When Should My Child Stay Home From School?
The purpose of keeping a sick child home from school is:
The following are some guidelines you may use when deciding whether to keep your child home or to send him to school. If you are unsure, call your child’s healthcare provider.
Fever is generally defined as a core body temperature of 100.4 F or greater (not 104.) Oral, tympanic membrane (ear), axillary (armpit), or temporal artery (forehead) methods for taking temperature are typically used for school-aged children. A reading of 100 F or more with any of these techniques qualifies as fever.
Your child should be without fever for a full 24 hours before returning to school. This is because sick children often do not develop fever until the afternoon or evening. If your child has fever, do not give a fever-reducing medication (Tylenol, Advil, etc.) then send him to school.
If your child vomits in the morning, observe him for at least 1 hour before sending him to school. If he has no further episodes and is able to eat a light meal, he may go to school. If he has a second episode, keep him home.
A child with one episode of mild diarrhea may be able to go to school, but if he needs to go to the toilet more frequently than usual due to loose stools, he should stay home. Vomiting and diarrheal illnesses are extremely contagious, so make sure he washes his hands with soap and water after toileting and before eating.
Most sore throats occur due to a mild viral illness and will self-resolve. If a child has no fever and does not feel otherwise ill, he may attend school. If the sore throat is accompanied by other symptoms such as headache, stomachache, and/or rash, he should see his healthcare provider to rule out strep throat.
Runny Nose or Cough
Most runny noses and coughs are due to mild viral illnesses which will self-resolve. If the child has no fever and feels otherwise well, he may attend school. If your child is sick enough to sleep extra hours during the day due to his symptoms, he should stay home. This typically occurs during the first 2 or 3 days of an illness. If your child is well enough to go to school, send him with tissues and have him wash or use hand sanitizer after using them. If his runny nose or cough lasts longer than 10-14 days or worsens instead of improving, he may need to see his healthcare provider.
Red or Runny Eyes
Bacterial conjunctivitis (“pink eye”) is a contagious infection of the lining of the eyeball and eyelids. Symptoms are redness of the white of the eye, swelling of the eye or eyelids, and discharge which is typically cloudy or yellowish-green. If your child wakes up with his eyelids “glued together” with discharge, call your doctor and keep your child home. If there is a little clear discharge and little to no redness, this is not likely a contagious conjunctivitis. Careful hand washing is essential with bacterial conjunctivitis.
Chickenpox is not common now that the vaccine is widely used. It can be found anywhere on the body and looks like a small blister on a red base (“a dewdrop on a rose petal”). It is typically itchy and usually accompanied by fever. A healthcare provider should see your child if you suspect chickenpox. It is contagious beginning 1-2 days before the rash appears, and lasting until all the lesions have fully crusted (no more blisters).
Scabies is a common, very itchy rash caused by a mite burrowing under the skin surface. Small bumps or raised lines are visible on the forearms and hands, and on the trunk and groin area. Often other family members have it as well. Your healthcare provider should see your child if you suspect scabies.
Impetigo is a contagious superficial skin infection which looks like a crusty yellowish scab or sometimes a large blister. It can be seen anywhere on the skin, but is often found around the nostrils and lips. Your healthcare provider should see your child if you suspect impetigo.
Staph Infections are commonly seen in school-aged children. Usually it manifests as a pink or red, firm, very sore area. It may or may not have a “head” on it. Your child’s healthcare provider should see your child if you suspect a staph infection.
Fifth’s Disease is a common viral rash which causes bright red cheeks (“slapped cheek disease”), followed by a pink, flat, lacy-appearing rash on the upper arms and tops of the thighs. Most children feel well with it, and once they develop the rash, they are no longer contagious. They may attend school.
Does My Child Need To See a Healthcare Provider?
Most illnesses may be safely managed at home with rest, fluids, good nutrition, and symptom-reducing medications if needed. It is impossible to list every condition for which a child should see a healthcare provider, but it is better to err on the side of caution. Call your healthcare provider if you are unsure how to manage your child’s illness. The following are conditions for which a child should definitely be seen by a healthcare provider:
Please call your school nurse with any questions or concerns.