Most experienced teachers have dealt with a variety of chronic health issues and minor injuries in their classrooms. Teachers may recall having a child with asthma or diabetes, but surprisingly few teachers are familiar with pediatric gastroesophageal reflux disease (GERD). Often when I talk to teachers and school nurses, they could not recall a single child with GERD. Perhaps children with GERD slip by the radar screen because they tend to blend in with the other children in the class. They are often average in growth and development, have physical stamina and basically look the same as the other kids in the class. I always tell the teacher: you will not be able to pick out my kid as having a chronic medical condition based on the way she looks. On the outside, she looks like all of the other children. What is different is the way she digests food. My daughter often suffers from bloating and stomach pain in silence. She seldom visits the nurse and often waits until she comes home to tell me how much discomfort she experienced during the school day.
Some teachers are very skeptical that your child has a significant health issue. You describe the special diet, the medications and the painful symptoms while the teacher is staring at your child, who looks and acts completely ordinary. So beware of the teacher or school nurse who thinks you are over-protective about your child and making a big deal about a little tummy ache. The school staff may label you as a nervous mom who is a tad worried about school and is having some separation anxiety, too. This can be terribly frustrating and even cause you to become overly anxious and nervous about sending your child to school!
Be prepared for some ups and downs at first. Hold you head high, smile, and communicate your concerns clearly. Be sure to give the school staff time to adjust to the new medical information and develop a routine. You can assist them by providing ongoing communication and information. For instance, the school staff may need some basic training on GERD so download an information sheet from the Internet. Be sure to keep it basic. You might have spent the evening surfing Medline for research articles on the latest treatment, but they just need to know a basic definition of reflux, symptoms and treatments. If this information is not convincing enough, ask your child's Pediatric Gastroenterologist or Pediatrician to write a note explaining the diagnosis and treatment. Again, the teacher and school nurse probably do not need to see the endoscopy report. They just need an overview of the situation.
It is likely you will need to have ongoing communication with the school staff during the school year through phone calls, notes, e-mail and meetings. Listen to their questions and concerns. Perhaps there is a scheduling issue with the snack or medication schedule. Maybe the other children are asking for a snack too. Assist the school staff in finding solutions to any issues, large and small. Don't forget to tell the school staff about any new treatments and symptoms that develop.
Remember to thank the teacher and school nurse for helping your child have a positive school experience and manage his or her GERD during school. When my daughter Rebecca was in first grade, she has difficulty maintaining her weight. Each illness caused weight loss, and it took a long time to regain the weight and grow. The school nurse and teacher did an excellent job of implementing a plan for her to eat snacks in the classroom and gave her extra time to eat lunch in the cafeteria. As a result, she gained weight steadily during the school year. She finally outgrew her clothes rather than just wearing them out! I sent the teacher and nurse a letter thanking them for helping Rebecca to grow.
Published On: August 10, 2007