State regulations require documentation that the child has received vaccines and screening tests according to the recommendations of the American Academy of Pediatrics and the Advisory Committee on Immunization Practices. Any document (including an electronic printout from the child's medical record) that provides this information is acceptable. The Office of Child Development and Early Learning (OCDEL) offers a form that allows health care providers to say whether the child is up to date, the CD 51. This Child Health Report form was last revised in 2008. It does not require the dates and results of the recommended screening tests. It has a check box to indicate "yes" or "no" that the child has received all the recommended screenings. The only screening information it requests is the results of any abnormal vision, hearing or lead screening. These are important, but not all the screenings that assess whether a child is healthy and ready to learn. 

This brief from Docs for Tots reviews the evidence of the cost-benefits of integrating health promotion with early learning in early care and education programs.
Reviewed and reaffirmed 4-2019 

RWJ is a national foundation focuses on health policy, prevention, leadership development and research. Recent work has focused on preventing obesity, ensuring health insurance coverage, and quality of health care. 12/2012

Children who eat more salty foods also drink more sweetened beverages. Children who drink more than one sugar-containing beverage per day are 26% more likely to be overweight or obese. These findings are from a study that enrolled over 4,200 Australian children. The study findings are in the January 2013 issue of Pediatrics, the journal of the American Academy of Pediatrics.

In a June 2011 report, the Institute of Medicine (IOM) recommended obesity control measures for children in 5 areas:
1. Growth Monitoring
2. Physical Activity
3. Healthy Eating
4. Limiting Screen Time and Marketing Exposure for Children
5. Sufficient Sleep

Since 1986, conference workshops, professional journal articles, manuals, national standards, and sample forms have described the risk to an unborn child if a pregnant mother is exposed to certain infections that commonly spread in groups of young children. Employers of female early education staff of child-bearing age should educate their staff members about this risk. They should urge them to discuss with their health care providers how to reduce their risk.

Cytomegalovirus (CMV) is one of the infections that pose a risk to an unborn child. CMV is a common infection among young children, usually without symptoms. Between 30% and 70% of children less than 3 years of age in child care excrete the virus in their urine, saliva and blood at any one time. Excretion of the virus may occur intermittently for years after the first infection. Women who work in child care may or may not be immune to the strains of CMV infecting children in their care. If a woman has her first CMV infection while pregnant, or has a CMV infection with a different strain than the one she had previously, her unborn child is more likely to be infected.

In utero (congenital) CMV infection occurs in only 1% of live births. However, CMV is the most common viral infection of babies before they are born and the most common cause of sensorineural hearing loss. About 10% of the CMV-infected babies have some symptoms or signs at birth. Those who do may have devastating multi-organ damage. These include poor growth, liver damage, brain damage, hearing loss, blindness, underdeveloped brains and developmental delay. About half of infants who have some symptoms of CMV at birth develop hearing loss from damaged nerves that are needed to carry sound sensations to the brain from the ear. About 15% of those who are infected but have no symptoms of CMV infection at birth develop this type of hearing loss as they grow older. In many children, the degree of hearing loss is progressive.

Nurses who conscientiously practice recommended hand hygiene don't get CMV infections from their CMV infected patients at a higher rate than other women. Teachers/caregivers of groups of young children could similarly reduce their risk by practicing hand hygiene after every contact with urine, saliva or blood. However, achieving this level of hand hygiene is challenging in group care. Teachers/caregivers have contact with more than one drooling child at a time, and frequently touch saliva coated toys or other surfaces. They change diapers or soiled underwear for children in their group multiple times a day.
At the least, women who teach groups of young children need to know how to reduce the risk if they might become or are pregnant. When properly informed, they can consider three options: 1) be very careful about practicing hand hygiene, 2) decide to provide care for preschool or older children instead of infants and toddlers when pregnancy is possible, or 3) choose to work in settings where they have less risk of contact with body secretions of young children.

Employers should explain CMV and other common occupational health risks verbally pre-employment. The information should be in an employee handbook given to each staff member, and discussed at a staff meeting at least once a year. It is best practice to use a Staff Health Assessment form that lists the common occupational risks. The list may prompt the health care provider who completes the form to assess and discuss these risks. Many health care professionals are unaware of the tasks performed by women whose work involves close contact with groups of young children. A list of these occupational risks is in Caring for Our Children, Managing Infectious Diseases in Child Care and Schools, and in Model Child Care Health Policies. Each of these publications has a sample Staff Health Assessment Form too.

Teach early education staff members about each of their occupational risks. Then have them sign a statement acknowledging the teaching received, that they understand and know how to reduce each risk, and that with this knowledge, they accept the risks.

• Animal Visits
• Transitions: Hand Washing to Eating
• Autism Resources
• Mold and Moisture
• Toddlers and Preschoolers: Help parents form positive parent-child relationships
• Attention Deficit Hyperactivity Disorder-Are We Doing All We Can?
• Food Preparation Techniques for Tasty & Healthful School Meals
• Diaper Rash Prevention and Management
• Staff Health Risk in Pregnancy

Stay Safe in Hot Weather

Extreme heat can make children sick in many ways, including dehydration, heat cramps, heat exhaustion, and heat stroke.

It is possible to safely participate in outdoor activities during the summer heat. To help protect kids from heat illness::

• Stay hydrated
• Dress lightly
• Provide shade in play areas
• Plan for extra rest time
• Cool off
• Prevent the effects of sun exposure

Weather monitoring resources:
Staff can use the Iowa Department of Public Health’s Child Care Weather Watch resource to help understand words used in weather forecast. This resource, along with local forecasts, can help staff monitor the temperature, humidity, and air quality. To stay up to date on current conditions: https://idph.iowa.gov/Portals/1/Files/HCCI/weatherwatch.pdf

Check the Air Quality Index at http://airnow.gov and subscribe to EnviroFlash. This service from the US Environmental Protection Agency and state/local environmental agencies provides daily emails with information about local air quality. Poor air quality can negatively affect children with asthma and other special health care needs.
Check the forecast for the UV Index at https://www.epa.gov/enviro/uv-index-overview to limit exposure to the sun on days when the Index is high.

Sign up to receive hourly weather forecasts from the National Weather Service on a computer or mobile phone. The National Weather Service (NWS) provides up-to-date weather information on all advisories and warnings. It also provides safety tips for caregivers/teachers to use as a tool in determining when weather conditions are comfortable for outdoor play. www.nws.noaa.gov/om/heat/index.shtml

Stay hydrated

Encourage children to drink water regularly and have it readily available—even before they ask for it.

Infants: On hot days, infants receiving breast milk in a bottle can be given additional breast milk in a bottle, but they should not be given water—especially in the first six months of life. Infants receiving formula can be given additional formula in a bottle.
Toddlers and preschool children: Provide regularly scheduled water breaks to encourage all children to drink during active play, even if they don’t feel thirsty. Fluoridated water (bottled or from the faucet) can reduce the risk of early childhood caries and is the best drink choice for young children in between meals.

Sources: https://www.healthychildren.org/English/safety-prevention/at-home/Pages/Protecting-Children-from-Extreme-Heat-Information-for-Parents.aspx

CFOC Standards: https://nrckids.org/CFOC/Database/4.2.0.6

https://nrckids.org/CFOC/Database/6.1.0.7

https://nrckids.org/CFOC/Database/3.1.3.2

National Center on Early Childhood Health and Wellness https://eclkc.ohs.acf.hhs.gov/about-us/article/national-center-health-behavioral-health-safety-nchbhs

Posted 8/10/2021 Updated 5/31/2022

Swaddling (wrapping tightly) in a blanket calms many young babies. However, improper use of this practice increases risk of harm. If the blanket is too loose, it can move up to cover the infant’s face. Loose blankets around the infant’s head are a risk factor for Sudden Infant Death Syndrome (SIDS.) Swaddling may cause overheating, another SIDS risk factor. If the blanket wraps the legs so they are not free to move, researchers find the baby is more likely to develop hip disease. 

Do you or the families you serve transport children? Review performance standards for transporting children safely in early care and education programs. Share this information with parents who transport their children in vehicles other than a public bus. The model policy is consistent with Caring for Our Children: National Health and Safety Performance Standards.

Common myths and scientific evidence about currently recommended vaccines are discussed on the website of the Vaccine Education Center of the Children's Hospital of Philadelphia. The Vaccine Education Center is funded by civic-minded donors, not pharmaceutical companies. View the facts about vaccines. Download information sheets for staff and parents, including one about common vaccine myths. Reviewed and reaffirmed 4/2018.

Early care and education staff members must check children's immunization records to be sure that the children are up-to-date and protected against vaccine-preventable diseases. This task requires looking at the record and understanding the abbreviations for the required vaccines. Vaccine products for children may contain single vaccines (protection against a single disease, e.g. Hepatitis b) or multiple vaccines (protection against multiple diseases, e.g. MMR for measles, mumps, rubella). These multiple vaccines are often called "combo or combination vaccines". Different vaccine manufacturers may produce either single or combo vaccines. Click here for the CDC website or put http://www.cdc.gov/vaccines/vpd-vac/vaccines-list.htm in your browser to view the names and components as well as learn more about vaccines in current use. Reviewed and reaffirmed 2/2019

“Vaccines and Your Baby” is a 28-minute video that explains the basics of vaccines. You’ll learn about vaccines and how they work, the science behind vaccines, immunity, and the 11 diseases that vaccines prevent. Parents of children who suffered vaccine-preventable diseases tell their stories. You may watch the video on line. Click here to watch the video. See the Vaccine Education Center | Children's Hospital of Philadelphia (chop.edu) for complete, up-to-date and reliable information about vaccines to parents and healthcare professionals. 7/8/21