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.

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.

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:

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.

This new quick reference guide provides child care directors, teachers, and caregivers with essential information on managing emotional and behavioral issues in group care settings.

Topics cover social-emotional development, biting, napping difficulties, post-traumatic stress disorder, gender development, self-stimulation behaviors, and more. In addition to behavioral issues commonly seen in small children, epigenetics, medications, toxic stress, adverse childhood experiences, and how to help children who have undergone traumatic experiences are touched on by the editors.

The book contains 25 quick reference sheets on topics such as ADHD, ASD, depression, tantrums, and separation anxiety. In addition, sample daily report forms, medication forms, and other informative documents to support working with young children are also included in this comprehensive guide.

Case studies are also presented on various difficult situations with small children in a classroom setting and discuss how these situations might be handled.

To order this book, go to the AAP bookstore at www.aap.org. Updated 3/2022

Managing Chronic Health Needs in Child Care and Schools: A Quick Reference Guide, 2nd Edition helps teachers and caregivers address the challenges of caring for children with chronic health conditions and special health care needs in child care and school settings. The health issues covered include chronic illnesses, acute situations, and selected developmental and behavioral problems, with a special emphasis on children with special health care needs. More than 50 quick reference sheets on specific conditions provide teachers and caregivers with guidance on how to help at a glance. New quick reference sheets include Childhood Obesity, Eczema, Fetal Alcohol Spectrum Disorder, Food Allergies, GERD, and more.  To order this book, go to the AAP bookstore at www.aap.org. Updated 3/2022

This workshop draws on the curriculum published  by the American Academy of Pediatrics 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.

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:

• PA Key Infant Early Childhood Mental Health Program (IECMH): https://www.pakeys.org/iecmh/
  The IECMH Program can help children, families and early child education providers through a reflective,
  collaborative, problem-solving and capacity-building relationship that builds stronger relationships and
  helps infants and young children feel safe, supported, and valued. Free support includes:
  • The Pennsylvania Key IECMHC Virtual Office Hours https://s35729.pcdn.co/wpcontent/uploads/2021/07/Pennsylvania-Key-IECMHC-Virtual-Office-Hours-7.21.pdf
  • IECMH Consultation https://s35729.pcdn.co/wpcontent/uploads/2021/03/IECMHbrochure_Feb2021.pdf
  • IECMH Resources: Newsletter, Reports, Early Childhood Mental Health Matters Handouts https://www.pakeys.org/iecmh/resources/
• Head Start Early Childhood Learning & Knowledge Center: https://eclkc.ohs.acf.hhs.gov/mental-health
• Head Start Campaign: https://eclkc.ohs.acf.hhs.gov/mental-health/article/head-start-heals-campaign
  • Supports increased awareness about how programs can provide protective factors, such as strong, trusting relationships and safe, stable environments that promote healing for children, families, and staff.
  • Resources created from FAQs submitted during the Head Start Heals Campaign and related office hours can be found here: https://eclkc.ohs.acf.hhs.gov/mental-health/article/headstart-heals-frequently-asked-questions. Topics include:
    • Child Abuse and Neglect
    • Engaging Families
    • Self-Care and Stress Management
    • Supporting and Understanding Trauma During COVID-19
    • Supporting Grief and Loss
    • Talking to Children about COVID-19
    • Transitioning Back to School after Quarantine
• Mental Health Resources to Support Response and Recovery During COVID-19 - https://eclkc.ohs.acf.hhs.gov/mental-health/article/mental-health-resources-support-responserecovery-during-covid-19
  • Provides resources that child care programs can use with families and staff affected by a crisis or tragic event and may be helpful as programs respond to COVID-19. Find materials on mental health and wellness, short- and long-term recovery, and caring for yourself during recovery.
• Mental Health America (MHA) offers a screening resource that can help determine if a caregiver may be having emotional, attentional, or behavioral difficulties: https://screening.mhanational.org/screening-tools/
• SAMHSA offers free, downloadable publications and tip sheets, as well as mobile apps for youth, teens, and young adults on topics such as substance misuse, common mental health conditions, and coping with disasters and other traumatic events. https://www.samhsa.gov/prevention-week/substance-use-prevention-resources-youth-college-students

Updated 10/11/22

The PA Chapter of the American Academy of Pediatrics and the American Academy of Pediatrics published the 5th edition of Model Child Care Health Policies in October 2013. Significantly revised and updated, the new edition is a practical tool for adoption and implementation of best practices for health and safety in group care settings for young children. This edition replaces the previously published version and updates of individual policies that were posted on the ECELS website. ECELS encourages early education and child care professionals to adapt the model policies as site-specific documents that fit their programs. Two formats are available: one replicates the hard copy publication. The other format, posted 12-12-2014, has form fields that allow users to insert their site-specific details directly into the PDF document.

The National Center on Health offers visually attractive, simply stated resources for infant, toddler and preschool care. Anyone can down-load the electronic copies from the Internet. Head Start programs can order hard copy from the National Center at This email address is being protected from spambots. You need JavaScript enabled to view it.. These materials have excellent content for teachers/caregivers to use in their programs and to share with families:

Growing Healthy Flipcharts http://eclkc.ohs.acf.hhs.gov/hslc/tta-system/health/healthy-active-living/HAL_Resources/NCHEnglishFlipChartF011514_7-7final508.pdf

Take a look at the National Center’s Health Tips (Fact Sheets) for Families* (and teachers): Download an individual one page fact sheets when you need a handout on one of the topics or download the complete series in English [PDF, 1.2MB] and Spanish (español) [PDF, 309KB]* The following topic are available as handouts:

Active Play includes tips to help infants, toddlers and preschoolers develop positive active play behaviors.

Health Literacy provides information about how to understand and use health information that doctors and other health professionals give.

Healthy Breathing provides information about eliminating first-hand, second-hand and third-hand exposure to tobacco smoke.

Healthy Eating offers easy tips to help infants, toddlers and preschool-age children learn healthy eating.

Mental Health provides information about how to help infants, toddlers and preschoolers develop positive mental health behaviors.

Oral Health offers tips to promote oral health in infancy through preschool age.

Safety and Injury Prevention: Tips for Families (2 pages) provides easy tips families can use to ensure their children's health and safety at home, outside, in the water, and in a car or truck.

Dealing with Stress is a 4 page guide with simply stated, clear tips to help cope with stress in a healthy way.

*http://eclkc.ohs.acf.hhs.gov/hslc/tta-system/health/health-literacy-family-engagement/family-education/tipsheetfamily.htm

This workshop addresses national and state initiatives to reduce obesity among children in group care. It includes nutritional needs of infants, toddlers, preschool  and school age children. Participants learn how to adjust portion sizes, and evaluate food and nutrition labeling.  The discussion includes comparing the standards for physical activity and limitation of sedentary activities with current practices. The participants learn how to use research about how children acquire attitudes about food and physical activity. They identify nutrition education opportunities at mealtimes, snacks, holidays and birthdays.

 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.

• https://nrckids.org/HealthyWeight/Resources
• https://nrckids.org/HealthyWeight

Managing peanut allergy is challenging for child care providers and families who use child care. Peanut butter and products that contain peanuts are among the easiest and most tasty lunch and snack foods. Peanut allergy only occurs in 1-4% of the population. However, reactions to peanuts can be severe.

In 2013, a Princeton researcher, Miranda Waggoner studied the emergence of what some have called an “epidemic” of peanut allergy. She found that the publicity about peanut allergy has overstated the risk significantly.

Teach how to manage aggressive behavior with "Play Nicely." Pediatrician Dr. Seth Scholer developed this 40 minute free instructional multi-media program. It is available at www.playnicely.org. The Multimedia Program: Smartphone and Tablet Version runs on a computer. The program is Research done at the Children's Hospital at Vanderbilt University shows the instructional video lessens physical punishment. Many studies show physical punishment of young children is harmful. It fosters aggression, later mental health problems such as depression and an increased incidence of spouse and child abuse as physically punished children grow into adults.