Daycare And Cross Contamination

[Burndee]

Hi, I have posted a couple other things on here but I had a specific questions or concerns about cross contamination. My 2 year old daughter was just diagnoised with Celiac (Postive Blood Test and Biospy). She goes to Daycare during the day while me and my husband work. Me and my husband have went gluten free as well at home and I have replaced just about everything in my kitchen and I only buy gluten free foods, shampoos,hand soaps etc. So I am not really worried about cross contamination at home, though I plan to remain diligent so that it stays that way and look for ways that cross contamination can happen at home.

 

I am really obssessed with cross contaimnation at daycare, I borrowed one of the 504 plans I saw posted on here and adapted it to the daycare setting. The daycare is supposed to treat it like a severe allergy (even though I and them know its not an allergy) but they have protocols for wearing gloves and serving her food first and not sitting any children next to her so she can eat thier food, washing her hands before she eats (with soap I brought in) and making sure she does not use any gluten containing art supplies etc.

 

I am still very concerned because I keep thinking that well after the other kids eat and touch toys she will touch the toys and its impossible to keep her fingers out of her mouth being this age etc and I keep thinking what if the teacher messes up and forgets to have her wash her hands before food, or touches someone elses stuff then gives my daughter her food etc. I'm not really worried they will give her gluten food because they know not to give her any food but her own that I bring in. She really doesn't have any symptoms right now, she was having diaherra for a couple months but that seemed to clear up and she has been normal for the past month even though we just started the gluten free diet last week after diagnois. But She did have atrophy so I know even if she doesn't have symptoms its hurting her. So its even more scary that right now she could be getting cross contaimentated and I wouldn't even know about it. I keep thinking should I quit my job and stay home with her? I can't really afford that, and I can't really afford a personal nanny, Plus she LOVES playing with the other kids, she is so social and loves the school setting, they do so much from Learning, music class etc, she just soaks it all up. I would hate to take that away from her because of her being a Celiac, but I"m not sure how else to control the cross contamnation.

 

Does anybody have any advice? I am driving my self nuts thinking about this....

[kareng]

Sure, it's possible to get gluten from a toy. Its probably a rather small issue , in my mind. Maybe they could have all the kids wash their hands after eating? Would keep sticky fingers from getting toys sticky - so it has a benefit for the workers as well as for you.

[Burndee]

I will certainly discuss that with them, thanks for the suggestion. They may say no though... they haven't said no on anything yet, but there are probably 12 kids in her classroom and I'm not sure what they will say to that request. When you say small issue, do you think its unlikely she will be getting gluten from the toys or that it would be enough to affect her? I'm trying to balance the line of doing what is needed to keep her safe and what may be going overboard on my part (I have a tendency to do that sometimes). I would love to hear how others are keeping thier preschoolers safe at preschool and daycare!

[africanqueen99]

One thing I would consider is to have her deal with her own snacks.  She opens her own lunch box and opens her own snack bags.  She'd also close everything up at the end.  I would take their hands out of her food to eliminate accidental CC.  My kids use a mix of reusable plastic (Gladware) containers and cloth bags with velcro.  Even my 1 y/o can manage these so your daughter should be able to after a few "lessons."

 

One thing my 7 y/o does is open a paper napkin before all meals at school.  She opens it and puts it on top of the table, but under her lunch box/food.  It's a visual barrier that the other kids see that's HER space for food.  I got the idea from someone here and it helped me stop stressing about my kid eating while I wasn't there (she also hasn't gotten glutened at school since we started this!)

 

Right now my 1 y/o attends "Mom and Me" classes at our Early Childhood Center, but she will be going to Kids Morning Out in the fall.  This group has always provided snack in the past, but I'm going to take care of all foods for my kid.  I know the ECC would purchase food that I approve (it's a really awesome place), but I'd rather just do it myself.  Then i can work with them on things like art supplies and the sensory table.  There really is a lot to consider for such young ones.

[pricklypear1971]

One thing I'd try to find out is if the kids wash up before/after eating. AND, how do they clean surfaces? Is it a bleach solution/water (which probably does zero to remove gluten) or is it soap/water (which will)?

It's a tough situation, and I understand your concern.

Personally, if they institute a wash hands before/after policy and no snacks dragged around the classroom - I think I'd feel secure.

I personally wash my hands after returning home from shopping/ out if the house and I don't feel ive ever been glutened by touching stuff. But I have been glutened by careless crumbs around the house from my son.

[Burndee]

Thanks for the input and suggestions everyone!!! It has made me feel better. I meet with a dietition on Friday she has a gluten free class, then I will meet with the daycare providers and go over what exactly needs to be done in order to keep my daughter safe. I will ask and bring up the suggestions you guys have mentioned. I am optimistic they will work with me on this because they are always telling me that they will work with whatever she needs.

 

As far knowing if she has been glutened or getting better, even if she doesn't show outward signs of being sick, will she start after she has been gluten free for a while? Will the blood tests be indicators that she is healing inside if they go back to normal?

 

Thanks again for the information! I feel a little lost on finding information because it seems like the doctor doesn't know a whole lot about Celiac as far as living with it. I am glad I found this forum! I have read tons of information online, but it really does help to talk to actual people dealing with the same thing.

[snowmom]

Burndee, I feel like I could have written this, and your follow-up questions! My 3 year old daughter is also at preschool, and we are trying to navigate these waters. We got the biopsy confirmation while the preschool was shut down for the holidays, and today is her second day back. My husband and I also wondered whether one of us should try to stay home with her (which would be a major financial stretch), but this preschool is just fabulous and our daughter is so happy there. 

 

We've been so focused on the food issue that we haven't even started to think about contamination from crafts and toys etc. We expected that we would pack our daughter's lunch going forward. But that will be a big challenge -- time is really tight, and our kid is super-picky. For example, she just won't eat sandwiches period, so gluten-free sandwich bread is a non-starter. A lot of the lunch ideas that we have come up with would require re-heating in the school kitchen, which still raises a potential cc issue.

 

And then, while we were still trying to think that through, the school surprised us by saying that they had a celiac kid attend a few years back. They said they were able to prepare separate gluten-free meals for the child out of their common kitchen, and that they are willing to try the same for our daughter. I am so touched that they have offered to take on this burden. At the same time, I am so overwhelmed by de-glutening my own kitchen that I don't know how to begin advising the school on meal prep there. The one plus I see is that they have a huge industrial kitchen to work with, so it seems plausible that they could find a gluten-free prep area for her. We meet with them soon to try to come up with a plan on meals, and I assume we will also discuss how to minimize exposure from playtime. If we go the route of the school making her lunch, I think we will offer to donate some dedicated gluten-free supplies (e.g., colander, toaster).

 

Anyway, I don't have any answers to offer you, but good luck in figuring this out!!

[africanqueen99]

Burndee - I put this together and took it to the head of the "Mom and Me" classes.  She's also the person that I'll work with the develop a 504 Plan for KMO.  That same 504 will follow her (modified, of course) through college.  Anyway, it might be a good starting point for you to work with the day care.

 

***

Celiac Disease

 

Child: X (DOB 1/23/12)

School:  Y Early Childhood Center

 

DEFINITION:  Celiac Disease (also called “Gluten Intolerance”) is an autoimmune disease caused by the body’s inability to digest gluten. Gluten is the protein found in WHEAT, RYE, BARLEY, SPELT and OATS. Even small amounts of gluten act like a toxic to a person with Celiac Disease, triggering the body to attack itself in the small intestines. There are fingerlike projections called “villi” which line the small intestines. Normally the villi are responsible for absorbing all nutrients. When the villi become exposed to gluten, they become damaged or blunted-off, which leaves the person without the ability to absorb nutrients.

 

TREATMENT:  The only treatment for Celiac Disease is a strict adherence to remaining gluten-free.  For adults this would mean not intentionally eating foods with gluten, but for children it also means not coming in contact with gluten containing items and then ingesting them unintentionally after touching face or mouth.

 

SNACKS:  All snacks for X will be provided from home and they will accommodate the Early Childhood Center’s “nut-free” policy.  She will need to sit in a space that does not have crumbs from previous gluten-based food - a simple wipe down of the table will be sufficient.  (Remember, I am with her during these classes so I am double checking that she's in a clean space.)

 

PLAY-DOH:  Unless the play-doh was made with a specific gluten-free recipe and the tools have only been used with that recipe it is not safe.  It is important to note that gluten can not be transferred through the skin, but can be ingested unintentionally through hand and mouth contact.

SENSORY TABLE:  

• Safe Options - dried corn, beans, rice

• Possibly Safe (depending on ingredient label) - corn meal, potato flakes

• NOT Safe - pasta, oats, flour

ART SUPPLIES:  

• Glue - Elmer’s Glue and Colorations Washable School Glue are gluten-free.

• Finger Paint - Colorations Washable Finger Paint, Crayola Washable Finger Paint, and Eco-Finger Paint are gluten-free.

• Markers and Crayons - Crayola are gluten-free.

Sources:

Open Original Shared Link

Open Original Shared Link

9/23/13

[greenbeanie]

You've already gotten some great suggestions - it will get easier to navigate all of this with time! One thing I have to add is to make sure you wash the outside of her lunch box before refilling it every day. Even if all her stuff is kept on a separate napkin or placemat while eating, it seems like the chances are pretty high that the (closed) lunch box itself might get set down on the floor or another part of the table at some point. My daughter's preschool has been outstanding about minimizing cc and making sure she has a clean spot to eat lunch, but there are still crumbs all over the floor after the kids eat, and the lunchboxes often get set down on the floor before they are returned to cubbies. Simply washing the outside of the lunch box with soap and water at home should reduce the chances of cc.

[Burndee]

Thanks everyone! This is great information, especially the list of art supplies, I am going to bring that to them to discuss what they use today and see if I need to provide other options. What I have been doing this week though, is packing her lunch in my tupperware and they heat it up and give it to her, so that she could have similar to what everyone else is having like today, they were having steak fingers and mashed potatoes, so I gave her chicken nuggets and rice. I like her having a hot meal too.  I understand that is more risky to contamination than her having her own lunch box. Do you guys see any major things to look for if I go that route? Like having the person wear gloves that heats up her food etc.

 

Snowmom, I am right there with you! Let me know if you learn anything along the way and I'll let you know too.

 

Thanks again everyone! It feels good to talk to others.