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.

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.

As we keep moving forward through the COVID-19 crisis, the mental health and wellbeing of children and their caregivers is an area that has increased in attention and need. It’s important to note that:

  • Nearly 1 in 5 American adults will have a diagnosable mental health condition in any given year;
  • 46 percent of Americans will meet the criteria for a diagnosable mental health condition sometime
    in their life, and half of those people will develop conditions by the age of 14.
    Source: Mental Health America (MHA) https://mhanational.org/

Below is a list of mental health resources that early care and education providers can use as they continue to serve children and families through the COVID-19 pandemic and beyond:

Updated 10/11/22

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.

Mosquitoes may carry serious diseases. West Nile Virus is present in Pennsylvania. Mosquitoes are spreading Zika virus in the US. Health departments in Pennsylvania are working to eliminate standing water where mosquitoes breed. Chemicals that kill mosquitoes are being used to treat some areas. Spraying may be done from the ground or from the air in larger areas. If your facility or child care home is located near a spray area, remain indoors while spraying is being done. Close windows, and turn off ventilation systems that draw-in outside air during and 30 minutes after spraying ends.

Nebulizers, Asthma and COVID-19

Do you have children in your care with asthma? Parents/caregivers of children with asthma who use nebulizers should contact their child’s health care provider about using a metered dose inhaler (MDI) instead of a nebulizer. Use of inhalers with spacers instead of nebulizers involves decreased close exposure time during the medication administration. According to The Centers for Disease Control’s (CDC), people with asthma should use inhalers with spacers (with or without a face mask, according to each student’s personal treatment plan) instead of nebulizer treatments whenever possible during the COVID-19 pandemic. Children’s medical records/care plans should be reviewed to see who may require nebulizer treatments. Care plans should be updated as per the health care provider’s recommendations. K-12 Schools and Child Care Programs FAQs for Administrators, Teachers, and Parents offers important guidance to consider and precautions to take.

Increased cleaning and disinfecting is necessary because of the pandemic. Disinfecting products maybe a trigger for some children so care should be taken to prevent exposure to them:

If you have asthma:
    •  Ask an adult without asthma to clean and disinfect surfaces and objects for you.
    •  Stay in another room when cleaners or disinfectants are being used and right after their use.
    •  Use only cleaning products you must use. Some surfaces and objects that are seldom touched may need to be cleaned only with soap and water.
    •  Make a list of the urgent care or health facilities near you that provide nebulizer/asthma treatments. Keep it close to your phone.
    •  If you have an asthma attack, move away from the trigger such as the disinfectant or the area that was disinfected. Follow your Asthma Action PlanCall 911 for medical emergencies. 7/8/21

 The National Resource Center for Health and Safety in Child Care has separately published the nutrition, physcial activity and screen time standards from Caring for Our Children. View these obesity prevention standards on the website of the National Resource Center for Health and Safety in Child Care.

Early education and child care professionals should include preventive practices in the curriculum. In addition, early educators have many opportunities to notice possible areas of decay on children’s teeth. Coupling prevention and early recognition of possible trouble with referral to an oral health professional can save significant suffering. Early decay looks like dull white bands on the smooth surface of the tooth at the gum line. It is caused by bacterial activity in the mouth. It is a form of infectious disease. Early decay may be reversible with fluoride treatment and removal of plaque that builds up on the teeth. If this early decay is not treated, it becomes yellow, brown or black spots. These spots are places where decay destroyed the tooth enamel. If you see chalky white spots or discoloration on a child's teeth, urge the child's family to take the child to a dentist as soon as possible.