Is my child too sick to return to school?

Abigail Puglisi, DO, Offers Advice on Making a Decision

It is a question parents everywhere grapple with at least once every winter: is my child too sick for school? Sending sick children to school not only puts their classmates at risk of developing an illness, but may also be a waste of time if they feel so awful they can’t pay attention or get so worn out that their illness gets worse.

Figuring out if a child should stay home from school is not always easy. Sometimes, the decision is obvious – the child has a high fever or is throwing up. At other times, however, the answer is not so clear cut. What if your child has a cold or extremely fatigued? Here is some advice to help you determine whether to keep your child home:

Fever: If your child has a fever, keep him home. A fever is a sign that your child’s body is fighting an infection. Most schools and daycares have a policy that children need to be fever-free for 24 hours without the use of medication before they can return to school. That rule is in place not only for your child’s health, but also to help prevent the illness from spreading to others.

Stomach issues: If a child is throwing up or has diarrhea, keep him home. He just needs to rest and stay hydrated. Again, most schools and daycares have a rule that students need to be symptom free for 24 hours before they can return. If your child complains of a stomachache, but has no other symptoms, it is OK to send him. Just remind him to let someone know if he feels worse.  

Cold symptoms: When a child has a cough or a runny or stuffed nose, making a decision about sending a child to school is challenging. A child should definitely stay home if she has a persistent cough with phlegm, wheezing or is extra cranky or lethargic. If none of those factors figure in, take into account your child’s age – for example a high school student can usually deal better with a runny nose than a kindergartner – and demeanor when making a decision. Is your child playing and behaving normally or is she just laying on the couch and not doing much? If unsure, have your child stay home an extra hour or two to monitor his behavior. If she acts normally, take her to school.

Red eyes: Pink eye is very contagious and children should stay home from school if their eye is red, stuck shut or has any yellow or green discharge. Your doctor can help you decide when your child can return to school. Some pink eye is caused by a bacteria and needs antibiotics, while other times it is a virus and an antibiotic would not help or shorten the symptoms.

Sore throat: A sore throat could be caused by cold symptoms or by a virus so look at other symptoms, such as a fever, headache or swollen glands, when making a decision. If your child has a sore throat combined with a fever, headache, stomachache or swollen glands, consider taking her in for a strep test. If your child does have strep, she cannot return to school or daycare until she’s been on antibiotic for 24 hours and feeling somewhat better.

Parents know their kids best. Your children may not have any of the symptoms listed above, but just seems “off” to you. In that case, go with your gut feeling when deciding to keep them home.

While I am focusing on children with this article, please note most of the advice applies to adults, too. Many adults go to work sick, which not only increases the chance that the illness will spread, but also affects productivity. A 2016 study from NPR, the Robert Wood Johnson Foundation and Harvard’s T.H. Chan School of Public Health found 55 percent of adults go into work even when battling cold and flu symptoms so think twice before you say no to taking a sick day. Your co-workers will thank you for keeping your germs to yourself and you will be more productive when you return to work.

Whether it is you or your children, carefully consider their symptoms and also use common sense when it comes to calling in sick.

Abigail Puglisi, DO, is a family medicine physician at ThedaCare Physicians-Berlin.