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How Sick is Too Sick for School?

TurnerTo go or not to go – to school, that is. This is an age-old question for parents. When your child is sick, the decision to send them to school or keep them home can run a fine line. Below are a few simple guidelines from Dr. Richard Turner, MMH pediatrician, that may be helpful when trying to decide which option is best. Remember, these are guidelines ONLY and if you have a specific question or concern about your child, it’s always best to contact his or her primary care provider.

What exactly is a fever? A fever is defined as any temperature of 100.4 degrees or higher. So, now what? This is where your judgment comes in. If your child has a temperature of less than 100.4 and is acting fine, it’s probably ok for him or her to go to school. If your child is lying around, not feeling well, or not being active, it’s probably a good idea to keep them home and consult their doctor.

In general, fever is a sign your body is fighting an infection. It can also mean you are likely shedding virus, bacteria or other germs, making it much easier to spread infection. Fever is a normal response of the body trying to fight off germs. With that being said, if your child has a fever, it is important to keep them home from school until the fever has been gone for 24 hours naturally, meaning without the use of anti-fever medications such as Tylenol or Motrin.

Generally, a child with a cough or congestion can go to school. If we kept every child home from school every time they have a ‘cold’ or cough, the teachers would be sitting in their empty classrooms twiddling their thumbs. However, if your child has a severe or prolonged cough (more than 2 weeks), they should be seen by their primary care provider to be sure the cough is nothing worse, such as pneumonia.

A child should not go to school if he or she has had more than two episodes of vomiting in a 24-hour period and should not return to school until vomiting has resolved for 24 hours. Similarly, a child with diarrhea should not return to school until the diarrhea has resolved for 24 hours. Vomiting and diarrhea from a stomach virus can last for up to two weeks! Yes, two weeks. The vast majority of stomach viruses cause symptoms for 3 to 5 days. If lasting longer than this or you are concerned your child is getting dehydrated, OR if they have bloody diarrhea, ALWAYS contact your child’s primary care provider or seek immediate medical attention through the emergency room.

Rough or Sleepless Night
If your child was up all night due to coughing, vomiting or diarrhea, it is appropriate to keep him or her home from school. They are not likely to be very productive and need rest to allow their body to fight off any infection. If he or she was up all night playing video games, well that’s a different story!

Pink Eye
Due to its highly contagious nature, children with bacterial conjunctivitis (pink eye) should stay home from school until completing 24 hours of antibiotic eye drop therapy.

This is a tricky one as rashes often require visual diagnosis. There are so many things that cause rashes in kids, many of which are infectious – including chicken pox, measles, strep throat, and hand, foot and mouth disease. However, many rashes are not contagious and do not require missing school. Examples of non-contagious rashes include eczema, poison ivy/oak/sumac, contact dermatitis, allergic reaction/hives.

My advice here is if your child has an UNUSUAL rash or you’re not sure what it is, keep them home and have it evaluated by your their primary care provider or a provider experienced in evaluating childhood rashes, especially if the rash has ulcers, blisters or open sores.

In summary, you know your child best. If you are concerned or uncomfortable, it is best to have your child looked at by their doctor.

Learn more about our Pediatric program by clicking here, or call 812.933.5018.