I probably am, but....

[cardamomginger]

DD (3) was diagnosed with a UTI yesterday evening and is on amoxicillin. She is fine in herself, certainly no more off colour than she would be froma mild cold.

I emailed her nursery to see whether they will administer her antibiotics at lunchtime. Like a flipping idiot I told them when she had been diagnosed. They have a policy that children who are on antibiotics are only allowed back to nursery after they have been on them for 48 hours.

She is pretty much fine in herself and a UTI is not contagious or infectious to others. She will have been on antibiotics for 38 hours by the time nursery starts. AIBU to think that this policy needs to have more flexibility built into it, to feel pissed off (pun intended), and irritated with myself for not reading the sodding policy first and then lying about the timing?

I know I probably am being a bit U, etc etc etc. But she will be fine and is not a risk.

Arse.

The policy is in place for a good reason. Your DD is on antibiotics because she is unwell. She needs time to recover. 48 hours is not unreasonable.

I agree with keeping children off nursery who are ill. I agree that they should not be sent in if they are clearly unwell and have symptoms. I just don't see what is so special about being on antibiotics that it requires an additional policy over and above the other ones that mean that children who are ill, have symptoms, are clearly infectious and a danger to other children are not allowed at nursery. She has been more 'ill', with more symptoms and more 'not herself' with a viral cold, which is infectious to others, where the nursery is prepared to accept her.

Bacterial infections may be milder than viral ones.
Bacterial infections may not be passed on as easily as viral ones (or at all, eg DD's UTI).
Other drugs may cause a reaction.
Antibiotics may cause a reaction more than 48 hours into a course.
A child may have had the antibiotics previously with no adverse reaction.

I've had a look through the NHS guidelines and I can't find anything that says that being on antibiotics in and of itself is a reason to keep a child off nursery for any length of time. Everything says that the child should be assessed on the severity of the illness. The other illness policies cover this.

I had a response saying it is because of reactions and they need 48 hours to 'get better'. I've asked them to re-word their policy to reflect the true intention behind it. I've also told them our paed consultant friend says it makes no clinical sense for the reasons I've given above and have asked them to refer me to the official guidance that indicates a child on antibiotics should be kept off purely by virtue of being on antibiotics.

For a good reason I'm perfectly happy to keep her off - I don't want to take chances with her health or the health of others. I am respectful of policies that are there for a good reason. This just doesn't seem to be there for any good medical reason.

Hope you and DD had a nice day today. Is she eating OK? My DD was totally off her food and took about 10 days for her appetite to come back properly.
xx

YSBU. Nurseries need very strict rules protect the staff and other children.

Yours has clearly stated that it is their policy to do this - unless this has changed since your dd started then you would have signed up to this from her very first day there.

There should be no room for negotiation in these things IMO. Yes, it's a pita for you on this occasion but what one parent thinks is acceptable may be very different to what the staff and other parents do. This policy is very clear and for the benefit of all involved.

I don't see a problem with keeping them off for the 48 hours till some improvement is actually seen and you know it's working

If the improvement is seen within a few hours and the child is perfectly well the next day, the policy requiring them to be kept at home is ridiculous.

All the setting needs is a policy that states that children who are unwell will not be accepted. The antibiotics are irrelevant.

What a stupid rule. Children with UTIs can be quite well apart from a bit of frequency or sore tummy. There is no reason for her to be kept off. I have never heard it before. (GP who agrees with your paediatric friend) now if it's a chest infection and they are unwell that is different but why a specific time frame there is no reason for this.

YSBU. Nurseries need very strict rules protect the staff and other children.

There is absolutely no evidence whatsoever that this policy protects anyone.

She's fine thanks . We went to the London Transport Museum and pottered about in Covent Garden.

To repeat myself: there are policies in place that exclude children who are ill - whether it is because they pose a danger of infection to others, or because their symptoms mean they should not be at nursery. I do not understand why there needs to be a separate policy for children on abx, simply by virtue of the fact that they are on abx. NHS guidelines do not suggest doing this and our consultant pasediatrician friend says that the policy makes no medical sense whatsoever.

Note: I have not at any time suggested that I will flout this policy. I am abiding by it, and I have made no attempt to sneak DD in somehow. Yes, I signed her up. Yes, these are their policies. Yes, I agreed to abide by them when I signed her up. And I will. But I do not see why I should respect a policy that appears to have no basis in reality and is not supported by NHS guidelines or the consultant we have spoken to. If the nursery owner had pointed me in the direction of the guideline she was relying on, or had said that they had drawn up their illness policies in discussion with a doctor and were therefore following medical advice, I would have some respect (although I might still think it was wrong). But she hasn't.

As an additional idiosyncracy, the nursery owner has told me that children who started abx, but were then taken off them, would still be excluded if the discontinued abx were started less than 48 hours previously (sorry for clunky wording). Huh????

Goldmandra - exactly! And a respiratory infection, whether viral or bacterial, would be covered by the wider illness policy.

In case anyone is interested, I kept on explaining why the policy on abx makes no sense and as a result the nursery are re-thinking this policy and whether it makes sense to have a specific exclusion for children on abx over and above the more general sickness policy that applies to all children who are ill.

Good for you.

I hope this helps you in the future, but IME it is a widespread policy so I'd keep a copy of your documentation for the next battle with any future care providers and schools etc.

our primary school doesn't have this policy - just child shouldn't come to school if unwell and 48 hours after last bout of D&V and they refer to Health Protection Agency website that you should ask about exclusions for lice and chicken pox. No mention of exclusions for specific drugs.

kew - exactly.

Well done. I think it's a good thing when people challenge ridiculous policies.

FWIW I know a lot of Early Years practitioners and we discuss policies quite often. I don't remember anyone mentioning having a policy of excluding children on antibiotics.

They don't have to say why it's their policy, but it is their policy and you have presumably signed something to say you agree with their policies.

You can talk to them about changing their policies.

I don't exclude children on ABs, but I do ask parents of children on medication to be contactable in case of a reaction. (And I am allergic to penicillin, so I have to be really careful when giving it to a child).

HSM - I've said I won't flout them, and I haven't. But I will disagree with them, when they appear to be misinformed, contrary to professional guidance/opinion and unfairly penalise a group of children. The part, which came out later in my conversations, about excluding children who HAD BEEN on abx, but were no longer, until 48 hours had elapsed since the first dose, is particularly daft.

I'm extremely allergic to nuts and get nervous if any are handled around me - it must be hard administering abx to children. Can you at least wear disposable gloves?

Yes. I do wear gloves. It is obviously not as scary as a nut allergy, but still a concern for me.

Probably when you signed the contract you saw the sickness policy as a protection for your child. I think that assuming the staff can make a judgment re what is infectious or detrimental to all the children in their care is unfair. They have to draw a line somewhere & their rules re ABs are about equivalent to the guidelines for schools re D&V. It may seem unreasonable but I'm glad that you had a good day at least. I've spent so much time at the Transport Museum that even thinking about it makes my brain hurt a bit!

I've gotta uti at the moment and feel crap.
I'm functioning but not up to par.

I think you should keep her off.
I wish I could stay home and be fed chocky and watch TV x

It's interesting that you were happy to accept and sign up to their policies until they inconvenienced you. Only then did you see fit to challenge them.

It's a ridiculous policy. The nursery we use has a separate sickness policy and exclusion depends on the illness. For medication, they can't take children within the first 24hrs of them being on a NEW medication, if it requires the nursery staff to administer it.

Iwish - it's not about being inconvenienced. if you read the whole thread, you'll see that the policy wrt abx is wholly unsupported by nhs guidelines, and the consultant paed I spoke to says it is medically meaningless, confers no benefit, and as such unfairly penalises children on abx. that is why I am challenging it. there is much in life that inconveniences me - where things are there for good reason, I just suck it up. the abx policy is not there for good reason.

yes, I signed the forms and by doing so I agreed I would not flout any of the policies. I have abided by all the policies. but signing does not mean that I won't challenge the reasoning behind them, when expert professionals better qualified than nursery staff wholeheartedly disagree with them.

spermy - the d&v exclusion is in accordance with NHS guidelines and medical guidance. so it makes sense. excluding a child for the first 48 hours of abx is not. and that us the difference.

great name btw!

Yes, it's the timing of you challenging the policy that I'm talking about - only now that you have been inconvenienced are you doing that.

I have read the whole thread, but as the policy has always been wholly unsupported by the NHS and medically meaningless I'm wondering why you didn't challenge it before it caused you this difficulty.

Yes, it's the timing of you challenging the policy that I'm talking about - only now that you have been inconvenienced are you doing that.

When it becomes an issue for you, you give it a little extra thought and realise how ridiculous it is then discuss it with an expert in the field who agrees with you seems like a very appropriate time to challenge a policy.