Medication Policies

[Sarahliz9]

Please excuse me, it's my first post...so I'll apologise in advance :D

I'm just wanting other peoples thoughts and opinions on this (always dangerous I know!).

My daughter has had recurrent ear infections since last November, to the point where it's been one ear one week and the next ear the next week. And over the last 7 months we've been in and out of the Dr's with various antibiotics and ear drops to try (there was a thought it was eczema related at one point). I've finally had her referred to the ENT specialist, and she's now been prescribed amoxycillin (which she's had several times before, along with stronger penicillin-based antibiotics) and low-level antibiotics for 3 months.

Her nursery have a policy whereby she has to have 24hrs off at the start of every course of antibiotics. Now this obviously got to the point of being ridiculous, as they said if she stopped the antibiotics for a day then she would need another 24hrs off, and she was on them every other week. So I discussed with the nursery whether she could go into nursery if she had the same antibiotics, with a dr's note stating she'd had them before & hadn't reacted. They agreed and she's been in once this year under this provision.

However, it's been about 6wks since her last ear infection which required antibiotics, and they have now said that she has to have 24hrs off because they are no longer in her system and that the break can only be for a few days.

Should I push the nursery to stick by our original agreement regardless of the length of time?

[HSMMaCM]

I think the problem is that if they don't follow their policy and your DC has a reaction, they could be in big trouble. They may be thinking they shouldn't have made an exception last time.

It is really unfortunate that you have an ongoing problem and maybe you could talk to them about whether they would consider revising their policy to include 24 hours after new medication, or medication they haven't taken at nursery before. They don't have to do that though.

[Sarahliz9]

That is exactly what I've asked them to do. I totally appreciate the safety concerns and have no problem keeping her off for any new medication.

All I would like to compromise on is medication which she has taken before and shown no reaction to, to not come under the 24hr safety window. I usually give her the medication 12hrs before she's due at nursery and any severe reactions would happen during those 12hrs.

After having glanced at their medication policy I think that this would technically come under their 'long term illness' section - since she has been suffering for 7 months and there is no guarantee that they will go in the immediate future. Under that they would be required to administer any medication which she has on a regular basis - which this is. I just need to investigate whether ofsted/hpa would class antibiotics under this.

[insancerre]

It won't have anything to do with nursery or the hpa
The nursery has to have a policy on medication, which it does
It also has to follow their own policy, which they are doing

[ReallyTired]

My daughter's nursery had a policy that if a child was on anti biotics they could not attend FULL stop.

My son went to a different nursery ten years ago. That nursery had a policy allowing medication prescribed by a consultant to be given if it was a long term medical condition. Ds had grommets that went wrong and he was on solfradex drops for 6 months.

The question. Is whether your daughter is well in herself or has a temperature. Is she infectious to other children?

[HSMMaCM]

As insancerre said, it's nothing to do with Ofsted or hpa. It's simply the nursery policy.

[Sarahliz9]

It's an independent nursery, their medication policy follows the ofsted/hpa guidelines. So if they chose they could make an exception in certain circumstances.

When she has an ear infection she is not infectious to other children. She does get a temperature, however this is normally prior to the ear 'popping' and once it's popped and the infection is a visible discharge she has no temperature, unless she has a secondary infection. She normally has antibiotics post the ear popping, to clear up any secondary infection or prolonged infection. But I have no problems collecting her & keeping her off when she does have a temperature, or even when she's particularly out of sorts as generally I'm up all night with her too...so I need the lie-in! Also, if she needs to go to the dr's she has the day off nursery (sometimes with a temp, sometimes not) for the appointment. Then I have to start the antibiotics...but it's then 2 days (day of appointment and day after) before she can go back, so if she had a temp on the day of the appointment she generally doesn't the second day.

This is purely for when she is well in herself, and her body just can't shift it on its own, so needs a bit of extra help.

[Dlah]

From a nursery perspective, we have this exact same policy, and the reasoning is that even with antibiotics they've had before a reaction can still occur 2nd, 3rd, 4th time around.

I can understand them agreeing to continue after just a 24 hour break to try and accommodate, but I can see why after a 6 week gap they'd invoke the 24 hour monitor period again to be honest

Sorry!

[ReallyTired]

I feel that there is no way that a child with an ear infection that is bad enough to "pop" or perforate should not be at nursery. Do you not realise how painful a perforated ear drum is? It's not fair on the child, the nursery nurses or the other children to send a child in who is that ill. The 24 hour break is to give the child a chance to rest and recuperate after the perforation.

My son had 13 perforations when he was a small child. Dd's ear perforated twice. I also know what is like to work and send a child to nursery. However a child who has suffered a perforated ear drum really needs that time off to get better. The rules are there for a reason.

[insancerre]

It could be worse, where I work the exclusion period is 48 hours for all medicines
HTH

[Sarahliz9]

@Reallytired My description is obviously not a medical one. The Drs do not know whether her ear drum is actually perforating. And yes, I do fully understand how painful it is for her. However I work full time. I cannot take 7 months off work to care for her - if I could I wouldn't be at work. She once there is a discharge from her ear she is happy, cheerful, playful - you wouldn't know she had any issue with her ear whatsoever. I keep her off where necessary.

Insancerre - by the time she's had the Drs appointment & had the 24hrs off it is 48hrs

I've come to an agreement now with the nursery that this is a long term illness which requires ongoing medical care.

[Sarahliz9]

Dlah - I totally understand the 24hr policy. However any allergic reactions to medication happen within a short time of taking the medication. Whenever that is. Her first dose is always 12hrs before she goes into nursery, time enough to show whether she will react to the medication severely enough to not take it again.

[ReallyTired]

No one is asking you take seven months off to care for your daughter, but I feel you aren't taking your child's ENT problems seriously. Is there anyone else who can look after your child and keep her away from the full on environment of nursery? Could she stay with grandparents or could your partner take some time off?

It could be argued that a child needs at least a week after perforating her ear drum. If she had time to recuperate then it might break the cycle of constantly perforating ear drums. The difficulty with sending child to nursery is that they wil simply pick up more germs.

European regulations currently give parents the right to unpaid leave for such emergencies. Employment law recongises that there are times when parental responsiblities have to come before work.

Do you realise that constant perforations of an ear drum can lead to permament deafness? The nursery insisting that the child takes time off is about putting the child's welfare first.

[Sarahliz9]

Considering you don't actually know me I can't see how you can possibly say that I'm not taking her condition seriously! You also do not know the extent of her condition.

Between November & December she was having ear infections every week, one in one ear then the other ear. January they started every other week, February it was every other week. So yes, I would have to have taken 7 months off to have left her off nursery for a week at a time. Between October & December I had a massive amount of holiday accrued, which the bulk went on taking time off with her (totally approx 32 days). I also took unpaid leave in order to care for her so that she didn't have to be in nursery - which considering I still had to pay them for the pleasure of holding her place meant I was out of pocket to the tune of hundreds of pounds!

So far this year I have taken 10 days annual leave, plus a few extra days I carried over, plus unpaid leave & lieu days in order to care for her.

I was the one who pushed the Drs to refer her to a specialist as they didn't seem to be getting to the bottom of it. We spent 3 months waiting for that appointment, only for the specialist to be running late and then we were told either wait a few hours or rebook for a months time - so that was another half day booked late for me, because there was no chance of me putting it off for another month.

I have to take her for bloods & have an ear test...so I am more than aware of the fact that her hearing may have been impacted - especially since her development has been stunted since she started getting them. I am praying that it hasn't impacted her permanently.

I live 5hrs away from my mum, and 2.5hrs away from my in-laws. We have no friends or family where we live. So no, no one else can care for her. My partner is the main earner & I had arranged to be able to work from home when I had to care for her, but that then caused arguments at work. The company are flexible to a certain extent...but I cannot take a week off for every ear infection when she is well in herself the vast majority of the time - and when's she's not I actually keep her off!!!

Please do not assume when you do not know the full facts.

The Drs do not know if her ear drum is perforating (I have been to weekly appointments so they can check!). She also suffers from eczema, which is likely to be causing issues as well. I am seeing the specialist and would take their advice above anyone's assumptions from a website.

I am only seeking a beneficial compromise between the nursery and myself, so that they can meet their requirements and I can not lose my job!

[ReallyTired]

Clearly I have hit a nerve.

"I am only seeking a beneficial compromise between the nursery and myself, so that they can meet their requirements and I can not lose my job!"

Sometimes your daughter needs come first. Should a child's health really be compromised? Maybe you should consider getting a nanny for a six month contract. Even if the nanny costs more than your salary, it may well be worth it to keep your career going.

Babies and toddlers don't need extensive soicalisation. I feel that there are times when the advantages of a nursery can outweigh the disadvantages. Constant ear infections can lead to glue ear. Glue ear can lead to delays in developing speech and language.

When my son was younger, my husband look time off as well inspite of being in a very well paid job. Taking time off to look after sick children should not always fall on the mother.

[Sarahliz9]

Should you really be pleased with yourself for 'hitting a nerve'?

I'm not going to bother conversing with you further, as what I do with my time actually has nothing to do with you. I am doing everything I can - but following your opinion that is evidently not enough.

You are accusing me of not caring for my child and not understanding. Rather than pointing fingers of blame and saying 'you don't do enough' you should take a step back and ask yourself why you feel the need to push your opinion on anyone.

We are all parents here. We would all do anything for our children. You certainly wouldn't like it if I accused you of anything when I don't know you from Adam.

I came here wanting helpful opinions - not to be lambasted for trying to work and care for a sick child.

[insancerre]

Its s shame that the staff in the nursery are not afforded the same opportunity to work without caring for a sick child
Nursery is not the place for poorly children
Even with the best will in the world, its not possible for staff to adequately met the needs of a poorly child whilst still caring for the others in the room

[Sarahliz9]

She only goes in if she is well in herself - laughing, playful, happy. If she is grumpy, clingy, whiny, miserable she stays at home.

If she becomes clingy, whiny, miserable & has any symptoms they call me & I pick her up.

[Sarahliz9]

The nursery has agreed to add to ear infections as a long term condition which requires ongoing medical care.

So this thread should be closed.

[ReallyTired]

Children go up and down like a yo yo. Young children do not understand the concept of rest. It is why a high stimulation enviroment like a nursery is unsuitable for a child whose body is fighting an infection. Just because a child is running about like a mad thing having fun doesn't mean that going to nursery is a good idea.

A child who has discharge coming out of their ear is very likely going to be infectious. It is not fair on the other children to have her at nursery. Even if she appears well in herself its likely that she is infectious until the anti biotics kick in. Once she has been on the anti biotics for a day or so she is less infectious which is why the nursery allows her back.

The rules exist for a reason, however inconvient it is to you.

[Kennington]

They don't have this policy at my daughters nursery - if they did no one would attend.
What is the risk? It is low. Unless the child is very very unwell they won't take them. Otherwise they are happy to give medicines as long as it is not too onerous on them.

[Sarahliz9]

@Kennington - the risk for her is low at the moment, obviously as others have said there is a chance she could randomly react to the antibiotics now even though she's taken them before, but she's had varying strength antibiotics and hasn't reacted to any of them...so far.