If your child is like most others, she'll get her share of illnesses, whether or not she's in a child-care program. In most cases, these illnesses will be colds or other respiratory infections which tend to occur more often between early fall and late spring. At times, she may get one infection right after another and be sick for weeks. If both parents have full-time jobs, this can be a big problem.

Even children who are only mildly ill may be sent home from child-care programs and for good reason. A sick child may be contagious and risks giving her illness to another child. Also, a sick child may need extra care and attention, which most programs are poorly equipped to provide.

Some states have regulations that require child-care programs to send sick children home. This makes sense, particularly when a child has a fever and is acting sick, is sneezing or coughing, is vomiting, or has diarrhea because it is under those circumstances that contagious diseases are spread to others.

Ideally, you'll be able to stay home when your child is sick. However, if you work full-time, this may be difficult. It's a good idea to talk to your employer ahead of time to see if arrangements can be made for you to be home when your child is sick. You might suggest bringing your work home with you, or try to identify in advance co-workers who can substitute for you when this situation arises.

If your job and your spouse's require full-time attendance, you'll have to make other arrangements for a sick child. These are days when you might arrange alternate care for her, preferably where both the caregiver and the setting are familiar. If you rely on a relative or hire a sitter to stay with her, make sure she understands the nature of the illness and how it should be treated.

You could also check around in your community to see if there are any home-based or center-based programs that specialize in care for mildly ill children. In sick-child programs, caregivers adjust the activity level of the youngsters to the child's ability to participate, and the children receive cuddling and personal attention. These programs should pay extra attention to hygiene for both caregivers and children. The premises and equipment, especially toys, should be cleaned thoroughly and often. Disposable toys may be necessary in some situations, depending on the nature of the illnesses involved. A pediatrician and public health consultant should be on call for every sick-child care facility.

If your child requires medication during her time in child care, write out detailed instructions. Tell the caregiver why it's being given, how it should be stored and administered (in what doses and at what intervals), what side effects to look for, and what to do if they occur. Explain that medicine should not be disguised as food or described as candy; instead, the child should be told what the medicine is and why she needs to take it. Ask the caregiver to record the time each dose is given. If your child is in a child-care center, you might be asked to sign a consent for the caregiver to administer the medication.

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