The 4 symptoms that mean your child must stay home from school or daycare

Claire McCarthy, MD
Claire McCarthy, MD, Faculty Editor, Harvard Health Publishing

Follow me on Twitter @drClaire

It’s a decision every parent faces regularly: whether or not to keep a sick child home from school.

It would seem like a simple decision. If your child is sick, of course they shouldn’t go to school or daycare. But besides the fact that it’s not practical to keep a child home for every sniffle, keeping a child home can be a real hardship for working parents — and it means that a child is missing out on learning and other activities. So it’s a decision that should be made as wisely as possible.

Sometimes the decision is clear. Your kid looks awful and you can’t imagine sitting them up, let alone sending them anywhere. But sometimes kids don’t look so bad and the decision is less clear.

Here are symptoms that mean your child must stay home:

1. Fever. Any temperature of 100.4° Fahrenheit (38° Centigrade) is a fever, and children shouldn’t go to school with fevers. Not only are fevers a sign of some sort of infection, it also usually means that they are shedding germs right and left. There’s just no way you can know whether things will get better or worse — and while giving them medicine might bring the fever down, it won’t stop them from being contagious.

Most schools say that a child should be fever-free for 24 hours before going back (no fair giving ibuprofen or acetaminophen regularly to tamp it down). That is very reasonable, but for practical purposes I think 20 hours is okay, meaning that if by lunchtime the fever is gone, I think they are okay to go back the next day.

What if your child has a temp of 99.9 or 100? Officially that’s not a fever. But as a parent I’ve certainly been called by a school nurse to pick up a child with a temp of 100, and often it can be the sign of a brewing illness. I’d suggest going by how your child is acting; if they are acting sick, keeping them home and keeping an eye on them might be a good idea.

2. Vomiting or diarrhea. It’s unfair all around — to the child and the school or daycare — to send a child with vomiting or diarrhea no matter how well they might look to you. The same 20-24 hour rule applies, although it’s worth checking with your doctor for advice. Some viruses, such as norovirus, can be contagious for an extra day or so. You do not want to be the parent responsible for an outbreak of norovirus at your school or daycare, trust me.

3. Bad pain. If your child has a sore knee or a mild headache but is otherwise acting okay, it’s likely fine to give some medicine and send them off. But if the pain is anything more than mild, don’t do it. Pain is always something you want to keep an eye on. Keep them home and call your doctor instead.

4. Coughing that won’t stop — or anything different about your child’s breathing. If we kept every child with a cold home during the winter months, there would be a lot of empty classrooms. But a really bad cough not only makes it hard for a child to learn or play, it also warrants a call to the doctor, as does breathing that sounds or looks different from usual.

If you’re on the fence, call your doctor for advice; you can always take your child in a bit later if you get the go-ahead. When it comes to your child’s health and the health of all the other children at school or daycare, it’s better to be safe than sorry.

Comments:

  1. Kathleen

    I am a school nurse. Our school policy is a child with a temp of 100 F or above should stay home. As you mentioned, the child should be fever free for at least 24 hours without the use of fever reducing medicine.

    I believe that most schools use the 100 F mark as their guide.

    Thanks for bringing this important subject to the attention of parents.