Your 3-year-old is playing listlessly with her breakfast. “I don’t feel so good, Mommy,” she tells you. There’s no fever, no vomiting and no diarrhea, but she’s not her normal bundle of energy.
Now comes the tough part. Do you send her to day care, or keep her home?
The American Academy of Pediatrics and the American Public Health Association have guidelines that can help you make up your mind. Drawn up in 1992 and revised in 2002, they cover kids in group care and school.
According to the guidelines, kids should stay home if the illness:
•Poses a risk of spreading a serious or harmful disease
•Needs more care than the staff can provide without a risk to the health and safety of other children
•Would keep the child from joining in activities
These are specific examples of when to keep children home:
•Fever higher than 101 degrees Fahrenheit orally or 102 degrees Fahrenheit rectally
•Diarrhea or blood in stools
•Persistent abdominal pain
•Vomiting twice or more in 24 hours
•Conjunctivitis (pinkeye), strep throat or chicken pox, until no longer contagious
•Sluggishness, uncontrolled coughing, constant crying or other signs of possible severe illness
Children with colds, runny noses or mild fever may be able to go to school or day care depending on other factors.
Deciding whether a mildly ill child can go to day care or school is difficult. What may have been just a tummy ache in the morning could lead to vomiting and diarrhea later in the day. Parents usually make good decisions, but sometimes work obligations make it hard for parents to keep children home. However, child care and school personnel have the final say on whether the child is too sick to attend day care or school. And, whenever in doubt, call the pediatrician!