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Balancing the Needs of Young Children: Strategies for Day-Care Centers and Play Groups by Anne Muñoz-Furlong   Many of you have requested ideas for managing day-care situations and play groups for children too young to enter school. To prepare this article we spoke with day-care center staff, parents, preschool teachers, and family day-care providers. We learned that as is the case with most other food allergy concerns, advance planning is the key to success.   To begin with, spend some time at the day-care center, church nursery school, and other places your child is likely to be without your supervision. Study how the staff handles mealtime, who selects menus, and what foods they serve. Educate them about any changes necessary to keep your child allergy-free while in their care.   Most day-care providers we spoke with were unfamiliar with food allergies. Once we explained what needed to be done, they became more confident about their ability to properly care for these children. Use some of the FAN materials to explain how to read ingredient labels and other aspects of managing food allergy.   One day-care center we contacted eliminated the chance of toddlers grabbing each other's food by putting the children in high chairs and spacing them a few inches apart. Another center divides the children into small groups for mealtime and makes sure their hands, clothes, and faces are wiped clean before they are allowed to return to the large group.   Below are examples of how several families are balancing the needs of their young children. I hope you'll send us your ideas so that we may pass them on to others in a future article.   Elizabeth Anne from Rochester, New York, wrote: "My son's EpiPen® and Benadryl® are kept in a fanny pack that hangs on a hook on the wall. It is easily accessible for an adult, but high enough so curious children cannot get it. The teachers wear it when the children go outside to play or for a walk.   His cubby (locker) is located on the end of the other lockers, with a space between his and the other children's, so that their clothing, which may have food on it, doesn't touch his.   Robert eats his lunch at a wider table than the other children. Two other children who are the neatest eaters and have the least amount of spills sit across from him. His bib, for a messy lunch day, hangs in a different area from the rest so that no one else accidentally uses it.   The teachers use placemats to help the children keep their food in their own space. Robert uses his own cup each day and his formula is sent from the kitchen for each meal.   Every Monday I go through the menu list and cross out the foods that Robert cannot have. The cooks and I choose foods to substitute. The teachers take home the How to Read a Label cards if they are going food shopping for a treat or a project that is food related."   Debbie, of El Cajon, CA has a system that ensures that everyone is always ready in case an accident occurs. She says: "We have a bright pink "hip pack" hanging near the front door. It contains my daughter's medications, copies of our insurance cards, emergency names and phone numbers, signed medical treatment release forms (in case another adult takes her to the hospital), and a quarter for a phone call from a pay phone. The hip pack goes wherever she goes."   One member, Elizabeth from North Brunswick, New Jersey, has found a clever way to make her daughter's baby bottle stand out. "I paint my daughter's name on all her bottles; that way if we're out with other people who have children we don't have to worry about whose bottle is whose. It also serves as a reminder to me to warn other care givers about her allergy." Be sure the paint you use doesn't wash off.   Another member adds, "Our church nursery workers no longer allow toddlers to walk around in the nursery with a bottle, in order to prevent our daughter from accidentally drinking any milk. They have also posted signs in the nursery to alert volunteers of Samantha's milk allergy."   As children get a little older, it's important to take their feelings into consideration so they don't feel "different" while keeping them allergy-free. Margaret, Ft. Wayne, Indiana, told us, "We allowed our son to pick his own lunchbox and this made him feel 'special' and more excited about having his own snacks when we go over to a friend's house at mealtime."   Most parents agree that it is important to allow their children to spend time with other children; equally important is an opportunity for parents to meet other parents, or to get away and recharge. Denise Lewis, Support Group Services Director of the Greater Kansas City Chapter of The Asthma & Allergy Foundation, found a way to balance these needs: "Through our adult support group I met some other moms who have kids ages 5 and under. With the help of one of the moms, we formed 'The Play and Learn With Asthmatic and Allergic Youth Group' (PLAY). We have been getting together for a few months and it has been fantastic for the moms and a great way for the kids to meet other kids. It is also becoming a much needed baby-sitting co-op."   Finally, remember that your role will always be to teach others about food allergies. You may find that, as with students, some people are more willing to learn than others. Look upon each situation as an opportunity to practice teaching others about food allergies and to learn what questions are likely to come up when your child enters school. Don't forget to call us if you need additional information.   Adapted from Food Allergy News, Volume 5, Number 1. Last modified on 12/29/00. [Copyright © 2001] [Disclaimer]