What Your Caregiver Needs to Know About Your Child's Seizure Action Plan

A babysitter who witnesses a seizure with no prior preparation will almost certainly call 911 and panic. That is the wrong outcome for a child whose seizures are well-controlled and typically brief. But a babysitter who has been clearly briefed on what to do, what not to do, and when 911 is actually the right call can stay calm, keep the child safe, and make the right decisions — which is a very different outcome for everyone.

This is what your caregiver needs to know about your child's seizure action plan before you leave.

What to do during a seizure

The most important things a caregiver can do during a seizure are:

• Stay calm and stay with the child. Note the time the seizure started.
• Clear the area. Move hard or sharp objects away from the child. Do not restrain the child's movements.
• Position the child safely. If the child falls, guide them gently to the floor. Turn them on their side (recovery position) if there is any vomiting or the child seems to have difficulty breathing. This prevents choking.
• Protect the head. Place something soft — a folded jacket, a pillow — under the head. Do not hold the head down.
• Do not put anything in the child's mouth. The old advice about holding the tongue is wrong. The child cannot swallow their tongue. Objects in the mouth during a seizure cause injuries.
• Do not give water, food, or medication by mouth during the seizure.
• Time the seizure. This is critical information for the ER and for you when you call.

What not to do

• Do not restrain the child or try to stop the movements.
• Do not put anything in the child's mouth.
• Do not give any oral medication during the seizure.
• Do not leave the child alone.
• Do not give water or food until the child is fully awake and alert.

When to call 911 — be explicit about your child's specific threshold

For children with a known seizure disorder, parents and neurologists typically establish a specific protocol. Your caregiver needs to know your child's specific threshold, not generic advice. Common 911 thresholds include:

• The seizure lasts longer than 5 minutes (or whatever your child's doctor has specified)
• The child does not regain consciousness within a few minutes after the seizure stops
• A second seizure occurs within a short period of the first
• The child was injured during the seizure
• The child has difficulty breathing after the seizure
• This is a first-time seizure

If your child's seizures are typically 1-2 minutes and they recover fully and quickly, tell the caregiver that clearly. Many parents of children with well-controlled epilepsy specify: "If the seizure is under 3 minutes and she recovers normally, call me — do not call 911. If it goes beyond 3 minutes, call 911 first and me immediately after."

Rescue medication: the complete protocol

If your child has been prescribed a rescue seizure medication — diastat (rectal diazepam), Nayzilam (nasal midazolam), Valtoco, or Seizalam — the caregiver needs to know:

• Where the medication is — exact location. Not "in the medicine cabinet." Which cabinet, which shelf.
• When to give it — the specific duration threshold your neurologist has prescribed. Typically: seizure continuing after 5 minutes, or after a specified time per your child's action plan.
• How to administer it — nasal spray rescue medications are straightforward. Rectal diastat requires a brief walkthrough. Do not assume the caregiver knows how.
• What to do after giving it — most protocols call for calling 911 after administering rescue medication, even if the seizure has stopped. Confirm your child's protocol.
• The dose — by weight. Confirm this is current for your child's weight.

Walk through the rescue medication with the caregiver before you leave. Open the packaging, show them the device, and talk through the steps. A five-minute in-person walkthrough is worth more than written instructions alone.

After the seizure: the postictal period

After a seizure, children typically enter a postictal period — a period of confusion, fatigue, disorientation, or sleep. This is normal. Tell the caregiver what your child's typical postictal period looks like:

• How long it usually lasts
• Whether the child is confused or agitated during it
• What the child usually needs (rest, a quiet space, water when awake enough to swallow safely)
• What a normal recovery looks like versus a sign that something is wrong

A caregiver who has never seen a postictal period may think something is very wrong when a child is normal — give her the context.

Your child's specific seizure type

Not all seizures look the same. Brief the caregiver on what your child's seizures actually look like:

• Generalized tonic-clonic (grand mal): full body convulsions, usually unmistakable
• Absence seizures: brief staring spells, blinking, a few seconds, may be subtle enough to miss
• Focal seizures: may look like unusual movements of one limb, eye blinking, lip smacking, or brief confusion
• Drop seizures: sudden loss of muscle tone — the child drops suddenly

If your child has absence seizures, the caregiver needs to know they are not just "spacing out" or daydreaming — they are brief seizures that require monitoring and documentation.

What to write down for the caregiver

• Your child's seizure type and what it looks like
• What to do during a seizure (step by step)
• What not to do
• Your child's specific 911 threshold (duration, conditions)
• Rescue medication: location, dose, when to give, how to give
• What to do after giving rescue medication
• What the postictal period looks like and how long it typically lasts
• Your neurologist's name and after-hours number
• Your pediatrician's name and after-hours number
• Your cell and partner's cell — when to call you vs. 911
• Preferred hospital or children's ER
• Health insurance card or photo

Baton Pass stores medical condition protocols in the same organized profile as medications and contacts. The caregiver sees your child's seizure action plan in the same place they see the allergy list and emergency contacts — all in one shareable link.

Frequently Asked Questions

Should I tell a new babysitter about my child's epilepsy?

Yes, always. The caregiver needs to know before the first sit, not during an episode. Parents sometimes worry about discouraging babysitters, but a sitter who is prepared handles a seizure; a sitter who is not prepared calls 911 and panics. The conversation is an act of respect — you are treating the babysitter as someone capable of handling this with the right information.

What if the babysitter is afraid to administer rescue medication?

Address this directly before you leave. Walk through the medication together in a calm setting. Most caregivers who are hesitant before a walkthrough feel much more confident after one. For nasal spray rescue medications like Nayzilam, the administration is similar to a nasal allergy spray — genuinely simple. If a caregiver genuinely cannot commit to administering rescue medication in the right circumstances, that is important information about whether she is the right fit for your child's care.

Do I need to tell the school about my child's seizure action plan separately?

Yes. Schools require a separate Seizure Action Plan or individualized health plan (IHP) as part of enrollment, and school nurses have their own protocols. The document you prepare for a babysitter is separate from what you submit to the school. Confirm with the school that their staff are trained in your child's protocol and that the rescue medication is available on-site during school hours.

How do I know if my babysitter is comfortable managing my child's epilepsy?

Ask her directly after the briefing: "Do you feel comfortable with this?" and "Is there anything you are not sure about?" Pay attention to the specific things she is uncertain about — those are the things to walk through again. A sitter who seems confident but has misunderstood the 911 threshold is a larger risk than one who says "I am not sure about the rescue medication — can we go through that again?"