WWYD: CMs - a child of mine is allergic, and has breathing problems but mum does not give me inhaler unless i ask for it. (bit long)

[Numberfour]

I have a very good relationship with the mother of the 3 year old I childmind. He adores me and I adore him and all is good!

However: two weeks ago I took the children to the park and when I put the child in the car,I noticed that he was really struggling to breathe. It was bad enough for me to race him to the GPs straightaway - which was quicker imo than getting an ambulance. By the time I got to the GP's, child's breathing had eased. He was checked over by the practice nurse and I was told that he was not having an asthma attack and was fine to go but that the doc would look him over first.

The nurse checked his records and told me that he had been prescribed an inhaler and that as a CM I should have one in my possession - I replied that I had not been informed that he had one and that mum had not mentioned it to me.

Mum then arrived at GP (I had called her to say we where there etc) and I talked to her about the inhaler. She said that she did not like to use it often, and had not thought about letting me have it. She said she would order one for me to keep at my house.

Then during half term I wanted to take the children to a different park, and because mum had still not let me have the inhaler each day, I specifically asked her to let me have it seeing that we were going to a park again and that the same problem may arise.

And it did: within about 40 minutes of getting to the park, the child was struggling to breathe and even asked me to take him to the doc. I was FURIOUS with myself that I had left the inhaler at home (yes yes yes - bloody stupid thing to do!) so raced (carefully) home.

By the time we got home, his breathing had eased quite a lot, but he was still not 100% so I administered the inhaler as per instructions.

Later I told mum about it and she said in a very decent, non confrontational and everything 100% fine way that his breathing eases up noticeably, that she would prefer the child not to have the inhaler. Also, that if the breathing becomes laboured, she takes the child out of that environment and if the breathing eases then she again would not use the pump.

I said very very carefull so as not to offend her, that when DS was prescribed an inhaler, I was advised to use it as prevention as well as to ease breathing and I suggested to her that she talks to the doc about how best to use the inhaler for her child. She said to me that she is certain the doctor would give her the same advice as I had but that she prefers not to give her child the inhaler if at all possible.

My concerns are as follows:

1. She does not let me have the inhaler despite knowing that the child has had two asthma / breathing difficulties in as many weeks while in my care.

1. She does not want him to have the inhaler if his breathing eases.

1. She suggests that a wait and see approach should be adopted when child's breathing becomes laboured.

1. She chooses to go against the doctor's advice as to how to administer her child's medication.

I am very worried that a similar situation will arise again - not being in possession of the inhaler while her son is with me puts her son at risk and I am not sure if it is a risk that I am able or prepared to take. IYKWIM.

Any suggestions or advice please? Apologies for it being so long..........

It is impossible to overdose on ventolin and taking it even when not needed will do no harm other than cause temporary light headedness. It is why even young children are allowed to carry their own inhalors, even if a classmate got hold of it and took numerous puffs it wouldn't matter.

It does not stay in your system.

Having uncontrolled asthma however can be very, very dangerous. I agree with whoever said that they have obviously never experienced a serious attack, I have, its not nice.

The Asthma society pre-school asthma policy sets an onus on parents as well as the childcarer. If the mum won;t comply then I would seriously consider whether I caould provide care. After all you can't never go to the park in case this child has an attack.

Using an inhalor is not the same as taking steroids, not using an inhalor is more likely to lead to having to take steroids if the asthma is oncontrolled.

No.3you need to do a asthma policy ( I think there is one in my pack, there was cos had a child with it) and ask the Practice Nurse if she can go through it with you, most practice nurses will as a update on your first aid, and then get Mum to sign it, if she wont then I would give notice, I wouldn't be responsible for a child without medication, I have had to rush DS to hospital to many times.

No.3 No.3 !!!!!!! I have promoted you Hope your DS dosnt mind

ROFL

this looks useful

i would not have looked at this had i not received the above info from everyone. Thanks so much!

mum says today that she is concerned that giving child the inhaler makes him hyperactive (or more active than one would expect from a child) and makes his excema worse.

Anyone found that?

And of course as I walked away (was a couple of minutes late in collecting DS from school) i realised i should have said rather bad skin then no breath.

But she was very concerned not to offend me and we will def be able to work this out. I just need to get it down on paper and record matters as suggested.

gosh No4, how frightening

the inhaler will not make him hyperactive; in fact I'll bet what she is seeing after inhaler use is a child behaving 'normally' because he is not feeling restricted due to shortness of breath

"Tell her that unless she allows you to follow the prescribed advice for her child's medication, you don't feel able to offer a place as you feel he is at risk."

and the liability will fall upon the childminder for not following proper proceedures. God forbid, but should the worse happen, you can be sure the childminder will be hauled up on safeguarding issues - as in failure to follow safeguarding guidelines.

My above post was meant to imply that I agree with colditz.

I had a less serious issue of a similar nature. So I added into our contract that I cannot accept the child without their inhaler and no refunds or reductions can be made for any period of absence due to necessary items not being provided by the parent.

2 sets of parents have told me "but they never use it anyway" ... I said as long as its on their prescription they must have an inhaler here, and also at school or preschool. Its on their presription for a reason, and I'd rather have one here that doesn't get used than not have one when I need it.

In case of emergency I've been unofficially advised that it is better to use someone else's inhaler than none at all. The rules on prescriptions mean than no-one can officially advise this, they have to tell us to only use the child's own inhaler they have provided because that is the rule for all prescribed medicines. If anyone who has asthma has an opinion on this, would like to hear your view TIA

yy ayla at my last St JA course we were told that if a blue inhaler is available then use it and sort out after because asthma can have such devastating consequences

it was indeed unoffical advice, though; the trainer said would you really watch a child DIE if you had your own blue puffer in your pocket

It was very sobering

same with epipen (as long as it's a child's epipen not adults) - better to use someone else's than none at all if you can't get to theirs.

I think this mother is just not understanding how devastating the consequences could be. If she did understand, I find it hard to believe she wouldn't leave you an inhaler. Is there a way to nicely and not condescendingly educate her?

StarExpat, you have hit the nail on the head: how to educate in a way that she would accept.

The mother, however, pointed out to me that the child has not in fact been diagnosed with asthma because of his age - this was after I suggested that she talk to the practice asthma nurse about the side effects.

(DH keeps on trying to talk to me about his day grrrrrrr so will post more later)

I really appreciate all the advice.

In you are in the UK, does your LEA give support to child minders? If so contact them for advice. You need to record these incidents in an accident book, and give a written request to the mother for an inhaler. (Your LEA maybe sterner than this.) Also check your insurance.

yes, mummytime, I am in the UK and I do have good support where I am. That's a great idea to contact them for advice - so obvious once it is spelled out to you (spelt?? sorry not sure!)

I have only read the OP but I was a nanny, I have asthma and I am a mum of three who isn't keen to give medicine unless really needed. However in this case I would be terminating the contract.

As a childminder, a mum to an asthmatic child, an asthmatic myself and a former a and E nurse who has seen the good and terrible outcomes of an asthma attack I would be terminating the contract with this parent.

Poor, poor child.

Ventolin will not make a child hyperactive, it might make him a litlte bit light headed if he takes a lot.

My doctor said that it is almost impossible to accureately diagnose asthma in very young children but the ventolin inhalor will proably help whether it is asthma or not and certainly won't do any harm.

My heart bleeds for this child having undergone hell as a youngster when my doctor wouldn't give me an inhalor.

On my 1st aid course, the instructor (who was an asthmatic) said I should not let a child through the front door unless they had their inhaler with them.