Biting is a natural developmental stage that many children go through. It is usually a temporary condition that is most common between thirteen and twenty-four months of age. The safety of the children at the center is our primary concern. The center's biting policy addresses the actions the staff will take if a biting incident occurs.  

Toddlers bite other toddlers for many different reasons. A child might be teething or overly tired and frustrated. He or she might be experimenting or trying to get the attention of the teacher or his peers. Toddlers have poor verbal skills and are impulsive without a lot of self-control. Sometimes biting occurs for no apparent reason. The center will encourage the children to "use their words" if they become angry or frustrated. The staff members will maintain a close and constant supervision of the children at all times. 

The following steps will be taken if a biting incident occurs at our center:

• The biting will be interrupted with a firm "No…we don't bite people!"
• Staff will stay calm and will not overreact.
• The bitten child will be comforted.
• Staff will remove the biter from the situation. The biter will be given something to do that is satisfying.
• The wound of the bitten child shall be assessed and cleansed with soap and water.  If it is determined that there was a blood exposure further steps need to be taken as outlined below: "Procedure for Incidents involving Blood Exposure."
• The parents of both children will be notified of the biting incident. Appropriate forms will be filled out (Incident Report).  Note: If a bite requires medical treatment, a copy of the incident report must be mailed to the licensing consultant within 7 calendar days. See Child Care Requirements Licensing Guidelines Section .0802 (d) EMERGENCY MEDICAL CARE
• Confidentiality of all children involved will be maintained.
• The bitten area should continue to be observed by parents and staff for signs of infection.

Procedure for Incidents involving Blood Exposure 

An exposure is defined as contact with blood or bodily fluids to which universal precautions apply such as:

• An injury to the skin (e.g.: cut with a sharp object)
• Mucous membranes
• Skin that is chapped, abraded, or otherwise affected so that an effective skin barrier is not present
• A bite or injury which results in blood exposure

 A human bite will rarely transmit a bacterial infection if proper first aid is given. Hepatitis B and HIV can potentially be transmitted during a human bite if the skin is broken and a blood exchange occurs. 

When a bite or injury occurring in the daycare setting involves a break in the skin and potential blood exposure, the Center will follow the guidelines set forth by the Mecklenburg County Health Department. The following steps should be taken:

• Assess the bitten area and clean with soap and water.
• Check both children's immunization records and determine if they are up to date on their tetanus (DtaP), and Hepatitis B vaccines.
• If the director or staff member is not sure if the child is up to date on his immunizations, call the Child Care Nurse so that child's record can be evaluated.
• Notify the parents of both children immediately.
• File an incident report as outlined above.
• Notify the center's licensing consultant by phone.
• Both children (or parties involved, e.g. teacher) involved in the biting incident) should be tested for Hepatitis B and HIV by their private physicians or the Mecklenburg County Health Department.  The testing should be done at a private pediatrician's office. However, if the patient has no financial ability to pay for the test and does not have insurance, they can have the test done at the Mecklenburg County Health Department.  The center should contact a Child Care Nurse so they can arrange for the testing to be done at the Health Department.
• If one parent refuses to have their child tested, the director or staff member should contact the Child Care Nurse from the Mecklenburg County Health Department immediately so an investigation can be initiated.
• The Health Department will not follow-up with the children if  both sets of parents refuse testing. 
• If both sets of parents agree to have their child tested, the Director will be responsible for exchanging the names of the children and their physicians.  In other words, the director will call each child's pediatrician with the following information:  
        1.  Child's name and DOB
        2.  Description of what occurred
        3.  The other physician's name and contact number
        4.  The other child's name and DOB
• The director should be a liaison between the parents and the physician in order to assure confidentiality.
• Physicians will exchange test results since there is counseling involved with Hepatitis B and HIV results. Physicians will also be responsible for contacting their own patients and giving them the test results.
• Confidentiality will be maintained at all times.
• If one of the children tests positive for HIV or Hepatitis B, the child's physician will contact the Health Department.