I really need some urgent advice please please please x

**Tippy Toes** · 05-10-2009, 07:03 PM

I have been looking after a 4 year old before and after school for 4 weeks.

When I met up to do the contract the parent told me the child had some 'accidents' and would I be able to deal with this, I said yes. She then added that the child sometimes had accidents 'the other way' (poo) but it was very rare.

Anyway I have not had the child for the last 2 weeks because she has been having these accidents in school and the school have been sending the child home saying the child has the runs.

Parent has taken child to doctors and they have found some problems and given the child laxatives to take! For several months! Parent has told me that child could be like this for a year!

Im just really worried, when I did contract for this after school child I did not realise/was not told the child has this problem. I dont think/know how I will be able to cope with looking after a child who cannot control her bodily functions, especially when I have five other children(mainily babies) in my care? If she has an accident how am I to clean it up and look after the other children in my care? Also it is my home and I am not sure If I like the idea of the child having 'the runs' and not being able to make it to the toilet!

Where do I stand ? What can I do?

Ive told parent we need to have a chat to discuss it all in more detail?

Can I end the contract? If so how do I go about it?

What would you do?

Im so sorry this post is so long! Its just this is stressing my out big time, its all I think about.

I dont feel like parent was completely honest with me from the start.

Thanks All

TheBTeam · 05-10-2009, 07:10 PM

I think i feel the same as you, and i know all about inclusion, but i don't think if this is going to be an ongoing issue, that i could deal with this in my home environment, or personally be able to give the time (and to some extent even want to!) to cleaning up the messes on the child or the house, especially with others around.

I think any parent should be able to accept this, even if they aren't particularly happy about it, and i would hope that they could agree that you could withdraw from the contract without any hard feeling on either side.

I had an issue with a child with a nut allergy and tried working with the parent whilst we sorted out training, advice etc as she had been misinformed about how to deal with it, i then felt that despite saying i could give the child the care they needed, that in reality i was not ab.le to, the parent was lovely in understanding that i was upset that i could not give the child the care, but with other commitments etc it simply would not work, we agreed to finish the contract without notice and I am still very friendly with her, even though it didn't work out.

I would be completely honest with the parent and explain how you feel that you can not offer the support or time that she may need given your other commitments and for this reason you dont feel you can continue, while the child is receiving this treatment or until the situation with them changes

**sarah707** · 05-10-2009, 07:12 PM

It sounds from the symptoms that you are describing and the medication that has been prescribed that the child is suffering from constipation.

The poo gets impacted and stretches the bowel and muscles and there is leakage of liquid round the sides.

It can continue for years as it usually takes a long time for the muscles to mend and the child to learn when they need to go / feel comfortable going to the toilet because they associate poo with pain and hold it in... hence it impacts even more.

it is a very nasty and painful condition and the child will need a lot of support.

If you do not feel you can offer that, for whatever reason, then you need to have an urgent meeting with the parents to discuss alternatives. It's not a bad thing to say 'sorry I can't cope' and it's much better to say that than to struggle on and get upset by it all, so long as it is handled professionally.

Call a meeting, sit down and explain that you are not set up for the issues the child is bringing.

Are you within your 4 week settling in period? That would make things easier for everyone as you wouldn't need to work out your notice period.

Hth

**Mrs.L.C** · 05-10-2009, 07:14 PM

I guess it would be no different to a younger child you were potty training.

Maybe you could suggest some sort or panty liner for inside the childs underwear abit like what you get for terry towling nappies? not sure if it would work. If the child was to have an accident then just put all underwear in a nappy sack and send home and just clean child up with wipes same as wehn changing a nappy

One thing though - If the child has accidents and its like the runs then why are they being given laxatives? I would bring this up with the parents

**Pudding Girl** · 05-10-2009, 07:19 PM

It's as Sarah says, fluid leaking round rather than actual poo/runs. I've had dealings with a couple of babies/toddlers upto 3yo with this kind of problem and it is obviously easier/more acceptable to people as they are younger but not an older one, poor thing.

**tammerisk** · 05-10-2009, 07:37 PM

my daughter now 10 has this problem and we have been on laxatives for nearly 6 years with it on and off

she also wet the bed and had accidents till she was 7 and even now she has poo accidents but i just send her with spare knickers and she can sort it out herself

if it is this problem it is not that much trouble just change them and wipe them like you would a baby with wipes nothing really major

but i would advive not to make it into a big deal ofr the child as they might end up not telling you what they have done as theymay be embarresed so making the problem worse

**Twinkles** · 05-10-2009, 07:54 PM

I have a mindee with this problem too - she's six though. To be perfectly honest it really turns my stomache when I have to deal with one of her accidents. Sorry if this is TMI but because it's waste that has sat too long in the bowel it reeks !

You have to consider how you will deal with the clean up if/when she has an accident. Is your house layout such that you can sort her out and keep an eye on the others ?

What about outings ? We go out for day long walks in the holidays and I have to take a travel potty for her and many changes of clothes.

It helped when we realised it was a medical condition and not just her being lazy.

I have been on the verge of giving notice once or twice but she needs me

**charliegee** · 05-10-2009, 08:02 PM

ah you poor thing - and poor little one- I don't have any advise - think lots of good advise has been given but just to say hope you are okay and that this forum is putting your mind at rest a bit and you feel a little more confident in what to do

...very difficult situation for you hun

x

**Hebs** · 05-10-2009, 08:10 PM

my son was like this for years

the smell is horrific

we eventually found out he had an intollorance to cows milk, switched him to goats milk, he eventually had a huge poo and after that he was fine

i wounder if this lo has the same problem??

my gp never suspected a cows milk intollorance

**miffy** · 05-10-2009, 08:17 PM

I think I would find this very difficult to deal with in my own home too.

I think you need to be totally honest with the parent and give notice now if you feel you can't/don't want to cope.

Good luck

Miffy xx

**cheeky monkeys** · 05-10-2009, 08:28 PM

I haven't been on here for a few months...due to circumstances..and I've read your post.

it brings back to mind my Ofsted report of 7 years ago that said that my after schoolers were demandng too much of my attention at the risk of depriving my under 5's.

I know there have been a lot of changes since then, but my main care is for under 5's and my after schoolers are secondary so if a child should upset this balance then I feel that things should be re addressed as i feel that Ofsted would see it that way since we now have the 3 registers.

Hope this makes sense

**Tippy Toes** · 05-10-2009, 08:30 PM

How would I explain my reasons for wanting to end the contract? How do I go about it nicely?

Its just so hard because the child is in the same class as my little one so will be awkward at pick up time?? I also pick up another child from the same school...

Sometimes I feel like the parent is putting pressure on me, she keeps saying how much the child likes coming to my house etc

At the start of the contract parent told me child had intolerance to X & Y and that if she ate X & Y then it would go straight through, that it why I said yes to taking on child, I didnt realise it was actually a day to day problem...I was made to believe it was only if child ate certain things then she had accidents

**nic76** · 05-10-2009, 08:30 PM

my youngest son has this problem and has done for years. medication can help but dependent on what it is i cant really say much but W was on lactulose which was rubbish but is now on movicol which is fantastic but can take a while to get the correct dosage. if this child has the runs now then its dosage is wrong and needs correcting.

W never has problems at school (i think he holds it all day)but does at home. he is now scared to go on the toilet because he is in so much pain and has to kneel on the floor. its like training him all over again but at 6yrs old.

i managed to get a referal to a childrens community nurse who was fantastic and came out to see me and phoned me everyday to see how w was getting on. maybe this mum needs more help than just her gp. i personally found them a waste of time

**Tippy Toes** · 05-10-2009, 08:35 PM

Originally Posted by cheeky monkeys

I haven't been on here for a few months...due to circumstances..and I've read your post.

it brings back to mind my Ofsted report of 7 years ago that said that my after schoolers were demandng too much of my attention at the risk of depriving my under 5's.

I know there have been a lot of changes since then, but my main care is for under 5's and my after schoolers are secondary so if a child should upset this balance then I feel that things should be re addressed as i feel that Ofsted would see it that way since we now have the 3 registers.

Hope this makes sense

Yes this is exactly what my concerns are. I look after 3 children under 2 and another 2 children in full time school 3 & 4 not to mention the child in question.

**miffy** · 05-10-2009, 08:40 PM

Originally Posted by twinkletime

At the start of the contract parent told me child had intolerance to X & Y and that if she ate X & Y then it would go straight through, that it why I said yes to taking on child, I didnt realise it was actually a day to day problem...I was made to believe it was only if child ate certain things then she had accidents

You could start by saying this to mum.

Then explain that care of older children must not compromise the care given to the younger children (sorry, can't remember the official wording) and you feel that, in her daughter's case, it might.

You don't have to justify yourself - you can simply say it's not working out.

I know it's not easy but if it's going to stress you out it isn't worth it.

Miffy xx

**gegele** · 05-10-2009, 08:45 PM

I feel bad for the little one but if you think you can't cope just be honest. it's better to admit that the extra care the child needs would impact onthe time and attention you can give to the other children in your care. you can't give enough time to all of them. you love having the kid but your numbers are too high to satisfy her level of need, she deserves more....
i think parents would understand. tried to find an alternative, an other minder you know who could take her on?

good luck

**mama2three** · 06-10-2009, 07:44 AM

just to say it may not be as bad as you expect once the laxatives start working - there are 2 types usually prescribed , the best being movicol , which my eldest has been on for several years.
Once the mindee isnt constipated any more then they may well be able to manage their own toileting without any real assistance , no difference to any other mindee of that age. as other have said the 'runs' is actually constipation overflow , the poo has to be loose as its the only way the body can get it past the blockage.
I would stick with it , for a set out period , then review - in my experience by the end of the review time although the child wont be cured as such , this can take months or years , the medication will have it under control.
If its lactulose thats being prescribed and the child is getting stomach pains then advise mum to ask for movicol , it works differently and through talking to other parents with the same problems as ds this is by far the better option.
Other things that can help are dietary - especially increasing the amount of water drank.
none of this is relevant if you feel you

cant go through the process with this family though ...but it really may not be so bad . hth , kath

**cuffleygirl** · 06-10-2009, 12:34 PM

If you don't think you want to cope with this problem in your own home - then don't - you are self employed and as long as you go through the correct channels for termination of contract you are entitled to do as you please.

If you are unsure it is probably best to duck out now rather than further down the line - it is a difficult one as its not behavioural and frankly its stinky!

Chances are you are doing this job because you love kids and also want to be with yours not for the stress. In your shoes I'm not sure I would want to as your work environment is your own home!

You are showing you obviously care by your anguish - good luck do what you feel is best.

**Tippy Toes** · 06-10-2009, 07:40 PM

Thanks so much everyone, your answers have been a real help.

xxx

**georgie456** · 06-10-2009, 07:57 PM

Originally Posted by George

It's as Sarah says, fluid leaking round rather than actual poo/runs. I've had dealings with a couple of babies/toddlers upto 3yo with this kind of problem and it is obviously easier/more acceptable to people as they are younger but not an older one, poor thing.

My dd (aged 4and a half) has this problem too. She holds her poo in when she is feeling anxious or going through any change (starting reception recently was a big trigger) and then gets the impacted and overflow problem.
Her school have been brilliant and she wears a tena lady pad in her underwear during the day in case of any overflow. Thankfully she is coming out the other side now - the movicol did the trick - but as others have said, it took a while to get the dosage right.

I think you are well within your rights to not want to have to cope with it long term. It's hard enough dealing with it when it is my own child tbh....