Children's Hyperinsulinism Charity

Courage Hope Inspiration

Starting Nursery with HI


By Ciara Grace. Mum to Cillian (3) & Abigail (15), CHC Trustee.

Holding you close, I knock on the door,
What am I doing this for?
You need to learn, You need to play
It’s going to be such a long day.
What will you do without me and what will I do without you?!?
A familiar face,
We enter the joyously noisy place.
I leave go of your small soft hand,
On your own feet, you now can stand.
Joining your friends and exploring new worlds,
As your growth unfurls.
With my heartache and joyful pride, I say goodbye,
And look into your eyes
Starting Nursery is just one of life’s stages,
But I will remember your hug that day for ages.

Starting a Nursery is a daunting experience for any parent and child. It’s such a bittersweet moment.  Your child is having their first experience of what is to come, Nursery, School, and life. When you have a child with Hyperinsulinism, the worries can be tenfold over those of a child without HI, especially if they also have special educational needs. Who will take their sugar? Who will know their signs and symptoms as I do? Who will give them their medicines? Not only do all the normal worries apply but there are so many other factors to consider for children with Hyperinsulinism and there’s no one size fits all.

Finding a Nursery

Before your child actually starts a Nursery setting, it is a good idea to go out and visit what’s available in your area. It may be the case you have a few nurseries to choose from, or maybe there is only one available in your area. When both of my kids started Nursery, I would visit multiple places, I think you always get a good ‘feeling’ and when you know you know. However, there are things you can check physically- is there enough light, space, and plenty of toys? Do you feel nice in the space(all being fair to small kids and noise and mess)? Is there a good mix of educational toys and other things such as sensory spaces? Looking at the Nursery’s ethos – do you agree with it? How do you like the staff? It can be hard to get to know them with only one meeting.

While there is a legal requirement on settings to accept children with medical conditions and make allowances for medical treatment, how do you feel about asking this Nursery to cope with your child with HI? Are they a small or large setting? What are the ratios in the room where your little one is starting? Honesty is always the best policy when it comes to your child’s medical needs. The reality is the more honest you are with a child’s setting the easier it will be.


Once you have decided on a setting, next is the preparation. I would highly recommend writing your own daily routine or care plan for your little one. This would be separate from any Hypo plan your medical team may have. Nursery setting should receive copies of all up-to-date medical information, or therapies such as Speech and Language, Physio OT, etc. from you too -however, your own care plan should reflect their likes, dislikes, and daily routines. Your own care plan should bring everything together and you should update it regularly.You should also offer training to your setting- while they may need medical training for feeds etc. you should also offer training as an expert parent, at the end of the day there is no one who will know their child’s needs better. Remember, looking after the medical needs of a child can be daunting for everyone.

Get Ready to engage and enjoy
After any normal settling-in period, you should still check in regularly with your child’s setting and keep your care plan updated as well as listen to how their day was or what craft project they undertook, also listen to any concerns your child’s key worker has, I cannot stress enough how important good communication is with your child’s setting. I would also recommend a daily communication book specific to their HI, we have an academic diary with times in it which has been invaluable for Cillian – if anything has changed I can write it in and all his sugars get recorded in there too.

Finally enjoy this time, knowing your child’s needs are being looked after, and they are starting this wonderful journey and it’s about teamwork.

Ciara xxx