I am a registered user, but logged out. I have a DCB who is 11 months. He's walking on his own. Today he came in and was acting 'off'. I chalked it up to teething, as his gums were pretty swollen and I took his rectal temp which read 99.4. He was refusing to eat, and was laying around and would go from happy to cranky pretty quickly. I contacted the DCP's because this behavior was so NOT him. He's really a happy baby. Well, Mom says he knocked his head pretty hard last night and she was worried about a concussion since he was so sleepy. She came early to take him to the Dr.

I get it text that DCB is not using his arm, and when he moves it he cries. Did anything happen today at daycare to cause his arm to hurt? I keep thinking of the day, and a little toddler did bump him over (accident, little guy is still getting his balance). It wasn't that big of a fall, and he didn't cry the 'I'm hurt cry". So now... I'm waiting. This is nice family. They're x-raying to see if he somehow BROKE his arm? I thought it was teething? Wha-Wha-What?

So, now I can write up an accident report... but I don't even really know what happened, or if it happened here. He was here from 7am-3pm and acted cranky from about 7:40-8:40 (chalked it up to teething). Toddler bumped him just before breakfast at 8:25. He slept from 8:40-11:20ish, ate lunch and snuggled, read books, and laid silently on the floor (weird for him) while I picked up lunch dishes. I contacted parents around 12:30 to let them know he wasn't acting himself. I put him down about 12:50 where he slept until 2:20 and then he ate a full 9 oz bottle (I still hold it for him), and changed his diaper, then she picked up? Any idea's on how to handle this? They were still waiting for x-ray last I heard, she's keeping me in the loop.

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Update*** X-ray was clear, but now they say they may see an orthopedic Dr. tomorrow.

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Have they told the Dr that he hit his head pretty good the night before?

You have to wonder if this is connected in some way...

I would document everything you know.

Did he favor his arm at all while at your house?

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This sounds really really odd to me.....I am more concerned that mom knew that boy had a hard fall yesterday yet told you nothing upon dropoff? I would write up the accident report but detail that you did not hear crying, see him favoring arm or any indicators that this was the cause of the arm injury. You dont want the parent to take the report as an admission of fault because from the sounds of it, something happened at home first. Its possible the second little fall made the injury worse. Detail what info you got about the first fall! Keep texts or whatever just in case as proof that something did happen at home! I would hate for you to be held at fault and parents push for medical costs to be covered....

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This!

Did they tell you he hit his head the night before when they dropped off? Or did they wait until you called about his behavior to give you an "oh, by the way?"
I would be documenting but also putting in a call to my licensor...

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** Update ... I guess they have an ortho appt. this morning at 10:45. When I checked on him last night he had just thrown up all over his room =( She said she'd keep me updated. There is no puking as of now running through the daycare. I don't know how a bump on the head, sore arm and puking go together, or if it's just one of those days when EVERYTHING that can go wrong, just does.

They did NOT mention the bump on the head upon drop off. Only after I started letting them know that he was listless and tired did they mention something, (out of character so much that it warranted them to come early to take him immediately to the Dr.!)

I just hope he's okay.

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Throwing up is a possible symptom with head injury.

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Those symptoms actually go together well. A concussion will make you vomit. He needs to be seen for his head injury. He may have hurt his arm as well or damaged a nerve somehow. I would not accept this boy back in my care until he is fully checked with a report from the dr

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Yes, insist on a Dr release before accepting him back. All these things could go together and be caused by a mild concussion. Document EVERYTHING!

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When he hit his head he may have tried to catch himself (I'm assuming he fell somehow) and pulled a muscle in his arm.

I'd be way more concerned about the puking, tiredness, etc after smacking his head. That screams concussion. Why are his parents so worried about the arm but la de da about the head? Doesn't make sense to me.

Thanks for the update, I really hope the parents told the Dr about the head smack too. Concussions can be serious.

Document everything. CYA. I would also insist on a Dr release (specifically the head & arm) before allowing him to return. You do not want that liability.

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I'm worried that mom hasn't mentioned them checking his head? I'm guessing she neglected to tell the dr about his head at all.

If he fell and smacked his own head hard enough for a concussion that's extremely serious and needs to be checked into ASAP. Like ER visit. I would skip the ortho and go straight to the ER. Delayed treatment for a head injury can be fatal.

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falling on his head could have resulted in a broken shoulder or collarbone, too. And sometimes, especially with babies and young children, breaks don't show up immediately. A friend of mine recently went through this with her son. He feel off the bed one night (not a long fall, their bed is on the floor) and seemed fine. Next day was using his arm, but favoring it at times. Took him to a doc who said he was fine and a chiropractor who said he was fine. Couple weeks later he still wasn't using it so they took him to urgent care where they finally could see a break. Baby bones are very soft and they bend more than break and problems can take awhile to show up.

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Yes, and I would insist that they get a doctors note that included the doctor stating that they checked for a concussion and he does not have one. The symptoms seem to back up a possible concussion and I would not accept that liability- the child could be in danger if it went undiagnosed/untreated. So scary!

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I would INSIST on the all clear from ortho and a ped about his head injury. I would also NOT write up an accident/injury form. He did NOT cry, chances are he wasn't hurt at your home. I think, imho, the incident report will be an admission of guilt.

I WOULD however, document that parents made no mention of the fall at home until YOU said he was acting off, and photocopy my daily health check reports, along with screen shots of texts to my registrar/licensar.

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Yes, I wouldn't document an injury since it did not happen at your house

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*****Update
The DCD just called me and said that the bump on the head did NOT cause a concussion, the vomiting was due to excessive crying, and they have no idea what happened to the arm. The ortho suggested a soft cast for 2 weeks to keep his arm immobile, since it appears to be causing him pain. After x-rays from the shoulder to the wrist showed no breaks, all the joints are good, no nurses elbow, can't find anything? He's generally happy with the cast on, now that the arm isn't hurting as much. He's just now getting frustrated with trying to get around using it. Learning how to sit up and such.

The are wanting to bring him back to daycare tomorrow, but DCD will be working from home in case I need him.

Thanks for all your help! I have them bringing sign off from Dr.'s and I have everything documented for their file.

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My sister broke her shoulder once and if I remember correctly the the break (or all the break?) did not show up on the X-Ray. Also, did they check the collarbone?

Glad they got the head checked, etc. and it sounds like the little guy will be okay!

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I guess he's okay lifting his arm from the shoulder, he's able to rotate his shoulder fine from what they've said, It appears to be the left elbow, forearm area? They said it's usually caused by an infection or hard fall. His ear infection from 3 weeks has cleared up, and there was nothing on the x-rays. They're at a loss. Hopefully in two weeks they'll take it off and he'll be good to go.

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Just a heads up if it continues, I was told children often don't show minor fractures, only major breaks. Sometimes it takes a few weeks to show up ad it's more of a shadow or an area that shows healing.

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** Update -

DCB is already showing signs that the arm is fine, he's using it more while in the cast now, DCM agree's. DCM let it slip that the Tuesday before this happened they saw him limiting his arm movements and were already keeping an eye on it. I said " So, you saw him not using his arm before bringing him to my house?" DCM says "Well, he might have injured it earlier, but I believe he RE-injured it at your house".

This is a good family to me. They pay on time, they gave me an extra week of pay for a Christmas bonus and even sent me a cookie-gram for Easter. I know they value me and what I do for their son, but... why would they keep this a secret and not tell me? I was racking my brain trying to figure out how he *might* of hurt his arm at my house. They kind of already knew there was an issue, why put it on me like this was the first time they'd seen it?

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[quote=KDC;455972]** Update -

DCB is already showing signs that the arm is fine, he's using it more while in the cast now, DCM agree's. DCM let it slip that the Tuesday before this happened they saw him limiting his arm movements and were already keeping an eye on it. I said " So, you saw him not using his arm before bringing him to my house?" DCM says "Well, he might have injured it earlier, but I believe he RE-injured it at your house".

This is a good family to me. They pay on time, they gave me an extra week of pay for a Christmas bonus and even sent me a cookie-gram for Easter. I know they value me and what I do for their son, but... why would they keep this a secret and not tell me? I was racking my brain trying to figure out how he *might* of hurt his arm at my house. They kind of already knew there was an issue, why put it on me like this was the first time they'd seen it?[/QUOTE]

Because they want the injury to be on YOUR WATCH, not theirs.

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