DD with mild health issues - questions re childcare (long)

[SongToTheSiren]

Hello I have a few questions re childcare for my DD and wondering if anyone has experienced similar / has any advice.

My DD is nearly 8 months old and I'll be returning to work in next few months. Unfortunately wouldn't be able to be a SAHM as DH and I couldn't afford it.

DD was born at 37 wks and spent about the first 4 wks in a neo natal unit due to some health issues that were first discovered after she was born. She possibly has something called Noonan Syndrome - the doctors haven't made a definite diagnosis as she "has a few of the signs but is not typical". Basically she has a mild heart condition (slight narrowing of her Pulmonary Valve) and mild hypotonia (low muscle tone) which means that she has slight developmental delay. She has also been on prescription high energy formula since about 3/4 wks old as she had some feeding problems to start with and is putting on weight slowly- at nearly 8 mnths she weighs about 14 lbs so is small for her age.

The thing is none of this really affects her on a day to day basis. The heart condition was assessed by several docs including one from Bristol children's hosp as being mild and not needing any treatment. The hypotonia is not much of an issue as she is very active, can roll over front and back easily, is on the verge of crawling and loves to stand up (whilst holding on to our hands). She can also pick things up and plays with her toys a lot. She's on one or two solid meals a day and can take food from a spoon and pick up finger food easily. She just needs an extra cushion on her high chair to support her. She can't sit yet and is a bit slouchy when she's in her high chair or pushchair but this doesn't bother her at all.

Considering all of the above would there be any problems with a childminder when I go back to work? That is would a childminder be willing to take her on or would the mere mention of the above put a childminder off as they might think she was a 'risky' baby?

I think a childminder would be preferable to a nursery as I'm concerned that DD might be overlooked being with so many other children if there is ever a problem. Have to say that we've never had any problems with her due to her health issues, never had any scares with the heart condition etc or had to take her to the docs other than her regular check ups.

If there are any childminders who could let me know what they think or anyone who's been in a similar situation has any advice that would be great.

Thanks for reading

Slightly different but I will give you my experience. My DS was prem, 29 weeks and I went back to work when he was 8 months old (so 5.5 ish corrected).

That was not a problem itself

I decided to put him in nursery and he may have been too weak to mix with the other children at that age given some other health issues (in his case lung not heart) so he was ill a lot to start with. I would therefore ask whetehr you DD has any greater risk with immunity due to her health. If she does then check the overall number of children, and mix of ages. If she is wekaer than average she may be off more than some others would (of course she may not too). Also are there any specific risks with the heart, in our case the nursery are all resuss trained and can cope when DS has a breathing fit which is very reassuring.

I would however also say that the nursery is IMO better with my DS muscle issues than I am, or than i suspect a childminder might be unless you had a very good one as the staff ratio means that there are always staff to do exercises etc as shown by the physio who comes in to nursery. I am absoultely sure than a good childminder could be as good but it is possible that there may be additional input requried at some stage.

Finally when chosing a childminder you may wish to ask about their general expereince with the local NHS and outside agencies as it is possible you may need those in the future and if the childminder knows the senco that may help at some point.

Good luck, whatever you decide I am sure it will be fine.

I am a childminder who wouldn't hesitate to take on your daughter. I have some special needs experience and also know that I have access to training and professionals for advice. I have also been approved by our local Parents Forum for disabled children to care for children with disabilities/additional needs. I am sure there are plenty of childminders around who would be happy to care for your dd.

I would however also say that the nursery is IMO better with my DS muscle issues than I am, or than i suspect a childminder might be unless you had a very good one as the staff ratio means that there are always staff to do exercises etc as shown by the physio who comes in to nursery.
Childminder ratios are actually lower than in a nursery, so a CM will often be in a better position to do exercises with lo. Also, there is no reason why the physio wouldn't attend the CM's house to do the session there. They are not restricted to going to nurseries!
I'd also prefer to have a CM looking after her all the time rather than her being in the care of a 17 year old for most of the day!

my point about CM is not that the ratios are better or worse, but that where the overall number of staff is greater things can be juggled. That was my very badly put point.

I suppose all I am really saying is that good childminders should be fine and good, and Badgerhead and other sound like they would be, but IMHO my DS nursery is so absolutely fantastic with his provision that they are better than I am. Because they are better than I am I suspected that they may be better than a childminder, but obviously cannot judge that as I don't currently use a childminder. I can judge that they are better than me though. And as a parent looking back I wish someone with personal experience had told me that and it would be fine when I put my DS with mild health issues into nursery (which became worse after he went into nursery)

As a parent I just therefore wanted to say don't dismiss all nurseries, nor tar them all with the same brush. MY DS key worker is about 30, and there is no-one there who is 17 as this particualr nursery don't recruit people without 3 years childcare experience.

I also would not tar all childminders with the same brush. Some are fantastic, but I have no doubts that for me, with DS and with health issues the current nursery cannot be beaten.

Separately if you do need a physio check about timings for appointments, if you use a childminder who does school runs etc that can be a pain when you are also tying into a physios diary. It may not be, but again that is one of the things I wish i had known earlier. Physios diaries can be a nightmare and My physio and OT prefers nurseries as they can juggle staff more easily. It may just be there view and others may have a different one.

I am a childminder and currently care a child who has hypotonia and global developmental delay.

Professionals,such as physiotherapists,visit him at my home just as they would with a nursery so there should be no issue there.

Prior to caring for this child I had no experience of looking after children with special needs but I have the view that every child is unique and has their own individual needs anyway.

Childminders vary a great deal as do nurseries you just have to find the one that suits you.I would look for someone who is flexible and who seems keen to learn and to develop their practice.

My friend works for a nanny agency specialising in childcare for families with additional needs, they might ba able to give you some advice if nothing else? I'm not sure if I'm allowed to post the details on here but please feel free to pm me if you'd like me to give you the agency details!

I am a CM and I have cared for a little boy who had special needs as a premature baby. I am still looking after him 2 yrs later. I have liaised with the family and their associated medical experts about his developmental goals.

I have also had experience of children with other special needs and have excellent backup from the local authority early years team.

I suggest visiting Childminders and nurseries and seeing what seems to be the best fit for you.

Another CM here with a little experience of SN, (LSA in Primary school to a child with Down Syndrom about 5 years ago, and currently working 1-1 to a LO with Downs at Pre School)
My youngest DS now 10yrs was born 5 wks early, 8lb 15oz, I had Gestational Diabetes.
I wouldnt think twice about taking her on

I may get flamed for saying this, but IME nurseries (have used four different ones) are a germ-fest and DC get sick a lot, much more than with CMs with small number of mindees. With your DD still being small with a heart condition that'd be a big worry and would avoid nursery til she's bigger.

Hi everyone, bit of a busy weekend so couldn't reply before now.

A huge thanks to everyone who replied. It's reassuring to know that childcare for my DD is not out of the question. I think I'm still preferring the Childminder option rather than a nursery but I won't discount that completely. I think the next step now is to contact local CMs and nurseries and see what they say.

Many thanks again

If you contact your local Early Years and Childcare service they should be able to give you details of childminders who are particularly experienced in caring for babies with additional needs.

Having said that any decent childminder should be more than happy to and capable of caring for your LO. What is most important is that you find someone in whose home you feel comfortable, who shares your views on caring for children and who is willing to tailor their approach to take into account the needs of all of the children in their care.

If you find someone who feels right the rest should just fall into place. Don't settle for somewhere that you don't feel 100% comfortable with because they seem clued up on special needs.