Day Care Workers Prescribing Too Many Trips to the Doctor
Although the organization of child care facilities is different in the U.S.,
the study in Canada points to two problems faced by parents whose children are
in centers during the day: children are being forced to stay home from the
center when they may not need to, and they're receiving advice on health from
those unqualified to give it. These problems are further complicated in the
U.S. by differences in day care center regulations from state to state and from
different child care center chains.
"The consensus of people who develop child care standards is that it
isn't the job of child care workers to make medical recommendations. This is up
to the parents and their doctors," Ruth Neil, PhD, tells WebMD. Neil is the
project coordinator for the National Resource Center for Health and Safety in
Childcare (NRCHS). The government-funded NRCHS develops health and safety
standards for child care providers in collaboration with the American Public
Health Association and the American Association of Pediatrics.
Angela Crowley, PhD, says, "There is a need for additional training of
child care workers in this area. The standards provided by NRCHS are a useful
framework to base this on." Crowley, an expert on child care health and
safety issues, commented on the study for WebMD. She is an associate professor
of nursing at Yale University.
"The study design was strong," says Crowley. Although this study was
conducted in Canada, Crowley says the results are representative of the U.S.,
where her staff has also conducted day care studies. "We found similar
findings in South Carolina in child care staff and parents. The [child care
staff] tended to overexclude [children]. There is a lot of confusion about when
to appropriately exclude children.
"Another important thing raised by the study was that if children are
not feeling well enough to participate, this must be provided for," Crowley
says, in response to the finding that most of the staff reported sending
diapered children home if they had an infection.
The National Center for Education Statistics (NCES) reports that six out of
10 -- nearly 13 million -- infants, toddlers, and preschool children are
enrolled in day care. According to the NCES, nearly 88% of children whose
mothers work full-time and 75% of children whose mothers work part-time are
enrolled in day care.
For a listing of each state's child care licensing regulations, visit the
web site of the National Resource Center for Health and Safety in Child Care at
http://nrc.uchsc.edu or call (800)
- A Canadian study shows that child care workers often pressure parents to
get antibiotic prescriptions for upper respiratory tract infections, not
knowing that the treatment will be ineffective.
- Antibiotics are not effective against viral infections, do not prevent the
spread of infection, and do not speed recovery, and the overuse of these
medications leads to drug-resistant bacteria.