Teething issues and symptoms... Help!

I have been operating my family day care for 15 years and never seen these symptoms of teething! Swollen cheek(s) and temple, deep red in colour, noticeably hot to the touch. The child is not crying but is almost un-reactive. Moves his eyes and seems to be alert but does not move about physically. Is happy to sit for very long periods of time with toys around him. He is only days away from turning one and only managed to get himself into a sitting position this week....although he has been able to sit if you arrange him. He can almost pull himself upright. I am afraid that he is in considerable pain and it is influencing his development.
We insisted that the parents get an assessment from their doctor...and were told that the doctor says he is normal and healthy.
We called Tele-Health Ontario and they told us that it is most definitely NOT normal, that he should see a doctor in the next 3-4 hours max., should be immediately dosed with ibuprophen, and have cool compresses applied 20 minutes on and 20 minutes off until he is picked up and taken to the doctor. We really need advice on this issue. Any assist is appreciated!:blink:

Hi dragonlady3,

I'm no doctor, but that really doesn't sound like just teething to me. It may be that he is teething as well, but for an almost one year old to not be moving around much - it sounds like there is some developmental delay there to me. Really hope you get to the bottom of this.

I would be awfully worried that he hadn't suffered a fall and bump to the head.

My first reaction when you said high fever and bright red cheeks was Fifth's Disease but with the other symptoms there is more than that too I would think.

The lack of responsiveness is for sure a medical concern and if you decided that you are getting no where with the parents or their doctor since you don't really have proof they ever took him you would be justified in calling an ambulance and sending the child to emergency due to the lack of responsiveness and then calling the parents and tell them what you have done as in not give them the option to come and pick up. Just give them them option to meet the child at the hospital. There will be no choice but for the child to be seen and assessed. Even if it is just teething the doctor needs to authorize a different meds schedule to control the fever. You can use the call to telehealth as your reasoning for sending him by ambulance because you did not want to be responsible for his deteriorating conditon. Poor little thing.

We had scarlet fever go through here recently too.

How long has he had these symptoms? Have you taken his temperature? Teething doesn't cause a fever higher than 99*, although it can cause flushed cheeks.

Oh my! I really feel for you and the decision you need to make!

In my opinion you have 2 choices : refuse childcare until the child comes back with a doctors note with a clean bill of health or do as Sharon suggests and call an ambulance to get the child assessed when he is non-responsive.

There is a chance that the cause is a developmental delay of some sort or something else could be wrong. What was the child like prior to teething?

The main reason I am concerned is because back when I first started childcare almost 16 years ago I didn't know any better, I accepted a little guy who was really sick into childcare. His parents kept telling me it was a cold, it was a cold! Until one day the child quite literally was brought to me lathargic, laid him on my couch and asked that I just let him sleep and rest most of the day. The child was only 2 yrs old. Within a couple of hours, I clued in that something was really wrong and requested the family pick the child up. Both the mom and dad refused to leave work. I called my husband home to watch the daycare kids and took the child to the hospital myself. The doctor accessed the child and told me that if I so much as left him on my couch for even another 2 hours he would have died in my care. The child was suffering from acute respitory distress. I stayed all day with the child in the hospital til his parents came at 5:30, yup neither one of them bothered to get off work early. After greeting me with hello, the parents then said to me 'by the way you will not be receiving over time for this one'. That was the last time I saw the child because I quit immediately.

A friend of mine saw a child's health / activity slowly deteriate over a few weeks. The parents insisted that they had taken her to the doctors and she received a clean bill of health. My friend knew in her heart that something was wrong and told the parents that evening that the child could come back to daycare once she had a doctors note saying the child had a clean bill of health. My friend received a call that night saying the child would be absent from daycare indefinitely because the child was rushed to Cheo due to a brain tumor. My friend quit daycare because of this, the child almost died, when I asked a few weeks later how the child was doing, she wouldn't answer so I don't know if the child survided the operations.

Both these are likely extreme cases, but I guess my point is, trust your instincts and if they are telling you something more is wrong with your little daycare guy please take the measures that you can to ensure that he is ok. My girls were horrible horrible teethers for their first few teeth. They would all of a sudden become lethargic, with high fevers, and I would spend 1 evening until about midnight, putting cool clothes on their little heads, then as quickly as the fever came, it left, they fell asleep and woke up fine the next morning. I know teething can cause grumpiness, red cheeks, diaper rashes, fevers, etc. But most children with a little bit of pain medication return to their normal selfs during teething, in my experience.

This is not teething only. The child needs thorough medical attention. It seems like an infection.
I know all you guys mean well but using the word "developmental delay" is not appropriate. Please do not suggest this no matter what you think. It takes a qualified medical professional to say that.
Certainly this is something that the parents must be worried about. As a provider you should put your foot down and ask for a medical certificate.
Most of all it is important to educate the parents that there are pretty bad viruses which can cause lethargy- neural debilitation and it is safe to take the child to emergency and explain all symptoms.

Quote:

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Originally Posted by Niveah

This is not teething only. The child needs thorough medical attention. It seems like an infection.
I know all you guys mean well but using the word "developmental delay" is not appropriate. Please do not suggest this no matter what you think. It takes a qualified medical professional to say that.
Certainly this is something that the parents must be worried about. As a provider you should put your foot down and ask for a medical certificate.
Most of all it is important to educate the parents that there are pretty bad viruses which can cause lethargy- neural debilitation and it is safe to take the child to emergency and explain all symptoms.

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An honest question...can I ask why? I've never been in this position and don't know this situation...I'm just wondering why it's not appropriate?

Oh no! Poor kid! I agree that seeing a doctor is an absolute must for this child. I have four kids and when my 1 year old is not active she is sick. really.

I think Niveah is saying- and correct me if I am wrong- that "Developmental Delay" does not seem to fit (I am not a doctor nor do I play one on tv) as typically "developmental delay" is not an acute issue, and this certainly seems to be acute. Also a lot of parents get very defensive if someone labels their child as "developmentally delayed".

Oh, she means to suggest it to the parent. I misunderstood...I thought she meant simply suggesting it here. Thank you for that bit of clarification. :)

I am the parent of a child with special needs and it's funny how parents without "special" children take more offence to the wording than those that do.

If you read the original post the fact the child is turning one and has only recently learned to get into a sit position - normally by 6-7 months for most children then there are already cause for concern. I am assuming at this rate the child is not crawling or pulling to a stand which would also be developmental milestones they have missed.

It is harder to assess sickness in a child with special needs because they act differently anyways so often when I would take my child to the clinic or emergency they had to just go on my say so that the behaviour was or wasn't normal.

I still think the observations made of the red cheeks, fever and general malaise are a cause for concern and need to be checked out.

I thank you all! I did insist the child was seen by the doctor and requested any input he could provide. The father came back and said the doctor said the little boy was fine except that he had a swollen arm. Nothing about the other symptoms! The father said that the doctor was sending his child to see a Pediatrician but only for the arm. I was really stunned. But then he added that the doctor had agreed to include a note to suggest the new doctor also check the developmental side of things but he made it sound like it was their special request, not a 'real' issue. I believe trust is one of the things that make it possible for us to care for another person's child and I have lost all trust in this family. I have decided to ask them to leave. I don't think I will ever get the truth from them. My personal opinion is that the little boy is experiencing chronic pain, and that is what is slowing him down. Anything that made my face frequently swell and feel hot would sure slow me down! I hope that the root cause is teething because it will pass as his teeth arrive. I also hope the new doctor can come up with a sound strategy for pain management!!! Thanks again....

Quote:

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Originally Posted by dragonlady3

I thank you all! I did insist the child was seen by the doctor and requested any input he could provide. The father came back and said the doctor said the little boy was fine except that he had a swollen arm. Nothing about the other symptoms! The father said that the doctor was sending his child to see a Pediatrician but only for the arm. I was really stunned. But then he added that the doctor had agreed to include a note to suggest the new doctor also check the developmental side of things but he made it sound like it was their special request, not a 'real' issue. I believe trust is one of the things that make it possible for us to care for another person's child and I have lost all trust in this family. I have decided to ask them to leave. I don't think I will ever get the truth from them. My personal opinion is that the little boy is experiencing chronic pain, and that is what is slowing him down. Anything that made my face frequently swell and feel hot would sure slow me down! I hope that the root cause is teething because it will pass as his teeth arrive. I also hope the new doctor can come up with a sound strategy for pain management!!! Thanks again....

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I think that you made a great decision in letting this family go, trust is a big aspect inthis business and if it is lost by either the parent OR the provider then the relationship will not work.

Thanks for the support...it has been a tough decision.