10.1: Promoting Good Health and Wellness

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Heather Carter and Amber Tankersley
Pittsburg State University

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Introduction

Healthy development continues to support learning throughout childhood and later life. “Health in the earliest years…lays the groundwork for a lifetime of well-being…”³⁰³ To promote the health of children in early care and education programs, it’s important to keep records of both children's and staff’s health. Programs can support children’s oral health and healthy sleep habits. And they can help identify developmental and health concerns with screening.

C:\Users\paris_j\Pictures\OER Images\water table play from it pg2.JPG — Figure 10.1.1 – Healthy children thrive!³⁰⁴

Daily Health Checks

Every day an informal, observation-based quick health check should be performed on every child (before the parent/caregiver leaves). Early childhood educators should use their knowledge about what is normal for a child to identify any concerns about the child’s well-being (but not as an attempt to formally diagnose illness). It is not a process that formally excludes children from illness, but following up concerns noticed at a health check may find reasons to exclude children.

“In a childcare setting where lots of people are coming at the same time, it is hard to take a moment with each child. However, this welcoming routine can establish many things and is a good child development policy. This contact will help [teachers] better understand each child, help the children feel comfortable and good about themselves, reduce the spread of illness by excluding children with obvious signs of illness, and foster better communications with [families].”³¹³

C:\Users\paris_j\Pictures\OER Images\drop off time from it pg2.JPG — Figure 10.1.2 – Teachers should do a health check when each child is dropped off.³¹⁴

Conducting Daily Health Checks

Teachers should use all of their senses to check for signs of illness. This includes:

Listening to what families tell you about how their child is feeling and what the child sounds like (hoarse voice, coughing, wheezing, etc.)
Looking at the child from head to toe (with a quick scan) to see if the child looks flushed, pale, has a rash, has a runny nose or mucus in the eyes
Feeling the child’s cheek or neck (as part of a greeting) for warmth or clamminess
Smelling the child for unusual-smelling breath or a bowel movement.

Here are the signs to observe:

General mood and atypical behavior
Fever (elevated temperature)
Rashes or unusual spots, itching, swelling, and bruising
Complaints of not feeling well
Symptoms of illness (coughing, sneezing, runny nose, eye or ear discharge, diarrhea, vomiting, etc.)
Reported illness in child or family members³¹⁵^,³¹⁶

Children’s Health Records

“The health and safety of individual children requires that information regarding each child in care be kept and available when needed. Children’s records consist of various documentation such as a child’s medical and immunization history, emergency medical care information, and parental permission to participate in specific activities…Each child care facility must keep accurate records on each child receiving care in child care.”³⁰⁵

Health records can help early care and education programs identify preventative health measures, develop care plans for children with special needs, and determine whether or not a child should be excluded from care due to illness.

Most child care licensing requirements list the following health-related and other items to include in the child’s records:

Contact information for parents, guardians, and at least two emergency contacts that can be reached at all times.
Medical assessment and the following health information:

Dietary restrictions and allergies.
Instructions for action to be taken in case the child's authorized representative, or the physician designated by the authorized representative, cannot be reached in an emergency.
A signed consent form for emergency medical treatment

Record of any illness or injury requiring treatment by a physician or dentist and for which the center provided assistance to the child in meeting his/her necessary medical or dental needs.
Record of current medications, including the name of the prescribing physician, and instructions, if any, regarding control and custody of medications.
Current and updated immunization records³⁰⁶

The National Health and Safety Standards recommends that the following also be included in the child’s records:

A health history completed by the family at admission
The ch’s health insurance information³⁰⁷

Image result for file folders — Figure 10.1.3 – Keeping health records for children and staff is important.³⁰⁸

Staff Health Records

It is also important for records to be kept to document the health of all staff in an early care and education program. Licensing requires the following health-related items to be in staff records:

Health screening report
TB clearance³⁰⁹

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The Importance of Keeping Staff Healthy

A culture of wellness is a working environment where an employee's health and safety is valued, supported, and promoted through worksite, health and wellness programs, policies, benefits, and environmental supports. A culture of wellness for staff is really going to be the foundation for creating a culture of health and safety for children.

Staff have health problems such as obesity and depression at rates above the national average. Early care and education salaries are often low, creating personal financial stress. Staff turnover rates are high. In general, early childhood educators are undervalued for the important and high-demand work they do.

Staff wellness and stability will affect the quality of services a program is able to deliver to families and children. Children need consistent, sensitive, caring, and stable relationships with adults. Adults who are well, physically and mentally, are more likely to engage in positive relationships. When we support staff well-being, we strengthen early care and education.

Programs can use the CDC’s Workplace Health Model to support the health of their staff.³¹¹ It is outlined in this image.

Workplace Health Model graphic that outlines how to improve employee health at work — Figure 10.1.4 – The CDC’s Workplace Health Model of assessment, planning and management, implementation, and evaluation.³¹²

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Pause to Reflect

What does staying healthy mean to you? What do you do (or could you do) to manage your stress, reinforce your resilience, and keep yourself physically healthy (nutrition, activity, etc.)? How could your employer help you stay healthy?

Lead Screening

Lead screening measures the level of lead in the blood. Lead is a poison that is very dangerous for young children because of their small size and rapid growth and development. It can cause anemia, learning difficulties, and other medical problems.

Children can inhale or swallow lead through exposure to:

Home or childcare environments, including those:
- Built before 1960 with peeling paint or renovation
- Located near a highway or lead industry
Family members who work with lead or have been treated for lead poisoning
Imported ceramic pottery for cooking, storing, or serving food
Home remedies with lead ingredients
Certain candies, may contain high levels of lead in the wrapper or stick. Be cautious when providing imported candies to children.
Eating paint chips or dirt
Water pumped through lead-based pipes

Lead screening involves a blood lead test, from a finger stick or a venous blood draw. It is recommended at 12 months and 24 months of age. Children from 3 to 6 years of age should have their blood tested if they have not been tested.

Immunizations

Prevention of infectious diseases starts with immunizations (or vaccines). Immunizations are considered the number one public health intervention of the 20th century and one of the top 10 interventions of the first decade of the 21st century.³⁵⁷

On-time vaccination throughout childhood is essential because it helps provide immunity before children are exposed to potentially life-threatening diseases. Vaccines are tested to ensure that they are safe and effective for children to receive at the recommended ages.³⁵⁸ See Figure 10.1.5 for the current schedule of immunizations.

Fully vaccinated children in the U.S. are protected against sixteen potentially harmful diseases (see Figure 10.1.5). Vaccine-preventable diseases can be very serious, may require hospitalization, or even be deadly — especially in infants and young children.³⁵⁹

Here is the schedule from the CDC to ensure a child is fully vaccinated:

2019 immunization schedule — Figure 10.1.5 – "Immunization schedule" by the Centers for Disease Control and Prevention in the Public Domain.

How Vaccines Work

The immune system helps the human body fight germs by producing substances to combat them. Once it does, the immune system “remembers” the germ and can fight it again. Vaccines contain germs that have been killed or weakened. When given to a healthy person, the vaccine triggers the immune system to respond and thus build immunity.

Before vaccines, people became immune only by actually getting a disease and surviving it. Immunizations are an easier and less risky way to become immune.

Vaccines are the best defense we have against serious, preventable, and sometimes deadly contagious diseases. Vaccines are some of the safest medical products available, but like any other medical product, there may be risks. Accurate information about the value of vaccines as well as their possible side effects helps people to make informed decisions about vaccination.

Potential Side Effects

Vaccines, like all medical products, may cause side effects in some people. Most of these side effects are minor, such as redness or swelling at the injection site. Read further to learn about possible side effects of vaccines.

Any vaccine can cause side effects. For the most part, these are minor (for example, a sore arm or low-grade fever) and go away within a few days.³⁶² Serious side effects after vaccination, such as severe allergic reaction, are very rare.³⁶³

Remember, vaccines are continually monitored for safety, and like any medication, vaccines can cause side effects. However, a decision not to immunize a child also involves risk and could put the child and others who come into contact with him or her at risk of contracting a potentially deadly disease.

How Well Do Vaccines Work?

Vaccines work really well. No medicine is perfect, of course, but most childhood vaccines produce immunity about 90–100% of the time.

What about the argument made by some people that vaccines don’t work that well and that diseases would be going away on their own because of better hygiene or sanitation, even if there were no vaccines?

That simply isn’t true. Certainly better hygiene and sanitation can help prevent the spread of disease, but the germs that cause disease will still be around, and as long as they are they will continue to make people sick.

All vaccines must be licensed (approved) by the Food and Drug Administration (FDA) before being used in the United States, and a vaccine must go through extensive testing to show that it works and that it is safe before the FDA will approve it. Among these tests are clinical trials, which compare groups of people who get a vaccine with groups of people who get a control. A vaccine is approved only if FDA makes the determination that it is safe and effective for its intended use.

If you look at the history of any vaccine-preventable disease, you will virtually always see that the number of cases of disease starts to drop when a vaccine is licensed. Vaccines are the most effective tool we have to prevent infectious diseases.

Opposition to Vaccines

In 2010, a pertussis (whooping cough) outbreak in California sickened 9,143 people and resulted in 10 infant deaths: the worst outbreak in 63 years (Centers for Disease Control, 2011b). Researchers, suspecting that the primary cause of the outbreak was the waning strength of pertussis vaccines in older children, recommended a booster vaccination for 11–12-year-olds and also for pregnant women (Zacharyczuk, 2011). Pertussis is most serious for babies; one in five needs to be hospitalized, and since they are too young for the vaccine themselves, it is crucial that people around them be immunized (Centers for Disease Control, 2011b). Several states, including California, have been requiring the pertussis booster for older children in recent years with the hope of staving off another outbreak.

But what about people who do not want their children to have this vaccine, or any other? That question is at the heart of a debate that has been simmering for years. Vaccines are biological preparations that improve immunity against a certain disease. Vaccines have contributed to the eradication and weakening of numerous infectious diseases, including smallpox, polio, mumps, chickenpox, and meningitis.

Polio physical therapy — Figure 8.7 – These two young children contracted polio.³⁶⁴

However, many people express concern about the potential negative side effects of vaccines. These concerns range from fears about overloading the child’s immune system to controversial reports about the devastating side effects of the vaccines.³⁶⁵

Although children continue to get several vaccines up to their second birthday, these vaccines do not overload the immune system. Every day, an infant’s healthy immune system successfully fights off thousands of antigens – the parts of germs that cause their immune system to respond. Even if your child receives several vaccines in one day, vaccines contain only a tiny amount of antigens compared to the antigens your baby encounters every day.

This is the case even if your child receives combination vaccines. Combination vaccines take two or more vaccines that could be given individually and put them into one shot. Children get the same protection as they do from individual vaccines given separately—but with fewer shots.³⁶⁶

One misapprehension is that the vaccine itself might cause the disease it is supposed to be immunizing against.³⁶⁷ Vaccines help develop immunity by imitating an infection, but this “imitation” infection does not cause illness. Instead, it causes the immune system to develop the same response as it does to a real infection so the body can recognize and fight the vaccine-preventable disease in the future. Sometimes, after getting a vaccine, the imitation infection can cause minor symptoms, such as fever. Such minor symptoms are normal and should be expected as the body builds immunity.³⁶⁸

Another commonly circulated concern is that vaccinations, specifically the MMR vaccine (MMR stands for measles, mumps, and rubella), are linked to autism. The autism connection has been particularly controversial. In 1998, a British physician named Andrew Wakefield published a study in Great Britain’s Lancet magazine that linked the MMR vaccine to autism. The report received a lot of media attention, resulting in British immunization rates decreasing from 91 percent in 1997 to almost 80 percent by 2003, accompanied by a subsequent rise in measles cases (Devlin, 2008). A prolonged investigation by the British Medical Journal proved that not only was the link in the study nonexistent but that Dr. Wakefield had falsified data in order to support his claims (CNN, 2011). Dr. Wakefield was discredited and stripped of his license, but the doubt still lingers in many parents’ minds.

In the United States, many parents still believe in the now-discredited MMR-autism link and refuse to vaccinate their children. Other parents choose not to vaccinate for various reasons like religious or health beliefs. Many states offer religious and or personal vaccine exemptions through the state's public health agency, where parents are required to submit a notarized document in return for an official state waiver in order to enroll in school.

Baby with measles — Figure 8.8 – An infant with measles³⁶⁹

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Pause to Reflect

Using the information that has been provided about immunizations, think of ways you could respond to the following:

“I don’t believe in giving all of the vaccines, like chicken pox. It’s better for children to just get the disease like we all did when we were kids.”
“Why do they have to give vaccines so early? It seems like it’s too much, too quickly.”
“I have heard that vaccines give some kids autism. And even if they don’t, the side effects are just too scary.”

References

This page was adapted from 7: Promoting Good Health and Wellness by Paris. in Paris, J. (2021). Health, safety and nutrition. LibreTexts.

For references according to subscript, please see pages 165-190 abd 198-206 of the original Health, Safety and Nutrition book (Paris, 2021) on Google Drive.

Centers for Disease Control. (2011a). Perceived exertion (Borg rating of perceived exertion scale). Centers for Disease Control and Prevention. Retrieved from: http://https://www.cdc.gov/physical-activity/php/about/index.html?CDC_AAref_Val=https://www.cdc.gov/physicalactivity/everyone/measuring/exertion.html

Centers for Disease Control. (2011b). Pertussis. The Centers for Disease Control and Prevention. Retrieved from: https://www.cdc.gov/pertussis/outbre...outbreaks.html

Conrad, P., & Barker, K. K. (2010). The social construction of illness: key insights and policy implications. Journal of health and social behavior, 51 Suppl, S67–S79. https://doi.org/10.1177/0022146510383495

Devlin, K. (September 24, 2008). Measles worry MMR as vaccination rates stall. The Telegraph. Retrieved from: http://www.telegraph.co.uk/news/ukne...tes-stall.html

CNN. (2011). Retracted Autism study an 'elaborate fraud,' British journal finds.” CNN. Retrieved from: http://www.cnn.com/2011/HEALTH/01/05...nes/index.html

Sugerman, D. E., Barskey, A. E., Delea, M. G., Ortega-Sanchez, I. R., Bi, D., Ralston, K. J., Rota, P. A., Waters-Montijo, K., & Lebaron, C. W. (2010). Measles outbreak in a highly vaccinated population, San Diego, 2008: role of the intentionally undervaccinated. Pediatrics, 125(4), 747–755. https://doi.org/10.1542/peds.2009-1653

Zacharyczuk, C. (2011). Myriad causes contributed to California pertussis outbreak. Pediatric Supersite. Retrieved from: http://www.pediatricsupersite.com/view.aspx?rid=90516

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The Importance of Keeping Staff Healthy

How Vaccines Work

Potential Side Effects

How Well Do Vaccines Work?

Opposition to Vaccines

Pause to Reflect