Sandboxes, Scissors, and Snot: A Beginner’s Guide to Preschool with CF

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Laura Spiegel

This week, my daughter started 4-year-old preschool, or as we say here in Indiana, “pre-K.” On the first day of school, she literally flew out of her classroom and declared that she had just had the “best day ever." And you know what? So did I. 

Not because I had spent the morning nursing a mug of coffee or pondering the meaning of life. I actually spent that time scrubbing bathrooms and plotting how to make all of the children’s books that I absolutely hate subtly disappear from our shelves. 

No, my day was great because I didn’t devote any time worrying about how my daughter’s cystic fibrosis would be managed at school. Thanks to some tips from other CF mamas and our hospital’s social worker, I felt really good about the plan that I’d devised with the school to help keep my daughter healthy and happy.

Since I benefited so much from the advice of others, I thought I would pass some of it along. Some tips may be old hat; others might put a new spin on things. Either way, I hope that this can help give the next parent of little a one a good start to preschool, as well.


1. Upfront teacher communication - I met with the school principal and my daughter’s teachers several weeks before school started. Since this is a private preschool, IEPs and such do not apply. But we did spend some time discussing what CF is and where I needed the teachers help. The social worker at our local children’s hospital put together a formal letter that outlined our specific asks (e.g. enzymes before meals, good hand washing, regular wiping down of the classroom tables, etc.). Most hospitals should have something like this that can be customized to your child’s specific needs, so if you’ve not seen one, ask. I also supplemented this with a less clinical version that focused on why these things were important and provided common FAQs.  


2. Pre-packaged enzyme baggies – Since this is a private preschool, we don’t have to worry about going to the school nurse for enzymes. Instead, I pack a Ziploc bag in my daughter’s lunch box that includes her enzymes; a travel pouch of applesauce; an individually wrapped plastic spoon (you can buy in bulk on Amazon); and a travel Wet Wipe. An Avery printable label indicates how many enzymes are in there and how to give them. The teachers then keep my daughter’s lunch box separate from the others as a reminder that there is an extra step to complete before she eats.


3. Hand-washing reminder sheet – I made a small sheet that could be posted in the class as a reminder of good hand washing times. It included obvious times like before lunch and after using the restroom, as well as more specific-to-CF times like after playing outside; after playing with the communal water table; and after playing with dirt or sand.


4. Plan to avoid others with CF – I was actually surprised, given the size of this preschool, that there is another child with CF. Fortunately, he’s in a different class that is located at the opposite end of the school. After speaking with the principal and teachers about why physical separation was so important, they helped map out a game plan so these two don’t cross paths during the school day. Recess breaks, music classes, and gym schedules are scheduled accordingly. Communal items like hand bells in the music class will be wiped down after each classes’ use. This was actually the part of the school care plan that made me the most nervous, and I was very pleasantly surprised at how seriously the school took the request and how diligently they are honoring it.


5. Parent support during cold and flu season – I went around and around on this one, and finally figured, what the heck. So I did it. I crafted an email to the parents in my daughter’s class that explained the situation. I explained that my daughter would be taking special medicine before meals “in case their kids noticed it and had questions.” I told them that CF would not affect their little ones at all, and that they didn’t have to worry about treating my daughter any differently because of her health. With one exception. We all know how hard it is to avoid someone who is coughing in a tiny preschool classroom. So I asked “from one parent to another," could they please do their best to keep children who had caught bad coughs home from school? I received a really nice note back from one parent, which helped ease my concerns that my request would be seen as selfish or over the top. Who knows? Maybe some parents thought that and just didn’t voice it. But if it helps sway someone who is on the fence about whether or not to send a sick child into school one day, I’ll count that as a win.


And that’s it. We are a few weeks into school, and I’m still feeling good. Talk to me again come November, and I might have changed my tune. But for now, the above plan is working well, and when I drop my daughter off every Monday, Wednesday, and Friday, I leave feeling as if I’ve done all I can to set her up for another happy and healthy “best day ever.” 

Now if someone can just help me with how to cut in a straight line, we’ll be all set.


                                                                                    Help Others Live STRONGER and LONGER- 





Laura Spiegel is the mother of two wonderful kiddos, one who has CF. She lives in Indianapolis and enjoys a good book, a great meal, and nightly dancing in her kitchen. Laura is also a member of the CFLF Board of Directors. She can be contacted at




***Views expressed in the CFLF Blog are those of the bloggers themselves and not necessarily of the Cystic Fibrosis Lifestyle Foundation***   


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