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..........

I thought it was sorted yesterday when I asked mum to put the inhaler and spacer in the child's bag today. When she dropped him off she said that she had not provided it because HE WAS GOING TO PRESCHOOL SO DID NOT NEED IT. I was hurriedly getting two school boys into the car at the time, so like a twit I said Yes Okay!

I have quite a bad dose of hayfever today and am sure (despite not being medically trained) that the child's allergic asthma could appear at any time and not only when we go to parks.

I must do her a letter this week setting out a few matters. StarExpat had a v good point of wondering how to educate the mother without being condescending. If anyone has any ideas, I would be really pleased to hear them.

Can you hand her a leaflet about asthma and highlight the areas that worry you?

yes, that sounds like a good idea. i am also going to ring our practice asthma nurse and childminding network coordinator for advice.

thanks, StarExpat.

Maybe try a different approach

He hasnt been diagnosed with asthma and seems to be having an allergy type reaction

Say that if he has an allergy (especially to an unknown) then you need the relevant medication in case of a reaction

Like people carry epipens/piriton everywhere even though the wont go near nuts etc.

I like littleducks' idea. True, because she may say "well, he doesn't have asthma, so no need for an inhaler"

Yes!! I really like Littleducks' idea, too! Thanks, Littleducks. Mum has said that the child has not been diagnosed with asthma so taking this route will do away with having to go over that ground again and again.

MN to the rescue, as always

PixieOnaLeaf, I doubt very much whether the school is even aware that an inhaler has been diagnosed for the child. Mum did not tell me until I raced her son to the doctor 2 weeks ago and he has been with me for 5 days a week since January this year!!!

duty of care..... probably yes. particularly seeing that i drop off and collect. i will def look into that. thanks for pointing that out to me.

Just to add my 2ps worth, prehaps you ought to get in touch with the legal line at the NCMA/Michael Morton or whoever your with and see where you stand also?
Just a thought..

Can I add my own tuppence here. A few have mentioned that asthma is often not officially diagnosed in young children because it is difficult to accurately diagnose and I agree. However, asthma is really a description of what happens to the airways when in contact with a trigger, whether this be an allergy such as pollen, a reaction to stress, or as in my daughter's case a reaction to a virus like a cold. The airways become inflamed & constrict, making it harder to breathe. So it doesn't really matter if the child has 'proper' asthma or not, if they are having breathing difficulties & they have been prescribed a ventolin inhaler you should give it as it will reduce the contriction and relieve the breathing. Presumably, the parent must have had some concerns about the childs breathing in the first place to go to the Drs about it and get a prescription.
On a practical note, you have been given some good advice
Write an incident report for every single time the child shows breathlessness, get parent to sign and give a copy
Tell parent in writing you must have the inhaler or no care until you do-tell her your insurance company are insisting on this if she is difficult (and check with them too as it may be true!)
Recommend you have a meeting with the Asthma nurse with parent to put together a care plan
Dig out literature to give to parent on 'asthma' management which includes undiagnosed asthma in young children.
Just because its undiagnosed doesn't meant it can't be life threatening or at least debilitating. My dd had a cough at night for 3 years, rarely ate, was massively underweight but I never thought of asthma as she had lots of energy & was never breatless. since taking her inhalers she's a different child

Latest developments, Pixieonaleaf, is that the mum brought the inhaler and spacer Thursday and Friday. I will talk to her on Monday morning about whether the school knows and will say that the inhaler has to go with the child, wherever he goes.

I know I am being ridiculous, but I am caught between telling her "what to do" and telling her what I know is right - ie her child DOES get allergic asthma, or call it what you may and he has been prescribed the inhaler and so must keep it with him. I will use the line of the epipen that a pp mentioned above.

ChildrenatHeart, the child is actually quite a slight and small child! I appreciate the comments you have made and will make sure I do the incident reports, etc. Good to hear that your DD is so much better since she has started using the inhaler.

It baffles me that mum is concerend about apparent hyperactivity and increased eczema when her son's breathing is the issue.

That's good that the mum now accepts you need to have the inhaler and spacer when you look after the child, that is at least progress!