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

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.

Molds grow quickly in moist areas. They are a potent cause of allergy symptoms. Quick response to moisture collections is key. Clean up mold and moisture on hard surfaces with water and a detergent, then dry the surfaces so no moisture remains. Remove surfaces that cannot be completely cleaned.

Pay attention to the humidity of the air. Hardware stores sell inexpensive devices that measure humidity levels. Aim for an indoor humidity between 30% and 60%. Dehumidifiers remove moisture from the air. Use them where needed to keep humidity in the healthful range. For more information about how to safely clean mold and manage moisture in educational facilities, go to the Environmental Protection Agency website: http://www.epa.gov/mold/index.html. Some of the materials are available in Spanish as well as in English.*

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.

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 organization provides updated, practical information on the management of lice and scabies infestations, emphasizing the need to avoid harmful applications of pesticides. Click here for the website with practical tips and tools to address a lice outbreak in group care. 12/2012

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

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.

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. 

Families, staff members and health professionals can help control infectious diseases among children and adults involved in group care settings. Each has a role. The three roles described in these fact sheets overlap. Families, staff members and health professionals benefit from ongoing coordination and collaboration with one another. Sharing these fact sheets may help those whose role is defined in them identify ways to contribute to reducing illness. Revised 4-2019

See the online (most recently updated) version of Caring for Our Children, 4th edition for the national stanards related to cleaning, sanitizing and disinfecting surfaces in child care settings. Details about how to select a sanitizer and disinfectant are in Appendix J. The table that lists Routine Schedule for Cleaning, Sanitizing and Disinfecting is in Appendix K . Reviewed and reaffirmed 5/2019.

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