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Managing Hand, Foot and Mouth in your setting

Winter is upon us and the light evenings are fading into dark nights. I notice a great difference at pick up time as the nights draw in, that last hour of care seems so much longer when it is dark and cold outside.

This is the time of year that we shut the curtains and turn up the heating to keep snuggled and warm. But this is also the time that we, as Early Years Practitioners, notice that the children are getting coughs, colds, sticky eyes and the dreaded hand, foot and mouth to name but a few.

We have all had it – the parent who brings their child to the door and you can see that they have blisters on their mouth. So, you ask the parent about it and they often haven’t noticed or don’t know what it is – but you do! It’s hand, foot and mouth.

What is Hand, Foot and Mouth?

Hand, Foot and Mouth is a common childhood illness but can also affect adults. It is usually mild and gets better on its own after seven to 10 days but can cause some discomfort and is easily passed on through coughs, sneezes, faecal matter and the fluid in blisters.

What are the symptoms of Hand, Foot and Mouth?

Symptoms are often similar in both adults and children but can be more severe in children under 5 years of age and babies. Signs to look out for include:

  • A sore throat
  • A high temperature
  • Loss of appetite
  • Mouth ulcer and a rash

The NHS website provides images of the type of ulcer and rash to look out for

Treating Hand, Foot and Mouth

You cannot take antibiotics or medicines to cure hand, foot and mouth disease. It usually gets better on its own in seven to 10 days.

To help the symptoms:

  • drink fluids to prevent dehydration – avoid acidic drinks, such as fruit juice
  • eat soft foods like yoghurt – avoid hot and spicy foods
  • take paracetamol or ibuprofen to help ease a sore mouth or throat

Do children need to be kept away from school and a childcare setting?

This is when we refer to the Government exclusion table for illnesses for further advice and guidance on exclusion periods. However, as you’ll see in the table, we look for it and it tells us that there is no exclusion period needed. This can then present challenges. It is often difficult to reason with some parents that they should keep their children at home when they have hand, foot and mouth as they will tell you it isn’t on the list for exclusion or that the Doctor has told them it is fine to bring them to childcare. If the child is visibly unwell then parents will keep the child at home but if they are not unwell and showing symptoms of hand, foot and mouth, they may pass it on to another child and this has the potential to make them quite poorly.

If you decide that you are going to exclude children from your setting with hand, foot and mouth, conjunctivitis or any other illness not listed as excluded, then you will need to make sure that they are clearly written in your setting policies and that parents have read and acknowledged your policy. PACEY can help you with writing policies and offer a fantastic variety of policy templates including ‘Illness/infectious disease and exclusion procedure’ that you can then amend as you need for your setting. All of PACEY’s templates are up to date with the EYFS 2021. Members can access these in MyPACEY.

PACEY understand the position that Early Years Practitioners are in and provide lots of advice and training including the blog Having difficult conversations with parents to help deal with situations that are tricky such as speaking to parents regarding difficult situations like this. Don’t forget that PACEY members can also access the PACEY Advisor helpline and speak to one of their experts.

How can I prevent Hand, Foot and Mouth and other winter viruses in my setting?

So, we know how to manage parents and the child who is unwell, but what can we, the Early Years Practitioners, do to safeguard the children and ourselves against these nasty bugs and viruses?

One of the simplest things that we can do is to ensure that the children are maintaining good hygiene, including washing their hands in the correct way. PACEY’s member-exclusive training on CEY Smart has free training on hand washing called ‘Promoting and supporting handwashing in your setting’. Access this in the Fit and Healthy course theme in CEY smart. It’s a simple action and we all know how to do it but by taking the course and recording it as part of your Continued Professional Development, you can assure parents and Ofsted that you are following the correct procedure in effectively minimizing the risk of infection and safeguarding the children in your care.

You can also take a look at the illness and infection control spotlight that has lots of fantastic information that helps deal with infection such as factsheets, policies and when to notify the authorities. PACEY members can also access all infection control resources in MyPACEY so that you can keep the environment a safe place for everyone.

Don’t forget that keeping up to date on the latest information and doing regular training helps us to keep the children safeguarded from harm, part of the Statutory Framework for the Early Years.

When should illness at our settings be notifiable?

The Statutory framework for Early Years tells us to refer to the Government Documentation

Health protection in schools and other childcare facilities - GOV.UK (www.gov.uk)

This document tells us that an outbreak of illness is to referred to if there are two or more cases at the setting (Chapter 4: What to do if you suspect an outbreak of infection).  If this is the case at your setting, then you will need to contact your local Health Protection Team who will advise you of any further action that is required.

It has been a tough 18 months keeping ourselves and the families we work with, safe and well from Coronavirus so it’s easy to forget that other winter viruses are prevalent now that winter has arrived. By thinking ahead, being informed, making plans and risk assessing for when the situation arises, we can be prepared for the winter and whatever coughs and sneezes we encounter.

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