As a mom of kids with severe food allergies, few things struck fear into my heart as much as having to go back to work and leave them in the hands of strangers. I spent many sleepless nights and cried way too many tears over this decision. For us, it was one of the most important decisions that we made for our kids. We are 4 years in on our journey with FPIES, and I wouldn’t trade any of their teachers for the world. Not everyone is that lucky, but knowing the right things to look for and questions to ask can help you avoid some major pitfalls.
With so many options out there for childcare, how do you know which options are good ? There are several steps that you can take to weed out the bad options and find one that will work for you.
Ask lots of questions
There are typical questions you would want to ask any type of daycare provider, like:
- How much is the monthly rate?
- What is your fee policy for missed days and holidays?
- How many teachers are in the class and how many children? (Aim for a low staff to child ratio, somewhere around 1:3 for babies and 1:6 for kids over 2)
- What is the classroom layout?
- What is your sickness policy?
Then there are more questions that you might want to ask as an allergy parent, like:
- What’s the food policy like? Do we prepare snacks and meals or do you?
- What is your medicine administration policy?
- Is there a nurse on staff or a designated person in case of an emergency situation?
Tour the building
Sometimes, when you physically walk through and see the area where your child will be staying, you can recognize issues. You may notice the way the room is set up or the way food is prepared is dangerous for your child.
When we were looking for a daycare, we settled on our local Montessori school. When we walked through the school for the first time though, I noticed that in the baby room, kids were all sitting on the floor in bumbo seats with trays for their snacks.
At the time, my son was 9 months old, was crawling, and was very fast. He would snag crumbs and food off of other kids trays at church nursery and at our house. We talked about the possibilities, and the teacher offered to get him a regular highchair so that he was up above the height of the other kids. They were very diligent and would sweep and mop the floor after every snack and lunch before my son got down out of his chair to play.
Dropping by the facility unannounced is also a great way to see what is going on during a normal day. You may see different behaviors from teachers or a facility that’s not as clean as it was when you came through for a tour.
Talk to any teachers that will be in your child’s room
You definitely want to make sure that any teachers (even temporary teachers) know how to keep your child safe. Sometimes this is hard to do without feeling crazy or super needy, but if it keeps you from having to deal with reactions at home it’s worth it. We had a meeting before my kids started at our daycare to go over food preparation procedures, what to do during a reaction, and to answer any questions his teachers had.
Make a list of your child’s safes and triggers, as well as how you prepare their food/formula
Some daycares will provide food, some will make you bring your own. Some facilities will require that all kids eat the food that they provide. You may need to get a letter from your doctor in order to get around this requirement.
If the school is receiving grant money from the government, or if they are a peanut free school, they will likely require you to have a doctor’s note and bring food with labels on it still (so they can check for peanut or other allergen cross contamination). Some places will require you to bring the ingredients to them and they will prepare food for your child there. If this is the case, you will probably need to tell the facility the importance of avoiding cross contamination, and talk to them about how to avoid it.
Keeping a list of the safe foods and triggers that your child has can help providers double check what they are serving your child. Even if you bring all of their food, you never know when a new sensory bin that contains rice might be brought in, or when oatmeal cookies will be served for a surprise birthday celebration.
I use the Google Sheets app on my phone, and I fill in all of the safe foods, safe spices, trigger foods, and foods we are trialing currently. I have two kids with FPIES in the same classroom, so I put all of the info on the same spreadsheet and just started a second tab at the bottom of the sheet for the second child. Then, I shared the document with the teachers in my children’s classroom as well as the school administrator.
Create a plan and set up a meeting before school starts to go over procedures
We created a plan of sorts (kind of like a 504 plan that you would have in primary school) and the school kept a copy in my kids’ classrooms as well as in the office. This was something that we all created together (us as parents, the school administration, and the teachers in each classroom) in one meeting a few weeks before my kids started at their school. This outlined all of the things I would want a teacher to know, and it was a huge help on days when there were surprise substitute teachers or food reactions during the day while my kids were at school.
Our plan included basic information on FPIES and why it was important to keep the kids safe from cross contamination and from trigger foods. It also included medication information and what to do in case of a food reaction. We listed symptoms they could watch for regarding chronic reactions and how to make notes on what foods were eaten and when.
I-FPIES has a pdf that you can use as a starting point to develop this type of plan with your child’s school.
Type of facility can make a huge difference
When we were looking for a daycare, we talked to several types of facilities, and we even tried several options before we found the type of daycare we settled on. The options in your area may include:
Church daycares (or Parent’s Day Out Programs)
In our area there are several really good church daycares. Some of them have full programs, while others only run a Parent’s Day Out program. Paren’ts Day Out usually lasts a few days a week for limited hours. I called a lot of these when we were looking. I found that the price was usually way lower than a regular daycare, but most of them were not prepared to handle the severity of our kids’ allergies. They also had a very long waiting list, so if this is an option you want to look into, I would start several months in advance.
Group Daycare
These are state licensed daycares that can be privately owned or sometimes found through large employers. These types of facilities are required to follow state regulations, so there is more oversight than some private daycares. There will be specific forms they need to comply with for things like medication administration. There are also regulations regarding teacher education (and continuing education). Teachers are usually required to be CPR and first aid certified as well as have completed at least some higher education.
Group daycares that are accredited by the National Association for the Education of Young Children (NAEYC) are held to a higher standard (but may come with a higher cost and longer waiting list).
Montessori School
Montessori schools use slightly different teaching methods than typical daycares. They are usually more like a school, where children are taught throughout the day even at younger ages. The Montessori school places a high emphasis on independence and self regulation. Kids learn and develop at their own pace, instead of on a timeline used for the whole classroom. Students are taught colors and letters and shapes, but also life skills like how to fold clothes, wash their hands and how to sweep up their classroom. Most are accredited as schools, but make sure to check credentials and references for any type of facility you look at.
Home Based or Private Childcare
Using one person or a smaller group of people to watch your child can be a huge blessing. There are usually smaller numbers of children in private daycares. Your child might be in your home with a nanny or in someone else’s home with a few other children. However, there are some things that aren’t as great about using someone for home based daycare.
One big issue is licensing and accreditation. You definitely want to make sure that you find one that has a state license (although some states just require them to pay a fee and fill out an application) and if possible you can look for one that’s accredited by the National Association for Family Child Care (NAFCC).
Our Experience
We use a Montessori school for our FPIES kids. We started there out of necessity – it was the only place willing to take my kids with their long list of allergens to avoid. However, I found that it was perfect for us in a lot of ways.
- First, they are an actual school, with primary level classrooms as well as baby and toddler classes. This was awesome because they are subject to the rules of the Department of Education for all of their classes. This means that we filled out medication forms detailing what days and times to give medications to our kids. The medications themselves stayed in a lockbox in the school’s office. Teachers in a Montessori school are also required to have many additional hours of training to be qualified to teach.
- Second, they already limited the types of food that were brought in, and each family provided their own meals and snacks. This allowed me to have control over what my kids were eating throughout the day while they were at school. The school required that no desserts or sweets were brought in, except for limited desserts for celebrations of birthdays etc. There was also a requirement to limit gluten, food dyes, and other “unhealthy processed foods”. This was a bonus for us, because it meant the baby classroom wasn’t going to be full of cheerios and goldfish like every other nursery classroom. Instead, most people packed their kids foods like they would eat for dinner, even in the baby class. This didn’t eliminate all of the potential triggers for us, but it did limit it more than what we would have found in any other school or daycare.
- Lastly, the school itself is amazing. The class sizes were smaller, which meant more individual attention per child. The curriculum they use is fantastic, with each of my kids being able to work and learn at their own pace. My kids were learning German and French at age 2. Now, they are studying the solar system and the continents at ages 3 and 4. We started because we had to, but it’s quickly grown to be a school we love.
This is just our experience, there are tons of options and any one of them may be the perfect fit for your family. Start your research, talk to other families with kids that are in daycare in your area, and ask lots of questions.
