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Is My Child Too Sick for School?

Veer

Last night your toddler was running a slight temperature and actually asked to go to bed -- not her usual MO. By morning she's fever-free, scarfing down her scrambled eggs and chasing the dog around the backyard. You're conflicted: Should you keep her home from daycare -- upending your finely tuned schedule -- or send her off as usual?

Sometimes a child's symptoms (say, Technicolor vomit or a cough like a barking seal) make the decision a no-brainer. Other times, not so much. To alleviate that early-A.M. angst, we consulted several top pediatricians to help you figure out when your child (and you!) should get the green light to carry on as usual.

Fever

Good to go:
Your child is good to go if he's over 4 months old, has a temperature below 100.4°F, is receptive to drinking fluids, and doesn't appear to have had a personality transplant.

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.

Red eyes

Good to go:
When the white part of the child's eye is only slightly pink and the discharge is clear and watery, he's likely got a school-safe allergy.

Too sick:
His eye is stuck shut, bright red, and/or oozing yellow or green discharge. These symptoms all indicate the highly contagious bacterial form of pinkeye (conjunctivitis), and the kiddo should stay put until he's been on antibiotics for 24 hours or until the goopiness dries up.

 

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.

All the above info is pediatrician-approved by: Tanya Remer Altmann, M.D., author of Mommy Calls; Laura Jana, M.D., a spokesperson for the American Academy of Pediatrics and owner of the Primrose School of Legacy, an educational childcare center in Omaha, NE; and Lorry Glenn Rubin, M.D., chief of pediatric infectious diseases at Schneider Children's Hospital in New Hyde Park, NY.

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