Day Care Optionsby Jan Gambino Patient Expert
Leaving your baby with reflux in the care of a day care provider takes some planning and research. You will need to find out what options are available in your community, evaluate the cost and, most of all, check your gut to see which one "feels" right for you and your baby. Every parent goes through this checklist, regardless of whether or not there is a health issue. A baby with reflux may need extra care and accommodations and your worry quotient may be much higher. Remember, all day care options should be explored. There are pros and cons to every type of day care option: in-home care, family day care in a home or a day care center. Babies with reflux do just fine in all types of day care situations.
In-home care includes day care provided by a family member, nanny or baby sitter. In-home care often offers a smaller ratio of caregivers to children, perhaps even one-to-one care. For a high-need baby, this may be essential. In-home care can give you more control over the feeding and sleep schedule and limit germ exposure from other children. It may be possible to leave a baby recovering from an illness in the care of your in-home provider if you feel comfortable doing so. An in-home provider may be able to help you in other small ways, such as preparing medicine and special meals and helping with the laundry. The down side is your in-home provider may receive little support or adult contact during the day. If your baby isn't able to tolerate the stroller or car seat, your day care provider might be stuck in the house all day. If your provider gets another job or quits unexpectedly, you will have to scramble to find another provider.
Out-of-home care includes a licensed family day care business in a private home or a day care center. Often there is an established ratio of adults to children, so it is unlikely your refluxer will get one-to-one care. However, a day care center may be able to adjust their staffing so that a high-need baby can have special care for feeding, rocking to sleep or a fussy period as needed. While one day care provider may be assigned to your baby, a day care center can offer many hands to help, decreasing burn out from caring for a high-need baby. On the down side, there is often more germ exposure from group day care, as well as stricter schedules for meals, naps and other routines. A baby who vomits may be sent home under the assumption that she is ill with the stomach bug, not from reflux. You will need to work with the center staff and the doctor to establish guidelines for assessing an illness vs. a reflux episode. Family day care and day care centers offer reliable, on going care.
In the beginning, you, your baby and your provider will need to adjust to the new day care arrangements. You might feel strong feelings, such as anxiety and sadness, while your baby may react to a new provider by temporarily changing her eating and sleep pattern. This is normal and expected. Give yourself some time to get used to the schedule and to develop a routine.
It is important to establish expectations and open communication with your provider early on. If there is a great deal of information to convey, provide a written schedule and instructions. Sometimes it helps to have a journal or checklist for each day for medication, bottles, vomiting, diapers changed and more. Listen carefully to your provider and let her know you value her opinion and observations. Let her know you understand how important her job is and how tough some days can be. Most of all, thank her for caring for your baby.