Health Capsules

ECELS offers brief articles to insert into parent and staff newsletters, post on bulletin boards or otherwise share information on health and safety topics. Whenever ECELS publishes a new Health Capsule, ECELS sends an E-Mail Alert from ECELS to everyone who signed up on the ECELS home page for these alerts. You may reproduce these brief articles as long as the wording of sentences is not changed, and ECELS is indicated as the source.

Children need active play opportunities to be healthy and able to learn. It doesn’t just happen. A quality curriculum provides opportunities for active play. ECELS suggests combining physical activity with other learning objectives. For example, children use math when they count the times they skip, jump, or toss a ball.

Plan more time outdoors. Children do more moderate to vigorous physical activity outdoors than indoors.  Caring for Our Children Standard for physical activity says that all children, birth to six years should participate daily in 2-3 occasions of active play outdoors. Toddlers and preschoolers should have two or more structured or teacher-led activities or games that promote movement over the course of an 8 hour day, indoors or outdoors. Use these guidelines to plan physical activity for each age group:

  • Infants: tummy time divided into periods the infant will tolerate. At other times, infants should have opportunities to roll, kick, reach for toys, and practice motions needed to crawl, stand, sit and walk.
  • Toddlers: 60 to 90 minutes of moderate to vigorous play per 8 hour day. Examples:  access to riding toys, balls, tunnels and low climbers.
  • Preschoolers: 90 to 120 minutes of moderate to vigorous physical activity per 8 hour day. Examples: free space to jump, dance, and dig, riding toys, balls to throw and chase, rocking boats, stairs and hills to climb, hopscotch, ribbons and hoops to twirl, and sweeping.
  • School Age Children: Keep everyone moving and having fun most of the time. Examples: skip, jog, climb structures/stairs/hills, ride scooters, throw/catch, run, jump rope, play hopscotch, go through an obstacle course, dig, or rake.

For more about active play, use the ECELS Self-Learning Module or recorded webinars about this topic at  Reviewed and reaffirmed 7/2018

Properly functioning Heating Ventilation and Air Conditioning (HVAC) systems reduce health problems. They dilute infectious particles in the air, so people in the facility don’t get sick easily. Good ventilation controls odors and reduce pollutants. They also remove dust and dirt, keeping the facility cleaner.

Anaphylaxis is a sudden and dangerous body reaction that involves two or more organ systems. An allergy to some substance such as a certain food, insect bite, latex or medication causes the reaction. This may be something that has or has not caused any symptoms in the past. Anaphylaxis is a life-threatening medical emergency. Waiting to get to an emergency room can be fatal.

Easter Seals is offering a free online version of the Ages and Stages Questionnaire (ASQ) developmental screening tool. Both parents and child care providers can use the ASQ to track children's development through age five. The tool can identify concerns for which children should receive appropriate services to be ready to enter K-12 school. The ASQ online does not include the component that evaluates behavior. However, it is widely accepted for basic screening. Many Keystone STARS programs are using a version of the ASQ now.

Asthma is among the most common chronic health conditions of childhood. Untreated asthma can make it difficult to play, learn, and grow. Warning signs include coughing, shortness of breath, wheezing, and tightness in the chest. An asthma trigger is anything that causes an asthma episode. Common triggers include allergies, illness, exercise, chemicals, and smoke. Consistent care of children with asthma at home and in the child care setting is critical to their wellbeing.

Many early education and child care professionals have heard reports about bed bug infestations in children's homes. Many fear the bugs will infest the program's facility. Learn about bed bugs and the Integrated Pest Management (IPM) approach to control of this bug.  Lyn Garling, Manager of Programs, PA IPM Program, Penn State University contributed the following expert content and links to credentialed websites where you can learn more. Handouts are available in English and Spanish.

Good health includes social, emotional, and behavioral wellness. Use approaches to support positive behavior in young children. This will encourage wellness for all children in your care. Teach children appropriate ways to manage their own behavior. The goal is to teach and guide children, not to punish. Strategies include using clear rules and supportive language. Offering alternatives to undesirable behavior and natural consequences are excellent options.
Common challenging behaviors in child care can include biting, defiance, and tantrums. Some behaviors persist and raise concerns. The child may not respond to appropriate positive interventions. Persistent difficult behaviors may include excess anger, aggression, and social withdrawal. What steps should be taken?

Many electronic toys, musical/talking books, mini remote controls, singing greeting cards and other electronics are in homes and early learning and child care programs.  Inside the battery compartment of these items are button-size, lithium batteries that can cause serious injuries when swallowed.  These batteries can get stuck in a child’s throat.  Saliva triggers an electrical current that causes a chemical reaction that can severely burn the esophagus (food tube) in as little as two hours.  Children under the age of 4 years old are at highest risk for the injury.  In 2010 alone, more than 3,400 button battery swallowing cases were reported in the U.S., resulting in 19 serious injuries and in some cases, deaths. To learn more, view the 2 minute video from The Battery Controlled, a campaign supported by Energizer® and Safe Kids Worldwide:  

Motor vehicle crashes remain the leading cause of death for children 4 years and older. The AAP updated the Child Passenger Safety policy statement and technical report based on new evidence gathered over the past 10 years. The documents will be published in the November issue of Pediatrics. The updated guidance advises children to ride rear-facing as long as possible. Two years of age is no longer a specific age criterion when a child changes from a rear- to a forward-facing car safety seat. View the AAP New article at

Angela Osterhuber, Ed.M., Director, PA Chapter, American Academy of Pediatrics, PA Traffic Injury Prevention Project (TIPP) offers this advice:
• Secure infants and toddlers in a rear-facing car seat until they reach the highest weight or height allowed by the manufacturer of the car seat. In Pennsylvania, children younger than two years must be secured in a rear-facing car seat.
• Never place a rear-facing car seat in the front seat that has an active passenger-side front air bag. If the airbag inflates, it will hit the back of the car seat, right where the baby's head rests, and could cause serious injury or death. 

ECELS-Healthy Child Care PA has prepared a Care Plan form to gather key information to provide care for children with special health needs.The majority of early care and education programs enroll children with special health needs. The most common chronic medical conditions among children are allergy and asthma. Teachers/caregivers need to know the specific details about each enrolled child with a medical or other special condition. These forms explain the process and documentation needed to enroll a child with special needs.

The Process to Support Enrollment of a Child with a Special Need form is an algorithm or map that describes the steps to follow to obtain and use a care plan. The Care Plan is a form to gather key information to provide care for children with special health needs. The form collects the essential information. It includes how to care for a child's daily needs and to handle an emergency. Early learning practitioners should arrange for parents and health professionals to complete the form when the child is first considered for enrollment and anytime a new medical condition develops. Download all four forms in the links below. Reviewed and updated 5-2019

Choking is a common cause of Emergency Room visits for young children. Nearly two thirds of choking episodes are associated with foods. Choking on food causes the death of approximately one child in the United States every 5 days. Hot dogs account for 17% of choking episodes related to food. Hard candy, peanuts, whole grapes, raw carrots, apples, popcorn, chunks of peanut butter marshmallows, chewing gum and sausages cause choking too. Of non-food causes of choking, latex balloons are leading trouble-makers. In addition to balloons, small, round or cylindrical toys can block small air tubes.

Follow these steps to make sanitizing and disinfecting easy.

First – any surface must be visibly clean. Use a detergent and water solution. Then rinse with water.
Second – which product to choose?
• Use Environmental Protection Agency (EPA) – registered products for sanitizing and disinfecting.
• Most bleach products now sold in retail stores are EPA-registered. There is no longer a standard bleach:water ratio or standard length of time a solution must remain in contact with a surface, such as those outlined in the PA Position Statements (July, 2018).

The EPA has a Safer Choice label program available at This label will help consumers find safer cleaning products. Manufacturers can use the new label only if the EPA Scientists determine that every ingredient in the product is safe for humans and pets, meets environmental standards, and cleans well. Look for the label when purchasing products for your early care and education program.  Also, you can search online for products that meet the Safer Choice Standard at Reviewed and reaffirmed 4/2019.

Simple steps can prevent harm when caring for active and curious young children. Exposure of children to toxic products, such as cleaning supplies, is easily preventable. Unfortunately, cleaning products remain a common source of poisoning for young children. Cleaning products are a necessary tool to maintain a clean and healthy child care environment. Improper handling and storage of cleaning supplies is a dangerous and unnecessary regulatory violation.

Colds, coughs and runny noses are more common in the winter than in any other season. Poor circulation of air, dry heated air and crowded indoor spaces make it easier to share germs. Children in their first couple of years of child care or school have one or two more colds than children their age who receive care only at home and who have no siblings to bring infection home. After three years of child care, children in child care have fewer colds than those who have not had the opportunity to build their immunity in group care.