Monday, 17 March 2014

Allergies, Asthma and Health Care Plans, My Top Tips for Early Years Practitioners



The most basic guidance is to check your insurance if you are a privately run setting. Below are a few of my top tips to produce a working, individual health care plan.

1) Get a prescribing doctor or pediatrics allergy clinic to give you advice regarding emergency treatment plan and prescribed medication.  For some parents this is the GP, or a local consultant, but ideally this should come from the allergy clinic/ immunologist.  However most allergy clinics are run part time and Parents may be referred to different medical experts depending on the condition, for example many children with food allergies have asthma, and rely on their asthma doctor for food allergy advice. It is important to get a written emergency plan from the treating doctor to act as a starting point for the individual health care plan.

2) Get a holistic picture of the child's allergies, so that you can gain a clearer picture of their health needs. Children with food allergies often have other chronic conditions such as asthma, eczema, and environmental allergies. These conditions all play their role in allergic reactions, and have an impact on education and general health of child.  For instance eczema, asthma and rhinitis disturb sleep patterns, and can lead to poor concentration, infection and greater time off school with illness.  Environmental allergies may be more problematic at certain times of year allergies such as tree pollen hay fever or mold allergy and again the all year round allergies such as dust mite, and animal dander have an impact on this child's health and education. It may be worth questioning how you can make simple adaptions to the environment of setting to make this child more comfortable. 

3) Medication changes: During the hay fever/tree pollen season a child may be on greater levels of antihistamine, nasal sprays and eye drops, and medication again has an impact on concentration ability due to side effects, or the eye, nose, throat, skin and rise in asthma irritation during this time of year.

4) Buy a trainer auto injector for your setting. Practice using it every term as a refresher. Re-visit descriptions of an allergic reaction and if you have time, practice a scenario that may happen in your setting should an accidental ingestion (or new allergy) is discovered.

5) Parental duties: teaching child not to share food. To update on any new allergy or medical condition the child may have. To be open to communication from staff queries that you may have, and vice versa so that you are forming a working plan around the child.  If a child has a long list of food allergies parents tend to teach child to not accept food from adults other than them and ask if parents have read label to see if it’s safe. If that is the case, staff should ensure they do likewise and check with parents.

6) Be aware that parents may have seen their child have a very severe reaction to food and may have high levels of stress. They are forming an assessment on you as a teacher / EY practitioner, they want you to understand the serious of the condition, keep their child safe, provide an inclusive school experience, and be capable of reacting and using the agreed emergency plan.

7) Remember that the important social skills learnt in the early years, to make secure friendships, to be confidant and to trust others are highly important for these children. Those skills will ensure that they grow up to become confident people with regard to their allergies. We cannot assume that each child will outgrow their allergies, many become lifelong allergic people and they need to be taught the skills needed to keep themselves safe.

Wednesday, 7 December 2011

Our Early Allergy Story.

Our Early Allergy story,

I have four children, who are now all in their teens, our third child, has multiple food and environmental allergies.
 He was born a respectable weight, and displayed the three main symptoms of food allergy before he was three months old. However, the medical profession’s understanding of allergy at the time of his birth 15years ago was patchy or totally unaware at best. That is still true for some today, depending on a GP’s and health visitors experience with patients with allergy.
The three main symptoms of an allergic infant, who is fully breastfed and under three months are, eczema, poor sleep pattern, and poor /slow weight gain.
 My son was fully breastfed, he had very dry skin ten days after birth, and by day fifteen we came home from boots the chemist with two carrier bags after being diagnosed with eczema.
 He was unable to sleep, and as my eldest child had colic I thought that he had it as well, showing all the signs of tummy ache that small babies often have.
 However, he was a tired baby, who scratched at his skin, and as the time went by, he slept for twenty minutes a day, and about two separate hours a night. He never slept for the four solid hours that most new born babies do. Of course sleep and weight gain in infants is linked, and although breastfeeding was going well, I was at a loss to understand his slow progress. At the time I had one son in afternoon nursery and a second son in morning pre-school. I was to put it mildly, rather tired!
Doctors and health visitors put everything down to the eczema and I concentrated on that, learning all I could about the routines, and how to apply the creams to stop the itch scratch cycle, and keep him cool and soothed. However, I think I knew something was wrong, the months passed, and the ‘colic’ didn’t disappear, still screaming at night and day by 5 months.
 By 7 months a health visitor and doctor asked me to keep a diary of the times he woke up during the night. By that stage if I got up past 8 times in one night I classed that as a bad night. They seemed shocked, and suggested I try a sleep clinic.
 I was on my knees with exhaustion and so we went. I was persuaded to try the controlled sleep method, something I had tried with my eldest and it did work very well for him. However, a child covered in eczema cries, gets hot, and starts itching, and the longer they cry the hotter they get and the more painful it is for them. I had to use cotton wool and warm water to remove his cot sheet from his bloodied face and neck. The resulting eczema flare up compounded my guilt. My eczema routine was all body moisturising about 5 times a day, with flare ups going up to 8 times or more.
 By 9 months we were referred for ‘wet wrapping’ by the GP, and suddenly he skin seemed a little better, (linked to time of year) and he slept for four hours for the first time.
 His sleeping pattern started to continue to match a new born, and he started to look better. Then by 12 months something happened to change all that, weaning was still a very slow affair, and started at 6 months. He still mainly preferred breast milk and only took small amounts of food, chewing well etc.
 I took older son to school one day and my hubby gave him toast with smooth peanut butter. I came back to a quiet baby, with glazed eyes, bright red skin, covered in white hard hives. His GP said it was a mild allergy as his throat was unaffected, of course this was totally wrong, but we were suddenly on a huge allergy learning curve.
 When he was 13 months, I tried giving him scrambled eggs, (still totally allergy unaware) in order to find something high fat to help him gain some weight. His symptoms were instant and horrific, violent vomiting and screaming and his bowels emptied with force (a serious sign btw) and were his vomit and poo touched huge hives erupted, and he went suddenly quiet. I gave him a huge dose of piriton, and washed him. Of course I should have called for help; I thought he was just exhausted after the vomiting. He recovered, and we were very, very lucky that day.
 My GP referred him to the local pead, who said his reactions were mild to moderate, and to just avoid all egg and peanut, and that he couldn’t have a epi pen because they were dangerous for infants under 25lbs (advice that was incorrect in so many areas…) but she did give me instructions on how to use a epi pen, which we would be able to have when he reached the magic 25lbs.
I went home and rang AllergyUK and spoke to a nurse, who sent me a letter, which explained that our son was at risk of anaphylaxis and did need an epi pen and referral to an immunologist. It took my GP two weeks to find one. We were sent a letter explaining that our first appointment date would be given between 8 months -18months.
These days London appointments only take 8-10 weeks which is a vast improvement. After his first appointment, we came home with a list of his allergies, peanuts, tree nuts, egg, dust mite, tree pollen, and hay fever. We were given a leaflet on dust mite allergies, with the doctor’s sage, if unhelpful advice to not vacuum if our son was in the house.
We came home and in the months that followed blew a pile of money on wooden flooring, chest freezer to freeze teddies overnight before washing, leather sofas, good quality allergy bedding, and to our joy, his skin improved and he slept and started to put on weight on a limited diet. One day a local nurse rang up about the wet wraps, but it was too little too late.
We found our own way to control his world as much as possible. The oncoming year brought new allergies that were discovered, so we were given epi pens by our gp and by the time we went back to London they were very surprised at the ever growing list of allergens and his symptoms, and were happy that he had epi pens. He didn’t reach the magic number 25lbs until he was nearly 3 yrs. old.
Our son followed the ‘allergic march’ growing slowly out of his eczema, and developing higher severity environmental allergies.
 As he had an ever longer list of allergies, and we were told that he might grow out of some, but not all , so we have brought him up to try and cope with his allergies. Teaching him in small steps to manage his own allergies, and this is still an on-going process.
 The impact on the family, and his life has been huge, every social occasion has food, and family trips to restaurants, days out and travelling have to be planned ahead to a vast degree. The emotional strain of being a young child and teen that has had many allergic reactions and has required his epi pen three times this year so far is huge.
 He is coping with a burden that an adult would find difficult.
By the time our son was two years old I was running a local allergy parent support group, was a member and volunteer for Allergyuk and the Anaphylaxis Campaign. My health visitors passed on my details to other parents struggling to cope with infants with eczema, and sleep problems and allergies. I spent time visiting these mothers, and passing on leaflets from the allergy charities. As time went by I had another baby and with all our boys at school, I organised open evenings with guest medical guest speakers, and raised money at carnivals. I worked part time with the campaign with teenagers, and started giving allergy management presentations to school staff, parents and school nurses and early year’s students at local colleges.
 This was a natural step for me, as my work background was in senior management roles in various child care establishments. I have given presentations on environmental allergies to members of the press; our family has appeared on documentaries, BBC breakfast news, sky news live, magazines and newspapers.
 I am currently a just starting my 2nd year of my early years degree, and work part time in a preschool, and still volunteer for the allergy charities, both local and national. I still support parents by e-mail or phone, as it’s important for parents of allergic children to be in contact with parents that few steps ahead of you, and support each other.

Sarah chapman.

Sunday, 1 November 2009

christmas is coming.

When the first catalogues   slip through the door.



why are they laughing so uncontrollably while pissing themselves?







Monday, 21 September 2009

Saturday, 30 May 2009

sifting through accidents.





'is it this one darling'?

'no mummy.'

'this one'?






'is like my t-shirt mummy'





Anyone who looks after them needs pre-training beforehand.









what kind of advice is that?


Wednesday, 13 May 2009

food shopping with allergies , and four children.




Here is a typical trip to a large supermarket.



















Strapped up , and shut up with a chocolate bar,
and allergic son with something safe to chew on.

pause to




well, that's what I do.