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Off-to-School Health Special

A guide to illness

Too sick for school?

"Mom, I don't feel good." Now what? Should you let your child stay home? Call the doctor? We asked Steven P. Shelov, M.D., coeditor of The American Academy of Pediatrics Guide to Your Child's Symptoms:

Sick child

Skip school: If your child's temperature is 100 degrees Fahrenheit or higher. A fever usually signals a contagious infection.
Call the doc: If he seems unusually lethargic, has a severe headache, is hallucinating or delirious, or still looks ill after the fever breaks.

Skip school: If his cough is persistent, severe, brings up mucus, or is accompanied by a fever.
Call the doc: If your child starts to have noisy, rapid, or difficult breathing, or you notice a blue tinge to his lips or fingernails.

Runny nose
Skip school: If he has other cold or flu symptoms. A drippy nose alone is no reason to skip school; just be sure he has plenty of tissues!
Call the doc: If your child is having difficulty breathing, is unusually sleepy or lethargic, or has a fever over 101 Fahrenheit.

Sore throat
Skip school: If the pain seems moderate to severe and isn't relieved by taking a drink
Call the doc: If there's also has a fever, spots on the throat, a severe headache, rash, swollen glands, red or painful joints, nausea, or trouble breathing.

Skip school: If the pain seems sharp or is concentrated in a specific area of the stomach, or is accompanied by fever, vomiting, or diarrhea
Call the doc: If it's severe and lasts longer than two hours, is accompanied by severe vomiting, or there's blood in vomit, stool, or urine.

Skip school: As long as your child is still having loose bowel movements
Call the doc: If it lasts past 48 hours, or if your child has a fever, is vomiting, there's blood in his stool, or you suspect dehydration

Skip school: If your child has thrown up within the past few hours, or has a fever or no appetite.
Call the doc: If your child also has a fever or diarrhea that lasts more than 12 hours, or shows signs of dehydration

Skip school: If your child also has a fever (this usually means an ear infection)
Call the doc: If your child has a fever, discharge from or swelling around the ear, headache, dizziness, or hearing loss

Skip school: Until it's diagnosed
Call the doc: No matter what. Many rashes are contagious; any skin eruptions should be seen and diagnosed by your pediatrician.

photo: Julie Toy

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