"It's a tough call because kids can look real sick and not be that sick sometimes," says George W. Shannon, MD, a family physician in Georgia and a member of the American Academy of Family Physicians' board of directors. "But if your child is lethargic, has a fever, is vomiting, or has diarrhea … those are signs that she should stay home."
Some other key reasons to keep your child home from daycare include a fever that can't be controlled, a known illness that is infectious, a sore throat, and skin rashes that look like red paint splattered on the skin. While different daycares will have their own health policies, many daycares will not allow a child to participate with a fever of more than 101 degrees, and it must be less than 101 degrees for 24 hours before returning.
Don't Send Her to Daycare If . . .
In addition to Shannon's general tips, the National Resource Center for Health and Safety in Child Care and Early Education advises you to keep your child home from daycare if she has any of the following symptoms:
- Blood in stools
- Chickenpox (until all of the sore are crusted and dry)
- Fever above 101 degrees orally, above 102 degrees rectally, or 100 degrees in the armpit
- Head lice
- Hepatitis A virus, until one week after beginning of the illness
- Measles, until four days after the start of the rash
- Mouth sores that include drooling
- Mumps, until nine days after the start of gland swelling
- Persistent crying and unexplained irritability
- Persistent stomach pain that lasts more than two hours
- Pinkeye, conjunctivitis
- Rash with high fever or a behavior change
- Strep throat until appropriate treatment has been given
- Trouble breathing or severe wheezing
- Uncontrolled coughing
- Vomiting two or more times in a 24-hour period, until vomiting stops
Children and Daycare: Prepare for Sick Days
Every child will get sick at some point. If it happens after your child is already at daycare, be sure her caregivers have appropriate permission to have your child treated.
"Recently a grandmother brought her granddaughter into my office for treatment, but she had no permission to treat and the parents couldn't be contacted. Be sure to provide your caregiver with a simple handwritten, signed, and dated note providing permission — with a phone number where you can be reached," Shannon says.
Of course in urgent, emergency situations such as an accident or if your child were to have a seizure, Shannon points out that your child will be treated regardless. But "a note makes it easier," he says.
Children and Daycare: Factor in Finances
It's a hard fact of life that finances come into play when your child becomes sick and you decide that you can't take her to daycare. You might have to take the day off. Your checking account may be dangerously low with no available funds for a doctor's visit co-pay and medicines. Shannon says he's seen this situation rapidly increasing in recent years for many parents. He advises the following:
- Establish a long-term relationship with your doctor. "I follow some patients for years and they run into some tough times. Most physicians with a long-term relationship with a family will allow you to take time to pay," he says.
- Take advantage of pharmacy discounts at big-box stores. "I send a tremendous number of people to a big-box store that's got $4 prescriptions. In many cases, generics are okay. But the least effective medicine is the one that you don’t take," Shannon says.
- Question the use of antibiotics. Don't be shy about asking your pediatrician if your child really needs an antibiotic, a drug that is often over-prescribed. "Kids are amazingly resilient; they'll bounce back without the antibiotics," Shannon says.
Children and Daycare: Trust Your Parental Instincts
If your child doesn’t have any of the symptoms that rule out daycare but you still feel that you should keep her home, trust your instincts. That’s a good rule of thumb to follow in most parenting situations, and especially when it comes to your child’s health. When Jessica Rinner’s 18-month-old daughter, Abigail, was recently sick, she kept her home from daycare. “Abigail had been fighting a cold and she was constipated and clingy,” says Rinner, a civil engineer in Shirley, Mass. “I was trying to go to work and she was clinging to my leg, crying. That’s when I decided to call out.”
It can be tough trying to decide if your child is too sick for daycare. Countless parents struggle with this every day. Consider the symptoms checklist above, call your doctor if you aren’t sure, and listen to your instincts.