Dreading Daycare

[jfindley]

I am having some internal conflict about what type of childcare will be best for my former 26weeker. I will need to either have someone come into our home or take him to daycare in January. He will be 14months(11.5 CA) at that time. He is really robust now and developing normally, but I still worry about RSV. His ped. says we should still keep him away from obviously sick people and children, but otherwise, we should began socializing him. All of the books say that if you were released from NICU in the middle of RSV season(which we were-Feb-completed Synagis treatment) then you should also "quarentine" your preemie for the following RSV season as well, as they need to get through one entire season. I know his extremely early arrival warrants these precautions, but I feel like our ped thinks he is doing so well, that we won't need to be that careful this winter. Which leads me back to my original issue- which is the better decision-Daycare for the socialization he will get, or in home care to assure to reduce his exposure to RSV? I feel like after coming through his early birth so well, why tempt fate, but I also don't want to be so overprotective that I impede his social development. Any insight would be appreciated.

[trish]

You could always do in home for a few months or a year even & then switch to daycare when he is a little older. I wouldn't think his social development will suffer if he starts at age 2 instead of 1. Are you getting Synagis shots this winter too?

[kara]

Our daughter had a congenital heart defect that wasn't fixed until age 2. She started daycare at 18 months. Our pediatrician assured us that because she didn't have any continuing lung problems, and she was over 12 months, that RSV was less concerning.

In NICU it is drilled into our heads that RSV should be our biggest nightmare - and that is true, when you have a brand new preemie. Once they are past 12 months, unless they have a lung condition, it is a normal part of life. Almost every kid will get RSV by the age of two. It's one of the most common cold viruses. It's an issue with preemies because of underdeveloped lungs, very low birth weight, underactive immune system. Our daughter had several colds the first and second years of daycare, but no more than any other kid. She also had heart surgery in between and we were told to treat her like a normal child. They have to get sick to develop their immune systems.

And while getting RSV is a risk, it's a risk for kids who were full term and have no health conditions, too...and even they can land in the hospital. But most kids who get RSV don't end up in the hospital.

I've never heard to quarantine a preemie a second year, if they were born mid-rsv season. The synagis shots don't build immunity, which is why they have to be given every 28 days. If they are not exposed, they won't build immunity.

You might want to consider an in home daycare or a daycare center where the ratio of kids under two is small. Our daughter went to a center, but she was only 1 of 4 kids in her class room, so there was always someone wiping noses, disinfecting toys, etc....

It'l be nerve-wracking...no doubt. It's VERY hard to send them off to "school". I can still remember my anxiety! EEK! But it was the best thing I did for my little social butterfly. Good luck in your decision.

[patty]

If in home care were in option I would definitly go for that and not a group situation. I don't think socialization is that important until the age of 3 or so and if you get a good care provider then the one on one is definitly going to be better then group care where the toddler to teacher ratio is often 1 to 6. I have worked in daycares and I don't care how clean they are they cannot prevent air born illnesses. My baby is 14 months now and I would not be comfortable with him in group care this winter but he has had pnuemonia twice and like I said in general I am not too comfortable with group care before age 3 even for full term babies. If they can stay home until that time I think it is always better but that is just my personal opinion having worked in daycares before in infant and toddler rooms. The toddler room in particular is not a dynamic I would want my child in especially a preemie who is likely to be smaller than the others. A lot of moms love their daycares and have good results so you should do what makes you the most comfortable. A good daycare with a good teacher to child ratio can be wonderful,but I would not worry about the social thing until they were older.

[aundapenner]

In Germany, it is common for children to start daycare at the age of 3 because of socialization. As a preemie mom, if I had found the right person and had the financial means, I would have taken someone in home for at least the first year (maybe 2-3).

Henry is getting ready to start preschool next month. I'm concerned about his health, but he really has done well the last few months.

My only advice - trust your instincts.

(((hugs)))

[hannahsmom]

We had the same dilemma. When Hannah, our 26 weeker, was first released from the NICU, my dh stayed with her for two months while I went back to work because I carried the insurance. After that, he had to go back to work and a friend of ours babysat Hannah. Our friend had school-age children, but no little ones, so that worked out. Then we moved, and we put her in a home daycare at a year old. When she turned a year and a half, we put her in a big daycare. Yes, she did get sick, but our ped. said he would rather her catch colds and build up her immunity early on instead of missing her entire first year of school due to exposure to illnesses. We made sure she got the synagis shot again during her second RSV season, and then every year after that, she has gotten a flu shot. At almost 8 years old, she still gets sick sometimes, but nothing too serious. I think she will forever have a low immune system. Having to put Hannah in daycare was really hard for me, but I had to work. It stinks! Best of luck to you on your decision.

[kdreher]

I am sort of like Suzanne was. Michael came home from NICU end of Dec. I had to go back to work in mid-March (leave ran out and I carry insurance), dad stayed home for 2 1/2 months. Michael is a 32 weeker and he started daycare around 6 1/2 months and our pedi had no issue with it. He rec'd Synagis shots from Dec through April. He is in a daycare facility at my work - it's highly accredited and just awesome. He did have a double ear infection about three weeks ago and then developed bronchitis (doc said it was viral and wasn't sure it he leaned toward RSV or asthma) but one week on a nebulizer and he was fine. Our pedi did not mention any issue with him going to daycare at this age and no matter what age they start they will be suspetible to getting sick from other kids. We are hoping Michael will get the synagis this coming season as well.

It's not easy - I was so upset he had bronchitis but little man was just fine. Michael is doing so well and being that he's 8 weeks behind, they do a great job with socialization and working on him to sit up on his own, etc. I love it. I can check on him any time :) and the daycare falls under my division so I know everyone :)

Right before we got our daycare slot I was interviewing LICENSED in home daycares and I got the list from our state website. Honestly my dh nor I wanted anyone in our home and I wanted someone licensed in case there was an issue - they could be held accountable somehow, the average babysitter in my home could not. Luckily we didn't have to go with an in home daycare.

[bethany123]

We've done both daycare and a nanny. My preemie started at 6 months and never had a problem. 2 years later DS who was full term did get a bad case of RSV and flu at the same time, go figure. While I prefer having a nanny and doing part time preschool now, daycare can be a very good option too. I don't think the socialization is necessary before age 3 either but its nice.

One option to consider if you have extra living space is an au pair. Several of the larger agencies offer an au pair extraordinaire program that costs a little more but offers older and more experienced au pairs. We have friends with an autistic child who found an au pair with a degree in special ed and speech pathology. They have former nurses, teachers etc. If you live in a metro area its cheaper than a nanny.

[jfindley]

Thanks for all of your thoughts. I ended up choosing a family style daycare run out of the providers home. I did some extensive interviewing and with assurance from our ped. that Isaac is not vulnerable any longer, choose this place. They only have 8 children, 2 caregivers. Very clean and very understanding of Isaac's difficult start and the need to wash hands etc. I feel good about the decision, but it really does break my heart that he will be away from me soon. I brought him in to observe and meet everyone twice and he had such a great time. It is a really nice, stimulating environment for him. I am prepared for a a few colds and ear infections, but if he seems to be sick too much I will not hesitate to make other arrangements. Thanks for all of your feedback during this difficult decision.