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.

Deciding when to exclude a child who is ill from early learning and education programs can be confusing for staff. Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide, clarifies the decision-making process. A child who is ill but does not require immediate medical attention should be excluded if the staff member determines the illness:
a. Prevents the child from participating comfortably in activities as determined by staff
b. Results in a need for care that is greater than the staff can provide without compromising the health and safety of other children
c. Poses a risk of spread of harmful diseases to others based on the list of specific excludable conditions
If any of the above criteria are met, the child should be excluded, regardless of the type of illness.

Immunization is a key component of early childhood development and health. Remember – early childhood and school readiness begin with good health! It is important for early childhood education staff to make immunization a priority. Foster an environment of health with:
• Immunization tracking
• Staff education and adult vaccination as needed
• Parent education
Early childhood education (ECE) programs are prone to disease outbreaks. Recent outbreaks of measles, flu and pertussis (whooping cough) have occurred in ECE settings. Unvaccinated children are at increased risk for disease and can spread disease to others. Babies are at high risk since they are too young to be fully vaccinated.

As you prepare for fall enrollment, now is a good time for early care and education programs to make sure all staff are up-to-date with recommended immunizations.  Getting vaccinated is an important part of staying healthy.  Routine immunization of adults is the best way to protect yourself against vaccine-preventable diseases.  Several of the vaccines routinely recommended for adults will prevent diseases that can be spread to children in the child care setting, including pertussis(whooping cough), varicella(chicken pox), measles, mumps, rubella and influenza.

Start your influenza vaccine efforts now too!  All children 6 months of age and older and staff should get influenza vaccine.   

Fall means cooler weather and is a good time to remind infant caregivers of safe sleep recommendations and the prohibition of use of blankets. The Centers for Disease Control and Prevention (CDC) offers the following guidance to promote safe sleep. Take these steps to help babies sleep safely and reduce the risk of sleep-related infant deaths, including sudden infant death syndrome (SIDS).

There are about 3,500 sleep-related deaths among US babies each year. CDC supports the 2016 recommendations issued by the American Academy of Pediatrics (AAP) to reduce the risk of all sleep-related infant deaths, including SIDS. See How to Keep Your Sleeping Baby Safe: AAP Policy Explained to learn more about these recommendations and other actions.

Parents and caregivers can help create a safe sleep area for babies by taking the following steps:
• Always place your baby on his back for all sleep times—naps and at night. Some parents may be concerned that a baby who sleeps on his back will choke if he spits up during sleep. However, baby’s anatomy and gag reflex will prevent him from choking while sleeping on his back. A baby who sleeps on his back is much less likely to die of SIDS than a baby who sleeps on his side or stomach. 

A recent study in Pediatrics, “Infant Deaths in Sitting Devices,” reviewed the safety of infant sitting devices. The study found over 300 sleep-related infant deaths from 2004-2014 happened in car seats, strollers, bouncers, swings, and other infant seats.

Follow the American Academy of Pediatrics policy about preventing sleep related deaths in group care settings. Standards 2.2.0.2, 3.1.4.1, and 3.1.4.2 of the updated, HTML version of Caring for Our Children, say what should be done. Many early childhood programs must change some common practices.

Infants need opportunities for physical activity many times a day just like toddlers and preschoolers. Tummy time is a great way to provide physical activity. This practice is an important way to help infants develop good neck and upper body strength and control. Infants need tummy time daily to reach these developmental milestones.

Outbreaks of influenza can be stopped by requiring that most child care workers and children who are over 6 months of age get flu vaccine. The CDC reported low influenza vaccination rates among child care workers in a national sample. The most common reasons for not getting the vaccine were mistaken ideas. The respondents didn't understand that they needed to get the vaccine, that the vaccine does prevent or reduce the severity of the flu, and that the vaccine is safe. Those who got the vaccine had the facts and felt some external pressure to receive the vaccine. Strong promotion of flu vaccine is associated with significantly decreased rates of emergency department visits for flu-like symptoms.

The influenza (flu) virus is common and unpredictable. It can cause serious complications – even in healthy children. The Centers for Disease Control and Prevention (CDC) reports 136 influenza-related pediatric deaths for 2018-2019. The 2018–2019 influenza season was the longest-lasting season reported in the United States in the past ten years. Certain people are more at risk for serious flu-related complications. These include:
• Children younger than 5 years of age, especially those younger than 2 years
• Preterm infants
• Children of any age with certain long-term health problems, for example, asthma or other lung disorders, heart disease, or a neurologic or neurodevelopmental disorder
• Pregnant women
• Older adults age 65 years and older: Immune systems decline as adults age.

The influenza vaccine is on the recommended Advisory Committee on Immunization Practices (ACIP) schedule and is mandatory for children 6 months of age and older in child care. Children enrolled in a before or after-school program at a licensed child care facility are required by the PA Department of Human Services / Office of Child Development and Early Learning (DHS/OCDEL) to follow the ACIP schedule. Child care programs must have documentation on file for each child that flu vaccine was given. DHS permits written exemptions from immunization for religious belief or strong personal objection equated to a religious belief or medical exemption. If flu or other vaccines cannot be given due to severe allergic reaction or other medical exemption, the child must have a written, signed and dated statement from the child’s physician, physician’s assistant or certified registered nurse practitioner on file at the child care program. If a child's appointment for flu vaccine is scheduled, have documentation in the child’s file at the child care program with the date.
The flu vaccine helps reduce serious illness and deaths that occur every year from influenza. For the 2019-20 flu season, the national American Academy of Pediatrics (AAP) advises that any licensed, recommended, age-appropriate vaccine available can be administered. Flu mist is an approved form of the vaccine for this season. Some children may need two doses of flu vaccine. Get flu vaccine as soon as it is available for the current season.

Children are more at risk than adults to the effects of lead because their brains are still growing. Lead exposure can cause problems with the brain. This may lead to learning difficulties and behavior problems. There is no safe level of lead exposure for children. Sources of lead can include old paint, contaminated dust and soil, and water in lead pipes. The most important step is to prevent lead exposure before it occurs.
Children are especially at risk of lead exposure if they:
• live in the inner city or in poverty
• live in a home built before 1978
• have poor nutrition

Early care and education programs can help prevent and reduce lead exposure in the following ways:

In August 2010, the American Academy of Pediatrics released a policy statement about the management of head lice infestations in typical K – 12 school settings. (Pediatrics 2010;126:392–403) The statement made some news headlines. It said no healthy child should be excluded or miss any time from school for lice.  Also, the policy said “no nit” policies in schools should be abandoned.   The AAP statement only applies to school age children in typical K-12 classrooms, not child care settings. However, the AAP book, Managing Infectious Diseases in Child Care and Schools, 4th edition (2017), echos this policy for child care too.

Liquid nicotine, used in electronic cigarettes can be deadly to children. Nicotine is an addictive chemical and a potent poison. The number of calls to poison control centers about liquid nicotine has risen significantly in recent years. During 2014, the poison helpline received more than 2300 calls about contact with liquid nicotine for children younger than 6 years. These children had ingested or had skin contact with liquid nicotine. Only half a teaspoon (2.5 ml) can cause severe stomachache, vomiting, seizures, fast heart rate, difficulty breathing, and even death.

HealthyChildren.org is a trustworthy website for parents. The American Academy of Pediatrics maintains the site. Recent articles were about measles. This article is in three formats. Choose the printed article in English or Spanish. You can have a narrator read the words. This option highlights the words in the article as the narrator says them. Combining visual and auditory presentation improves understanding.

Early care and education programs need a note from a licensed health care provider for over – the-counter (OTC) and prescribed medications. Prescription medicines should include clear instructions on the pharmacy label. OTC medications need a note from a health care provider in addition to the label on the medicine container. The note must specify the name of the child and medicine, when, how much and the route to give the medicine.

West Nile Virus (WNV) has been a problem in the U.S. for more than ten years. The virus spreads to humans who are bitten by mosquitos that have fed on infected birds. Several types of ticks are common in gardens and bushes. They carry infections from animals to humans when they feed while attached. Prevent these diseases by preventing mosquito and tick bites. Use insect repellent as recommended below and follow instructions on the product label.