Default Style Register
Daycare.com Forum
Daycare Center and Family Home Forum>At What Point Would You Require A Dr Visit?
jenboo 08:43 AM 01-06-2017
DCB is 6 months. He started with me the week of Thanksgiving. The first day he came with a cough and congestion. We are now into January and it still hasn't gone away. Some days are worse than others... one week the cough was very barky, one week it was dry, one week it was wet. Some days he can barely drink his bottle and breathe at the same times. He coughs most when he is first dropped off and at nap times, often times waking himself up in a coughing fit. When you hold him, you can feel rattling inside and it sounds very mucousy when he breathes.
I mention it to mom almost every day and she either says she didn't notice it at home or mentions how it must have come back.

At what point would you require DCB to see the dr? My ds hadn't had more than a cold that cleared up in a couple days so I'm not sure what is the typical wait time.

If you would require a dr visit, do you have a form you send with him?
Thanks!
Reply
daycarediva 09:15 AM 01-06-2017
I would send them with BC's form. It's awesome and CYA really well. (haha)

also, after 5 days, especially young infants. He could have bronchitis or pneumonia, and there is NO WAY that they aren't aware of it. Coughing is also a symptom of asthma or allergies, and if it's chronic with no other symptoms....
Reply
jenboo 09:37 AM 01-06-2017
Originally Posted by daycarediva:
I would send them with BC's form. It's awesome and CYA really well. (haha)

also, after 5 days, especially young infants. He could have bronchitis or pneumonia, and there is NO WAY that they aren't aware of it. Coughing is also a symptom of asthma or allergies, and if it's chronic with no other symptoms....
Thanks! I'll definitely tell them that he needs to see the dr
Reply
Snowmom 10:08 AM 01-06-2017
After 7 days if it's persistent or worsening.

It sounds like asthma to me.
Reply
Blackcat31 11:02 AM 01-06-2017
Originally Posted by jenboo:
Thanks! I'll definitely tell them that he needs to see the dr
I private messaged you my form.
Reply
jenboo 11:18 AM 01-06-2017
Originally Posted by Snowmom:
After 7 days if it's persistent or worsening.

It sounds like asthma to me.
Some days he barely coughs, other days he caughs a ton. Today his nose is very congested and when he breathes is all gross mucousy sounding
Reply
Snowmom 12:22 PM 01-06-2017
Originally Posted by jenboo:
Some days he barely coughs, other days he caughs a ton. Today his nose is very congested and when he breathes is all gross mucousy sounding
I would mention it to the parents.
The cold weather (plus colds and allergies) can trigger asthma, wreaking havoc on the respiratory system. It can be quite dangerous for some kids.
I've suffered from it since childhood and have been hospitalized multiple times because of it (progressed into pneumonia 3 times).
http://www.healthline.com/health/ast...duced-asthma#2
Reply
debbiedoeszip 07:18 AM 01-07-2017
I don't require doctor visits unless I suspect something especially virulent (chicken pox, measles, etc).

Like schools and daycare centers here, if a child is unwell then I send them home. If I think that a child is being medically neglected (for example, not being treated by a doctor when their condition is obviously serious) then I call the authorities.

If I suspect something like chicken pox or measles, then I require a doctors note stating that they are not contagious and can attend daycare.
Reply
jenboo 08:06 AM 01-13-2017
I got the note back.
He has an upper respiratory infection and mucous in his lungs.
The doc says to monitor him.

How long do these things last?!
Reply
childcaremom 08:15 AM 01-13-2017
Originally Posted by jenboo:
I got the note back.
He has an upper respiratory infection and mucous in his lungs.
The doc says to monitor him.

How long do these things last?!
Don't know. But he would be excluded from care until better.
Reply
Baby Beluga 08:21 AM 01-13-2017
Originally Posted by jenboo:
I got the note back.
He has an upper respiratory infection and mucous in his lungs.
The doc says to monitor him.

How long do these things last?!
Isn't mucous in the lungs considered bronchitis?
Reply
jenboo 08:23 AM 01-13-2017
Originally Posted by Baby Beluga:
Isn't mucous in the lungs considered bronchitis?
The note said he was afebrile... not sure what that means..

Now i feel dumb.... looked it up...he doesn't have a fever
Reply
jenboo 08:27 AM 01-13-2017
Originally Posted by childcaremom:
Don't know. But he would be excluded from care until better.

...he's had it for almost two months...well that i know of. He came with it his first day so idk how long he had it before...
Reply
Baby Beluga 08:28 AM 01-13-2017
Originally Posted by jenboo:
The note said he was afebrile... not sure what that means..

Now i feel dumb.... looked it up...he doesn't have a fever
I'm not a doc, but this is just my hunch. Doc diagnosed "mucous in lungs and a URI" because little one doesn't have a fever. I am betting if he doesn't get better, a fever will eventually spike and a diagnoses of bronchitis will be made.
Reply
Baby Beluga 08:29 AM 01-13-2017
Originally Posted by jenboo:
...he's had it for almost two months...well that i know of. He came with it his first day so idk how long he had it before...
He is 6 months now, has had the cough for two months with you and mom/dad aren't worried?
Reply
jenboo 08:34 AM 01-13-2017
Originally Posted by Baby Beluga:
He is 6 months now, has had the cough for two months with you and mom/dad aren't worried?
According to them, he doesn't show half the symptomsfrequency he shows here.
Reply
childcaremom 08:35 AM 01-13-2017
Any of those symptoms are exclusionary for me.

Also, the fact that doctor said he needs to be monitored, to me, signals mom and dad doing the monitoring.
Reply
jenboo 08:35 AM 01-13-2017
Originally Posted by Baby Beluga:
I'm not a doc, but this is just my hunch. Doc diagnosed "mucous in lungs and a URI" because little one doesn't have a fever. I am betting if he doesn't get better, a fever will eventually spike and a diagnoses of bronchitis will be made.
Guess I'll be watching for a fever.
Reply
childcaremom 08:35 AM 01-13-2017
Originally Posted by jenboo:
According to them, he doesn't show half the symptomsfrequency he shows here.
Of course not. Because then they'd have to keep him home.
Reply
jenboo 08:38 AM 01-13-2017
Originally Posted by childcaremom:
Any of those symptoms are exclusionary for me.

Also, the fact that doctor said he needs to be monitored, to me, signals mom and dad doing the monitoring.
Ugh. Idk what to do.
The dr doesn't seem concerned, it isn't affecting his behavior... he was just home for a week due to snow days and seems the same as he was last week.

At what point would you allow him to return?
Reply
jenboo 08:43 AM 01-13-2017
Originally Posted by childcaremom:
Of course not. Because then they'd have to keep him home.
Ive never had a child who was sick longer than a couple days... do parents take take weeks/months off of work? How does this typically work???
Reply
childcaremom 08:50 AM 01-13-2017
Assuming that mom and dad are telling the truth and he isn't exhibiting symptoms at home, is there anything in your environment that could be triggers for these reactions? Allergic or otherwise?

How concerned are you with this cough? Is anyone else in care getting sick? What are mom and dad response when you talk to them about it?

I send home when symptoms are present. So a barky cough? Home. Wet, chesty cough? Home. Not eating because they are too stuffy? Home. To return when symptoms are no longer present for at least 48 hours.

I do find it hard to believe that they don't notice this at home.
Reply
jenboo 09:01 AM 01-13-2017
Originally Posted by childcaremom:
Assuming that mom and dad are telling the truth and he isn't exhibiting symptoms at home, is there anything in your environment that could be triggers for these reactions? Allergic or otherwise?

How concerned are you with this cough? Is anyone else in care getting sick? What are mom and dad response when you talk to them about it?

I send home when symptoms are present. So a barky cough? Home. Wet, chesty cough? Home. Not eating because they are too stuffy? Home. To return when symptoms are no longer present for at least 48 hours.

I do find it hard to believe that they don't notice this at home.
I can hear him breathing and i am about 10 feet away from him. I think they just don't notice it at home. Maybe they are busy with dinner, the other kids, etc?

His cough is minimal right now, usually just when he is drinking a bottle. He drinks his bottles but usually has a couple coughing fits during it. No one else here is sick or has been sick since he started.

When i mention it, they usually say something like oh we didn't notice or he was fine all weekend or he didn't cough at all while sleeping (usually that's when most of coughing here occurs).
Reply
daycarediva 09:07 AM 01-13-2017
Do you have pets in the home that he doesn't?

Had a dcg have this reaction with a previous provider to cat dander. Her cat/daycare space was all shared so the cat would sit on everything. Here I have indoor cats but they aren't allowed in my dc space, I was a little concerned with the AC/heating vents, but since we use a good filtration system, she never exhibited symptoms.

Either that- or they are straight up lying about his symptoms or not seeing it because they aren't paying attention to him (eek).
Reply
jenboo 09:23 AM 01-13-2017
Originally Posted by daycarediva:
Do you have pets in the home that he doesn't?

Had a dcg have this reaction with a previous provider to cat dander. Her cat/daycare space was all shared so the cat would sit on everything. Here I have indoor cats but they aren't allowed in my dc space, I was a little concerned with the AC/heating vents, but since we use a good filtration system, she never exhibited symptoms.

Either that- or they are straight up lying about his symptoms or not seeing it because they aren't paying attention to him (eek).

Well since the dr said it's an upper respiratory infection then I'm guessing it's not environmental. I do have two noon shedding dogs that are kept away. He has pets at home.
Reply
Baby Beluga 09:25 AM 01-13-2017
Does he drink the same breast milk/formula at home that he does at your house? Or does he use the same type of bottle at both home?

Perhaps it's a milk allergy or a nipple that is too fast of a flow?
Reply
jenboo 09:28 AM 01-13-2017
Originally Posted by Baby Beluga:
Does he drink the same breast milk/formula at home that he does at your house? Or does he use the same type of bottle at both home?

Perhaps it's a milk allergy or a nipple that is too fast of a flow?
Same bottles and milk. It is a very fast flow.
Reply
childcaremom 09:34 AM 01-13-2017
Originally Posted by jenboo:
Well since the dr said it's an upper respiratory infection then I'm guessing it's not environmental. I do have two noon shedding dogs that are kept away. He has pets at home.
Here's an interesting bit about upper respiratory tract infections. The symptoms of upper respiratory infection usually last between 3-14 days; if symptoms last longer than 14 days, an alternative diagnosis can be considered such as, sinusitis, allergy, pneumonia, or bronchitis.

I think it is in dcb's interest for you to keep pushing this with the parents. If that is the first time that dcb has been taken to the doctor's, then the doctor may not be aware of how long this has been going on.

If you are comfortable to continue care for him, do so. If you are going to exclude for symptoms, do so (this is what I would do). I would also be tellling parents that you expect it to be cleared up in 14 days or he will need to go back to the doctors. Or something along those lines.
Reply
jenboo 09:38 AM 01-13-2017
Originally Posted by childcaremom:
Here's an interesting bit about upper respiratory tract infections. The symptoms of upper respiratory infection usually last between 3-14 days; if symptoms last longer than 14 days, an alternative diagnosis can be considered such as, sinusitis, allergy, pneumonia, or bronchitis.

I think it is in dcb's interest for you to keep pushing this with the parents. If that is the first time that dcb has been taken to the doctor's, then the doctor may not be aware of how long this has been going on.
I'll mention it to then again. I wrote on the form that the dr had to fill out the symptoms i had seen and the date they started.
Reply
Snowmom 09:55 AM 01-13-2017
I find this really strange.

What did the parent's say and how did they react to the diagnosis?

Since they don't seem to be concerned, it makes me think that they think it's normal- or the child has been like this since birth, therefore "normal" to them.

Is the child underweight at all?
Does he seem to be bothered by his breathing?
Reply
jenboo 10:06 AM 01-13-2017
Originally Posted by Snowmom:
I find this really strange.

What did the parent's say and how did they react to the diagnosis?

Since they don't seem to be concerned, it makes me think that they think it's normal- or the child has been like this since birth, therefore "normal" to them.

Is the child underweight at all?
Does he seem to be bothered by his breathing?
Dad just handed me the paper. I'll talk with mom at pick up. He has barely been gaining weight. Mom was concerned about that.

He doesn't seem bothered by anything.
Reply
daycarediva 10:13 AM 01-13-2017
poor baby. I'm so stuffed up it's difficult to eat/swallow and it's an awful feeling.
Reply
jenboo 11:34 AM 01-13-2017
So what questions should i ask mom when she picks up?
What should i say?
Reply
childcaremom 11:58 AM 01-13-2017
Do you have time to chat at pick up?

Maybe tell dcm that you are sending her an email. That way you can outline your concerns and get her response in writing. I like paper trails.

I think what you say depends on what your concerns are. How much are you prepared to deal with there? Where are you drawing your line? What do you want to see happen?

I can answer you how I would handle it but it may be different than how you would.
Reply
Snowmom 11:58 AM 01-13-2017
Originally Posted by jenboo:
So what questions should i ask mom when she picks up?
What should i say?
First, I'd sort out how you feel about the situation.
1. How do you feel about him being in your care with these symptoms?
2. Are they symptoms you'd normally exclude for?
3. Are you contemplating letting the family go if it persists?

Then I'd probably start a conversation with mom telling her your concerns, why you have those concerns (your experience= to his symptoms) and what you want to see happen.

Just in my personal opinion, 6 months old is awfully young to be shrugging off any kind of breathing issues.
Reply
mommyneedsadayoff 12:00 PM 01-13-2017
Do his parents smoke? And do they have dogs too? I saw you said they have pets, but sometimes an allergy can be specific to a certain type of pet.
Reply
Ariana 12:29 PM 01-13-2017
Originally Posted by jenboo:
Some days he barely coughs, other days he caughs a ton. Today his nose is very congested and when he breathes is all gross mucousy sounding
It sounds like a dairy sensitivity to me. Dairy causes excess mucous to form in the lungs so if he has slight congestion or asthma, dairy will make it infinitely worse.
Reply
jenboo 12:29 PM 01-13-2017
Originally Posted by mommyneedsadayoff:
Do his parents smoke? And do they have dogs too? I saw you said they have pets, but sometimes an allergy can be specific to a certain type of pet.
No smoking. I think they have a dog and a cat. The room he is in at my house, our dogs are not allowed in it.
Reply
jenboo 12:30 PM 01-13-2017
Originally Posted by Ariana:
It sounds like a dairy sensitivity to me. Dairy causes excess mucous to form in the lungs so if he has slight congestion or asthma, dairy will make it infinitely worse.
Mom makes a homemade formula with raw cows milk. I can ask if this started when she started that.
Reply
jenboo 12:33 PM 01-13-2017
Originally Posted by Snowmom:
First, I'd sort out how you feel about the situation.
1. How do you feel about him being in your care with these symptoms?
2. Are they symptoms you'd normally exclude for?
3. Are you contemplating letting the family go if it persists?

Then I'd probably start a conversation with mom telling her your concerns, why you have those concerns (your experience= to his symptoms) and what you want to see happen.

Just in my personal opinion, 6 months old is awfully young to be shrugging off any kind of breathing issues.

His actual behavior here is fine. He is happy and doesn't fuss.
I am worried that this has gone on so long. It makes me nervous since he is so young. I'm nervous about it turning into something worse on my watch.
Reply
Ariana 12:46 PM 01-13-2017
Originally Posted by jenboo:
Mom makes a homemade formula with raw cows milk. I can ask if this started when she started that.
I had a child with severe environmental allergies (I suspected dust) and she was possibly allergic to my dog. She was diagnosed with asthma but I find most kids with any sort of food allergy are just dismissed and diagnosed as having asthma and then given a puffer of very strong corticosteroids. Dairy exacerbates all of those issues. I would strongky recommend suggesting that the mom give up all dairy for 2-3 weeks just to see if symptoms improve. I was never able to get the parent to give up dairy just to see and it was heartbreaking to see the child suffer so much.

I also suspect that your parents are lying about what they are seeing at home. Most parents do
Reply
Blackcat31 12:50 PM 01-13-2017
Originally Posted by jenboo:
Mom makes a homemade formula with raw cows milk. I can ask if this started when she started that.
Does the child's Dr know this?

It is NOT recommended that parent's use raw milk to make home made baby formula. It's imperative the formula meets the nutritional guidelines that infants NEED to grow and develop.

“Consumption of homemade formulas can lead to potentially serious health consequences for babies. There is no nutritional analysis for these home recipes, and consuming improper quantities of nutrients can cause poor growth and development. Some recipes call for the use of unpasteurized or raw milk, raising the risk of the presence of E. coli, Listeria, Campylobacter spp, or Salmonella—pathogens that can cause serious health risks.”
Reply
jenboo 12:51 PM 01-13-2017
Originally Posted by Ariana:
I had a child with severe environmental allergies (I suspected dust) and she was possibly allergic to my dog. She was diagnosed with asthma but I find most kids with any sort of food allergy are just dismissed and diagnosed as having asthma and then given a puffer of very strong corticosteroids. Dairy exacerbates all of those issues. I would strongky recommend suggesting that the mom give up all dairy for 2-3 weeks just to see if symptoms improve. I was never able to get the parent to give up dairy just to see and it was heartbreaking to see the child suffer so much.

I also suspect that your parents are lying about what they are seeing at home. Most parents do
Ill have to see if she will do that. She makes his formula with cows milk.
Reply
Pestle 04:18 PM 01-15-2017
Raw milk is illegal to purchase for human consumption in my state. I wouldn't permit her to send it, if it were me--even if it were legal here.
Reply
Tags:doctor's note, illness policy, sick policy
Reply Up