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newbie
27-01-2014, 06:28 PM
I have a mum and dad of baby mindee (12 months) who are continuously blaming that LOs runny nappies on teething. The other month I went along with it but then baby was physically sick so I sent LO home. Then one by one all my mindees ended up with the bug and I got the guilts that I had allowed baby to stay and pass it around :(.

Last week baby had runny nappies again and when I mentioned it to parents they once again blamed teething! Then on Friday first thing, baby was sick all over my playroom floor!!! I sent LO home but felt like a mug for not acting on the runny nappies sooner :(. Mum has said that last runny nappy was on Sat so LO stayed home today but is due in tomorrow.

What do I do if there is a runny nappy tomorrow? Do I immediately send LO home?

MessybutHappy
27-01-2014, 06:49 PM
Yes! Oh, and for good measure, yes! again!!!
Tummy bugs can last and last. If a child has "normal" nappies and then one slightly looser then normal nappy, my antenna go up, a second and they're homeward bound! I have little truck with the teething story.

I also have had a child who developed revolting nappies due to too much wheat, but these were identifiable to the individual child!

bunyip
27-01-2014, 07:44 PM
Apologies to those who've already read this, but I'm dragging out my old 'copy/paste' post again. Hope it helps.

I would absolutely refuse to have any child with diarrhoea until 48 hours after the last episode. The cause of the diarrhoea is absolutely irrelevant whether it is teething, exam nerves, change of diet, snotty nose, anything- this is frequently overlooked by parents and, sadly, by some childcare workers.

Really this isn't about my policy, your policy, anyone's policy. It's about the welfare of everyone at your setting and about our legal responsibilities. It's not a CM's rules: it's the rules of the Health Protection Agency and every local Environmental Health Officer in the UK. Breaking the 48 hour rule can see you being closed down, sued and you might even end up killing a child.

Here's the science bit (cue Jennifer Aniston smiling and flicking her hair back.) Your body contains more bacteria than it does your own body cells (in fact, only about 10% of your body is really ‘yours’.) In the right place these are quite safe and they do a mighty fine job; in the wrong place they can kill. That's why, when god designed your body, she put your bottom a long way from your face. There's some pretty deadly stuff in your lower intestine, just below your belly button there's a whole colony of E-coli just for starters. The danger with diarrhoea (and vomiting, to some degree) is that it can flush a lot of this 'bad' bacteria out of the body and (via hands, proximity or even airborne transmission) into your food chain with very nasty, potentially fatal results.

FSA guidelines are very clear about the serious risks posed by any condition of the stomach and gut. Vomiting and diarrhoea are the most common means by which dangerous bacteria are spread. This remains the case no matter what is causing the diarrhoea, including teething and 'infant diarrhoea' (which is still diarrhoea - the clue is in the name.) Without getting too deep into the bio-chemistry, let's just say that diarrhoea carries a lot more nasty micro-organisms than your ordinary poo. This includes potentially lethal bacteria.

Food handlers are required to stay away from work until 48 hours after their symptoms have ceased. This is why CMs generally apply the same '48 hour rule' to mindees. So the need to exclude lo's with diarrhoea is not just because they can directly infect other lo's or the CM.

We change a lot of nappies in relatively close proximity to food handling areas (I know we don't do it in the kitchen, but it is close, compared with the environment of restaurants, shops, etc.) We also tend to have handwashing facilities that are not 100% as good as other food businesses (how many of us have elbow-operated taps, for instance.) So any CM who is caring for a lo with diarrhoea is at an increased risk of contaminating the food, no matter how careful we are.

Whatever the cause (which can be teething or even emotional) do not let that affect your decision. It's about the frequency and liquid nature of intestinal evacuations. There are no hard and fast rules to the diagnosis call (except that neither you nor the parents are medically qualified to make a diagnosis) but if in any doubt send them home and exclude until 48 hours after they are clear.

Yes, parents are going to get annoyed. That's when we have to be firm and explain that we are legally obliged to exclude under guidance by Health Protection Agency and Food Standards Agency. They can close you down for non-compliance, and that will leave all your families up an appropriately-named creek.

Glitter
27-01-2014, 08:12 PM
Bunyip- Please can I copy your post and show it to parents who question why I am sending their child home when they are ill.

Smiley
27-01-2014, 09:10 PM
Thank you Bunnyip for reminding us why we send children home. I have recently done that and always exclude for 48 hours after last bout

bunyip
27-01-2014, 10:11 PM
Bunyip- Please can I copy your post and show it to parents who question why I am sending their child home when they are ill.

Of course you can. :thumbsup:

Actually, I can't stop you now I put it in the public domain.

But sweet of you to ask. :littleangel:

bunyip :)

newbie
28-01-2014, 07:43 AM
Thanks for this Bunyip. It's the one thing I struggle to stand firm on as so many parents blame runny nappies on teething and it's so difficult to know what to do :(. I understand how parents must get annoyed/frustrated/upset with having to take time off work but I just can't risk my own family coming down with some horrible bug let alone my other mindees.

Simona
28-01-2014, 07:50 AM
Public Health England (previously the Health Protection Agency) used to have a very useful leaflet called: Give the bug the boot...does anyone remember it?

It was easily downloadable but unfortunately I cannot trace it
This leaflet should be in our parents Information pack ...for those lucky enough on their information board too....so parents have no misunderstanding as to why we must exclude....and if possible also give parents a photocopy when you hand them their copy of the contract

I will try to see if I can find a link to the leaflet

Miss freckles
28-01-2014, 09:15 AM
Thank you so much for this thread. It's made a very interesting read.

I have one child who has constantly runny nappies but has had them on and off since after Xmas. I've changed the most disgusting nappies to the point where it's is yellow, very runny like water and very smelly. Mum has taken lo to the dr who just says it's teething so I've been letting lo come as mum says he hasn't been having them at home.

Although almost everyday I have to change these horrible nappies, which are sometimes that bad it comes out of the nappy. Maybe I should show her this!!

unalindura77
28-01-2014, 01:35 PM
What if it's one really runny nappy? Would you turn away then or wait until there's another bout, as I have read that it's only diarrhoea if it continues...??

Littleglees
28-01-2014, 02:02 PM
Thank you bunny :-) ive got a parent who sent child Friday one runny nappy - teeth - came yesterday had been at grannys all weekend runny nappy - teeth.

Well by 9am he had two explosive nappies.so I phoned dad, who said he was in a meeting !!!! Said he needed to go home hour later dad came after yet another nappy !!!!

I will certainly use this x