How to tell if your child is too sick to go to childcare?

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Kids get sick.

In fact, there are periods where you struggle to remember when they were last well.

As parents we teach the benefits of sharing, and while the concept is often lost on them when it comes to the latest Lego set, iPad or the tastiest treats from the Halloween haul, they ALWAYS seem extremely capable and often eager to share whatever bug they’ve picked-up. And not just picked-up … they’re like magnets. It doesn’t matter how clean an environment is, it’s basically impossible to stop those little hands exploring by touching anything, everything, everyone, and eventually finding their way into a mouth or nose. As much as I love my little petri dish, there was a period of about three years where it seemed like he had his finger surgically inserted into his nose.

Invariably, we all ask ourselves at one point or another whether our child is too sick to go to childcare. It can be tough to gauge, as not all sniffles, red eyes or tummy aches require you to take a day off from work to nurse them back to health - Sometimes a child's symptoms (say, Exorcist style vomiting or a cough like a barking seal) make the decision a no-brainer. Other times, not so much. More often than not, it comes down to a judgement call.
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Most childcare centers have specific guidelines for when to keep your child at home, and are usually derived from pediatrician recommendations whose main goal is making sure your child feels well enough to participate and allowing for class to run as usual, with minimal disruption. Not to say that they aren’t concerned about transmission, but according to the American Academy of Pediatrics, most disease is actually spread before symptoms occur, so the current exclusion recommendations recommend that most illnesses don’t require exclusion, provided “the needed care is not greater than the staff can provide without compromising the health and safety of other children, and the child poses no risk of spreading harmful diseases to others.”
While you should always check your specific center’s illness policy, below is a checklist to help those early morning, coffee starved Go/No-Go illness decisions:

Fever

Good to go:

Your child is good to go if he's over 4 months old, has a temperature below 100°F, is receptive to drinking fluids and doesn't appear to have had a personality transplant.

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Too sick:

If your baby is 4 months old or younger, call the doctor at the slightest indication of fever (anything above 98.6°F) or a sudden change in behavior; daycare is out. Older children should stay home if their temps rise above 100.4°F. A feverish child is not only considered contagious, but he's also probably not feeling well enough to learn or participate. Keep him home until he's been fever-free for 24 hours and is feeling like his usual self.

Vomiting

Good to go:

She's heaved only once in 24 hours. It's not likely she has an infection, nor is she at risk for dehydration. Sometimes kids throw up because mucus left over from a cold has drained, in which case it's also not worthy of a sick day.

Too sick:

If your child has vomited two or more times in 24 hours, she's benched. Watch for signs of dehydration as well: She's peeing less than usual and her urine is dark yellow; she doesn't produce tears when she cries; or there are no bubbles between her lips and her gums. To ward off dehydration, offer small amounts of fluid frequently, increasing the amount as tolerated. One more thing: Don't automatically send your child back once the vomiting stops. If she's not markedly better after a few days, call the doctor.

Diarrhea

Good to go:

Your child's stools are only slightly loose and she's acting normally. Some kids develop "toddler's diarrhea," triggered by a juice OD; as long as the poop isn't excessive, the child has the all-clear.

Too sick: Kids who have the runs more than three times a day and/or have poop so watery it leaks out of the diaper need to stay put. They likely have an infection that can spread. If you see blood or mucus in the stool, call the doctor; she may want to do a culture. As with vomiting, watch for signs of dehydration and follow the same prevention advice.

Sore throat

Good to go:

A sore throat accompanied by a runny nose is often just due to simple irritation from the draining mucus; send him off as long as he's fever-free.

Too sick:

If the achy throat is accompanied by swollen glands, a fever, headache or stomachache, bring him to the doctor for a strep test, especially if he's 3 or older (the bacterial infection is unusual in younger kids). Children with strep should be on antibiotics for at least a full day before mixing in with the class.

Stomachache

Good to go:

If this is your child's only symptom and she's active, send her off. It could signal constipation or even a case of nerves (in which case, a hug will go far).

Too sick:

Any stomachache associated with vomiting, diarrhea, fever or no interest in play warrants a trip to the M.D. Sharp stomach pain and a rigid belly can be signs of severe constipation, appendicitis, or a bowel obstruction.

Colds

Good to go:

If your child is fever-free and isn't hacking up a storm, he's a go. After all, if children with snotty noses were excluded, schools would be empty!

Too sick:

Junior is staying home if he has a persistent, phlegmy cough and seems cranky or lethargic. He's also couch-bound if his cold symptoms are accompanied by a fever or wheezing.

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Contagious Disease
• Your child should stay home from school if he has a contagious disease. A contagious disease is one that can be spread by close contact with a person or object. Examples are: chickenpox, flu, vomiting, diarrhea, colds, strep throat and "pinkeye." A disease may be contagious before the child shows signs of illness. It is very hard to prevent the spread of some germs, especially in a school classroom. Good hand washing will help prevent the spread of germs.

• If your child has chickenpox, ask your doctor when he may return to school. Generally, children who have active chickenpox should not return to school until all the lesions are dried and crusted.
• Hand, foot and mouth disease: A common outbreak in day-care facilities, this can cause some painful mouth ulcers and a rash. Kids should be kept at home for fever or if they are unable to control their drooling.
• Erythema infectiosum (Fifth disease): This is a viral infection common in preschoolers that can cause fever, rash (classically a “slapped-cheek” appearance) and sometimes joint pain or other symptoms. In most healthy children, it resolves without major problems. The rash tends to show up late, after kids are no longer contagious. So if they’ve had it long enough to figure out that they have it, anybody who was going to get it already has it. Send the child to school.
• There are other illnesses that require children to stay out of school, such as measles, mumps chickenpox and pertussis. Fortunately, these diseases are preventable with routine vaccines.

References:

•https://offspring.lifehacker.com/how-to-know-if-your-kids-too-sick-for-school-1821782564

•https://www.washingtonpost.com/national/health-science/sometimes-you-really-do-need-to-keep-your-kid-home-from-school/2017/01/20/e8018410-cde4-11e6-b8a2-8c2a61b0436f_story.html?utm_term=.4475730057ce

•http://www.nationwidechildrens.org/school-and-illness-should-your-child-stay-home

•http://www.parenting.com/article/is-my-child-too-sick-for-school