When to Keep Kids Home?

It never fails. One of your children gets sick when your spouse is away on business and you have a full schedule. The domino effect for a family with a sick child is enormous - home, work and school lives are all impacted and often at the least convenient times! To complicate matters, it can be difficult deciding when to keep a child home and when to forge ahead business as usual.

Sickness is a part of childhood, whether it's a fever, sore throat, cough or just not feeling well. According to the Centers for Disease Control and Prevention, the typical child
has 6 to 12 illnesses a year ranging from mild to severe. Illness can occur throughout the year, but tends to cluster in the winter due to flu season. These illnesses can seem to spread like wild fire affecting other students, teachers, and family members. Families and schools need to balance the child’s school attendance with the risk of spreading the illness to others in the school. Sometimes even minor illnesses require the child to stay home just to prevent the further spread of a contagious disease.

In addition to consulting your pediatrician and school nurse, these tips can help you decide whether to keep your child at home:

1. If your child complains of not feeling well but otherwise has no definite symptoms, your child can likely attend school. The school nurse will typically call you if something more develops. Be sure to contact your pediatrician if the complaints persist or other more definite sick symptoms develop.
2. Fever is a symptom of illness and not an actual diagnosis. Fever usually indicates that the body is battling an infection. A child with a fever greater than 100.5 degrees Fahrenheit needs to stay home from school until the fever is gone for at least 24 hours. If the fever does not resolve in 2 to 3 days, or if your child appears sick with any fever, call your doctor to have your child evaluated.
3. Many rashes will resolve spontaneously and are not reason alone to keep a child home from school. Any rash associated with symptoms such as trouble breathing or swallowing, fever, or ill appearance, should be evaluated by your physician. Rashes that are itchy or scaly may be contagious and should be evaluated before sending a child back to school.
4. Cough alone may not prevent your child from attending school unless it is interfering with a child's sleep or ability to participate in school activities. If the cough is productive and has phlegm or is associated with fever or trouble breathing, keep your child home from school and arrange to have the child seen by their pediatrician.
5. Stool problems do sometimes require a child to stay home from school. This is especially true with diarrhea where the stool frequency is often many times an hour. Diarrhea that is bloody or associated with fever, abdominal pain, or vomiting should be evaluated by your doctor.
6. A child with vomiting, with or without diarrhea, needs to stay home from school. Your child can return to school when the symptoms have stopped and the child can tolerate a regular diet.
7. Children can attend school with mild sore throats if no other symptoms are occurring. Any child with a sore throat associated with fever, vomiting, abdominal pain, or difficulty swallowing should be evaluated by a doctor before returning to school. Call your child’s school and ask if strep throat is going around; if so, have your child tested. A child with a diagnosis of strep throat needs to stay out of school until on antibiotics for 24 hours.
8. If your child appears really sick, keep your child home and arrange an evaluation by your doctor that day. If you can't get through to your doctor and you are really concerned, either call 911 or bring your child to the nearest emergency room for evaluation.
9. Call your doctor's office for advice if you are not sure about your child’s condition or have questions about whether your child should stay home from school. Physicians have an answering service 24 hours a day, 7 days a week. So, even after hours, you will be able to reach someone for assistance.

Many illnesses can be stopped before they spread by reminding everyone to practice frequent handwashing, blowing noses into tissues, covering mouths when coughing or sneezing, and asking other parents about sick symptoms in their kids before arranging playdates and carpools. If only it were so simple – even the best hygiene practices can’t avoid the spread of all winter illnesses. Sometimes staying home is the only way to benefit our kids, ourselves and our communities.

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