Oct
28
2014

How To Choose Who Will Look After Your Child

Stay-At-Home-Parent, Nanny Or Daycare? Who Provides the Best Care?

How To Choose Who Will Look After Your Child

Choosing a care provider for your kids is one of the hardest things a parent has to do. You are talking about hiring someone to look after your most-prized possession, for many hours a day, for potentially many months or years before they start school. This is a BIG decision. It doesn’t help that both nannies and daycares are expensive, sometimes prohibitively so. Then parents may face another decision — should one parent stay home and forgo a salary? Should a grandparent step in to provide childcare? These are tough decisions!

In North America many parents are entrenched in debates about what is best for children: being a stay-at home mother or father, using daycare, or using a nanny. Of course, these are not all equal, and not all stay-at-home parents, daycares, or nannies are equal. Some stay-at-home parents or nannies are uninspired and bored, and their lack of enthusiasm is inferior to daycare. Some daycares are unsafe, unclean, or over-capacity. We are not comparing apples to apples all the time. There are many factors to consider.

I cannot imagine how hard it must be to be a stay-at-home parent. Would I be as enthusiastic playing with my children day-in-day-out if I were home all year? Or is someone else better-suited for this most difficult task?

 

What to consider

Cost to the various options is of importance, naturally. Stay-at-home parents forgo a salary. If this salary is more than the cost of daycare or a nanny, this may be a financial tipping point. Is the quality of childcare from a parent higher than that of daycare or a nanny? Surely, this is sometimes the case. In other families the parents may feel they would provide inferior care to their child. At the end of a weekend I am exhausted. I cannot imagine how hard it must be to be a stay-at-home parent. Would I be as enthusiastic playing with my children day-in-day out if I were home all year? Or is someone else better suited for this most difficult task? I am a great parent because I can also do what I do professionally, a job I adore.

Daycares are variably expensive. This depends on your location, child:caregiver ratios, whether they are government subsidized, meal inclusions and many other factors. Home daycares tend to be cheaper than larger daycare settings, and may provide a smaller child:caregiver ratios. Ensure that these are credentialed and they are following all guidelines.

If staffed by well-trained individuals such as early childhood educators (ECE) they can be very good environments in which to learn motor, communication and socialization skills

Daycare provides a simulating environment often filled with toys and books and fun people to play with. If staffed by well-trained individuals such as early childhood educators (ECE) they can be very good environments in which to learn motor, communication and socialization skills. Daycare is the most like school, preparing children for the years to come.

Nannies can be live-in or live-out. Live in caregivers are sponsored by the family under the Live-In-Caregiver Program in Canada and there are strict guidelines to their compensation, vacation, living situation and more. These caregivers live in your home, pay room and board (within specific guidelines), and the employer pays taxes. The minimal amount of pay is based on the current minimum wage.

Nannies may be more expensive for one child compared to daycare, but add another child in the mix and daycare may be cost prohibitive. Conversely, stay-at-home parents lose only one salary when they care for one or more children.

Live-out nannies usually charge $3-5 more per hour, in addition to taxes and often a stipend for travel to and from the employer’s house. This can cost the employer significantly more, though these nannies have been in Canada longer, have usually worked as nannies for more time and may have more experience. Some people may not have a room for the nanny to stay in, so live-out is the only option.

Do you have one child or more? Nannies may be more expensive for one child compared to daycare, but add another child in the mix and daycare may be cost prohibitive. Conversely, stay-at-home parents lose only one salary when they care for one or more children.

Having a nanny or stay-at-home parent allows children to nap in their own beds/cribs, and eat their own prepared food.

Nannies generally work in the environment you set up, your home. So you have more control over what the child is exposed too. Granted many nannies will set up play-dates (great for socialization) and your child may be in unfamiliar houses. Having a nanny or stay-at-home parent allows children to nap in their own beds/cribs, and eat their own prepared food. Some parents prefer the cooking at a daycare. There are many things to consider.

 

What do I think? 

I think you should consider a few things when deciding who should care for your child during the day:

1. Who is the most ‘fit’ person to do so?

Who is the most enthusiastic and eager person to care for your child? This may be a parent. This may be a nanny if parents are not thrilled by the concept. This may be a daycare provider. You have to look at the options and weigh the benefits and downsides to each. Then do the best you can afford.

2. Price

As much as we all wish this wasn’t a factor, it is. Most of us do not have endless amounts of money and need to make hard decisions. This begins with child care for your little ones and continues to primary schools, high schools, university, after school programs and the like.

3. Safety

Where do you think your child will be most safe? A particularly overburdened daycare may not be the best choice if you have the means to do something else. A reckless nanny is not a great option. Some parents may not be the best option either.

4. Stimulation 

This is huge for me. I believe all children should be exposed to other developmentally similar children. Whether you are a parent or nanny who takes the child to the community centre, library or park often, or are in a developmentally appropriate daycare, kids need to be stimulated. Kids should be played with one on one, read to, taken outside to play and have an opportunity to play with other kids.

5. Location 

There are areas of the country where there are few options. If no daycares or nannies are accessible, parents may have no choice but to stay home. Metropolitan centres often have more options, though there may be higher demand and long wait lists. An excellent daycare down the street is going to be a great option. Having to drive or take public transport for an hour or more each day with your child may be less desirable.

The most desirable option may be out of reach. Some parents would love to stay at home, but this isn’t financially feasible.

At the end of the day each family has to decide what is the best option for them. The most desirable option may be out of reach. Some parents would love to stay at home, but this isn’t financially feasible. Some parents strive for the very ‘best’ daycare, only to find out it is too expensive or the wait list is too long.

My hope is that all of us are able to find affordable, safe, enriching childcare for our children.

Oct
13
2014

Up the Nose or In the Arm? How to Choose Your Flu "Shot"

Before you book your appointment for the flu vaccine, read this.

Up the Nose or In the Arm? How to Choose Your Flu "Shot"

flu vaccine

We can’t deny that viral season is upon us. My office and emergency room is filled with children and parents with runny noses, coughs, fevers, and fatigue. Many worry it’s the dreaded enterovirus-68, with fear over respiratory illness requiring hospitalization. Though I am sure that many of my patients do in fact have this infection, thankfully very few are becoming ill enough to require hospital-based care.

This high viral season reminds us that we should consider getting flu vaccines. Influenza has maintained a low profile so far this Fall, though no doubt it will rear its head in the coming month or two, as it does each year. Have you forgotten H1N1 from last year?

In North America, we now have two excellent flu vaccine optionsthe classic flu shot and the lesser-known flu nasal spray. Both offer similar levels of protection, but some people are better suited for one or the other option.

The Big Debate: Should You Even Get A Flu Shot?

Who should be vaccinated against the flu?

 

The Centre for Disease Control (CDC) and National Advisory Committee on Immunization (NACI) recommend that everyone 6 months and older get immunized against the flu, unless there is a medical reason not to. Why risk getting sick if you don’t have to?

Those most encouraged to get the vaccine include:

  • Children age 6 months and up
  • Adults 50 years and older
  • Children on Aspirin therapy, who are at higher risk of Reye’s syndrome (that can lead to liver and brain swelling) if they catch the flu
  • People with lung, heart, liver, and blood diseases, and those with diabetes
  • Kids and adults with weakened immune systems
  • People who work with those at risk (health care workers, caretakers of patients with the above conditions, teachers)
  • Caregivers to young children

Here are some details to help you decide which you want to use:

 

The Flu Shot

 

The vaccine is given by injection into the upper arm. It is made from dead influenza virus and cannot infect you with the flu.

Side effects:

Most side effects are mild and short lasting. Soreness of the arm is most typical. Mild fever and achiness is also possible.

Who can get the flu shot?

  • Children and adults 6 months and older

Who shouldn’t get the flu shot?

  • Babies less than 6 months of age
  • People who have had the illness Guillain-Barre Syndrome in the previous 6 months
  • People who have had life threatening anaphylaxis to the flu shot in the past

Egg allergy is no longer a contraindication to flu vaccine. The Canadian National Advisory Committee on Immunization (NACI) and American College of Allergy, Asthma, and Immunology say the vaccine has such a low amount of egg protein that it's unlikely to cause an allergic reaction. If you have a severe egg allergy, please discuss with your doctor.

Ten Things NOT To Say To Someone Who Has Allergies

Pros:

  • Most patients can get the flu shot
  • It is considered safe and effective at preventing the flu

Cons:

  • Let’s face it, it’s a shot, which many kids and adults are not a fan of.

The Nasal Flu Vaccine

 

This vaccine is sprayed into the nose. The vaccine is ‘live,’ though weakened, and cannot cause the flu. Flu-like symptoms may occur, however.

Side effects:

  • Side effects from the nasal flu vaccine can be more severe that those from the shot.
  • Runny nose, wheezing, fever, vomiting, headache, sore throat, and cough are common side effects.

Who can get the nasal flu vaccine?

  • Most people between 2-49 who are healthy and not pregnant

Who cannot get the nasal vaccine?

  • Children less than 2 years of age
  • Adults older than 50 years
  • Pregnant women
  • Anyone taking ongoing ASA therapy
  • Children with heart disease, severe asthma, diabetes, and kidney disease, Guillain-Barre Syndrome, or with weakened immune systems
  • Anaphylaxis to eggs or previous flu vaccine

Pros:

  • The nasal spray may be more palatable to some people compared to the shot.
  • It may be more effective at preventing the flu in kids 2-8 years of age.

Cons:

  • There are more limitations on who can safely get this vaccine.

Talk to your doctor or health care practitioner about which option is best for you! For more on colds and viruses going around, check this out.

Is It A Cold Or The Flu?

Entero-What? What You Need To Know About The Enterovirus 68.

Oct
01
2014

How Vision Problems Can Affect Your Child’s Abilities

Preparing Your Child For His or her First Eye Exam

How Vision Problems Can Affect Your Child’s Abilities

How Vision Problems Can Affect Your Child’s Abilities

My husband has been wearing glasses since he was 5 years old and is almost blind without them. To put his contact lenses in, he holds the case mere centimetres away from his face or else he can’t see.

My vision is also imperfect and I have been wearing contacts since adolescence. Because both of us have less-than-perfect vision, we were eager to ensure our kids had their eyes examined before they started school. To be sure our eldest, Dylan, wasn’t missing out on seeing the world clearly, we had his eyes examined by a Doctor of Optometry when he was 2. Our youngest will be examined this year as well.

The pre-school eye exam evaluates tracking, focus, and how the eyes move in tandem. These things are necessary to develop fine motor skills, hand-eye-coordination, and visual perception abilities. I generally recommend all kids see a Doctor of Optometry when they are 2 to 3 years of age, but infants can have their first eye examination between six and nine months of age.

If your child is experiencing any of the following, you may want to have him or her checked out even sooner for peace of mind:

  • Sitting too close to the TV or holding books very close to the face
  • Squinting
  • Turning one eye to the inside or outside ("lazy eye" or strabismus)
  • Tilting the head to one side
  • Poor hand-eye coordination
  • Light sensitivity

Did you know that one in four school-aged children has a vision problem?

80% of a child’s learning and development is obtained through vision, so it is especially important to find out if your child’s vision is good to ensure optimal success. Many vision problems in children have little or no symptoms and some kids will accept their vision problem as normal because they assume everyone sees the way they do. In my medical practice, many parents ask me if the problems their child is having at school could be related to vision. My response is always the same — absolutely. Poor vision is an easy thing to rule out before investigating for other problems.

Take a look at this:

October is Children’s Vision Month, so right now is a great time to get them checked, even if you don't suspect that they are having issues.

Bringing your child to a Doctor of Optometry for the first time can be a little scary for him or her. Here are some tips I used to help our son prepare for his first eye exam:

  • Talk about the upcoming visit with excitement. If children are excited they are less likely to become fearful.
  • Schedule an appointment at a time when your child is alert and interactive, not during a naptime or mealtime.
  • Book yourself plenty of time. Rushing will stress you out and by extension your child will have less fun.
  • Use books or props to help prepare your child for the experience; we have a book about ‘Critter’ getting his eyes checked.
  • Use a low power flashlight on yourself or partner to show your kids how the eyes grow and shrink to the light. Then let them try it on you. Use this time to talk to your child about the use of bright lights before the appointment.
  • Rewards, rewards, rewards. When you start talking about the appointment tell your child about the reward he or she will get for behaving well. 

The earlier we identify a vision problem, the sooner it can be addressed and a treatment implemented. This will help ensure your children reach their best possible potential with excellent vision skills.

Did you know your child could have problems seeing things clearly and not even know it? Don’t make the mistake of thinking you’ll know if your child has a vision problem.

Visit Doctors of Optometry to find a Doctor of Optometry near you.