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What Would You Do?


Hello Kitty
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Sorry if this is in the wrong section.

 

Basically we have a child who has often been 'ill' to the extent that we wondered if mum was bordering on Münchhausen's by proxy (I know it's changed name now but I couldn't remember what to!) as she never seemed to show signs of illness at the setting.

 

Before half term she told us that the child may be lactose intolerant and that she wasn't allowed any dairy for 2 months so could we make sure she didn't have any at snack. That day in her lunch box she had a frube, a chocolate bar and a cake bar as well as her sandwich. Her key worker went to speak to her after the session and asked her to clarify the situation and mum said it was because she didn't have any other food in the house.

 

She has continued to send her with dairy items but also sends in soya milk for her to have at snack. As an example this was her lunch today: A ham sandwich with what could have been soya margarine, two iced biscuits, a kit kat, a chocolate cake, a baby bel cheese and a frube.

 

Sorry for TMI but her poo is paler than usual and looks like clay. I asked her key worker to just tell mum in such a way that we assumed she needed to know rather than accusing her of anything so that it could open the lines of communication... mum said she hadn't been told to keep a check on anything like that and actually didn't know what she was meant to be doing at all. I wish I'd gone out myself as at this point I would have asked what she had been advised re: diet and then try subtly to see if she actually realised these items contain dairy.

 

On the one hand you'd think it was obvious that baby bel CHEESE and frubes were dairy but who knows? She may genuinely think they're OK...

On the other hand we are worried in case she is actually doing it to make her ill BUT would she be doing it so blatantly???

 

What would you do? I'm planning to speak to her as i said above but what on earth do I do if she says she knows they contain dairy? She is still sending in the soya milk and expecting us not to let her have milk or cheese at snack so it's not like she's decided that she's not going to keep her off it.

 

We have been logging it as CP but are really stuck on what to do as we've never had anything like this before :o

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Tricky, never had anything like this before ourselves. Wonder if mum thinks that it only applies to blantant things like milk and cheddar, and has had no advice or diet sheet to refer to from GP, I think I would ask her to get that type of clarification from her GP, so that you both work for the good of the child, its obvious that we understand no dairy means no dairy and what constitutes dairy, but as you say, giving the benefit of the doubt, does she?

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Tricky, never had anything like this before ourselves. Wonder if mum thinks that it only applies to blantant things like milk and cheddar, and has had no advice or diet sheet to refer to from GP, I think I would ask her to get that type of clarification from her GP, so that you both work for the good of the child, its obvious that we understand no dairy means no dairy and what constitutes dairy, but as you say, giving the benefit of the doubt, does she?

Hi I'm new to the forum so I'm not sure where to put answers - I'll have a try! If mum is saying she has had no advice/diet sheet I would recommend she speaks to her health visitor/school health advisor or her GP. In our LEA we can refer directly to the paediatrician with parental permission but I don't know how common this is. Also, mum could get advice from Surestart staff on how to eliminate items from the child's diet. I would go about it as 'we can learn about this together' rather than mum feeling she is being blamed/accused. I have also in the past got leaflets/information from a health visitor/Surestart and passed it onto parents - not for lactose intollerence though. Hope this helps.

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Honestly, you're rightly worried & I think a call to children's services is indicated. Not necessarily a 'get the police in now this child is not safe' call, but an 'I'm not happy & I want it logged that this family need support' call.

 

If mum is happy, I'd phone the health visiting team & see what support they can offer, find out if you can be copied in on letters from dietician etc.

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I have recently been frustrated by parents not sharing important information, and telling one childminder one thing and me another, so I instigated a home-diary. Showed up several inconsistencies and the parents are much more sharing (and also confident). It was also a good tool to show the doctors. However, this sounds like it could be something serious - I note that you have been careful not to make any suggestions about what you think may be the problem, but it sounds like you think the stool colour is an issue here.

 

When I was a neurotic mother of teeny children who continued to lose on their weight targets, the doctors were VERY accommodating regarding blood tests (even though I really only asked for counsel).

 

I really advise a food and stool diary to be shared between all settings and for parents to write in too.

 

Very best of luck.

 

Honey

 

And well done nursery teacher on first post (sure the Moderators will be on here to to welcome you properly

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And well done nursery teacher on first post (sure the Moderators will be on here to to welcome you properly

No need, when you've done it so well! :o

 

Great advice already about how to support the parent to recognise what consitute 'dairy' - this is always a source of confusion!

 

There was a very similar thread a while ago, with a parent who was inconsistent about her claims of her child's medical needs. It might be worth having a search for that thread, Hello Kitty.

 

I think it will be a good idea to have a meeting with the parent (as I think Cait reported she did in that thread) to talk about the child's needs and how the setting could meet them effectively, and as part of this you could ask the parent share key information in order to agree an action plan, which is written together and signed by both parties.

 

Keeping detailed notes of all conversations you have with mum, as well as detailing when inappropriate foods are provided for lunch/snack is going to be crucial in building up a picture of what is happening for this child and family. I'd also be inclined to ring my early years team for advice to clarify what they think your duty of care towards the child are in the light of the information you have been supplied and the fact that the parent is providing food they acknowledge is likely to make the child sick.

 

Good luck!

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is Mum confused by the term'lactose'? (rather than dairy....which can be misleading !) lactose is in all sorts of things and is added to things like packets of ham and stock cubes it doesn't just exist in cheese and milk. I would think health visitor support is the way to go (do you have one that you could liase with!)...my feeling is that this is more to do with lack of info than lack of ability but of course i don't know the family :o could you ring the dietician at yur local hospital and get them to send you some info (there is usually a childs dietician who can be contacted)...also i am assuming that literacy is not a problem and Mum is able to understand the written word, you may also need to check this and find an excuse to talk through the info.

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A lot of the lactose is removed during the process of making cheese and yoghurt so she may have been told to avoid milk but still allow cheese. I was allowed to give my daughter cheese when she was suspected of being lactose intolerant as a toddler.

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Thank you for all your replies. We do have other concerns so I think it will be a phone call :o

I didn't know about the processing thing Upsy Daisy so thanks for that but mum did specifically say to us no cheese and said 'How am I meant to stop her having it when her brother's having it?'

We said that she should either tell the child that it will make her poorly so that she understands why or possible even not give it to the brother while she's there - he could have it in his lunch box at school.

We will speak to mum tonight and assess what she is aware of and go from there. I really don't like this part of the job xD

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Hi

 

As an experienced lactose intolerant person I thought I would offer my advice.

 

Lactose is in alsorts of crazy things, so can be quite hard to cut out without checking everything. When I was diagnosed, I got leaflets from my dietician which were quite helpful, but you are kind of left to it a bit!

 

Also, might be worth recommending 'Lactofree' to Mum - it is real cheese, yoghurt and milk with just the lactose removed so she can still eat the same things as her brother! They also have a website which might help - google Lactofree

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Hi

 

As an experienced lactose intolerant person I thought I would offer my advice.

 

Lactose is in alsorts of crazy things, so can be quite hard to cut out without checking everything. When I was diagnosed, I got leaflets from my dietician which were quite helpful, but you are kind of left to it a bit!

 

Also, might be worth recommending 'Lactofree' to Mum - it is real cheese, yoghurt and milk with just the lactose removed so she can still eat the same things as her brother! They also have a website which might help - google Lactofree

 

 

Thanks for that.

Originally she told us that she had to cut all dairy out of her diet for 2 months then they were going to reintroduce items...

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