There are enormous differences between an acute and a chronic illness. An acute illness only affects you temporarily, meaning that you can recover in a matter of days: for example, a cold or flu.

A chronic illness, however, is a condition that lasts months or years, where the illness recurs over and over again. Asthma is an example of a common chronic illness, as is arthritis and diabetes. Chronic illnesses can sometimes be hereditary; they travel through the genes from generation to generation.

If a child with an acute or a chronic illness is going to join the child care, make sure that the parents provide updated information about their child’s state of health and special requirements. Adjust schedules, food, and activities according to each child’s specific needs. Establish very clear policies about what you can and cannot do to manage the child’s illness. And make sure to contact health care resources to get more information about a particular illness.

Once the child is enrolled, the provider must receive the medication in its original container and with directions. He or she must make sure that the medication is not expired and that it is legible. The parent has to give written authorization to the provider to administer medication. If the parent wants to be the one to administer the medication, welcome them to come to your facilities.

Over the years I’ve dealt with many kids with chronic illnesses. I had a little boy who had asthma and another one who had diabetes. I also taught special education where most of the kids had feeding tubes.

My experience has taught me that the most important thing is to have constant communication with the parents. You can never ask them too many questions. You need to know everything and have extensive knowledge of the child’s specific situation.

And you need to be prepared, in more than just a casual way. You really need to be ready. If you have to give the child a shot, for example, make sure that you practice first, on a cantaloupe.

I had a little boy with a chronic ear infection; he was about two-and-a-half years old. The mother took him to the doctor and I gave him antibiotics at the daycare.

But something bothered me, and I kept asking her, “Do you notice him scratching his ear? Tell me what you do with your son when you pick him up from the daycare?”

When she said she would put him down to sleep with a bottle, I realized what the problem was. Fluid was draining into his ear passages.

She knew we didn’t give children bottles past 12 months of age, so I think that’s why she kept the information from us. But she stopped giving her son the bottle and his ear infections stopped.

If we suspect that a child has a chronic illness, we have the parents take him to the doctor to get them checked. But when it comes to allergies or asthma, I rely on the parents to tell me what their child’s needs are, such as an inhaler, foods to avoid, that type of thing.

When I have children with special needs in my child care, I work with a couple of assistants that help me take care of the healthy kids, while I find special indoor activities that I can play with the children in need.