Whether you’re new to parenting a child with diabetes or your family has lived with the condition for years, finding excellent childcare is crucial, but it also might be challenging. Here are some tips on finding the right childcare provider and ensuring the safety of your child.
Having access to consistent and reliable childcare is the foundation for successfully working part time or full time and balancing your professional and personal life. However, whether you’re seeking a sitter for an occasional night out, a childcare facility, an au pair, or a nanny, it can be hard to find a trustworthy childcare provider who understands the needs of a child with diabetes.
“It’s important that your [role] as a parent isn’t just as a caregiver, and that you do get out,” said Josephine Bennett, whose daughter, now 31, was diagnosed with type 1 diabetes at 12. “If you have a partner or a spouse, you really have to nurture the relationship. Often, it’s the primary caregiver who is less likely to want to go out.”
Education and communication with your childcare provider about how to handle diabetes will help you find the right situation for your family and help you feel secure as you leave your child for the day or evening.
So, what is the best way to find the right caregiver for your family, whether your child has type 1 or type 2 and takes insulin, uses injections or an insulin pump?
How do I find the right caregiver for my child with diabetes?
There are several approaches you can use to find a care provider, no matter whether you are looking for a babysitter, childcare facility, or long-term care. Regardless, ask early on about their experiences working with families who have had children with diabetes or who have had other medical issues that require close attention to detail in the same way diabetes does.
If you’re seeking a babysitter, reach out to other parents, particularly parents of older kids in your community, to see if they have recommendations either for sitters they have used, or if their own children are old enough to babysit. Tap into any online groups for parents in your town or area. This approach can also help you locate child care companies or agencies that find au pairs and/or nannies for families in your area. Facebook groups or Instagram pages such as Type One Together, for example, can help you locate a sitter.
There are several companies that specialize in locating childcare. Two of the better-known ones are Care.com or Sittercity.com, which are online platforms that allow you to either search for a sitter through a database or to place your ad seeking childcare. You can search the database based on your zip code, days and hours needed, and sometimes, you can look for sitters with experience caring for kids with diabetes or other health issues. These sites offer both free membership with limited search capability as well as paid memberships.
College students studying nursing, medicine, or special education can be another source—if there’s a nearby college, ask if there’s a way to advertise your need for a sitter directly to those students.
If you belong to an online group like a local chapter of JDRF or another diabetes organization, ask about sitters or childcare facilities where other children with type 1 have already gone. You can also ask the nurses at your diabetes healthcare provider’s office for recommendations.
Helping the Helpers
“Sitters who may not be familiar with diabetes, but are willing to learn, may surface in your search for care,” said Gary Scheiner, owner and clinical director of Integrated Diabetes Services in Wynnewood, Pennsylvania. Scheiner has lived with type 1 diabetes since childhood and is the father of four children, ages between 18 and 26.
“You can always ask them if they have any experience with medical issues or diabetes specifically—for a sitter, a childcare center, preschool or daycare,” he said. “If they haven’t, but are willing to be trained, that is good.”
If you feel their response to these questions is unwelcoming in any way, he cautioned, then move on.
“Don’t push the issue if they don’t have a positive attitude and don’t want to collaborate with you,” Scheiner said. “If their attitude is negative from the get-go, there are plenty of places that are happy to accommodate, help and learn new things. It’s a matter of getting them up to speed.”
Parents can also train childcare providers themselves. For those who lack the time or confidence to do this, a diabetes care and education specialist can help do the training. However, these fees are not covered by your health insurance plan and may need to be discussed with the specialist.
“Have them spend a day with you to see exactly what you’re doing with your child’s routine, such as counting carbs, dosing, and pre-filling a syringe,” said Carrie Blasi of Boca Raton, Florida, whose daughter, Emma, 13, has lived with type 1 diabetes since age 2. “Make the steps easy.”
Blasi added that parents of a child who has experience managing their diabetes may only require a childcare provider for supervision, rather than intense diabetes management. Her daughter Emma, now 13, has lived with type 1 since age 2.
“[The provider] can always be in contact with the parents for details about dosing insulin,” she said. “Communication is key. With communication and technology, it’s easy to manage.” Blasi was referring to devices such as a continuous glucose monitor, which can send readings directly to a parent’s smartphone who is away from the child.
Blasi also provides the phone numbers of people who can offer insight as needed, such as the doctor’s emergency number, neighbors’ phone numbers, and in her case, “friends with type 1 diabetes who are willing to step in if needed.”
Resilience, maintaining calm in changing situations, and having common sense are all great qualities in a childcare provider.
“Being able to respond to any crisis is important,” said Scheiner. “Education solves a lot of things. If the babysitter isn’t prepared and educated, that’s not appropriate. You have to be up front and transparent about things.”
This can mean that the childcare provider will remember to refill a diaper bag not just with diapers and wipes but with snacks and treatments for low blood sugar readings before the next walk to the park, for example. Or keep an eye on a high blood sugar reading and know how long it has been since insulin was last administered—so that the person knows to wait long enough to see if insulin on board will help lower the number on its own, rather than stacking insulin doses and triggering a low blood sugar hours later.
And knowing how to administer a glucagon–via a shot, nasal spray or inhaler–and when, even if it is never necessary.
“Early on, keep it chill,” said Scheiner. When hiring a sitter for an occasional night out, “don’t put pressure on them to manage the kids’ blood glucose, because that is not their role. The fewer responsibilities you can give them, the better. You just want them to perform certain tasks to ensure your child’s safety,” said Scheiner.
Ultimately, keeping your child safe and healthy while you as the parent or caregiver are away, for whatever reason, is what it is all about. If your child’s blood glucose reading is temporarily higher than you’d like, but not necessarily causing your child to be uncomfortable for the time you are away from them, that’s OK.
“We try to teach parents about the importance of kids being kids,” he added. That can include a wide spectrum of experiences, such as going to the playground with a babysitter or playing and learning with others at a childcare center.
Life with diabetes is full of ups and downs, even if you never hire a babysitter or use any childcare at all.
“Don’t expect it to be perfect” when your child is in a childcare scenario, said Scheiner. “It’s OK, as long as your child is safe.”
For additional information, check out these resources:
Type 1 Diabetes Support for Parents
Helping Your Child With Diabetes Feel More Comfortable at School