Daycare and pump

[coeen]

Hi all,
Anyone have a three year old in daycare with a pump?
Just wondering your experiences. His daycare will gladly work with him
if we get him on the pump. I figured I would start him in the summer on it so he is used to it and me too. Then send him back when school starts. The staff will be trained as we are being trained. They only require that it have a carb calculator wizard on it.

[Sarah Maddie's Mom]

Our daughter was 4 at dx and in preschool at the time. Her school was with us 100% and, quite amazingly, took all their new tasks in stride. However, she was in a 9-1 program and on NPH so she didn't need injections at school, just bg checks and regular snacks and meals, so I can't really speak to how they would have been at delivering insulin.

When she was older, and pumping at school, I made-up a set of index cards on a ring for the nurse to use as a cheat sheet for correcting and treating lows.

Overall, I do think that pumping makes D care far easier for school staff and allows D kids to be received by school staff with less trepidation.

I think it sounds like you have a good plan to train over the summer and hit the ground running in the fall.

[zoomom456]

M y son was 2 when he started his pump and was in daycare full time. The staff and I all agree that the pump was the best way to manage his diabetes as a team.

[cdninct]

DS was diagnosed while in daycare last year. When we started out, we were on NPH, so they did not have to worry. I was concerned that they might balk at having to use the pump, but they got right on board (too much so, in fact--I was the one that did their training, and I only figured out months afterwards that it should have been the job of a doctor/CDE/official trainer!). I did all of the carb counting, and they did the checking and bolusing. They got quite good at deciding when to bolus him for the full amount and when to give a half dose and play wait and see. Despite the fact that it was not a stellar daycare centre overall, they did an excellent job of attending to his needs without making me feel like I was inconveniencing anybody.

Now, his new preschool still doesn't have the training to use the pump, and they are really dragging their heels about getting it done. Luckily, it is only a half-day program, and snack time is 20 minutes before pick-up, so I deal with it when I get there. Not ideal, but it works.

As long as your place is on board with you, it should be pretty straightforward. Good luck!

[Cookie Monster]

Our son is nearly 4 and has been at nursery for 3 years with a pump. They have been excellent and we have no issues leaving him in their care. We have a plan for what they bolus at snack times with a sliding scale based on his BG. If he is outside set limits they give us a call and we tell them what to do. The plan changes as he changes and they have learnt to go with the flow around that.

We find that some teachers really step up and learn as much as they can, others are happy to take a back seat in his D care but that works fine and there are always enough people around who know what to do.
I have talked them through some procedures over the phone, such as suspending/restarting pump, priming pump etc and this has worked well.

The CDEs gave initial training on the pump (and some of his other medical needs) and go in occasionally for new teachers/refreshers (about a year ago he had to move to another nursery in the same chain after his was damaged in an earthquake - long story - so the CDE went in and trained them up again).

In the 3 years we have been taking him to nursery there have been no emergencies and the glucagon has never come out the box (I wish I could say the same for home!!) And he loves it there!

[cm4kelly]

We did the same thing. My son started on his pump during the summer that he turned three. Since I teach school and was off the summer, it gave me a chance to learn it myself and get his basal rates adjusted.

I think most daycares are willing to work with you. The pump just makes it that much easier that with a push of a button they can administer insulin. Much less intimidating than with MDI.

My son is in 4 year old preschool now. We pack his lunch and 2 snacks a day with index cards. All carbs are listed on index cards for each snack and meal.
You can train people yourself - and I have a typed set of step-by-step directions on what buttons to push to give insulin that I leave with everyone whenever he stays out.

Good luck! We love our pump!

[cdninct]

Originally Posted by cm4kelly

You can train people yourself - and I have a typed set of step-by-step directions on what buttons to push to give insulin that I leave with everyone whenever he stays out.

Do check into this--I think it varies state to state. In CT I was not allowed to do it (even though I did), but that rule may very well not apply elsewhere.

[BaltoMom]

My son was diagnosed last year when he was 3. He went back to daycare pretty quickly on MDI, but even with training from a great person at ADA, they were terrified to take on the responsibility of giving his shots. They claimed some was due to liability, but the director had a huge needle phobia as well. My husband or I went out every day at lunch to do his shots. In June (when he was newly 4 y.o.), we got him on the pump and had the Animas rep come out to do the pump training with them. The daycare folks felt that it was so much simpler overall - not to mention easier on them, that they very quickly agreed to take over administering his insulin via the pump.
I'm not sure what the situation is at your daycare, but ours serves breakfast, lunch, and a pm snack. Our son eats breakfast at home and takes a free snack to eat while the other kids are having breakfast. He eats lunch there, and to start with, I went through every single food item on the lunch menu and made up a carbs/serving list for them to refer to. As they've gotten more accustomed to it, they've been good about finding out carbs for the random foods that the kitchen staff manage to come up with. They check him before lunch, feed him, and then take him to the office where they then call one of us to review the numbers and have us OK the dose that's suggested by the pump computer. Depending on where his numbers have been, sometimes we get them to do an afternoon check of his BG (and correct with us if it's too high). Usually they don't do an afternoon check and he gets a free snack that we bring from home for him. On special occasions - like yesterday when a mom brought frozen yogurt - they bolus him for it using the same plan as at lunch. In my ideal world, I'd like for them to check him routinely in the afternoon, but we've generally felt that his settings are good enough that he's not flying to some wild place with his BG in the afternoons. I also worry about them feeling too put out by it all and starting to balk.
Our daycare staff is a mixed bag of folks. To quite a few, any of his numbers mean as much to them as they do to my 4-year old, which is to say not much. The one thing they're pretty universally good at is figuring out how to modify the meal to keep his carb count in a reasonable range. But one teacher/admin especially gets it so much more and is a great person to have on our team. And she gets onto the others when she feels like they haven't done something right. Also our state regulations say that a person has to have a particular medications training in order to administer any kind of medicine, so that limits who can give him insulin. They've been good about trying to make sure that the 3 folks at our center who are medi-trained know how to use his pump, but again, they never give him any insulin without our OK.
Sorry this is long, but hopefully it's helpful. Because our son has been in full-time daycare forever, for his sake it was important for us to try to keep him as much on his same schedule as we possibly could. That meant we had horrible schedules especially while he was MDI, but his life stayed relatively normal and he was happy. Things are so much better now for us all since he's on the pump. Good luck!

[Beach bum]

Originally Posted by coeen

Hi all,
Anyone have a three year old in daycare with a pump?
Just wondering your experiences. His daycare will gladly work with him
if we get him on the pump. I figured I would start him in the summer on it so he is used to it and me too. Then send him back when school starts. The staff will be trained as we are being trained. They only require that it have a carb calculator wizard on it.

Our daughter was 4, taught the teachers/director the basics. They would bolus, but only after she had eaten. All they had to do was plug in numbers since the pump did all the work.

No problems at all

[coeen]

Wow. Thanks for all the feedback. Just got in touch with the MM person and he said he and his nurse will go out and do the training. He seemed very nice and interested in our family. Will be meeting with him soon.