This workshop enables the user to learn how to assess health and safety practices in programs for infants and toddlers in conjunction with use of the ITERS assessment tool. Discuss feeding, diapering, sleeping, fostering early brain development, managing illness and more. Use the assessment to make improvements in the program. 

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, third edition, say what should be done. Many early childhood programs must change some common practices.

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 in 2010. Only 22% received the strongly recommended annual vaccine. 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.

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:

Early education and before and after school child care providers may adapt this model letter to send to heatlh professionls to explain the need for the health professionals to complete required health forms. It one of the documents posted on the WellCareTrackerTM website. WellCareTrackerTM is a secure Internet software application developed and maintained by ECELS to evaluate and track health service reports to be sure that children are up-to-date with vaccines and screeniings. On the WellCareTrackerTM website, select the letter from the left pane under "Sample Letters." 

Low income children enrolled more than 30 years ago in a high quality early care and education program grew up to be healthier and better-achieving as adults.

Many children who are enrolled in early education and child care programs have chronic health problems or special health needs.  In the United States, 14% of all children have such conditions. The American Academy of Pediatrics (AAP) published Managing Chronic Health Needs in Child Care and Schools  to help teachers and caregivers understand these conditions and work with health care professionals to be sure children who have them stay well. The book explains how to develop specific Care Plans for educational settings. One section offers information about types of health professionals who might be involved in a child's care. Half the book is devoted to condition-specific Quick Reference Sheets and sample forms.   To order this book, go to the AAP bookstore at www.aap.org. Reviewed and reaffirmed 11/2012.

ECELS Pediatric Advisor, Beth DelConte, MD, FAAP presented an audio conference on Wednesday, October 26, 2011 from 9 to 10:30 am for Pennsylvania Child Care Health Consultants, Child Care Health Advocates, STARS TA Consultants, STARS Specialists/Managers, ERS Assessors, Certification Representatives, and Specialty Discipline Instructors. Giving medication in early education and child care is common and poses significant risks. Frequently, program staff are unaware of and fail to perform correct procedures to minimize the risks when giving medication. Act 48 and PA Keys to Professional Development credit is availble from ECELS for listening to the audio conference and then completing and submitting the Evaluation Form.  Open the attachments for the Healthy Futures Module handouts (allow for brief loading time), Supplemental Handouts and the Evaluation Form. For questions, contact ECELS at This email address is being protected from spambots. You need JavaScript enabled to view it.">This email address is being protected from spambots. You need JavaScript enabled to view it. or call 484-446-3003. 10/2011

This workshop draws on the curriculum published  by the American Academy of Pediatrics in 2010 to teach how to manage the risks involved in giving medication in group care settings using the 5 Rights: the right child receives the right medication in the right dose, by the right method at the right time.  Participants practice skills and discuss scenarios to identify gaps in practice.  Key elements that should be in documentation of medication, policies and procedures are reviewed. Demonstrations and discussions include tips for giving a variety of different types of medication: liquids and pills, eye, ear, nose, topical medications such as diaper cream and sunscreen, inhalers and emergency medicines.

Many children's medicines come in liquid form. Household spoons may be handy for giving children liquid medicines, but using them is not a good way to give the correct dose. Parents and educators should use a syringe, special medicine cup, special dosing spoon or dropper. These devices are marked in milliliters (mL).

Different household teaspoons hold different amounts of liquids. Tablespoons vary in size too. A spoon that gives too little medicine may keep the medicine from working. If a spoon gives too much medicine, the overdose may cause a serious problem. For example, repeatedly giving a child too much acetaminophen (Tylenol)can lead to liver failure. More than 70,000 children go to emergency rooms each year for accidental medicine overdoses. Use of the wrong measuring device causes some of these. Many liquid medicines come with a special dose measuring device calibrated to accurately measure the particular medication. Be sure to use it. If there is no device with the medication, a pharmacist can provide one. If a syringe is used, squirt the medication slowly and gently between the child's tongue and the side of the mouth. This makes it easier for the child to swallow the medicine.

The American Academy of Pediatrics urges parents, physicians and pharmacists to use only metric measurements for oral liquid medications. Metric measurements for liquids in milliliters (ml) or cubic centimeters (cc) should be on prescriptions, medication labels, and dosing devices. This helps children get the correct dose of medication. Do not measure liquid medication in teaspoons or tablespoons.

Please share this information with teachers/caregivers and families. Download and display the new poster in English and in Spanish. Copy and distribute the updated article - also available in both English and Spanish. To access the article in in Spanish, click on "en Espanol" on the page. On the same page, you can listen to the article read to you in English or Spanish.

Families and early childhood educators need to understand how much medicine to give. They should know how often and how long to give it. If they are uncertain about the instructions, they should not give the medication until they have asked the child's health care provider about how to do it. Use the forms in the Medication Administration Packet, Appendix X in Model Child Care Health Policies, 5th edition. This publication is available at www.ecels-healthychildcarepa.org.

Health professionals recommend keeping medicine out of children's reach. Use child safety caps, understanding that these are not "child-proof". They make it harder for the child to open the medicine, giving adults more time to stop the child from getting the medicine. Check labels carefully before giving two medicines together because they may have the same ingredient. Do not mix medicine with food unless the instructions on the medicine say to do so. Also, urge families to bring a list of all medicines the child is taking each time the child sees a health professional.

For medicine mistakes, call the Poison Help number at 800-222-1222. If the child is unconscious, not breathing or having seizures, call 911 first. Be careful when getting rid of unused medicines. In some places, you can drop off medicines at a police department. Make sure to remove labels with personal details. Another way to safely dispose of medicines is to mix them with coffee grounds or kitty litter in a plastic bag you can seal. Throw this sealed bag away in a trash container where children and animals can't get to it. Don't dump the medicine in the toilet or drain, unless the medicine label says it is safe to do it. If you aren't sure how to dispose of a medicine, ask a pharmacist about what to do.

Contributed by Nancy Alleman, ECELS Lead Training and Technical Assistance Coordinator, in collaboration with Ian M. Paul, M.D., M.Sc., FAAP, a member of the American Academy of Pediatrics Committee on Drugs.