Daycare & Pre-school
If you are a caregiver for a baby or young child with hemophilia, rest assured that you will receive assistance from the child's parents, Hemophilia Treatment Centre (HTC), and many others in the hemophilia community. The best thing you can do for the child and the family is to be open and learn as much as you can about hemophilia. Several other sections of this website provide useful information about what hemophilia is and how it affects patients and their families at different stages of life.
As you gain the knowledge and the skills needed to help the child you will also gain the confidence to alleviate some of the impact on the family. There is a caring community of medical professionals and other families facing the same challenges, who can help you to be an informed and valued support person at every stage of the child's development.
How Hemophilia Affects Young Children
Remember that hemophilia is a condition in which patients lack the necessary clotting factor in their blood to stop bleeding. They will stop bleeding eventually—it just takes longer than normal. While most people think of bleeding as external (such as when you cut your finger), with hemophilia the more critical bleeds are internal and most often occur in joints (such as the knee) or in the soft tissue or muscle, as a result of injury.
Myth: People with hemophilia can bleed to death from minor cuts
False. External wounds or cuts are usually not serious. However, internal bleeding can be serious. Internal bleeding can occur in the joints (especially knees, ankles or elbows) and vital organs.
Children in daycare and pre-school are often at an age of eager exploration—and their physical coordination may not yet be caught up with their enthusiasm! Trips and falls are common at this age.
For a normal child, a fall can result in a bruise that heals easily. But for a child with hemophilia, the bruise may continue to bleed below the surface of the skin, creating a painful and slow-healing injury. Over time, repeated joint bleeding can weaken and damage the joint. But the most dangerous internal bleeds occur in the brain, neck, chest, or major organs—these can be life threatening and require immediate medical attention.
There is no cure for hemophilia, but patients can get infusions (injections) of factor replacement therapy to control, manage, and sometimes prevent bleeding.
How You Can Help
Anyone caring for a baby or child with hemophilia needs to assume an extra level of vigilance over the child's activities and safety. In a daycare or pre-school setting, extra supervision might be necessary to ensure the child is playing safely, prevent injuries, and be aware when accidents do occur so you can take appropriate action.
You'll need to learn how to recognize the signs of a bleed in the child, and what to do (and who to contact) if one occurs. You may even be taught to administer treatment, or asked to provide information for the child's bleed records and treatment diaries. You should also be prepared to reassure and soothe the child if treatment is needed, as many at this age have anxieties about factor injections and needles.
Most of all, do your best to treat the child with hemophilia the same as other children. Encourage them to explore, within safe limits. They are facing the same milestones, such as learning to walk, talk, and socialize, as their peers—just with a few added challenges.
Creating a Safe Environment
If you're taking responsibility for a child with hemophilia, there are several issues to consider in creating a safe environment for them. Talk honestly with the child's parents, their care providers, and any other staff members at your daycare or pre-school about the best ways to accommodate the family's needs. Here are some points to consider:
- The staff's willingness to learn the basics of hemophilia
- The staff's willingness to work with parents and the Hemophilia Treatment Centre (HTC) to develop a care plan and a plan of action for emergencies
- The professionalism and maturity of the staff
- The ratio of staff to children—will there be sufficient supervision?
- The physical safety of the environment (e.g., stairs, sharp protruding edges)
First and foremost, make sure you and all other staff members always have the necessary contact information for the child's parents, doctor, and Hemophilia Treatment Centre.