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“Mommy, I don’t feel good,” says the little voice. Those five words are tough for any parent to hear, not only because we don’t want our kids to be sick, but also because we know how illness can disrupt our family life. Every child reacts differently when he or she is ill so it can be hard to determine just how poorly he or she feels, particularly if the child is too young to talk.
Certain symptoms in children, such as fever, vomiting or diarrhea are indicators of a communicable disease. When those are present it’s best for the child to stay home to reduce the risk of the illness spreading to others. Public health experts say that if the child has a temperature (without fever-reducing medications) above 100°F when taken in the armpit, 101°F when taken in the mouth or 102°F when taken rectally, keep the child at home until he or she is fever free for at least 24 hours. Fever is usually not serious, but is a sign of infection or other inflammatory process. A high fever that is not controlled by fever-reducing medicines, fever for several days or fever in a child younger than four months old are all reasons to contact a health care provider.
Children with stomach ailments, including vomiting and diarrhea, should be kept home. If the child has diarrhea that lasts several days, he or she should stay home until a medical provider indicates that he/she can return to school or child care. Gastrointestinal illnesses including Shigella and Cryptosporidiosis spread easily in schools and child cares. Keeping children with diarrhea or vomiting home can help limit this.
The last category is the most subjective when the child just isn’t acting right. Symptoms include unusual fatigue, controlled coughing, irritability, persistent crying or wheezing. If any of these are severe, you not only want to keep the child home, but also contact a health care provider.
If your child has a rash, persistent sore throat or pink eye you should keep him/her out until cleared by a health care provider.
When your child is in that gray area, perhaps with a common cold, use common sense in deciding whether your child is acting “normal enough” to send him or her to school or child care.
You know your child best, and should be able to tell when something’s not right. But if you’re in doubt, experts say you should always call your child’s health care provider for advice. If you’re not sure about whether or not your child can leave home with a particular illness, check with the school or child care center. All have policies regarding the exclusion of ill children.
Even if the decision to keep your child out of school or child care is clear, the arrangements to make that happen may not be. Plan ahead. Figure out in advance who can watch an ill child. Can grandparents, neighbors or other family members help? Can you or your spouse work from home or shift your hours? What about when the illness lasts for several days or spreads from one child to another in the family?
Think about it this way, Would you want your child’s classmate coming to school with a communicable illness potentially infecting your child? One sick child in a class can infect more than 20 others, who then infect siblings and then…well we have an outbreak on our hands.
We are always promoting ways to prevent the spread of illness like proper hand washing and food safety. If illness has crept into your household, help protect others by keeping your child home when needed.
(Guest column by Dr. Lynne Sadler. She is the District Director of Health for the N. Ky Health Department.)