Nappy rash at nursery

[Verso]

We've had an ongoing battle with DD developing nappy rash at nursery and then us 'curing' it at the weekend. Have spoken to the manager(s) several times about it and also written once, after Christmas.

Anyway - just wanted to get an opinion or two on whether I'm expecting too much or not. This was brought to a head by the last Bank Holiday weekend as nursery was closed on the Friday as well as the Monday and so DD spent four days with me looking after her. Result? Peachy clear skin on her bottom!

The evening of her FIRST day back - bear in mind her skin was clear in the morning - she could hardly bear to be bathed as she was red raw. :(

I sent another firm letter about this last week and gave them two weeks to turn it around before we start looking for alternative childcare.

Any thoughts? I don't want to move DD to another nursery if it this is normal, as she loves her key worker and is very settled and happy. Is it common for nappies at nursery to be changed by the clock instead of according to need? Any nursery works shed any experienced light on this?

[misdee]

do you provide your own nappies, wipes and creams to the nursery?

[anchovies]

Is it definitely the frequency of nappy changes that's the problem? Only asking because ds's nursery used heavily frangranced wipes that caused a very severe rash that cleared and reappeared like clockwork depending on when he was in nursery.

[waterfalls]

Are they providing her juice? it could be too acidy.
Do they use their own wipes/nappy cream?
Have you tried putting a barrier cream on her bottom before you drop her off?

[Katemum]

How many times a day do they change her?
We also had a problem with the wipes that nursery were using. Luckily for us they changed suppliers soon after dd started.

[Verso]

I provide nappies and wipes (and cotton wool for when it's v bad). I always put ointment on her bot before dropping her off too and as far as I know she doesn't have juice yet, just water or milk.

So - I really do think it's frequency. Well, not exactly frequency, but responsiveness. We change as soon as we realise a nappy is soiled. They change by the clock and only seem willing to increase the frequency of changes, not to alter the pattern - ie to change when required.

I suppose what I'm asking is is it unrealistic of me to expect ANY nursery to change a soiled nappy immediately? If so, we will have to make some BIG changes work and childcare-wise, as I can't have her sitting in poo just because it's not 'time' to change her!!!!!!!

[Verso]

P.S. They were changing her three times and now are changing her five times - but see my previous post. I don't think it's the exact amount that matters. It's WHEN it's done that matters.

[threebob]

Soiled nappies should be changed immediately. Wet ones, well that would have to be a routine or they would go insane.

[Twiglett]

personally I'd look for another childcare option .. you've already brought it to their attention you shouldn't have to give them a 2 week warning as well

have you thought about a childminder?

[HappyMumof2]

sorry to say, this was standard practice in the nurserys I worked at. It was all done by the clock, as is everything in an institutional environment.

As you are providing your own nappies/wipes it's obviously not that. One nursery I worked at used Johnson's Baby lotion on their bums (cheaper)

I would definately expect a poo to be changed when first noticed but unfortunately in many nurseries these things just aren't noticed - no body is actually close enough to the child to smell it Is she in the baby room?

[Verso]

Twiglett - why would a childminder be any better? They usually look after more than one child so the child/minder ratio wouldn't be any better than at nursery.

I'd love to hire a nanny - it seems to me to be the only option (apart from either me or DH giving up work) that would guarantee this wouldn't happen. I'd love to - but I also like to be able to do crazy things like eat and pay the mortgage!!!!

[Verso]

P.S. We went down the nursery route because of continuity of care - if a childminder fell ill one of us would have to take time off work at short notice, which is difficult to arrange and we don't have any family locally as a fall-back position for emergencies. Also, I must reiterate that DD is very happy at her nursery. It's very clean and bright and friendly. I'm just worried about this awful nappy rash problem!!

[ayla99]

Most childminders would change the nappy immediately, as they would do for their own child - I don't know any childminder who would change by the clock.

You will be faced with the same problems at work when your own child is ill, this is likely to be more often than the childminder being ill. Most childminders will have back up plans, although obviously you don't have to use any other childminder they may suggest. And if you're really stuck you have a legal right to time of work for this reason.

Verso, I would tell the nursery that you are more than happy with every other aspect of care but if they don't resolve this you will move your child. She deserves better. If they don't already, get them to write down the times your child was changed & if there is any evidence of rash. Do the same and compare the results with the nursery manager.

[HappyMumof2]

I agree with alya. Childminder's have a much closer relationship to the children in their care and would change a nappy as soon as they realise it is dirty. There is no way any childminder (that I know of) would leave a child in a dirty nappy. Childminders can make sure the child has some time with the nappy off etc, which helps to prevent this kind of problem. Children in nurseries have no time with their nappy off at all which encourages nappy rash.

As for childminders having lots of children, this is a bit of a myth. None of the childminders I know have lots of children. Some (including myself) have one minded child, others may have two. We are only normally registered for 3 under 5 anyway so it's unlikely we would have more than 2 in nappies.

And the time off sick thing, I know this is an issue for some parents, but most childminders I know hardly take any time off sick. I have worked when ill and when my children were ill. I have also taken ill children (which nurseries wouldn't)
Most childminders have friends (other registered cms) they can call on who can be their back up carer.

This is simply not acceptable. You say you are happy with all other aspects of their care, but leaving a child in a dirty nappy (particularly when you know the child is prone to nappy rash) is neglect. The very fact that it clears up so easily when she is with you, shows that you are nuturing and caring for her, and they are not.

Sorry.

[nurseryvoice]

did you know, that when ofsted visit and regulate nurseries that nappies should be changed in accordance with the childs need and not part of the nursery routine?
we have always changed nappies at my nursery when the child needs it, not by the clock??? find this a bit strange in this modern day nursery world.. our baby room is small though only 6 under twos, however this shouldnt make a difference. have a word with the manager and ask? are nappies changed on the hour or when it is needed? if they are unable to abide by yours and ofsteds wishes then you may have to move baby.

[Verso]

Thanks for all your responses. In my letter, I did say I thought it was unacceptable and would be moving DD if it did not improve. I gave them two weeks to see a significant improvement.

I just wanted to find out on here whether it's a problem I'm likely to face at any nursery and not just there, before uprooting her. I don't want to cause her unnecessary upheaval since her relationships there are good and she gets excited about going there. I worry I have a tendency to be overprotective as she is my first child, so I wanted to sound out whether opinion was that this is normal or not!

Sounds like my nursery are failing in their duty of care and I will think about reporting them to Ofsted if we do decide to move her.