Nut Allergy

[Guest]

I have been advertising a childminding vacancy for a while. I got a call today from a mum with alittle boy similar age to my daughter, all sounds fine. He has quite a severe nut allergy - he got taken to hospital becuase she kissed him after eating a nut chocolate.

 

I would like to work with this family but I would like to find out more about people who have experienced dealing with an allergy of this level before. We don't eat a huge amount of nuts (although we love our marzipan) but I would be loathe to become a nut-free setting because of having to censor everything that comes in, including if a friend alls round for cofee and I have to vet her biscuits when the boy isn't even there.

 

Also, suppose I then took on another child who was vegan and needed nuts as part of their diet?

 

I would love to hear thoughts on this - I want to do wat I can to support the family but not sure if just not eating nuts when he is there is enough.

[eyfs1966]

I am not a childminder, but work in PVI but just wanted to give you something to think about here. When we had a child with a severe nut allergy it was necessary to inform our insurance company. There was no additional premium charge but we had to provide information from the child's doctor and we had to get a letter to show that all staff were trained by a doctor in epi pen use.

 

I hope that a CM wil reply shortly about how to keep a home nut free. As a PVI we are nut free anyway, but as a nut lover (and vegetarian) I would not find this easy to do in my own home!!

[calicojo]

We have child with a nut allergy in pre school but I guess he is not so severe as your prospective child. We have all been trained in epipen use and have instructions from doctor etc for the insurance cover. We ask all parents to keep lunch boxes free of nuts (and will remove anything if they forget) and obviously monitor the snacks we give him but we don't go as far as banning all biscuits which may have been made in a factory which may have used nuts somewhere! He is also allergic to raw eggs so we just have to keep him away from the cooking table when we're making cakes.

 

We are in a village hall so others users may well have nutty biscuits in their storage. Can't really do any more though....

 

We have had a child in the past who was severely allergic - but her mum stayed with her full time just in case (she was only with us for a term while waiting to move house) but obviously not an option for you!!

[Guest]

This is really tricky in your own home and a big decision to take it on!

 

I minded a little boy whose Mum had severe nut allergy and carried an epipen. I have experience of dealing with allergies and avoiding allergens because of my own daughter but nuts are really difficult Twice Mum had minor reactions when she kissed him at pick-up time and something he'd been in contact with set her off.

 

Potential danger spots in my day were breakfast cereals, cereal bars that the others ate on the way here (what if they then touch a toy that he plays with?) taking him to Toddlers etc and not having complete control of what everyone else ate.... PLUS considering what would happen if he had a reaction? Emergency treatment, emergency cover, the distress to the other children in my care????? It's difficult in any setting but when you're working alone it's a nightmare!!

 

I have to confess to being relieved when they left (for other reasons)

 

Nona

[Guest]

Thanks all - plenty to think about here.

 

C

[suebear]

I nannied a child with a severe milk allergy (epi pen etc) yet the family didn't want the house to be milk free and the child's sister would drink milk at the same table where he sat. This was interesting as it taught the child and sibling from a very early age to look at what they were drinking, touching and how to handle spillages etc. Mum's logic was the world wasn't milk free and she wanted the child to understand how to be careful etc so she knew he'd be just as safe in the real world.

[Lyanne]

I'm in a PVI and we had a child with a nut allergy - it was quite severe and he had other health issues too and we actually had it written into his care plan (with mum's agreement) that if for some reason neither of the 2 staff who'd had epipen training for him were not in, mum had the choice to either keep him at home or stay with him , and in either case she would not be charged for that session. Not really an option for a childminder, but I think your lack of availability would be more of a concern anyway! Must say, we never had to do that, and when he was fundable he went off to the school nursery, so we didn't have to thinka bout what we would have done if one of us had been absent for a funded session.

 

Getting epipen training was a big problem - he could have started a term earlier if we'd have more support getting it. Ended up with 2 of us going off to St Johns Ambulance in the summer holidays for training.

[Guest jane707]

I am a childminder and have cared for children with severe nut allergy.

 

To ensure the child's needs were met I was advised by the medical professional who gave me Epipen training to become a nut free provision - all nuts have been banned and labels are carefully read.

 

If a child brings a nut snack or nuts into the house, they stay safely out of the way until parents collect him and then the dangers are explained.

 

A consultant explained to me why chocolates often say 'may contain nuts'. You might find it interesting if you do not know. In factories the chocolate comes down the chocolate line and ingredients get added. If there is any chocolate left when the ingredients have run out, it is moved onto the next line. It may contain nuts from its run through the first lot of ingredients.

 

You will also need to discuss confidentiality with the parents because there will be circumstances such as on outings or visiting friends when you might need to tell someone that the child has an allergy.

 

Write a risk assessment for storing the Epipen and any other medication - while it must be safe and away from children's reach, it must also be immediately accessible.

 

Consider how to keep medication safe on outings and write a risk assessment for that.

 

Epipens don't last long before they expire so have a system of writing it in your diary, asking parents for replacements well in advance, taking the old pens to the chemist for safe disposal etc.

 

You should also consider writing a care plan for the child with details of what you will do if the child has a reaction, who you will call first, what medication to give etc.

 

I hope this helps

Edited October 24, 2010 by jane707

[Guest]

I think the problem of taking on another child who's vegan and needed nuts is definitely a case of overthinking the situation! In the unlikely event that this happened you would simply have to explain to the parents of said child and let them make the choice of whether they thought their child would be getting enough protein whilst at your house. It's such an unlikley scenario though that I wouldn't add it to a list of 'worries' with regards to the situation.

 

I think you need more information from the parents in order to make a decision though. What is their stance on things which "may contain nuts" or "is produced in a factory which handles nuts"? Do they allow the child to eat these? All the children I've come into contact with who have nut allergies (including those who have reactions when people touch them after handling nuts) the parents tend to allow them to eat at least some of these things as otherwise so many foods are off the menu that actually don't cause any reaction at all (they usually have some sort of list of those that do so they can be avoided). If they do then obviously you can follow the same guidelines which would probably help. It might also be worth talking to them about how nut free their own house is and how nut free they would expect yours to be.

 

Others have already pointed out other potential things for consideration like other children in the setting eating cereals before arrival so I won't repeat them, but it's possible that it might require fewer adjustments than you think.