Infant and Toddler Care Improving Quality Through Health

Infant and Toddler Care: Improving Quality Through Health and Safety Practices Danette Swanson Glassy, MD, FAAP CA Head Start Association 2015 Health Institute Los Angeles, CA April 29, 2015

Danette Swanson Glassy, MD, FAAP • Mercer Island Pediatrics • Advisory Committee, Head Start National Center on Health • Co-Editor, Caring For Our Children, National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs, 3 rd Edition School readiness begins with health!

Agenda • National Center on Health • Best-Practice/Standards/Regulations Oh My! • Infant/Toddler Care-a few highlights – – – – Medical Home Infection Control Immunizations: children and adults Safe Sleep Developmental Screening Feeding solids (anemia/allergy issues) Nutrition/Physical Activity Others? • Resources • Measure Your Quality School readiness begins with health!

What is Health? “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. ” World Health Organization, 1948 School readiness begins with health!

Office of Head Start National Centers • Program Management and Fiscal Operations • Quality Teaching and Learning • Parent, Family, and Community Engagement NCPMFO NCQTL NCPFCE • Cultural and Linguistic Responsiveness • Early Head Start • Health NCCLR EHSNRC NCH School readiness begins with health!

Head Start National Center on Health Our Goal: Fostering a culture of health and wellness for children, families, staff, and communities Our Foundation: School readiness begins with health!

Sound Management Systems Safety & Injury Prevention Applicable to Home Visits & Child Care Settings Nutrition & Physical Activity Health Literacy Staff, Parent, and Community Engagement Oral Health Mental Health Positively Associated with Improvement in Learning Culturally & Linguistically Appropriate

National Center on Health Partners • American Academy of Pediatrics • Education Development Center, Inc. • Center for Child and Human Development at Georgetown University • National Maternal and Child Oral Health Resource Center at Georgetown University • UCLA Health Care Institute at the UCLA Anderson School of Management School readiness begins with health!

NCH Resources http: //eclkc. ohs. acf. hhs. gov/hslc/tta-system/health/center • • • Newsletters Online courses Webinars Fact sheets T/TA tools School readiness begins with health!

OHS Priority Health Issues Healthy active living Mental health Safety and injury prevention Health literacy Oral health and dental homes • Asthma prevention with special emphasis on tobacco exposure prevention • • • School readiness begins with health!

Emerging Issues • Emergency preparedness and response • Connecting children with medical and dental homes • Health manager networks • Health and home visiting • Toxic stress and trauma in early childhood • Orientation for new health managers • Staff wellness School readiness begins with health!

Who’s Here Today? • Health Managers? • Family Services Managers? • Other Area Managers? • Classroom Staff, Home Visiting Staff, or Family Child Care Providers? • Parents or Family Members? • Directors or Administrators? • Governing Boards/Tribal Council/Policy Council? • Community Partners? • TA Staff? • Federal Staff? • Other? • From California or Other States? School readiness begins with health!

Quality • Evidence-based, expert informed * • Head Start Program Performance Standards • Accreditation Requirements • State Child Care Regulations • Evaluator Interpretation School readiness begins with health!

Medical Home Overall better health with true Medical Home • • accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective School readiness begins with health!

Medical Home • Access-Use local outreach advocates: – Covered California Outreach and Education Grant Partners – http: //www. dhcs. ca. gov/services/medical/eligibility/Documents/OE/Outreachand. Educntygrantees. pdf – Promote www. Well. Visit. Planner. org • Communication – Call, really, I mean it! School readiness begins with health!

Infection Control • Infants and Toddlers more vulnerable • Infants with fever hospitalized if under 2 -3 months • With flu hospitalized at the same rate as senior citizens • Diarrheal illness significantly reduced with proper hand hygiene, sanitizing/disinfecting School readiness begins with health!

Infection Control Cleaning, Sanitizing, Disinfecting – Written policy – Which-for-What: CFOC Appendices J and K • http: //cfoc. nrckids. org – Alameda County Green Child Care: • http: //acgov. org/ece/green_childcare. htm – Coalition for Safety and Health in Early Learning: • http: //cshelwa. org/downloads/13_Disinfect_E 15 L. pdf School readiness begins with health!

Infection Control Hand Hygiene http: //www. cdc. gov/CDCTV/handstogether/ http: //www. cdc. gov/CDCTV/Wash. Your. Hands / School readiness begins with health!

Infection Control • Diapering – Use posters: • http: //www. ecels-healthychildcarepa. org/ • http: //here. doh. wa. gov/materials/how-to-change-adiaper/12_Diaper. CCsm_E 12 L. pdf • Policy for parents using the diapering area • Hand washing nowhere near food and bottle prep sink/area School readiness begins with health!

Infection Control • Inclusion/Exclusion • Written policy shared with parents-Plan B • Help from health professional– Child Care Health Consultant – Health Services Advisory Member (Weaving Connections) – Specific child’s Health Care Provider (call, really) School readiness begins with health!

Immunizations • Timing critical for Infants and Toddlers • Trusted Advisor • Parent Friendly resources • Staff Immunizations a must • Parent Immunizations • http: //www. cdph. ca. gov/prog rams/immunize/Pages/School s-and-Childcare-Centers. aspx School readiness begins with health!

Immunizations Resources Measles Simulation: http: //fred. publichea • CA DOH: lth. pitt. edu/measles/ http: //www. cdph. ca. gov/progr results. php ams/immunize/Pages/Schoolsand-Childcare-Centers. aspx • AAP: https: //www 2. aap. org/immuni zation/index. html School readiness begins with health!

Developmental Screening Critical Elements • Evidenced based tool • Easy to understand use • Practice communicating results • Know how to refer • Always share results with health care provider School readiness begins with health!

Developmental Screening • EHS tip sheet No. 6 • Learn the Signs, Act Early – Home pagehttp: //www. cdc. gov/ncbddd/actearl y/index. html – Free online training for Early Education and Child Care Providershttp: //www. cdc. gov/ncbddd/watch metraining/index. html School readiness begins with health!

Safe Sleep • More than SIDS, think SUIDS— Sudden Unexplained Infant Deaths • Positioning AND Environmentcribs, blankets, temperature, cords, bumpers • Resources and Free online traininghttp: //www. healthychildcare. org /sids. html School readiness begins with health!

Safe Sleep http: //www. healthychildcare. org/sids. html • A Parents' Guide to Safe Sleep ( Also available in Spanish) This brochure includes information for parents about infant sleep positioning and practices as well as describes how parents can work with child care providers to ensure that safe sleep practices are used in all child care settings as well as at home. (Updated April 2012) • A Child Care Provider's Guide to Safe Sleep (Also available in Spanish) This easy-to-read brochure provides child care providers with information about ways to promote safe sleep practices and reduce the risk of SIDS. (Updated April 2012) • Tummy Time This brochure provides information about the importance of supervised tummy time and how it promotes healthy development. (Revised 2011) School readiness begins with health!

Safe Sleep • More information about the new play yard standards. Links to keeping babies safe in their sleeping environments is at the Crib Information Center on CPSC’s website. Online learning module: Safe Sleep Practices and SIDS/Suffocation Risk Reduction This spinoff includes safe sleep practice standards from Caring for Our Children, 3 rd Edition. www. healthychildcare. org/sids School readiness begins with health!

Feeding Solids • “Cue feed”, just like feeding bottles • New recommendations: – Promote iron-rich foods early on – Introduce allergy-prone foods before 12 months School readiness begins with health!

Nutrition/Physical Activity Remember NCH website: • http: //eclkc. ohs. acf. hhs. gov/hslc/ttasystem/health/nutrition. html • http: //eclkc. ohs. acf. hhs. gov/hslc/ttasystem/healthy-activeliving/healthy-active-living. html School readiness begins with health!

Little Voices for Healthy Choices School readiness begins with health!

Nutrition/Physical Activity Containers Resources to keep infants and toddlers moving: • Motion Momentshttp: //nrckids. org/index. cfm/ products/videos/motionmoments 1/ • Bright Futureshttp: //www. brightfutures. org /physicalactivity/pdf/Infancy. pdf School readiness begins with health!

Others School readiness begins with health!

Resources • Caring For Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education, 3 rd Edition • http: //cfoc. nrckids. org • Available in print or online School readiness begins with health!

Resources CFOC Spinoffs: • Caring for Infants and Toddlers in Early Care and Education • Stepping Stones* • Preventing Childhood Obesity in ECE Programs* • Safe Sleep Practices and SIDS/Suffocation Risk Reduction • Oral Health in Child Care and Early Education • Environmental Health in ECE • Coming Soon: Caring for Children with Special Health Care Needs in ECE School readiness begins with health!

Resources • Healthy Child Care America – www. healthychildcare. org – AAP – Information, resources, trainings – Sign up for newsletter School readiness begins with health!

Resources National Resource Center for Health and Safety in Child Care and Early Education • www. nrckids. org • Houses CFOC and Spin Offs • Search state child care regulations • Child Care Health and Policy information • Sign up for E-Resources Newsletters School readiness begins with health!

Resources AAP books • Managing Infectious Diseases in Child Care and Schools, 3 rd Edition • Easy to use guide with specific diseases and conditions • Easy to copy information about inclusion and exclusion School readiness begins with health!

Resources AAP Books • Managing Chronic Health Conditions in Child Care and Schools • Easy to use format, specific conditions addressed, easy to reproduce forms and handouts School readiness begins with health!

Resources AAP Books • Model Child Care Health Policies, 5 th edition • Also available online at http: //www. ecelshealthychildcarepa. org/publications/ manuals-pamphletspolicies/item/248 -model-child-carehealth-policies School readiness begins with health!

Resources AAP Books • Ped. FACTs-Pediatric First Aid for Caregivers and Teachers, 2 nd edition • Manual and a training program • www. pedfactsonline. com School readiness begins with health!

Resources Health Consultation Websites • California Child Care Health: http: //www. ucsfchildcarehealth. org/ • Disinfecting/Sanitizing Worksheets • Integrated Pest Management Toolkit • Health and Safety Checklist School readiness begins with health!

Resources Health Consultation Websites • Early Childhood Education Linkage System – http: //www. ecels-healthychildcarepa. org/ – Professional Development, Training, Tools • Public Health Seattle King County Child Care Health Program – http: //www. kingcounty. gov/healthservices/health/childcare. aspx – Trainings, Tools, Model Policy recently updated School readiness begins with health!

Measure Your Quality • Head Start Health and Safety Checklist • Stepping Stones to Caring for Our Children, 3 rd Edition Compliance/Comparison Checklist http: //nrckids. org/index. cfm/products/steppingstones-to-caring-for-our-children-3 rd-edition-ss 3/ • CCCH Health and Safety Checklist http: //www. ucsfchildcarehealth. org/pdfs/Checklists /HS_Checklist. pdf School readiness begins with health!

National Center on Health Contact Information Toll-free: 888 -227 -5125 E-mail: nchinfo@aap. org Website: http: //eclkc. ohs. acf. hhs. gov/hslc/ttasystem/health/center School readiness begins with health!