even funny................
SO the older brother comes today and gma just picked him up. He is only here for the preschool prgram then goes home..
I asked the gma how the baby is doing and she asked me what happened the day the baby was at my house....When I told her, she said yeah I know he was doing that all last week when I had him and I told my daughter to take him to the hospital, but they said he was still breathing so he was fine...............They knew about this and did not tell me...WTH.. now I WANT TO TERM THEM... How dare they put me in this situation........
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Lilbutterflie 11:47 AM 01-11-2011
My son has been diagnosed with asthma, he has shown symptoms since he was 6 weeks old and got his first cold. Luckily, his is virally-induced; so he mainly shows symptoms when he gets a cold or flu virus.
I have been giving him nebulizer treatments since the age of 3 months old. It is not difficult at all, and now he can use a regular inhaler with an attachment.
If you are not willing to give him the medication... PLEASE PLEASE PLEASE tell the parents they need to find someone else to provide care for him. It's one thing to be sued for administering medication incorrectly, but this child can DIE in your care if you are not willing to give him his rescue medication!!! I'm not trying to say you have to change your policy about medication, but I'm trying to stress that he needs to be in a facility that is willing to give him rescue medication. That is why it's called rescue medication... b/c if a child has a severe asthma attack (depending on the child; but this child sounds like he has pretty severe asthma) and does not get this medication, it can be a matter of minutes before they stop breathing. No joke.
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lvt77 12:35 PM 01-11-2011
Originally Posted by Lilbutterflie:
My son has been diagnosed with asthma, he has shown symptoms since he was 6 weeks old and got his first cold. Luckily, his is virally-induced; so he mainly shows symptoms when he gets a cold or flu virus.
I have been giving him nebulizer treatments since the age of 3 months old. It is not difficult at all, and now he can use a regular inhaler with an attachment.
If you are not willing to give him the medication... PLEASE PLEASE PLEASE tell the parents they need to find someone else to provide care for him. It's one thing to be sued for administering medication incorrectly, but this child can DIE in your care if you are not willing to give him his rescue medication!!! I'm not trying to say you have to change your policy about medication, but I'm trying to stress that he needs to be in a facility that is willing to give him rescue medication. That is why it's called rescue medication... b/c if a child has a severe asthma attack (depending on the child; but this child sounds like he has pretty severe asthma) and does not get this medication, it can be a matter of minutes before they stop breathing. No joke.
I am not aganist it completely..I was however, advised by my lawyer from day one not to administer medication, as it was a huge liability to put on myself....My husband and I both agreed that since I have no medical back ground, then i should stick to teaching. I know that part of daycare is to deal with all of the issues that it brings on, but when children are sick, they are sent home... I understand that this is more serious, but again, if they wont help me understand their childs medical issues then how can I help the child.

I have invited the parents to inform me of thier childs health and what is going on, but they wont tell me...Or should I say they dont tell me anything. I have also invited the parents to come and administer his medicaiton at any time of the day, my front door was always open for them to do so.....They declined...
I was trying to do them a favor by watching him one day a week and in the end, I am feeling hopeless about this who situation......I think they wont tell me about his medical condition, because they know that in my policy it states that I don't administer meds...so instead of telling me, they hide it so they wont have to find someone else to watch him..
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marniewon 12:52 PM 01-11-2011
Originally Posted by lvt77:
I am so angry right now its not even funny................
SO the older brother comes today and gma just picked him up. He is only here for the preschool prgram then goes home..
I asked the gma how the baby is doing and she asked me what happened the day the baby was at my house....When I told her, she said yeah I know he was doing that all last week when I had him and I told my daughter to take him to the hospital, but they said he was still breathing so he was fine...............They knew about this and did not tell me...WTH.. now I WANT TO TERM THEM... How dare they put me in this situation........
I would so report this family - this is NOT responsible parenting!!
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Lilbutterflie 01:00 PM 01-11-2011
I totally respect your policy for not administering medication. I really do. But that policy probably should result in you not taking any children with asthma. I cannot stress enough... a child can die in minutes of having an asthma attack if they do not receive rescue medication. Think of it as someone who is allergic to nuts and needs an epi pen within minutes to open their airways. It's not enough to invite the parents to come and administer the medication, by the time parents get there the child may not be breathing. Not all asthma is this severe, but it can be. And if he's already turned blue on you, it sounds like his asthma might just be that severe. All I'm trying to say is that you should not be providing care for this little boy.
I also agree with you that the parents should be much more informative. It actually makes me sick to my stomach that it seems they are not taking his condition seriously. This poor little boy probably already has damage done to his lungs from lack of oxygen. I even wonder if you should call CPS about this. Abuse is not providing the appropriate health care that a child needs. If he was in the care of his grandma and she was watching his lips turn blue and the mother said not to do anything about it... that is absolute neglect.
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lvt77 01:14 PM 01-11-2011
We both know that I could not write in any policy i dont except kids with astma..That would be discrimintation....
I am so sick to my stomach right now over all of this, that I feel the only thing that I can do it ask them to term care. No child should be in care that ill, asthma or not..3 days out of the hospital.........
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Unregistered 06:07 AM 01-12-2011
You most certainly should term care in this situation. I can't believe the parents are willing to leave their asthmatic baby in your home, knowing you can't administer medication if needed.

I am a mom w/ 2 boys with asthma and also work in a daycare toddler room with 2 dcks with asthma. When dealing with asthma, time is of the essence! We are allowed to administer nebulizers and inhalers and in the year that these children have been in our room, we have done so. A few of the times, we had to administer the meds when the child developed a breathing problem in a very short time period. One child was perfectly fine all day but after playing outside during the Spring allergy season, started having trouble breathing. Because we had the child's inhaler, were able to get it under control. I don't want to know what would have happened if we didn't act quickly or were forced to wait for mom to arrive to administer the medication. Having an asthmatic child but being unable to medicate them would be like playing Russian Roulette with the child's life. There is nothing more frightening than hearing a child struggle to breath.... seconds seem like hours. You are doing the right thing in terming this family.
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Tags:asthmatic, sick, special needs
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