New and need advice !

Hi there,

First off, thanks to all for your posts ! It's my firts time wirtting on here but have been reading since I opened my daycare in Jan. 2012. You guys have been most helpfull ... and now I have to ask for your advice.

Other than my own 2, I currently have this little guy, the only one I have so far but I have families starting in September. He as been with me since I opened. He started when he was 12 months old. He has been doing well here normal adjuments I would say but he is a very anxious/nervous 'paniquy' little one by nature. We have made big progress together on some of his little problems like eating, naps and stuff. However, ever since I have known him he seemed to have skin problems. It's very dry and he scratches himself especialy when he's mad or unhappy, tired ..whatever. When he first started I had a discussion about his 'rashes' with his mom and I knew he had seen the doctor and according to her he was not too concerned. 'Normal dry skin just put baby cream on it'. But lately it has been worst . Soo bad it he has scabs and it's really all over his legs and arms a little bit on his face too. It's very nasty to look at. I know he has seen the doctor and the mom still tells me that the doc. just says to put baby cream on it. I do tend to beleive her but I can hardly imagine that the doc would not have prescribed something ...it really is very very bad. He is not bothered by it here and I don't catch him scratching all the time, he does not cry or anyhting when I do put cream on it but I AM worried for him. If it was my child I would go get a second opinion for sure.*I do not think it's comunicable as he has been like this for ever but not nearly as bad. However, I am tempted to ask the family for a medical paper to confirm. The parents to tend to be a little layd back and too seasy going but that's MY opinion. They often forget some of his supplies, don't really have a rountine ... you know the type I'm sure but nothing that would have me concerned for the child's security or wellbeeing. However, I am concernt about this very much so but since he is my only icome for now ... What would you do ???

Thanks a bunch !

I would guess by your description that it could be eczema. The dr should be able to diagnose it's very common, but not contagious .... Stress and acidy foods can cause outbreaks.

Sounds like eczema to me too. Very common in little kids and the good news is they tend to outgrow it somewhat as they get older. The best non prescription cream right now that one of my daycare families is using is made by aveeno and is meant for dry skin from eczema. All of the aveeno products do well on sensitive skin. I use their diaper cream on my own daughter as well as several of the daycare use it. I find the body wash with the oatmeal in it is good too since that is what is often prescribed is an oatmeal bath to soothe the skin. Worth looking into the entire line and no I don't get paid by the company to say that just tried them all.

My DD also has eczema nd in the winter months its pretty bad, thankfully its mostly on her legs, lower back and back of the arms....no face! Baby cream, even the aveeno one didn't do much. I had to use adult lotions with extreme moisture on her 2-3 times daily. I tried to reapply at each diaper change during the day. It helped a BIT

Lately I've noticed something else, with the warmer weather it went away! so it's either the #1 the heat or #2 not wearing pants/long sleeves to rub against it. OO also if her bath water is a bit warmer then normal she flares up again. Its a constant battle...

A Dr. should have told them that BUT even if they did most will say, there isn't anything you can do to make it go away. Some things may help but suddenly next month the 'thing' that worked doesn't anymore. So annoying......

Thanks guys !

I should have mentioned that I have eczema and am familiar with the aveeno products as I've used them on my own kids however they do not have eczema. Just beeing safe with what I use on them. It did look like very very bad eczema or sometype of allergies to me and I have told the mother but he has seen the doctor just last week ... and still nothing. I do not get it. The cream she is providing right now is a sented one which if it is eczema can only make it worst and I have not seen any improvement so far. I'm also worried that infection can get into it because let me tell you he is full of open wounds now all over his legs and arms. It almost looks like burns after the skin peels off. ( I know they are not burns as you see the cratches from his fingers) but it's just too give you an idea how bad it looks right now. I guess I just reallly want something done and make sure I>m giving him sometype of proper treatment and not actually making it worst.

Life brand ( shoppers) makes a hydrocortisone cream that I used for my kids cause they get it too.

If the doctor does give a cream it will likely be a hydrocortisone based one. Just be very careful using it on the face or the diaper area as repeated use thins the skin and makes it more prone to breakouts of other kinds for some reason. Only seems to be on those two area but then again they are thinner to begin with I guess.

It is the humidity in the summer that makes the eczema seem to get better and why it is worst in the winter when the air is heated and dry.

It might also be some form of contact dermatitis and any scented product will really make that worse. Experimenting with switching laundry soaps, making sure clothes are washed before wearing, sticking with cotton vice anything wooly or scratchy. Although lanolin which is made from sheep might actually help when applied as a cream.

The fact the sores are open means you may just have to treat them like sores and apply polysporin instead of lotion to aid in healing. That will at least keep the chance of infection somewhat at bay. I have used vaseline on my own child after a bath and that seems to help moisturize well. The pores are open from the bath and the vaseline rubs in easily.

As a side note rubbing my hands with vaseline is the best treatment I have found for the red dry cracked hands we get in daycare. Doing it at bedtime and just keep massaging till it soaks in and it doesn't stay greasy feeling for long. But for both it has to be the stuff in the jar not the vaseline brand lotions which are useless as far as I am concerned.

For lotions for my own dry skin I like the St. Ives oatmeal and cocoa butter version.

My problem is that this little guy does not have any diagnostic or a good cream to treat it. So I dont know if I should just use a cream that I provide for him myself and hope that it works or ask the parents for a medical confirmation or just let it go. But I really do have a hard time seeing him like this.
For myself I use the avon therapie moisturinzing hand cream and vaseline an it does work well. But that,s when it's well controlled. I NEED my precription when it decides to act up.

Anyway, I just hope my little guy is not suffering from it.

As hard as it is to see a child in discomfort I would not apply anything not provided by the parents or with written permission for you to use something you supply - you open yourself to liability if it made it worse or an allergic reaction occurs.

If you are really concerned and wonder if perhaps he has not REALLY been seen by a DR I would draw up a "treatment form" that must be signed by a Dr that outlines the symptoms and concerns your seeing and need for clarification this is not a communal rash and what treatment for symptoms are to be offered both at home and in group care setting to ensure it is not aggravated ... that way your ass is covered and if the Dr says to avoid scented creams you can refuse to apply the one they have provided and demand one that matches the treatment plan ... win win ;)

I agree with Reggio. I would go with the angle of making sure that it's not communal for the other kids in your care especially now that there are open wounds if you're nervous about how to approach the parents. And insist on getting the Doctor's signature as well as phone number and address just to make sure they don't just make it up. Poor little guy.

I would also take that approach... not that you think they are negligent in not seeking more attention for it, but that you just need the verification that it's nothing contagious.
Has he had any allergy testing? This kind of insanely dry skin/excema, etc usually comes hand in hand with severe allergies, usually to something dietary. I would suggest to mom and dad to get him tested. The testing method now is MUCH better than even a few years ago.

Thank you all !!! I mostlikely will give her a form to have filled out by her doctor. It's just really really bad and WHAT IF it is communicable or that the current cream is doing harm which I seriously beleive it is ... I still dont think the mom lied but I just don't get that the doctor would approve a cream like this and this little guy NEEDS to be treated at this point. If this is what I need to do to cover my ASSETS then that's what I'll do.

Once again thanks guys ! I was afraid of beeing to fussy about the issue but you have validated that in this case it was OK :)

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Originally Posted by crafty

Thank you all !!! I mostlikely will give her a form to have filled out by her doctor. It's just really really bad and WHAT IF it is communicable or that the current cream is doing harm which I seriously beleive it is ... I still dont think the mom lied but I just don't get that the doctor would approve a cream like this and this little guy NEEDS to be treated at this point. If this is what I need to do to cover my ASSETS then that's what I'll do.

Once again thanks guys ! I was afraid of beeing to fussy about the issue but you have validated that in this case it was OK :)

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Dairy products cause most cases of eczema. How about working with the Mom in keeping a food diary. Try and see what it is that he might be eating or drinking that could be causing the problem. Then through the process of elimination you may find a solution.

Cutting out all dairy maybe the answer, there are plenty of non-dairy yogurts, cheeses and drinks available that provide a great source of protein and calcium.

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Originally Posted by Skysue

Dairy products cause most cases of eczema. How about working with the Mom in keeping a food diary. Try and see what it is that he might be eating or drinking that could be causing the problem. Then through the process of elimination you may find a solution.

Cutting out all dairy maybe the answer, there are plenty of non-dairy yogurts, cheeses and drinks available that provide a great source of protein and calcium.

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It could very well be related to allergies. I know the father has some allergies. I have told them about it but they just seem to do nothing. In my opinion this little guy does not have a very well balanced diete either but that I can't do anything about.

I just dont understand why would the doctor not give them better instructions to help their child but then again maybe I am not getting all the info. from the parents. I still dont think they would purposly whithold information. They are very young parents so ... I don't want to make any judgement on them I just really want to ensure he gets what he needs. Half his legs and arms are covered in scabs, open wounds and severe irritation and when I say half ... I really mean %50. It looks so painfull.

Thanks to all, I have been working on a form to have the doctor fill out all last evening. If anyone has a sample I could check out, I would appreciate it.

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Originally Posted by crafty

...I just dont understand why would the doctor not give them better instructions to help their child but then again maybe I am not getting all the info. from the parents.....

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Sadly like every field there are Dr at the bottom and top of their field, Dr who are passionate about their work and Dr who are burnt out and not giving things their 'all' so to speak ... sadly based on my experience with Health Care, at least in Ontario, it would not surprise me in the least if their Dr told them having skin like this was 'normal' and not be concerned in the least about WHY it is like that (aka an allergy to something) and address that but rather just treat the SYMPTOM verses the CAUSE cause this is the current 'doctrine' in Canada ... why CURE the skin rash when you can make hordes of money in topical creams treating the 'symptom'.

Sorry for the rant - as someone whose suffered with skin issues since childhood with no one able to explain to my WHY and just keep pushing more and more DRUGS at me it frustrates me that when I was wee no one thought to look at my DIET as a root cause .... I ended up as an adult finding out I have Celiac and only because I kept PUSHING to find out why I had the issues I did ... if this were MY child I would want to know WHY and would be taking the diet back to basics and seeing what 'helped or made it worse' and than avoiding those issues. Seriously if the 'outside skin' is being affected like this by something just imagine what is happening on the INSIDE of the body and the stress being created there????

So I gave the parents a medical treatment to be filled out to the parents. I told them that I was mostly worried about other families also being afraid that it could be communicable. I do not have other families attending at this time but I do have playdates with the one registered for september. Not that I talk about the medical conditions of the kids but it is visible. I also stated that I wanted to ensure I was providing the proper care. They seem to understand.

The next day, they FINALY provided some polysporin which WAS reccomended by the doctor not scented baby cream. Anyway I still told them that I would not use ANY products until I had the medical form. A few days later the scabs had been getting better but still did not fix teh ski problems anyway. He still itched and scrathed everywhere. I mentioned the form a few times during the following days. I strongly suspect they did not even call the doctors office.

Now I told them they had 2 weeks ( today would be the deadline) to return the signed form. I received nothing and no mention of it this morning. So ... What to do ? He is my only income right now, there as been other issues with this family like failling to provide the proper supplies after many warnings, not sticking to pick up times and one more thing I have never metionned to them however but it does grind my gears ... She often tell me she finished at 3h00pm and picks him up at 5h25 ! I had chosen not to say anything at first because, once in a while I could undertsand but now it happens almost every week.

So what to do ? Is this enough to terminate ? I knwo I am goign to have a discussion with teh mom tonight but ... I still not sure what to do. The child himself is great, not major issues with him.

Any advice ladies ??

Well you have to decide how much you need his income versus how much of an aggregation he is. You gave them a deadline and they have failed to meet it. It's not unreasonable to take your child to a dr and have him checked out and give you verification that he is safe to be with other children. The other issues such as not bringing necessary supplies and failure to pick up at contracted times have gone unchecked so she probably figures you will let thus slide as well. I would not be treated that way in my home/business and I would have their things at the door with an immediate termination letter for when they decide to pick up. I would tell them that due to their failure to comply with the rules set out in the contract ( supplies and continual lateness) and failure to return the required form and just a general air of disrespect towards your business that you have no choice but to terminate the contract. Then hand her the letter which will have all of what you said in it. She will realize in a hurry that you mean business. But if you let this slide she will never respect you or your business. ..... I understand that this is your only dck at the moment but is it worth being treated the way she treats you? Only you can answer that. Good luck

Thanks Crayola !! I really do need the income right now but at the same time I really want to be appreciated. The work we do and effort we put in is very demanding. I want to be flexible when I can but I do not want to be taken advantage of. When I have bent the rules for them, I did tell the mother that it was only because at the time, I did not have other children that would be affected by it and could manage it. I realise I'm responsible for that and agree.
But the parents have signed a very detailed policy document. In the long run, this is not the type of family I want to work with. But still, I find myself not beeing able to make the decision. I like the little dude, I can't afford to loose the income, my kids like him but I value myself and the service I give way above what I'm getting in return . Since we are closed next week for renos, I'm thinking to give them an extension but the form must be submitted first thing once daycare is open. I will also clearly advise mom that there will be no more flexibilities, one more strike and you are out. Should I put this in a letter you think ?

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Originally Posted by crafty

Should I put this in a letter you think ?

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Anything that could result in 'termination' I always do in writing and I make two copies of it - they sign receipt of BOTH one for their records and one for MINE so they can not later claim they were not 'aware' of the expectations ;)

Personally - unless my income was needed for a STAPLE like the roof over our heads I would do what needed to be done to my budget to allow for the loss of income if the client was making me think about termination on that level and making be feel under valued and taken advantage of - life is too short - I have one I muse about being DONE with but they only have 2 months of care before being naturally done with and in reality they pay on time, supply what they need and so forth it is just that they are not EASY to work with that's for sure.

However I have always been one to put my quality of life about financial things ... I have always trusted that my 'financial needs' will be met in one way or another .... I once took a job working in a factory because I felt burnt out in this field and needed a change and well partially because I was feeling 'undervalued' for the amount of work I was doing for the company ... the factory job paid $6 more an hour than my current job and was a job a MONKEY could do it was so repetitive and brainless so I thought 'oh awesome what I could do with all that EASY money' .... however I HATED it ... the people were horrible and lazy and did nothing but complain about not being paid enough for the work - the work was so mundane I would be falling asleep standing up at my station - I felt so bored and unhappy and well that the work had no meaning despite the pay it was not 'enough' cause it was affecting my mental and physical well being ... I quit that job without even having a new one lined up and ended up going back to working in centre care for not only less than I was making in the factory but less than I had been making before I took the factory job because it was a new company and I lost my seniority ... it was a financial adjustment however I had never been HAPPIER and in the long run that is what matters in life because being stressed and unhappy does damage to your body that no amount of $$ can repair!