Sunday, December 10, 2023

The holidays are here (and so are respiratory illnesses!)

Winter and the holidays are upon us. With the cold weather, we are staying inside more. The holidays mean more gatherings and close contact in crowded stores and holiday-related events and activities. We are seeing a rapid uptick in respiratory viruses, including COVID, RSV, and influenza. Here are links to the latest CDC guidance regarding COVID exposure and infection:

If a positive case is identified in your center, all who were present should wear a mask for the next 10 days and get tested on Day 6 if test-to-stay is not currently practiced (unless they develop symptoms, then they should test sooner).

On the page “If You Were Exposed” (What to Do If You Were Exposed to COVID-19 | CDC), the following is stated:

If you were exposed to the virus that causes COVID-19 or have been told by a healthcare provider or public health authority that you were exposed, here are the steps that you should take, regardless of your vaccination status or if you have had a previous infection. 

Exclusion criteria for influenza (“flu”) and RSV include fever and severe respiratory symptoms that prevent the child from full participation.  Usual health routines should be maintained – good handwashing, covering coughs/sneezes, surface cleaning, and observing children for signs/symptoms of illness. Children may return once fever-free without fever-reducing medication for at least 24 hours and able to fully participate in activities, or upon the advice of a healthcare provider. The CDC provides resources to guide decision-making around respiratory illness prevention, diagnosis, and treatment.

As a reminder, the Maine Department of Education recently posted this Communicable Diseases Quick Guide for Schools and Child-Care Centers in Maine: This is a handy guide to help you with decision-making around inclusion/exclusion criteria. If you have not yet received your copy of the "purple book" Managing Infectious Diseases in Child Care and Schools, please check with your licensing specialist, as copies were purchased for every licensed child care provider in Maine. 

Wishing you all a happy, healthy holiday season!


Saturday, September 16, 2023

A New School Year Has Begun!

Hi Everyone,

I can't believe it's been over nine months since I last posted! Where has 2023 gone? I hope you were able to enjoy what little summer we had and that the new school year has gotten off to a good start.

This year has brought some changes for me - I left the University of New England at the end of May to return to my roots at Maine Medical Center as Director of Nursing Education and Professional Development. This has been an exciting opportunity for me to combine my love of education and working with nurses who are practicing at the bedside. Due to this change in my work schedule, I no longer have the flexibility to provide CPR/AED/First Aid classes. I realize this may be an inconvenience to those of you for whom I have provided these classes in the past. I can help with finding new resources for you.

With the return to school comes increases in exposures to communicable illnesses. We are starting to see an uptick in COVID-19 cases, not surprisingly. We are also just starting to see cases of influenza and RSV. Symptoms of these respiratory illnesses are similar, so it is important to follow CDC guidelines. The latest COVID-19 guidance can be found at The Maine Department of Education recently posted this Communicable Diseases Quick Guide for Schools and Child-Care Centers in Maine: This is a handy guide to help you with decision-making around inclusion/exclusion criteria. If you have not yet received your copy of the "purple book" Managing Infectious Diseases in Child Care and Schools, please check with your licensing specialist, as copies were purchased for every licensed child care provider in Maine. 

Please reach out to me with any questions and concerns you have to help keep your children, families, and staff safe.

Be well!


Sunday, January 1, 2023

Happy New Year 2023!


Happy New Year 2023!

Well, 2022 certainly continued to be challenging! While pandemic guidelines were relaxed somewhat, we faced several surges, exacerbated most recently by RSV and influenza. We can’t seem to catch a break! Decisions around inclusion and exclusion for these respiratory viruses can be confusing. Children diagnosed with RSV or influenza should be excluded until they have been fever-free without fever-reducing medication (acetaminophen or ibuprofen) for 24 hours AND can fully participate in center activities without need for additional care. Keep in mind that providers do not test for RSV or influenza in all cases of respiratory illnesses. If the child is not experiencing severe illness, providers may not recommend a sick visit, so I advise against requiring a provider note for return to the center, which could unnecessarily burden the family and the provider. Of course, it is important that any new symptoms be ruled out for COVID, as exclusion criteria for COVID are different than those for RSV and influenza. COVID isolation and quarantine guidelines for child care have not changed since the spring of 2022. The OCFS COVID response updates can be found at Please remember that a negative test should not be required for return to the center, as an individual can continue to test COVID-positive after they are no longer communicable.  

My wish for you, your staff, your children and families in 2023 is for health, harmony, and happiness!

Warm regards,


Monday, September 5, 2022

Welcome to the start of a new school year!

Where has the year gone? I’ve clearly lost track of time since the last time I posted was in January. COVID-19 has continued to impact us all in ever-changing ways, confounding recommendations on how best to contain the spread and manage outbreaks. Hopefully we are learning how to live with this virus that seems to be with us to stay. It appears that the Office of Child and Family Services is no longer posting regular COVID-19 updates on its website but rather referring providers to the FAQ, which is updated frequently:

Providers are also being directed to the U.S. CDC for updated guidance:

Although this document is the last OCFS update from spring 2022, it is still relevant:

On another more positive topic, those of us who provide consultation through private practices are working on formation of a network to share resources and best practices. One of my colleagues from northern Maine is hosting several conferences for early childhood education and care providers.

To sign up for both sessions:

To sign up individually:

Dates: Topic 1 - October 5th and Topic 2 - October 12th

Times: Topic 1: 10/5/2022 6:30-8:30 p.m. =2 hours Continuing education 

Topic 2: 10/12/2022 6:30-8:30 p.m. =2 hours continuing education 

Topic 1: Behavioral Health in the Early Childhood Setting with child psychiatrist Julie Balaban, MD.

Topic 2: Understanding and assessing normal childhood speech and language development with SLP Brittany Bubar CCC-SLP

This is a wonderful opportunity to learn about these topics, ask questions, get advice from experts, and hear how other providers handle situations.

Wishing you a smooth, safe, and healthy start to the school year!

Warm regards,


Saturday, January 22, 2022


Addendum to previous post:

My apologies for the confusion and additional message – unbeknownst to me, the Recommendations for Childcare Facilities with COVID-19 Positive Staff or Children ( were just updated January 20th. The guidelines posted on the OCFS website do not align with these updates (they are still from November 2021). I’m not sure when licensing plans to reach out to you all with this update – I have reached out to them for more clarification. I will do my best to try to get answers so that I am providing accurate recommendations. Thank you in advance for your patience.


Belated Happy New Year!

This omicron variant has certainly proven challenging for most (if not all) of you as you continue to care for our youngest children. Some of you are dealing with your first positive cases of COVID despite immaculate adherence to all guidelines for reducing the risk of exposure. The changes in isolation and quarantine periods for the general public (from 10 days to 5 days) has confused and complicated the situation. I understand your feelings of anxiety and frustration; you are likely having to make snap decisions, especially during “off hours” when state resources are closed. Parents are also likely anxious and frustrated, as quarantine and closures impact their ability to work, and I’m sure you are feeling it. My heart goes out to you all.

Please be aware that isolation and quarantine guidelines for early childhood education and care settings have not changed since November 2021 to reflect the CDC recommendations for the general public and for public schools. The U.S. CDC also still recommends the full 10-day isolation (for COVID-positive individuals) and quarantine (for close contacts) – see So, I continue to recommend adherence to the November guidelines from Child Care Licensing until we hear otherwise – see and scroll down to Child Care Licensing.

I am doing my best to keep up with your calls, texts, and email messages and try to respond in a timely manner. I ask for your patience as I may not be able to respond immediately (the spring semester started this week). Remember to check your resources to see if your questions might be answered.

Below are some additional resources that might help inform your decision-making.

Recommendations for Childcare Facilities with COVID-19 Positive Staff or Children:

Isolation and Quarantine (replace 5 days with 10 days):

I continue to hope that this surge, along with more children being vaccinated, will soon lead us to fewer restrictions and a clearer sense of what might be considered “normal.”

Warm regards,