# Carb counting, pumps and Pre-School



## Ruthie (Jun 12, 2012)

Hi!

A bit of advice please.

My son is due to start Pre-School in September.  We met with the SENCO to discuss his pump and the training they will need.  I've offered to calculate the carbs in the rolling menu before he starts. The snacks offered is a table of fruit that the children can go and help themselves to. (Fruit is becoming the bane of my life!) I think we'll have to get them to give him a portion in a bowl and avoid the table.

I was just wondering how others deal with food issues at Pre-School. Any advice would be gratefully received!

Thanksx


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## Hanmillmum (Jun 12, 2012)

Hi,

I'm afraid our pre-school is on hold and has been for a while, it seems like it will be for ever with all the red tape this way   


The fruit thing is an issue, it is left out for the kids to pick at all session which is not the best approach with our little ones. We had to view the fruit on drop off and decide what to bolus for, there was supposed to be a week ahead menu but this didn't happen in reality so couldn't plan ahead. We had to set a time for the snack so it wasn't overlapping breakfast or impinging on lunch something like 9.30 to 10.30. It was just one piece, we made it clear she would not keep going back to the table (like the others) Goodness knows why the other kids can't have a set time to eat then put the darn lot well away! Not exactly rocket science nor great on the teeth 

Sadly the level of support was inappropriate for my daughter and failed before it took off.  


I hope you have a much better experience, I know many others that do. Our only saving grace is she has another year ahead in pre-school so I am hoping we too can get the right person on board and trained up so she can go back in Sept. The pump is harder for others to look after them in school when they are so small, and it's the first in our behind the times area that the Local Education Authority have faced but I won't compromise on her health to make life easier for the LEA for sure, and her Consultant blasted much the same lol.


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## Hanmillmum (Jun 12, 2012)

Just to add, it is worth going in with your digital scales and carbs and cals book to get an idea of the weight of the fruit they offer as they are quite small sized compared to what's in your fruitbowl, I would have over-bolussed if not checked


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## Ruthie (Jun 12, 2012)

I took the carbs and cals book to the meeting and that went down well so I will provide them with one.  Once she'd seen us do a basic demo of his pump whe seemed much happier.  Our diabetic team (at Addenbrooks) will train as many as they want on the pump and finger pricking but anything else like changing a canula set (should it  get pulled out etc) I'll have to go in to do.  They seem really helpful.  I think the fruit table is only there for a specific period but his key worker can't have eyes in the back of his head and he is pretty cheeky when it comes to stealing food!

I realised today that we didn't discuss Hypo's at all!  Whenever, I ring up they say ' Ah, the boy with the pump' which is great that they are already familiar with him but it's not a moniker I would want him to have for the rest of his school life!

Thanks for your comments Hanmillmum, they're really useful and I hope everything works out x


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## Hanmillmum (Jun 12, 2012)

Let us know how you get on, sounds like they are on board with it all which is lovely to hear.

It will work out for us as I won't let it not - grrr (LOL) x


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## Tina63 (Jun 13, 2012)

Sadly you will encounter the fruit (and milk) everywhere.  It's an Ofsted thing.  Children have to be allowed access to snacks and drinks (milk, water) at all times!  Our primary school have a nursery unit and each afternoon as I enter to collect a child (I am a childminder) I am horrified at the pool of milk all over the table, as again it's an Ofsted initiative that the children should be allowed to serve themselves.  4 year olds with big jugs and cartons?  Utter chaos.  The fruit in the nursery unit is just left for them to help themselves to, not cut up, and so many children take 2 bites out of an apple then dump it, so even weighing it is not necessarily going to get the calculation right.

Unfortunately, if the schools, nurseries, and playgroups do not comply with this initiative, they will be marked down on it, but of course Ofsted don't take problems like ours into account. 

There was a child at our playgroup once who had a milk allergy.  Not only were all children stopped from having milk at playgroup and had to take their cartons home, but each child on arrival was made to go in and wash their face and hands under supervision to make sure there was no breakfast milk residue before playing with this child.  I don't know how on earth this is now policed at a primary school with 350 children, but the child has moved up to school.

Personally, I don't understand (diabetic children actually being the exception) why children _need_ to eat a snack during a 2-3 hour session.  20 years ago we were told to just give them 3 square meals a day and a milky drink at bedtime.  If they have gone just after breakfast or lunch surely they should be able to last?  Children in my care don't regularly eat snacks, I have had too many who then can't eat their lunch properly.  These days children seem to graze all day long and never actually know what hunger properly feels like.  I do wonder whether we will only fuel the obesity problem feeding children non-stop like this.  It may be fruit at school/playgroup, but you can't tell me all parents stick to the fruit snack at home, biscuits and other 'bad' snacks being given.  

That's it, rant over, just wanted to give my two pennyworth!


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## Tina63 (Jun 13, 2012)

I would just add I do offer a snack to any school aged children who are not having a main meal at my house, but also not being picked up until fairly late, as I appreciate they may have as much as a 6 hour gap between main meals, and that maybe is a bit extreme after a day at school, a good play in the park and a fairly long walk home.  I do take parents' views into account though and act accordingly.


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## Ruthie (Jun 13, 2012)

Oh Tina63, I hadn't even thought of milk!

The snack table wasn't there when we looked around so I'm pretty sure it's only for a specific time.  I am worried that he'll graze other children's plates (and the floor no doubt) and they won't be accounted for.  He is an absolute nightmare when it comes to secret eating.  I really want him to have a 'normal' experience where I don't have to pop in all the time to sort stuff out.  I'm happy to do that where neccessary, like Hanmillmum said-their health is paramount, I just don't want it to be the go-to solution. You may have seen from my other posts I'm becoming obsessed about getting back to normal-whatever that is!

Thanks Tina63, this has been so useful in highlighting things I hadn't considered!


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## Tina63 (Jun 13, 2012)

No problem, glad to just give my view/knowledge of things.  Unfortunately (well fortunately) my son was diagnosed at the age of 15 so I have no idea what it's like dealing with a much younger child with diabetes.  It must be a nightmare.  Would an extra piece of fruit make a massive difference?  Sorry for my ignorance, but I have a lad who eats what he wants when he wants (teenage rebellion going on) and can't be bothered to inject half the time.  At his age we were told he could have an apple without needing to inject for it, but I guess as a smaller child it would have a much bigger impact.

It is so hard getting the balance right between protecting them and not allowing them to live as normal a life as possible.  As my boy was the age he was at diagnosis, I have had next to no control over his choices and ways of doing things, much as I desperately would like to 'control' things for him.  Hopefully you will get some help from the setting your son is going to to iron out some of these problems.  I do believe our nursery had a T1 child in last year (I asked my DSN if she had any children 'on her books' from the primary school I take children to - of course she couldn't give names but did say yes she had one just about to start nursery, that was a year ago) so I would love to find out how they dealt with it.  Maybe I could ask some of the staff as I am known pretty well, asking how they dealt with it.  As long as I can remember though, the fruit and milk are always there, free for them to help themselves to.  I often wonder how many hours the milk has sat out on the table, but then that's another issue.........!


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