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From The Nurse's Office: When Should My Child Stay Home From School

Our expert says to have a plan mapped out for contingencies at the start of the school year.

Deciding when to keep your child home from school due to illness can often be stressful and challenging.  When a child is sick, it has an effect on the whole family and can impact home, work and school.  And, illness always happens at the most inopportune times.

Sickness is a part of childhood.  According to the Centers for Disease Control and Prevention (CDC), the typical child has 6 to 12 illnesses a year ranging from mild to severe.  Illness can occur throughout the year, but usually there is a significant rise in the winter months due to influenza.

The school environment provides an abundant opportunity to spread illness.  Students spend a significant amount of time together in a closed environment with re-circulated air.  They share crayons, pencils and desks.  They cough and sneeze. They open and close doors as they roam from classroom to classroom.  They participate in PE where “high fives” reign and they pass between them the same balls, hockey sticks and baseball bats.

It is difficult to balance your child’s school attendance with the risk of spreading illness to others in the school.  It is always useful to consult your pediatrician or your school nurse and they can help you decide if it is appropriate to keep your child home.

Generally speaking, if your child complains of not feeling well but otherwise has no definite symptoms, your child can likely attend school.   Fevers are a symptom of illness and indicate that the body is battling an infection. If your child has a fever in the morning before you send them to school, keep them home.  A fever is considered to be 99.5 or greater.  If the fever goes away because you administered acetaminophen or ibuprofen, they are still sick and will need to stay home.  Once the fever is gone for 24 hours without medication it is appropriate to send your child back to school.   

Rashes alone are not a reason to keep your child home from school, however if a rash is associated with symptoms such as trouble breathing or swallowing, fever, ill appearance or is itchy or scaly, we recommend consulting your pediatrician prior to sending your child to school.

If a cough interferes with your child’s ability to sleep or concentrate, or if your child is coughing up phlegm or having trouble breathing it is appropriate to keep your child home from school.

Diarrhea that is bloody or associated with fever, abdominal pain or vomiting is reason to keep your child home.  Many times a decision made to keep a child home with diarrhea is made dependent on your child’s developmental age.  If a child understands and demonstrates good hand washing skills, then they can likely attend school with diarrhea.  If you child is having frequent diarrhea it is understandable that they are not able to concentrate in class and it is advisable to keep them home.

A child who is vomiting needs to stay home from school and can return when the symptoms have stopped and the child can tolerate a normal regular diet.

A child who has a sore throat associated with fever, vomiting, abdominal pain or difficulty swallowing needs to stay home and be evaluated by a physician before returning to school.  If your child is diagnosed with strep throat, they need to stay out of school until they have been on antibiotics for 24 hours and are fever free.

Eye symptoms that include redness, swelling, tearing, itching or burning, mild sensitivity to light, drainage or overnight crusting require evaluation by a physician prior to attending school.  If diagnosed with pink eye, 24 hours of antibiotic therapy are required prior to returning to school.

If your child appears sick, do not send them to school to see how it goes.  You should do just the opposite; assume your child is sick until you can determine otherwise.  Many times as the day progresses the symptoms worsen and additional symptoms develop.  

Understandably, it is difficult for many parents to keep their children home.  It is important to make plans at the beginning of the school year in the event that you have a sick child.  Set up a system that you can activate if your child is ill and needs to stay home and also set up a plan for when your child becomes ill at school and needs to be dismissed early.  If you have these in place, you will not be caught off guard when the dreaded phone call comes from the school nurse.

Tom Bedwell March 05, 2011 at 04:20 PM
Great picture, nice article...
Jennifer March 05, 2011 at 11:19 PM
The problem is that parents either don't care or their employers make it EXTREMELY difficult for them to take a sick day.

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