Epilepsy in Early Years Settings: A Guide for Nurseries and Childminders

Early years settings have a duty to keep children with epilepsy safe and included. In England, the EYFS framework sets the welfare standards. Good practice means an individual healthcare plan for the child, a clear medicines procedure, paediatric first aid, and staff trained to recognise and respond to seizures.

Why early years settings need to be prepared

Young children with epilepsy can attend nursery and childcare like any other child, provided staff understand their needs and know how to respond to a seizure.

Epilepsy can present differently in young children, and some seizures are easy to miss. Preparation protects the child and gives parents confidence. Our guides on epilepsy in school and managing a child’s epilepsy at school cover the next stage of a child’s education.

Your duties under the EYFS (England)

In England, the Early Years Foundation Stage (EYFS) statutory framework requires providers to keep children safe and well. This includes managing children’s medical needs and having trained first aiders.

In practice this means:

• meeting the safeguarding and welfare requirements that apply to all providers
• having a policy and procedure for administering medicines, and telling parents the same day a medicine is given
• paediatric first aid: childminders must hold a current certificate, and group settings must have enough paediatric-first-aid-trained staff

Once a child starts school, usually the term after they turn five, the statutory guidance Supporting pupils at school with medical conditions applies in England and requires an individual healthcare plan. Scotland, Wales and Northern Ireland have their own early years and education frameworks, so check the rules for your nation.

Individual healthcare plans for under-fives

An individual healthcare plan (IHP) is the single most useful document for supporting a young child with epilepsy.

Although the school-based IHP duty applies from school age, an IHP is good practice in any early years setting. It should describe the child’s seizures, their triggers, what to do during a seizure, any emergency medication and consent for it, who to contact, and when to call 999. Build it together with the parents and the child’s health team, and review it regularly. Our guide to the importance of care planning explains the principles.

Managing medicines and emergency medication

Settings need a clear medicines procedure and, where a child is prescribed emergency medication, staff who are trained and competent to give it.

Some children with epilepsy are prescribed emergency (rescue) medication, such as buccal midazolam, for prolonged seizures. This should only be given by staff who have had specific training and a signed competency assessment, following the child’s IHP. Record what is given and tell parents the same day. You can read more about how rescue medication works.

Recognising and responding to a seizure

All staff should know how to recognise a seizure and follow simple, safe first aid.

• stay calm and note the time the seizure starts
• protect the child from injury and cushion their head; do not restrain them or put anything in their mouth
• after a convulsive seizure, place the child in the recovery position
• call 999 if it is a first seizure, it lasts more than five minutes, one seizure follows another, or the child is injured or struggling to breathe

See our full guide on what to do when someone is having a seizure. It can also help to know how to explain epilepsy to children so that peers understand too.

Staff training

Epilepsy awareness training gives early years teams the knowledge and confidence to support a child safely and to meet their duties.

Training should cover what epilepsy is, the seizure types seen in young children, seizure first aid, when to call 999, and, where needed, emergency medication competency. Refresh it regularly and whenever a new child with epilepsy joins the setting.

Frequently asked questions

Can a child with epilepsy attend nursery?

Yes. With the right plan, training and procedures in place, children with epilepsy can take part fully in early years settings.

Does an early years setting need an individual healthcare plan?

It is not a statutory requirement before school age in England, but an individual healthcare plan is strongly recommended as good practice.

Who can give emergency epilepsy medication in a nursery?

Only staff who are trained and assessed as competent for that child’s prescribed medication, following the child’s individual healthcare plan.

What should staff do if a child has a seizure?

Keep the child safe, time the seizure, do not restrain them, place them in the recovery position afterwards, and call 999 if it meets the emergency criteria.

Is epilepsy training a legal requirement?

The EYFS requires paediatric first aid and the safe management of medical needs. Epilepsy-specific training is the practical way to meet that duty for a child with epilepsy.

Epilepsy training for your early years team

National Epilepsy Training delivers epilepsy awareness training for nurseries, childminders and early years teams, in person or by video conference.

• meet your EYFS welfare and first aid duties
• build staff knowledge and confidence
• keep children safe, supported and included

Explore epilepsy awareness training for early years settings