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From San Antonio, Texas, USA:

My friend works at a daycare facility that cares for a 10 year old girl whose mother allows her to eat chips and candy and refuse daycare dinners. The child will not listen to the teachers or directors and the mother says it's okay. Teachers have found lancets, bloody strips and, once, a syringe. The director refuses to do anything. As a matter of fact, the director suggested that the mother bring the child later in the day when she, the director, would not be there and a different manager would be responsible. Is there anything that can be done? This child is adamant about having her way and only the director can dismiss her, which she won't because of the money.


It may be fine for the child to eat a varied diet and miss meals occasionally if she is on intensive insulin regimen (MDI or pump). This is something the parents and the child's medical team should address, NOT the daycare providers. However, the daycare providers can let the parents know if they are concerned about something they see.

As for used medical supplies, the daycare or family should provide a container or needle box for proper disposal of these items. It can be hard for a child to remember to do this especially when these items are so much a daily part of her life and she may not recognize the potential risk to others. Let the parents and child know that in a daycare setting, these used medical items need to be disposed of in a safe manner and come up with a plan to do so.

As for the child being "adamant about having her way," is there a discipline problem or is it all related to the diabetes? Many school age or pre-teen children with diabetes do an excellent job of self managing and know what they can eat when and how to adjust their insulin for it. The child may just be advocating for what she knows is right to care for herself. I believe the general population has many misconceptions about what children with diabetes should and should not do. A family meeting may be helpful so that the parents can explain the child's medical regimen and what they expect form the daycare and vice versa.


Additional comments from Debbie Butler, MSW, LICSW, Licensed Clinical Social Worker:

There are a few things that are not clear to me, so I will try to answer your question as best as I can. I am assuming that the 10 year old that you are describing has diabetes. I would recommend that an adult should be responsible for the 10 year old's diabetes care and not the 10 year old herself/himself. The adult would be a parent or legal guardian at home and then one of the daycare staff when the child is at day care. So, I would recommend that one of the daycare staff become responsible for the storage and disposal of the lancets, syringes and strips. I am also assuming that the daycare must follow certain guidelines to remain registered, so I am assuming the day care would have looked into this as well.


Original posting 29 Jun 2006
Posted to Behavior and School and Daycare


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Last Updated: Tuesday April 06, 2010 15:10:08
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