Care planning for poorly tummy in childcare setting

[Maz007]

Does anyone have any experience of developing a care plan around loose poo / diarrhoea related to food intolerances?

DD is about to turn one and start at a lovely CM who is experienced in allergies and very sensible. Developing care plans around her known allergy to egg is fine.

I am struggling to know what to do about her intolerance type allergies, some of which we know about, and some of which we have not yet got to the bottom of... In the event that she eats something she has an intolerance to, she will have horrible diarrhoea and tummy pain. I am concerned that this will mean that she will have to be sent home and kept away for days until she is completely back to normal... which will be a nightmare especially if she reacts to something new (very possible as at her age she's trying new things all the time) and it takes us a while to be clear what it is...

Her reactions are different from a tummy bug as she is well in herself (other than at night when her tummy pain keeps her awake) and never has a temperature or any other symptoms.

Has anyone had any success is agreeing that these reactions can be handled differently to tummy bug diarrhoea or is that an unreasonable thing to ask of a childcare provider and do I just have to accept that I'll be home with her every time she has a whiff of milk?

I think it's a reasonable thing to ask of a childminder if you can help the childminder get a medical professional to clarify how to tell the difference and agree the care plan you suggest before the contract starts.

Infection control guidelines which exclude children with diarrhoea are designed to prevent the spread of the illnesses which cause them so, as your DD won't be spreading infection, I think it's reasonable for a childminder to accept her into the setting if it's clear that her symptoms are caused by food intolerances.

I think you need to speak to the childminder and suggest that she speaks to her development worker/early years advisor if she has any concerns.

Yes, this is definitely a reasonable thing to ask of a childminder. I am a childminder myself, and I think that refusing to work with you on this issue would actually be discriminating against your daughter because of her medical condition.

Obviously, you'll need to try and limit any exposure to foods which give your DD diarrhoea - as well as affecting her health, it also won't be very nice for the childminder to have to deal with runny poo every day! However, I know this will be hard when you are introducing so many new foods at this age.

Your childminder should write a daily diary with details of everything your daughter has eaten and how many nappies she has had changed as well as general activities that day. This will help you to work together to pin down the causes of any tummy upsets.

Most childminders are able to take a commonsense approach, and to take childen's individual constitutions into account. For example, when my 1 year old mindee gets a new tooth (a regular occurence recently) this is always accompanied by horrendous diarrhoea, and I have never sent him home for teething related diarrhoea.

A Goldmandra says, the rules about tummy bugs are to prevent the spread of infection. You may need to provide documentation to say that your daughter has food intolerances which may give her diarrhoea (the childminder can then show this to Ofsted if necessary, to prove that she is not disregarding the rules).

Thanks so much both. That's really really helpful... Also helpful to hear that you find teething leads to diarrhoea greenbananas - medical opinion seems to say that it shouldn't but I am increasingly thinking that this accounts for at least some of what's going on in DDs nappies.

She is a really lovely childminder and I'm sure won't mind being sensible - just aware of how much pressure there is already for her - and you all :) to stick to all sorts of rules (all sensible in principle but enforced by Ofsted in a slightly inflexible and unhelpful way at times I think) and just wanted to check that I wasn't going to be making things unreasonably complicated when she is already being a legend about emerging allergy worries. I feel very lucky to have found her to share the care of my LO.

Ah, the things that medics say shouldn't be happening... Lots of health professionals told me that my baby DS 'shouldn't' be reacting to my diet when I was breastfeeding but I know that he was.

My feeling is that mums know best, and are usually the most accurate judges of what is going on with their own children. My DS never had diarrhoea or any other problems when he was teething, but there is no doubt that little mindee does. He gets a rash on his bottom, he dribbles incessantly and his poo is awful. I was sceptical to start with, but after talking to his mum and getting to know him a little better it was clear that his runny nappies were related to his teeth coming through. Many experienced health visitors say that this does happen (the older ones, who have dealt with hundreds of 'normal' children and are not just reading out of a textbook).

Are you already keeping a diary of what your DD eats and any symptoms she has? Might be worth adding a column to record any teeth coming through?

Good luck with your childminder. She sounds lovely.

Yes, children don't seem to read the right textbooks in my experience :)

I do have a comically headed column 'alternative explanations' on DD's food diary... It's included 'licking brother's shoes' before!

Thanks again.