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FAMILY CHILD CARE TRAINING PROGRAM
LEVEL ONE - UNIT THREE
HEALTH
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FAMILY CHILD CARE TRAINING PROGRAM
LEVEL ONE - UNIT THREE
HEALTH
LEARNING OBJECTIVES
1. Recognizing the vulnerability of children and the importance of protecting
their health.
2. Reviewing good health practices.
3. Identifying how children can be helped to develop good health practices.
| CHATTER BOX "I am happy (and relieved) to report that children really can learn to cover their mouths when coughing, use tissues to wipe their nose, wipe, flush and wash hands after toileting and even brush their teeth and hair and wash up at other appropriate times during the day. After more than a year with two three year olds and a four year old when I seemed to spend all day making sure these tasks were completed, I suddenly realized today that for months now they have been doing all of those things without my constant reminders. Eureka! But before I start celebrating too much, little Luke is just 18 months old now, so here we go again..." |
THE BASICS
Healthy children are happy children. They enjoy daily
activities and have the energy and enthusiasm they need to grow and develop.
The children in your home child care depend on you to nurture and care for
them in a way that will promote their optimum well-being.
Healthy home child care benefits the child’s parents as well as the child.
Parents will feel increased confidence in a caregiver who practices healthy
habits and provides a healthy environment. They will appreciate their child’s
good health (and fewer days off work to care for a child who is ill).
In a healthy environment, illnesses occur less often and are usually less
severe.
As a caregiver, you will take pride in knowing that you are encouraging good
health in children. Healthy children are a joy to be around but when
children are not feeling well, just like us, they can be tired and cranky.
Sickness in your day care group could also increase your own and your family’s
exposure to germs. Promoting healthy child care will benefit the
health of everyone concerned. In order to provide healthy home child
care, you need to understand and satisfy children’s basic health needs.
CHILDRENS’ NEEDS:
A safe environment, good nutrition and warm, nurturing care
contribute significantly to a child’s health and well-being. These essential
components of healthy home child care are all discussed at length in other modules
in this series. There are many other ways that we can promote good health.
Children also need:
A clean environment to reduce the number of germs that the children are
exposed to;
Good hygiene to maintain good health and to develop healthy habits, through
your teaching and example;
Regular exercise and fresh air to ensure healthy growth and development
and provide an appropriate outlet for children’s natural energy;
A smoke-free environment to promote good health and reinforce nonsmoking
attitudes;
Rest and relaxation to maintain good health and re-energize children as
they move through their busy day;
Up-to-date immunizations and regular checkups with a health care professional
to safeguard the children’s health;.
A caring partnership between parents and caregivers around health care
policies.
A CLEAN ENVIRONMENT
Germs spread easily in home child care because of the number of children,
their immature immune systems and the way they play and share toys. It
only takes one exposure to a very small number of germs to make a person ill.
Many germs that are spread from person to person will stay on surfaces in the
child care setting for hours, days and even weeks. Cleaning and sanitizing will
greatly reduce the number of germs on surfaces, toys and other objects.
Cleaning involves the removal of dirt using a cloth and a mild household cleanser. The surface should then be rinsed and dried. This also removes some of the germs.
Sanitizing greatly reduces the number of germs on a surface or object. It should be done after cleaning using a household bleach and water solution. A fresh solution should be prepared each morning for that day’s use.
A small quantity of sanitizing solution can be prepared in a spray bottle by adding one tsp. bleach to two cups water (or 5 ml bleach in 500 ml water). This can be used to sanitize food preparation and eating areas and diaper-changing surfaces and potties (which should be sanitized after each use). Spray solution on and leave for thirty seconds. Wipe surface dry with a single use cloth or paper towel.
A larger quantity can be made by adding one-quarter cup bleach to one gallon water (or 50 ml bleach in 5 L water) in a clean container, such as a pail. Toys, plastic bibs, and teethers can be dipped in the solution for 30 seconds and air-dried on a clean towel. Because the bleach to water solution is so weak, there’s no need to rinse with water.
Infant and toddler toys get a lot of mouth to mouth exposure and should be cleaned and sanitized at least daily.
Wear disposable or rubber gloves when cleaning and sanitizing to prevent hands from becoming dry and/or irritated.
Hand washing is the single most effective method for controlling
the spread of infection.
Washing your hands, effectively and consistently, will not only maintain your
and the children’s health but also model a very important healthy practice for
your group. Proper hand washing procedures will ensure the most effective removal
of germs. Children need help in learning how to wash their hands properly.
Here are some simple steps for effective handwashing:
1. Use soap and warm running water. Pump soap is preferable (a soap
bar and dish can collect germs).
2. Wet your hands, add soap, and rub vigorously for 10 seconds. Wash all over
hands, back, front and between fingers.
3. Rinse thoroughly under warm running water for 10 seconds.
4. Dry hands with a paper towel or single-use disposable cloth. (Or you
could provide an individual towel for each child which you launder daily. To
avoid transfer of germs, provide hooks for towels with enough space for towels
to hang without touching.)
5. Turn off tap with paper towel or tissue and dispose of tissue
or paper towel.
6. Apply hand lotion if hands are chapped or dry.
ACTIVITY
"I finally came up with an inspired idea to help children remember to wash
their hands after toileting without my nagging. I put a big shiny school
bell on the counter beside the sink. After toileting, children wash
their hands and then ring the bell. Believe it or not, ringing that
bell is a big deal to them - in fact, I have to remember to ring it after
I’ve been in the washroom or someone is bound to ask if I forgot to wash my
hands."
When should children wash their hands?: after coughing, sneezing;
blowing their noses; using the toilet or having a diaper change; before and
after eating; after playing outdoors or touching pets; and whenever hands
are dirty.
- When should caregivers wash their hands?: after using the toilet or assisting a child on the toilet; before and after changing a diaper; before and after preparing food or feeding the children; after wiping a child’s nose or caring for an ill child; after handling pets or cleaning up their excrement; after being outdoors and/or removing the children’s shoes or boots; after cleaning and sanitizing; after removing disposable or rubber gloves; and whenever hands are dirty.
Proper diapering techniques help stop the spread of germs
which cause diarrhea and other illness.
Organize an area which is specifically for diaper changing. You will need:
a washable surface to change the child on, preferably with a safety belt
to secure child
access to a sink (note: do not set up changing area in kitchen where germs
can easily contaminate the food, counters and table)
any necessary ointments and lotions
disposable paper or wax paper to cover diapering surface or individual
change pads which can be sanitized
sanitizing solution to clean change table surface and change pads. To
prepare water and bleach solution combine 5 ml (1 tsp.) bleach and 500 ml (2
cups) water. Use in a spray bottle or a small container with a clean rag.
diapers and, if used, diaper pins, diaper liners, rubber pants
securely covered diaper pail to dispose of soiled/wet diapers
wet wipes or face cloths for cleansing child
tissues
Check your own diaper changing procedure against that recommended by the
Canadian Paediatric Society :
1. Remove the diaper. Fold it closed and put it out of the baby’s reach.
2. Clean the baby’s skin with warm water and dry well. Use soap only if
the baby has a bowel movement. Diaper cream is only necessary if the baby
has redness or a rash. If so, apply a thin layer of diaper cream with
a facial tissue and use another clean tissue if you need more cream.
3. Diaper the baby.
4. Wash the baby’s hands.
5. Move the baby to a safe place.
6. Shake formed stool into the toilet and flush - this applies to both cloth
and disposable diapers. Avoid rinsing the diaper in the toilet, because this
will spread germs to the toilet, floor and other places.
7. Dispose of the dirty diaper. Cloth diapers need to go into a diaper pail
with a snug-fitting lid. Disposables into a garbage can. Diaper
pails and garbage cans need to be kept out of children’s reach.
8. Spray the changing surface. Use a bleach solution, and let it stay
on the surface for 30 seconds while you put away the diaper supplies.
You will need to sanitize the change surface with bleach after every diaper
change.
9. Dry the surface with a clean paper towel.
10. Wash your hands.
Good dental hygiene is an important part of good health. Ensure children brush teeth after meals (younger children will require your help).
A SMOKE-FREE ENVIRONMENT
One of the most important ways that a child care provider
can promote good health in children is to ensure that they are not exposed to
smoking. Children are particularly susceptible to adverse effects from
second-hand smoke because their lungs are less developed and their rate of breathing
is faster than adults. Some important facts about children and second-hand
smoke are:
· Children who are around second-hand smoke have more illnesses, such
as asthma, bronchitis and pneumonia, ear infections, colds and throat infections.
· Infants who are around second-hand smoke are more likely to die of
SIDS (Sudden Infant Death Syndrome)
· Infants who are around second-hand smoke are more likely to refuse
feeding and spit up.
· Children who are around second-hand smoke are more likely to be irritable
and cranky.
· Day care parents prefer, and usually expect, a smoke-free environment
for their child.
· Children in a nonsmoking environment are more likely to be nonsmokers
themselves.
Because your home is also your place of business, you are justified in making
no smoking rules for family members or visitors, especially when the children
are present.
REGULAR EXERCISE AND FRESH AIR
Regular indoor and outdoor physical activities have a number
of benefits for children. They ensure healthy growth and development;
provide an appropriate outlet for children’s natural energy; help children eat
and sleep better; and encourage a lifelong interest in physical endeavours.
Be prepared for inclement weather by having some indoor activities organized
and ready to go. For example, purchase a child’s exercise CD or video and work
out with the kids. Enjoy some of the traditional children’s musical games
such as "Ring Around the Rosie," "The Farmer in the Dell," and "Head and
Shoulders."
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ACTIVITY |
Time outside provides a change of scenery for the children.
It’s also the place for all kinds of physical activities and use of
"outside voices." Children need a place where they can run, climb and
play in ways that are not safe or appropriate indoors. After their
exercise, the children will return inside, refreshed and relaxed.
Sun screen is a necessity all through the year, winter and summer, and
in all kinds of weather. A "broad spectrum" sun screen with a sun protection
factor (SPF) of at least 15 should be rubbed on to any exposed skin at least
half an hour before going outside. It should also be reapplied every
few hours. Ask the parents to send a container of sun screen for their
child, marked with their child’s name. Make this a part of your
regular "going outside" routine so that if you forget, one of your children
is bound to remind you!
It is also important that children wear a hat to protect them from the
sun.
Children must be dressed appropriately for the weather. A friendly
letter to remind parents to bring seasonal items will ensure that each child
is organized for any outing. It’s also a good idea to keep a bag of
clean "cast offs" such as socks and underwear, sweatshirts and pants, and
hats and mitts in case someone needs to make use of extras.
During warmer weather the children will need: extra socks and underwear;
shorts and a t-shirt; a sweater or sweatshirt, for outings to air-conditioned
museums, restaurants, etc., a bathing suit and towel; and of course, a hat.
Sunglasses will protect children’s eyes from the glare from the sun.
Other summer tips: avoid excessive sun exposure, especially between
10 a.m. and 3 p.m.; choose parks with shaded areas; and always provide
water to drink.
Children need boots and a raincoat or splash suit for those wet days.
Having suitable rain gear means that you can get outside for a walk, splash
in puddles and watch for rainbows.
During colder weather the children will need: warm slippers and a cozy
sweater for inside the house; extra mittens to replace wet ones or to double
up with other mitts on an especially cold day; and appropriate outdoor dress.
Children will stay warmer if they’re dressed in layers. Put heavy
socks over leotards or long underwear; a hat under a hood; and two pairs of
mittens, one to tuck inside the cuff and one to put over. An outgrown
pair of blanket sleepers with the feet cut off makes a cozy snowsuit liner.
On days when the snow is wet, put a nylon splash suit over the regular
snowsuit to prevent it from getting soaked through.
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ACTIVITY Prepare a list of seasonal ‘must haves’ to share with parents. |
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ACTIVITY How do you handle nap time in your child care home? Do you have any difficulties involving naps? Think about possible solutions. |
IMMUNIZATION & REGULAR CHECKUPS
Immunization is the best protection children have against
serious childhood diseases such as diphtheria, tetanus, hepatitis B, polio,
measles, mumps, rubella (German measles) and the potentially life-threatening
complications of these diseases. The Ministry of Health for each province
and territory has developed a recommended schedule of immunization. Information
on recommended immunization schedules are available from doctors, clinics and
public health offices. Ensure that all the children in your care are up-to-date
on their immunization schedule. If parents have chosen not to have their
child immunized, consult your public health office and your family doctor about
potential risks to others in the home before making a decision to provide care.
Regular check-ups are one of our most important tools
in maintaining good physical and dental health. Encourage parents to ensure
that children follow the recommended schedule for physical and dental examinations
- and make sure that your own family does the same!
A CARING PARTNERSHIP
Families appreciate knowing that you are interested in their
child’s well-being. Developing policies around health lets parents
know that you take their child’s well-being seriously. Think through your
own policies and practices regarding health and share them with parents at the
pre-placement interview. (It is very helpful to put your health policies
in writing for parents.) Ensure that you get the health information you
need by developing a medical history and emergency contact form for parents
to complete and have them update it at least annually. If you are working
with an agency or are a licensed caregiver, your system may provide any necessary
forms, but in any case you should consider all of the following:
1) Before any child enters your care, you should have basic health history
and emergency contact information. Such information should include:
Child’s full name, address, phone number and birth date.
Parent’s/Guardian’s home and work addresses and phone numbers.
Name and phone number of an emergency contact in case parents are
not available if an emergency arises.
Child’s health/medical insurance number.
Name of child’s doctor, address and phone number.
Information on past health such as illnesses, accidents, surgeries.
Information regarding known conditions (e.g. developmental, emotional,
physical).
Any known or suspected allergies (foods, drugs or other substances).
Child’s immunization record.
Information about medication that child requires regularly.
2) Decide what your policies/rules will be about children’s illness and
the administration of medication including:
- How ill is too ill to come to care? While some providers are willing
to provide care to children who are mildly ill, you should think through and
make sure parents understand how ill is too ill to come to care (for example,
diarrhea, vomiting, temperature over 38.5 degrees Celsius, contagious infection)
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What will you do and what do you expect of parents if a child becomes
ill while in your care?
Are you willing to administer prescription or non-prescription medication
to children?
If you are going to administer medication it is advisable to have parents complete
a form stating the name of the medication, the time and amount of dosage, whether
it should be administered before, after or with food, possible side effects
you should be watching for, how medication should be stored (refrigerated?),
the date you will start giving the medication and the date you will stop, and
the parent’s signature. In many jurisdictions, child care regulations also require
that medication must be in its’ original container.
Never administer medication of any kind (prescription or non-prescription) to a child without their parents’ knowledge and consent.
3) Be prepared to deal with a child’s illness:
Ask parents to keep you up-to-date about their child’s daily health status
and to inform you if the child has been in contact with any contagious illness.
Explain that you will be observing children as they arrive in the
morning to look for any specific signs of illness such as fever.
Prepare an area where you could provide care to a child who becomes ill
until parents can arrive. The area should be separate from the other children
but still allow you to keep an eye on everyone.
Learn the symptoms of common childhood illnesses and share this information
with parents.
4) Be prepared to deal with an injury or other emergency:
Ensure that you have a current certification for First Aid and CPR.
Such courses not only prepare you to deal with injuries and emergencies but
give you and the parents more confidence.
Post lists of emergency phone numbers and parent contacts by all the phones
in your home and in your vehicle or travel bag for field trips.
Have a well-equipped first aid kit on hand. At a minimum, your kit
should include:
First aid manual
Band-aids in assorted sizes and tensor bandages
Gauze pads, 1-inch rolled gauze and adhesive tape
Disinfectant soap
Thermometer
Cotton swabs
Scissors and tweezers
Calamine lotion
Syrup of Ipecac
Antiseptic cream
Teach older children how to cope in an emergency. Children may be
able to help by getting you the first aid kit, a pillow or blanket, or by calling
911 in an emergency situation.
for more information
Little Well Beings: A Handbook on Health in Family Day Care, available from the Canadian Paediatric Society Children’s Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario, K1H 8L1.
EVALUATION
OPTIONS FOR EVALUATION
1) ASSIGNMENT
2) QUIZ
ASSIGNMENT
Develop your own health policy. Your policy should include:
practices you will put in place to protect children’s health (e.g.
diet, exercise, fresh air, hygienic practices, etc.)
your policies and practices regarding the illness of a child (e.g.
what will you do if a child becomes ill while in your care; how ill is too ill
for a child to be brought to care)
your responsibilities regarding providing parents with information
(e.g. in the event of their child’s exposure to a contagious disease)
parents’ responsibilities regarding information they must provide you
with (e.g. child’s immunization record, exposure to a contagious disease)
your preparedness for emergency situations (e.g. current first aid
certification)
QUIZ
1. Children need a safe environment, good nutrition and warm nurturing care
for a healthy beginning. What are some of the other essentials in providing
for good
health? List at least four.
2. When should children wash their hands?
3. What supplies should you have on hand in the diaper changing area?
4. What are at least three hazards in exposing children to second-hand smoke?
5. How do children benefit from fresh air and exercise?
6. What are at least three of the precautions you should take during outdoor play in summer weather?
7. The children are having a difficult time settling down at nap time. What are some of the strategies you could use to help them?
8. List at least five things that you should ask parents regarding health before a child starts in your care.
9. Joanne, a five year old, came home from kindergarten looking pale and listless and did not eat any lunch. What action do you take?
10. How might older children help out in an emergency?
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