DS drank milk at nursery?

[PonderLand]

My son (2) started at nursery a few weeks ago, I'll start by saying the positives. He's settled in really well and has really come out of his shell around other children. I've noticed he's playing differently to how he did before, pre nursery he would just push cars back and forth all day if given the chance. Now he seems to be playing with teddies, figures etc putting them to bed, feeding, making them 'dance'. The other kids seem to love him and always come up and say hi/bye when we arrive or leave which is really nice. The age range goes from 2-4 during the holidays. His key worker gives us enough information at pick up, if he's napped, what he's eaten etc.

In his first week he scratched his leg when they went into the woodland part of the school, they gave us an incident report and my son seemed fine so no issues there. I should say that my son has a disorder which effects his blood sugars, as long as he eats an adequate amount of food then he is fine. It is important that the staff ring me to get him if he doesn't eat or he seems off colour as it can lead to dangerously low sugar levels and require a hospital admission if not sorted quickly. He also has a dairy intolerance, we've done the milk ladder 4 times and he's never got past the first stage. We provide his lunch and snacks for him.

This week the usual staff weren't there when I picked him up but the manager was in and another staff member id never met. The manager said 'it's best we make you aware that ds drank another child's milk at lunch today he said 'yuck' then gave it back to the little girl' then she said 'before ds nap I noticed he had a rash on his forehead which must be from the milk' I asked her how much he had and she said she couldn't be sure, i've never known him get a rash on his forehead from milk or say 'yuck'. When we got home I had a look at ds and the 'rash' was actually a bruise about 2 inches big. We didn't get any kind of accident report about either issue. I'm worried now that they just let the children take each others food, not keeping a close eye on kids with food intolerance or kids who need food like its medication. It must of been quite a knock to his head to cause such a big angry bruise and they had no idea. It's worth noting that this nursery thought dairy allergy included egg and stopped ds from doing numerous activities due to this. They did eventually mention it in passing to me and I told them egg is fine. They said 'so it's not dairy then, just milk?' I'm really struggling now with the lack of competence. I feel that the staff didn't hand over correctly when my son had milk and they are just covering up the fact they gave him it because they didn't get information from his key worker. He isn't a very good eater and I can't imagine him grabbing another child's cup and drinking an unknown substance. Anyway now my ds is not well, has diarrhoea and he is refusing to eat which is probably going to set off his hypoglycaemia.

Sorry I know that's long. I'm just not sure what to expect from this nursery. An apology or something would of nice, maybe a suggestion on how to stop it happening again. Sit him next to a child who drinks water, I don't know. We've had no contact from the nursery since regarding this.

I would be seriously questioning thier food standards training! How can they not know what dairy is?
As an ex cm i had strict guidelines to follow with food prep and allergies or intolerance. I imagine nurseries are the same.
I suspect they didnt see your ds bump his head but they should know the difference between an allergic reaction and a bruise. And any possible reaction should have been relayed to you pronto.

You need to have a meeting with the manager and ask them what they are doing for your sons care plan/risk assessments.
How they plan to stop him drinking any milk or eating others food in future.
What training do thier staff have in food and nutrition regarding allergies and intolerances. sounds like none at all
Can they accurately recognise if your sons blood glucose levels drop?
Are his health issues well documented and do all staff know about them?
Is there a list of kids with allergies/intolerances in the food prep area?
Make sure you have given every bit of info you can on your sons health and that it has beeni written down.

If they cannot reassure you that they will do everything within reason (they cant actually spend all day 1:1 with him but can minimise risks especially at snack and mealtimes) to stop your son injesting dairy again then i would remove him. Once trust is gone in a childcare setting its gone.
Good luck.

Excellent advice there from Willow. Does he actually have to go to Nursery OP? If it’s not necessary, I’d remove him.

Wow thankyou so much for that willow. You've given me lots to think about and plenty to ask the nursery.

When they came to do a home visit I explained to them the issues my son has, the intolerance and the blood sugars. I told them what to look out for in regard to sugars, he usually goes very pale, gets agitated and cries. He does ask for food when he's going low but his speech is delayed and things that we can understand the staff can't so it's best for everyone if they just ring me if their concerned and offer food straight away, if he goes floppy or sleepy then call an ambulance.

The doctor told me not to let them take blood sugar readings (it would require someone to train them too which I suppose there's no money for) as he thought they could do it too often or feel daunted by the idea of it. Given that food is what he'd need if he was having a low anyway it makes sense to just push food rather than mess about with finger pricks.

I've been waiting for my sons doctor to send them a detailed emergency regime to follow but they've received nothing so far, I've given them information and his keyworker looked up the condition also. I think when they finally get the doctors letter they will take more notice, I didn't want to scare them with the worst possible scenarios but it can be very serious if untreated resulting in seizures/coma/brain damage. Maybe now I should just be very blunt about this in case they treat it the same as they do for his milk intolerance. I've sent 7 emails to his doctor about this emergency regime for nursery and I've received no replies, we are going for an appt in October so I'll be asking a lot of questions about what's gone wrong.

And yes that's what really concerned me, they thought my son had an allergic reaction which caused a rash on his forehead but yet they still didn't ring me and let me know/make a decision on the next step. Another concern I had is that they filled in an incident form when he scratched his leg but we received nothing about the rash or him consuming milk. And to top it off it was the manager who was with him that day.

The mix up with egg and dairy just baffled me, I went to pick my son up and three members of staff were talking to each other. When I went in one of the staff members said they did baking today but then realised my son couldn't do it due to the ingredients, i thought she was on about butter/Marg which confused me as they have dairy free marg for him. Then another staff member shouted over how restricting the allergy was and she thinks there should be substitutes available for it, she said 'We could of used dairy free marg but egg!? What can you sub egg for?' They all agreed, it was so so awkward for me. I didn't say anything as I didn't want to come across as rude, how do you explain the difference without sounding patronising? The next morning I talked to his key worker who wasn't there the day before and she said that about it being just a milk and not a dairy allergy. I just wanted to face palm myself. 4 adults not understanding the difference.

Another thing that confused me about the drink of milk is how well the manager recounted the scene and his words/expressions, that he was the one who took the milk. It just left me feeling like I wasn't getting the whole picture, and if she was being honest then why watch it all unfold rather than step in and say no?

Sorry I know I'm rambling, my son loves it there and I'm enjoying myself at a new job. I want to trust them to care for him properly and safely.

@JiltedJohnsJulie he doesn't really have to but I hoped it would help him socially, help his speech and give me a bit of a break. I work weekends and now have a second job Monday-Wednesday which is more for the love of the job than the money. It basically pays for the nursery. Now I feel that he's at risk when he's there, my parents won't have him and they've made mistakes with food too so I know it's easily done. It's the fact I don't believe their version of events I suppose.

Socially I think all of the research shows that they’re better off with Mum for the first 3 years. I could be wrong though, there may be new research. If you want to socialise them, there are plenty of groups and activities you can do and even socialising with family is good for development.

If you don’t believe them, what are you planning to do?

I really feel for you. I have 2 children with allergies and know how you feel. I have had a few incidents at school and with family. Its really hard coping with this at times.

You should definitely do as Willow2017 said and see what the outcome is. You could maybe see after a week or two, if things get better and if not take him out and look at another nursery.

Another option is to look at other nurseries and explain in full details about his allergies and blood sugars. Find out about staff training, ie first aid, epipen training.

I also feel that your doctors are not very good. He should of been given an emergency regime immediately. I would phone your surgery and either speak to a doctor or book a doctors appointment and speak to him/her and explain your situation. I would politely demand an emergency regime as it could be life or death for your son.
I hope your son gets well soon.

@JiltedJohnsJulie I did and still do take him to play gyms, we meet up with the ante-natal group, friends and their children we'd see weekly, we see my parents twice a week at least, his other grandparents come every other weekend too plus two uncles and a cousin his own age that we see regularly but he's never really come out of his shell with other children or unrelated adults. He sits in the corner with a car/train and he's been like that since I remember. When he was a few months old and I tried a messy play group he would cry until I sat us away from the group. Sensory group was the same, music group too, even a cafe that has a toddler bit in he'd only be happy there if he was the only one in it. He was an unhappy baby and has never enjoyed the normal baby/toddler activities.

At nursery he's been completely transformed in a matter of weeks! It's took me two years and I got nowhere. He's so giddy and excited to see his friends. My parents picked him up the other day and my dad said he'd never seen him so excited, he grabbed him by the hand to see his friends and the nursery toys which weren't cars. I think it has to be the setting that's done it, the routine and the 'order' no matter how hard I try I couldn't recreate that for him every day.

It was working really well for all of us so I need to try and broach the issues I have in a way that won't make things worse. I don't want to come across as over the top, too protective or patronising. That's the reason why I didn't really drill into them the importance of sugars etc, I wanted them to just get a list of facts and steps to follow from the doctor and keep it simple and easy to understand as I find it hard to explain it to people and I didn't want to worry them or give the wrong advice. Obviously the doctor hasn't contacted them so they probably think that it's not a big issue or he'd of been in touch.

@Monny1 would the gp be able to help us on this? I didn't think they'd get involved as my sons had problems with another issue before and the gp said as they're not specialised they can't give us any advice! I bet I sound so wet but you get passed from one person to the next so often that you feel like a real nuisance to the system. The doctor my son is under is at the hospital and I try his secretaries phone often and there's not even a voicemail option. I asked the dietician to get him to send the letter, she said she would talk to him and that was a month ago.

Sounds like nursery is going to be great for him, don't get into a spin about that.

However they do need to be much more professional about how they handle allergies and other health conditions like the hypoglycaemia. Re allergies, he should have a written allergy plan making clear what he is allergic to (milk is technically correct, not 'dairy') and what substitutes he tolerates (e.g. Soya milk?). The plan should state clearly what a reaction looks like and when to administer antihistamines or an epipen as directed by your doctor. The nursery should have a system in place for storing labelled medications for each child. And they should have a policy on what sorts of incidents warrant a call to parents. My DD's nursery do a courtesy phone call for bumps on the head but minor incidents would be notified at pickup, such as the time a child spilled his milk on DD and they gave her piriton.

Ask for a meeting to go over all this in detail. Ask about first aid training and how they make sure all staff are acting in line with the allergy plan, not just the key worker. If the answers are a bit vague and 'what can you do?' I'd seriously consider changing nursery.

Thankyou @tinymeteor I am going to request a meeting to talk about it all. I need to make some notes of key points that concern me or I need clarifying so I don't forget anything that will niggle at me later.

I think part of the problem is my own trust in people that deal with my son, if I can carry on having a good relationship with the nursery then it will be good for everyone. We've had a few blunders from hcp's in the past and I'm sure it clouds my judgement on things like this. I immediately felt defensive or that something was being left unsaid which doesn't help things going forward.

Sorry Ponder I wasn’t having a go at you, it’s just a bit of a bugbear of mine when people say they are sending their kids to Nursery for the benefit of the child when all the research says they’re better off at home. In your case though, he does seem to be enjoying it

Hope the meeting goes well.

I was also trying, rather clumsily, to say that if the Nursery doesn’t work out he’s not going to miss out developmentally by not going IYGWIM.

I have been thinking about you last night.The nursery really need to look at the situation and be honest and they say that they didn’t handle the situation well. You should of been informed immediately informed about the milk and rash/bruise. As stated before you should have a meeting preferably before he goes back.

I am a bit confused, has your ds just been recently diagnosed and you are waiting for an appointment at the children,s centre/Allergy clinic to see the doctor in October?

I’m not an expert, l don’t see why your doctor, can’t write a simple note, detailing what needs to happen in an emergency. This could then tide you over, until you get your hospital appointment. Then in the hospital, they should give you a Allergy Action Plan, which is a official paper detailing all you need to know to deal with an emergency.

There is the anaphylaxis campaign and they are very knowledgeable in dealing with allergies. Please google them. I have found them very useful for help and support. They also have free parent support groups around the country. There might be one near you. I attend my local one and the support and advice is second to none.

Please feel free to pm me anytime for more information, help, advice and support.

As they say, unless you have walked in my shoes, you don’t really understand what it’s like to have children with allergies etc..

@Monny1 sorry I don't think I've explained properly. He was diagnosed with milk allergy at 4 months old, I was ebf but having milk in my tea, meals etc. We switched to neocate as soon as they suspected and he's been fine ever since. He's under a dietician for the milk allergy who we also see when he goes for his appointments for ketotic hypoglycaemia. He's under the hospital doctor for the hypoglycaemia and also under the same dietician for that. The doctor and dietician put together his emergency hypoglycaemia regime with correct scoops/medication amounts for different stages of hypoglycaemia.

My son is still not well today, I've rang in work sick. I should of just been honest with work about the situation but I told them I was sick. No idea why I came out with that, very stupid of me.

He's been laid up on the sofa since Wednesday night and is constantly whinging or crying if he stands up. I suspect he's got tummy pain. Monday is a training day at nursery so I'll have to wait until Tuesday to speak to them. I'm not happy to send him back as this feels like an extreme reaction to just a sip of milk.

I think because I've always had my son with me and I've done most meals etc I was too lax with the nursery it becomes like second nature to check packets, prepare meals etc, I thought they'd understand what a milk allergy was as it's so common these days.

@JiltedJohnsJulie no need to apologise I totally understand where you were coming from. I was never interested in sending ds to nursery until recently when I got the job opportunity. I always said if he had trouble settling in I'd remove him.

When we went for one of the settling in sessions there was a boy who was just crying for his mum for the whole 1 hour we were there. I felt so sorry him and his parents who probably didn't realise how much he was struggling. The nursery told me he'd been there for a few months and followed the staff around asking for mummy :( I just hope they're honest with the little boys parents so they can make the decision about nursery or not.

I haven't got much advice to offer OP but I might lurk on the thread if you don't mind as DD is about to start nursery and I am concerned about accidents like this jeopardising our very slow and careful work on the milk ladder. One careless thing like this could see us back at the very beginning.

@INeedNewShoes I know how you feel! The last time we did the milk ladder my parents messed up and gave him cream cheese. We were on the first stage and it was so frustrating. They didn't understand why it was done in stages.

I thought a nursery would have fool-proof procedures in place but apparently it's all there for the taking and is down to my two year olds self control

His eyes and lips have been swollen these last few days too, I've never seen him react like this when we've done the milk ladder

With lip swelling I think you need to see DS' allergy specialist as he should probably be carrying adrenaline (epipens) in case he has another reaction.

I suffer from allergies myself and for me the next symptom after lip swelling is mouth swelling which is edging towards dangerous. I don't want to scare you but I'm telling you this because you need to take it seriously.

@INeedNewShoes we don't see an allergy specialist, we're just under the dietician for it. I've never seen a reaction like this even when he was a baby, he was just very very unhappy and had bad ezcema on his face/scalp plus digestive problems. I'm going to email the dietician and let her know what his reaction has been like, she might be able to provide us something if anything happens again in the future. Does this reaction seem to warrant an epi-pen? I'm really not sure when one is given, or if this is serious enough to need one.

Mouth swelling could be why he's not eating too, I never thought about that. He had a bit of a jam sandwich so I'm hoping his sugars are stable.

Lip swelling will be taken seriously. If he was older I have no doubt at all that you would be set up with an epipen for him, I just don't know if it is the same for toddlers.

I think calling the dietician is a good first port of call as long as they are linked to an allergy clinic as they will probably do a direct referral for you to see the allergy clinic (we saw a community general paeds dietician who was fairly hopeless but we are now looked after by a dietician who works with the allergy clinic). If you can't get a response from the dietician on Monday then get an appointment with the GP who can get a referral underway.

In the meantime if he has another reaction where his lips swell I would get him seen straight away as this can very easily progress to mouth/tongue swelling and breathing difficulties.

That’s ok, thank you for explaining your situation.I am so sorry to hear about your son. I hope that he gets better soon.

I don’t blame you, about not feeling happy to go back to the nursery.

I can see it from both sides, as l have worked in nurseries and had to deal with children with allergies and also in my personal life as a mother with children with allergies.

I think at the end of the day, accidents/incidents at nurseries do occur, nothing is 100%. It’s the way, that they are dealt with, that really count. Obviously, as long as the emergency regime is followed to the letter. I hope that doesn’t come across as harsh, as it’s not meant to be.

As a parent of a child with an epipen for a dairy allergy I would be talking to them.

I would also be withdrawing my child from their care with immediate effect and without whatever the required notice period is.

Find another nursery, there are plenty who can deal with very severe allergies safely.

I would have totally lost faith in the nursery over their handling of this.

They should have a watertight procedure in place to ensure all staff are aware of each child's allergies and care plan and to make sure children only get suitable food.

They should have also called you immediately!

After reading these after posts, you should ask for an epipen , your doctor could prescribe it for you. I don’t think like to prescribe them as they are expensive.

My children are at the Children’s Centre at the local hospital under a Allergy Doctor and sometimes we see the dietician.

You just have to keep making yourself vocal about needing help via your doctor/dietician. It can be a pain, but that’s what we have to do, Hope l am not sounding bossy, sorry if l am. I am just so passionate about this subject.