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Rhonda
07-29-2013, 10:55 AM
My youngest daycare child had a reaction to peanuts at home a while ago. We discussed peanuts and I told them that I was not a peanut free home and neither was daycare. The parents were ok with this and stayed with me.

About 2 weeks ago the child has the testing and it came back the child is allergic to peanuts. The parents never mentioned that they were uncomfortable with peanuts in daycare or my home. (but I rarely serve peanuts, maybe once every other month).

Anyway, last week we had peanut butter. I just received an email from the parents stating that they want me to refrain from serving peanut products during daycare hours due to cross contamination and the children sharing toys.

My biggest problem is, if they had concerns shouldn't they have come to me when the child was diagnosed and not the first time I serve peanuts? They have always known that I serve peanut products to the children (family has been with me for years). They also knew that I would not stop serving peanut products, as the only thing I agree to with allergies is that I will not serve peanuts to children under 2.

Finding new children has been really difficult, so I don't really want to terminate, but I will not stop serving peanut products in daycare. The child has survived, 2 months with me serving peanuts during daycare.

Is there a way to have both, or to calm the parents ... the child has never went into anaphylactic shock, only had a rash. The rashes have always occurred at home, despite that I have serve peanuts.

The reason why I don't go peanut free is because my family already has our own allergies and I won't eliminate another food, when peanuts are a staple for us and a tread for daycare.

Thanks,

playfelt
07-29-2013, 11:41 AM
Since the kids will grow up not allowed peanut products at school I just don't serve them at daycare either although it is so tempting when kids get to the won't chew other meat proteins stage. The fact the allergy is not anaphylactic in nature at the moment means I would read labels but not be fretful about them BUT mom must store an epipen at the daycare for your use.

My family still uses peanut butter and I even eat peanut butter cookies during naptime but I brush my teeth and scrub my hands well when done, etc. Family knows they must use a plate, only put the peanut butter knife in the far sink etc. I had another child for 3 years whose sister had an allergy so they just wanted him not exposed just in case and that is where the family protocol started and now it is just habit so wasn't as big a deal once current child was diagnosed.

Good news is that because her reaction was only rash/hives/redness doctor said she would probably outgrow it and after a year when retested it is now borderline status so it could be a lot more temporary than you think as in the child I have has to actually eat it for there to be a reaction where as some react to touch or even smell.

momofnerds
07-29-2013, 01:43 PM
we ahve peanut products here. We don't serve them or eat them when dcg is here. Its not hard. I don't serve peanut products to the children just because you don't know till they have eaten them at home, this goes with eggs and shrimp.

sunnydays
07-29-2013, 01:44 PM
I don't serve any nut products in the daycare either even though I don't accept kids with nut allergies into care. I am just concerned about the young ones who haven't yet tried nuts and may have their first reaction here...not a position I want to be in. However, this is easy for me because I have a separate basement daycare with it's own kitchen...my family eats tons of nuts in the upstairs kitchen and I don't have to worry. That said, I still would not take on an allergic child because the risk is just too high for me and I don't want that extra liability. In your case, I would either agree to not serve nut products or I would terminate care. It is a huge risk to continue exposing the child the nuts...sometimes reactions can be worse over time. I wouldn't want to take that risk.

treeholm
07-29-2013, 01:53 PM
It is up to you to decide how much you are willing to do to keep this family. The first family I accepted were vegans. I was reluctant to take them on, but didn't know I would fill up before I even opened, so I took them on. A year later, this little boy is my little sunshine, and I would cook any kind of weird concoction they want me to just to keep him. Family is wonderful, and I am so glad I made allowances. Would I be willing to stop serving peanut products (which I don't serve anyway since I have mostly little ones?) to keep him now if asked? In a heartbeat. Great clients who appreciate us and pay on time, with adorable little ones who behave themselves, are worth it in my book.

Momof4
07-29-2013, 04:16 PM
I had a child in care with a peanut/tree nut allergy and I learned to read labels. It isn't hard to switch to crackers, bread and a few other prepackaged products that are made in nut-free facilities. Everything else I make is from scratch so it wasn't a big problem for me. But my little one had to carry around an epipen everywhere and still does because her allergy is very serious.

If your dc child is allergic and you don't want to change your food products then for everyone's sake can you replace the family? Do you really want to take the chance on being responsible for a child who could go into anaphalactic shock?

Have you tried the soy butter as a replacement for pb? It's pretty good.

Rhonda
07-30-2013, 05:55 AM
Morning,

I've personally lived with a food allergy for 20 years or more, I likely had it when I was a kid, but I didn't have a good Mom and she just passed off all my problems as me trying to get out of my chores. My own daughters have food allergies and sensitivities as well. I could be a little more relaxed because things have been fine with my daughters and I, my daughters are teens now. Our allergy can become anaphylactic at any point as well, in fact, I do get swelling of my tongue and lips. I had to stop eating eggs completely because the allergy was getting worse.

The child in question has survived my home daycare for a few months with peanuts being offered to the other children and has had no attacks. The child has never had anaphylactic shock, just a rash/hives, the doctor/allergists say it may or may not ever get to that point. The child's last attack there were no signs of anaphylactic shock. That was the child's 3rd exposure (at least), and it wasn't a small amount, the parents fed the child about a handful of peanuts. Testing showed the child was only allergic via ingestion, not touch or smell.

The parents have known for 2 months the child was allergic to peanuts, the parents knew 2 months ago my home and daycare were not going to be peanut free and they were fine with that, saying they still served peanut products to their oldest child. I've had the family in care for 2 years, so they know that I only serve peanut products about once every 2 to 3 months. So my problem isn't that the child has an allergy, or that I am not willing to take precautions to ensure that she doesn't eat peanuts in my care, but the problem is the parents didn't even ask me if I was willing to make changes, or discuss if there precautions that can be taken etc. All I get is an email the first time I serve peanuts after the diagnosis.

I can't help but believe all the attacks have happened at home, despite that I have served peanuts in my daycare. Is it a possibility that I can continue with the precautions I take and everything work out? I'm not prepared to become peanut free, but replacing children is also very difficult to do right now. So I'm kind of stuck.

The biggest problem still is the parents didn't even talk too me about their concerns and expect me to make changes without trusting me that I am taking precautions.

playfelt
07-30-2013, 07:18 AM
Could the parents be using this as an excuse to pull child from care to go to someone with better hours, less closures, better rates, closer to home, or whatever other excuse parents come up with thinking it is in their best interest - in other words the complaint has nothing to do with peanut butter and more about how do we pull her. You mentioned having the older child didn't you in the sense you have a longer relationship with this family than just a new mom to care that I would come out and ask what is really going on. While you might not like the answer at least you will know where everything stands.

Rhonda
07-30-2013, 08:28 AM
Playfelt, with the history I've had with this family in the last 6 months it is hard to say. I can't say it has been smooth sailing. We've had some issues with my illness policy twice, meaning I've sent the child home sick and they have disagreed said child was sick and refused to follow through with my illness policy. Their emails that they send to me during that time were also disrespectful. I would have terminated, but it was more advantage to keep them.

I send the family an email this morning basically saying the precautions I take when serving peanuts, and have always taken with a child under 2, that I wasn't aware they were making changes at home or wanted changes at daycare, because the last time we spoke about peanuts they said they weren't expecting changes and were going to still serve peanuts in their home. I did maybe in a round about way ask what changes they were expecting in daycare, when they knew in advance my daycare wasn't peanut free.

I won't cry to lose the family, I haven't had enough time to get attached to the younger sibling and the older sibling leaves care at the end of Aug, so I've already been preparing myself. I will cry to have an empty space. Depending on how this email goes, I guess will depend on whether the family stays with me. Although, I admit I do not serve peanut products to the daycare often (and never knowingly to a child under 2 without parents permission), I will not become a peanut free home or daycare. Peanut conscience yes but not peanut free. Peanuts are a staple for us and with having 2 teens we don't have to worry about nut free products because nuts are allowed at high school. I know there are peanut alternatives like almond butter, BUT and here is the big but, but I am allergic to tree nut oils, not to ingest (that I'm aware of, but I admit I don't willingly eat tree nuts else than hazelnuts) but I can't touch tree nut oils without breaking out. My skin is on fire at the smallest amount of tree nut oil. I did write in the email that when my hubby is home, I would be willing to test the alternatives, but can't until then.

Crossing my fingers all works out well. But how this will work out, not sure.

Thanks

bright sparks
07-30-2013, 08:44 AM
Here is my thing. This is all over peanuts. Would it really be such a big thing to eliminate them from your daycare meal plan? I appreciate that it's hard to be 100% peanut free as processed products can easily be cross contaminated but to just cut out the occasional PB that you serve is not going to be detrimental to the other kids and as a result reduces your liability ten fold. You could explain that you can't guarantee peanut free but can reduce the exposure by not serving things that are clearly made with or from peanuts. While you clearly are knowledgable on allergies with your personal experiences, who knows how this allergy will evolve in the child and the next allergic reaction could be the one that has them on the floor blue unable to breath. It's not like you have to eliminate a main food group which will take something away from the other children such as dairy, or gluten. It's just peanuts. Regardless of them signing up knowing you are not peanut free, circumstances have changed and the fact that you know about the allergy, and that it has been confirmed by an allergist but you still continue to serve peanuts, when exposure could be so dramatically reduced, won't prevent them from taking action should the worst happen. Your daycare, your rules. If you don't know how this is going to turn out, IMO it's because YOU haven't made the choice of how it is going to turn out. Either stop serving the peanuts in the best interest of the child and put something in writing to the parents to explain to them that you are not 100% peanut free but don't knowingly serve peanuts, or alternatively if it means so much to you to keep that food in your meal plan, terminate them. Remember it's about the child in care regardless of a parents attitude. Either make it work or cut all ties. I have been faced with this exact problem with a child in care who was also confirmed allergic to tree nuts, sesame and peanuts and due to the liability on me, I gave them the same outline of what I could do and if this wasn't satisfactory to them then they would have to find alternative care. I just kept my focus on what was best for the child, and how I would feel in their shoes.

Rhonda
07-30-2013, 10:59 AM
Bright Sparks. It's not just that the family has signed on knowing I was not peanut free and then discovered an allergy. Even after the allergy was discovered they stayed with me knowing I was not peanut free, knowing I fed the kids peanuts, stating it was ok they weren't peanut free at their home either. So, yes it is a little bit of a shock to receive the email I did.

I agree that I need to make a decision, but I didn't expect to have to make this decision.

playfelt
07-30-2013, 11:10 AM
Do you think it is possible the parent was in denial about what a peanut allergy means and figured oh it was just a rash not a big deal. Then after the allergist appointment she got info drummed into her about peanut allergies and how the reaction can escalate and now she is fearful. My child with the allergy still had peanut butter in the home but precautions were taken and brother was scrubbed down before being allowed near his sister etc. I sent a notice to all parents asking them to do the same should they let their child have peanut butter for breakfast - most just said thanks for letting them know and they would keep it an evening/weekend thing and no problem.

My daycare as such is peanut free from a meal standpoint although my own family has it but again they know the required precautions which are not a big deal. Just explaining to our girls using your own issues and they will understand and while it will take time and they will forget every once in awhile they will master the use a plate, put knife in certain place, wash thoroughly etc. Since the child doesn't come in contact with your kitchen other than to sit at the table it shouldn't be a problem if it is ingestion only. The other thing is you take precautions using a special silicone mat to butter bread on just in case the counter had a peanut butter slice on it and then it isn't as big a deal if the girls forget.

Problem with comparing allergies is that I have had kids in care with egg or carrot or rice allergies and all that happened was they got an upset stomach and if too much threw up. That is not the same as breaking out in hives which have the potential if they happen in the mouth/throat area to make the area swell and cut off breathing - equivalent to anaphylactic shock symtoms. So the issue does have to be taken more serious because it is more serious than just not serving it to the child. And that is where you will need to decide if losing the family over serving pb and j sandwiches once a month is worth it or not.

sunnydays
07-30-2013, 12:56 PM
I totally agree Playfelt! I have a child with a rice "allergy"...it isn't exactly an allergy, but if he eats it he might throw up for hours on end and in worst case end up in hospital...but it is not really life threatening. This is the only child I have taken on with a food sensitivity and I have to say, while I totally love this kid and family, I would not do it again. I have to read all labels (rice is in a lot of things!) and then I have to worry about other kids giving him something from their plates. As such, I have completely removed rice from my menu as well as rice cakes because the risk was too high. Parents didn't ask me to do this and even signed something saying that I would not be responsible if the child accidentally eats a rice product while in my care. BUT, I would feel awful and I do not want this child to get sick! There is no way I would continue serving peanuts to other kids in care if I knew one was allergic. I would either terminate or eliminate peanuts completely. What if one of the other kids shares their PB sandwich with allergic child when your back is turned? What if you miss a fallen piece on the floor and the child later eats it? Too many risks. If I were his parents I would find a nut free daycare. This is actually why I don't serve nut products in my daycare...I don't want the risk of an under 2 who has never had it getting ahold of an older child's peanut butter etc. It is just too much too keep track of.

playfelt
07-30-2013, 01:09 PM
Sunnydays when I had the child with the rice allergy it was worse than almost anything else I have dealt with. Her list was a mile long - just started out as a cranky baby but over time they kept testing and the list got longer and longer and sure enough once eliminated she was much more civil to deal with. Rice was the worst as it is used in most foods to help with consistency. She also had a dairy, egg, cherry, carrot, almonds (other nuts were fine) but then I had to watch for flavourings in stuff, - good reason to bake my own stuff. Parents provided a special margarine for her and she couldn't do soy or goats milk so she drank juice or water only while here and parents had a special formula from the hospital for a daily feeding. I had never heard of a child with a rice allergy till this one. Interesting to hear of another one. Guess is struck me as odd since rice is the first grain we introduce to babies and with so much gluten intolerances rice is one that most of them can tolerate. Really seemed weird after nearly 3 years to actually make rice krispie squares for snack.

sunnydays
07-30-2013, 01:19 PM
I know rice seemed odd to me as well. They call it FPIES (Food Protein Induced...something someting...LOL). When they were interviewing they said it was rice and oats...but then provided me with a list of many other possible culprits including sweet potatoes, cucumbers, etc. When I saw the list I actually told them I had changed my mind and could not take on their child as there was no way I could eliminate so many things! So they promised to trial all of the foods except rice before he started...and it was all fine...so we are left with the rice. You get used to it, but it is complicated because if I am really tired or distracted, I am always worried I will forget and give him the wrong crackers. My 3 year old daughter helps me a lot with this as she knows exactly which crackers he can and can't have and she is on top of it...LOL. I buy multi-packs of crackers at Costco, so she knows he can have the red box ones and the green box, but not the purple or white. And his parents have supplied a box of back-up crackers in case I am ever stuck with only the ones containing rice. I used to serve a lot of pasta that contained rice...and then I had separate pasta for him...but even that has become too much trouble and I have just switched everyone to the non-rice kind. It happened once where I forgot to cook his and realized when it came time to serving...that was the last time I bothered making two kinds.

madmom
07-30-2013, 01:34 PM
I just took a course on anaphalaxis and it scared the heck out of me. An allergy can go from zero to full blown unable to breathe in less than 3 minutes! I have a little guy in my care who has peanut allergy and has only reacted in the past by vomiting and nothing else. His last reaction was a total accident and his eyes swelled up, his mouth and throat swelled and he was miserable. I would say it is your daycare to decide what your course of action would be but to be honest think of how you would feel if the child collapsed after ingesting peanuts "by mistake" good luck

Rhonda
07-31-2013, 06:20 AM
I've taken the anaphylaxis course as well but I didn't find it scary. Maybe it is because I live with food allergies and my daughters both have hyper sensitivities to a food, and my oldest daughter also has a food allergy. The difference between a food allergy (as explained to me by my doc) is that a food allergy has anaphylaxis while a hyper sensitivity there is limited to no risk of anaphylaxis. Yet, when I speak with my family doc he says as long as there is a reaction it is an allergy, so at times I find the definitions of allergies to be conflicting. My oldest also has so many environmental allergies she should never go outside.

I could certainly be more relaxed about allergies because I have always caught my signs on time, or because my oldest was diagnosed with her allergy at 6 months old and she is now an adult, that I taught her to overcome her allergies and live life, her allergies never controlled her she controlled them. By the time she was 4, she was able to fully manage her allergies, her asthma, and her meds, she knew the signs she knew what foods to avoid etc. Though I admit the one thing I did forget to tell her is that she shouldn't eat certain foods at friends; she was staying with a friend of mine while I was away, the friend knew my daughter's allergies, but my daughter said we eat that all the time at home and ate it. Well, at home we always make foods that are safe and we use substitutes. All turned out ok, but my daughter quickly learned that lesson the hard way, she was 15 at the time.

I think I am struggling with 2 things. I know how hard it is to eliminate foods from a menu. And maybe my problem right now is I feel the daycare family being new to the allergy is a nervous nelly. I also think that once I've had a few days to get over being upset with the family, that I might be ok with it. But, for me, I've never wanted to be peanut free, always have enjoyed when my daycare children are over 2 and we can have peanuts. I find the precautions a pain in the butt when I have children under 2 in care. The hardest part is still, I'm not a peanut free home or daycare, the family knew this, stayed with me, and then when I'm feeling vulnerable because I have too many daycare spaces becoming available (in less than a few months I could have all but 1 of my daycare kids leaving; mat leave, moving, going to school, etc) the parent then wants me to go peanut free.

I will never be a peanut free home, I won't take peanuts away from my family. I might be able to get used to being a peanut free daycare, I don't know, it's not something I ever considered doing. I can't use many of the substitutions for peanuts because of my allergies :( The substitutions would have to be completely nut free.

bright sparks
07-31-2013, 08:26 AM
Can I just ask what it is that you generally serve that includes peanuts? Is it just pbj or something else? I suppose I have a hard time wrapping my head around why eliminating peanuts from your meal plan would be so difficult so that's why I ask, to get a better understanding of how it would actually effect you. I understand with your allergies that a lot of peanut butter replacements are still nut butters but other than that I'm not clear on the issue. Thanks

Wonderwiper
07-31-2013, 08:43 AM
I'm with Brightsparks...I don't really get it. Regardless of what they originally signed up for, the current situation is stop serving peanut butter sandwiches or lose the client. It's really up to you. Surely it's not hard to take those sandwiches off the menu....I don't use peanut butter or any of the substitutes and my children are not starving. If there are other issues than term them and find a new family.

sunnydays
07-31-2013, 12:50 PM
I have used sunflower butter or soy butter (they both look and taste a lot like peanut butter), but I do not serve any nut products at all...even though I don't have allergy kids. It isn't hard at all. My family can still eat it...just isn't served in the daycare. Personally, if my child was diagnosed with a peanut allergy, no matter what the severity, I would be a "nervous nelly" as well. It's just not something to take chances on.

Rhonda
07-31-2013, 04:11 PM
My family has two life threatening allergies plus other allergies (hyper sensitivities). We already have a lot of foods that can't come into the house. It's not as simple as saying it's easy to go peanut free. It's a staple for my family. I also have a non meat eating child who eats peanuts daily. We eat a lot of peanuts and peanut butter. I admit I don't serve peanuts often to the daycare and they have peanut butter about every other month. But the kids above two will have snack that may contain peanuts, I buy a lot of school snacks for my family that has peanuts and give those to the kids sometimes if we are having snack on the run. My family has certain safe foods and it would mean going back and starting to read labels again and getting my family on board.

Maybe if we didn't have our own allergies it might not seem so hard to remove another food from the house. I've never had a peanut free daycare, not served peanuts to children under two, so I've had substitute snacks handy.

But the child has had no more than a rash/hives from eating a large amount of peanuts. The allergist said that the allergy may never become life threatening. The reason is because the testing showed the child is not allergic by smell or touch. They aren't even re testing for 4 years.

Money is tight at the moment and I have 3 spaces out of my 5 coming available soon. Finding children is a nightmare in my area. Been looking 7 months for my sep space and it's still not full. If I terminate 1 more that leaves me with 1 child come jan. So it's not a simple decision. I've seen good caregivers quitting in my area because they can't find children.

I'm torn between trying to make money but my family does not want to go peanut free. That's why I was asking if there is a middle ground especially when the child has been with me a few months and around peanuts the whole time without even a rash.

momofnerds
07-31-2013, 05:49 PM
I think the problem is that sometimes parents will say that a child is allergic to something when its acually a sensitivity to something. My ds is allergic to penicillin-full of hives (top of head and bottom of feet) next time it can be even worse, now dd has a sensitivity to yellow dye--she throws up bright yellow till its out of her system, but its easier to say allergy so she can avoid it rather than saying a sensitivity and her eating it.

now I have watched kids with peanut allergies (I have one now) and an egg allergy. Its not that hard, once you start you will know. I read labels, feed my kids all the same stuff and no one complains. We do eat alot of fruit lol!

bright sparks
07-31-2013, 06:20 PM
My son is vegetarian and while seeds and nuts are a great part of his diet, it does not need to be peanuts. In fact, nuts of any kind to frequently are not good for you as they are extremely high in fat.

I think the middle ground is to not serve peanuts or peanut products all together during daycare hours. You then say you are not a peanut free home but you do not serve anything with peanuts in it to your daycare children. There is obviously still a risk of cross contamination but the risk towards the child has been reduced.


But the child has had no more than a rash/hives from eating a large amount of peanuts. The allergist said that the allergy may never become life threatening. The reason is because the testing showed the child is not allergic by smell or touch. They aren't even re testing for 4 years. ...The allergist said MAYnever be life threatening, this is a very uncertain statement meaning "I don't know", but who really knows how things might change. You can take the risks as you so choice with your own children, but with someone else's child its a huge liability. Also with all your experience with allergies, you still can not compare one person to the next, so you really shouldn't down play the allergy of another persons child because you never know how their next reaction will be.

Most of the time people say put your family's needs first but in the case of the safety of someone else's child in your care, regardless of all the but's, maybe's and uncertainties, their safety has to be priority. You need to do what's right for you but not if it puts another child at risk.

If you are comfortable with the middle ground of not handling peanut products during daycare hours, but not being a peanut free home then It may reduce the risks somewhat and you can still serve peanuts to your family. I would however be asking the parent's to sign a waiver so they agree to this arrangement in writing, and to prevent any comebacks on your part. Then it's down to the parents to decide what their comfort level is.

Everything is okay, until it's not.

Rhonda
07-31-2013, 07:13 PM
Momofnerds I agree with you. There are times sensitivities are called allergies. I don't think this is necessarily the parents fault but the doctors / allergists. One of my old doctors explained to me that there is a difference between an allergy, hyper sensitivity, and sensitivity to foods. Doc explained that a food allergy the person will go into anaphylaxis shock if exposed / ingested. Hyper sensitivity is when the person who is exposed to the food has a rash or hives and vomiting/runs but doesn't have anaphylaxis. But my other doc says any type of reaction means an allergy. Which is right, I don't know. I gave up trying to research the answer, and just differentiated it for my families allergies. I think if there is a difference than people with hyper sensitivities and sensitivities should be better educated. I think labelling every type of reaction an allergy will send some into a panic where panic may not be needed. But, truthfully, I found the same thing when it came to my daughters asthma, I did my research, attended asthma workshops and such, and it seemed that I was more knowledgeable than some doctors. With years experience I have come to realize that doctors are general practitioners, they know the basics and that is why they send us to specialists.

My daughters are allergic to penicillin too :( They broke out in full body rashes their first exposure. I remember begging my doctor to let me try penicillin a second time with them just to ensure that they were allergic to it. The chances are high seeing the allergy runs in both my family and my husband's, so they have never had penicillin again. Not by my choice but because the doctor wouldn't allow it. Though, my oldest has been accidently given eye drops that had penicillin in them and else than her complaining that her eyes burned when they were put in, nothing more severe happened. So I'm not convinced they have an allergy, maybe just a sensitivity.

My daughter is allergic to red food dye, she has never thrown up as a result. The first exposure was head to toe rash/hives. She was only 6 months when we discovered the allergy, so we eliminated it from her diet/medicines, and I have to admit, it became 2nd nature so early in the game. Every now and then we will try out red food dye and it has never gone away, she still gets rashes, but now she has swelling of the tongue and throat :( I haven't done much research of dye allergies, but you are the first person I've met who also has a child with one. It's nice to know that there are others, I think food dyes are common allergies though.

Rhonda
07-31-2013, 08:23 PM
Oh, I am curious about the waiver as it has been mentioned a few times?

Would anyone be able to provide an example of the content?

We had a verbal agreement/understanding that I would still continue to serve peanuts and that neither my home/daycare or the family home were going to be peanut free. So the waiver would prevent the parent from coming back and saying that they never knew my daycare/home wasn't peanut free, in the event that a reaction occurred while the child was present (hopefully that would never happen)?

Thanks