When is a kid too sick to go to school? It’s a tough call

Look for signs of RSV such as wheezing and cough. photos.com 2007

Not sure if your child should go to school? Consult a doctor.
photos.com 2007

A University of Michigan poll of parents found that there are many differing views about when a child should stay home from school because of illness. The C.S. Mott Children’s Hospital National Poll on Children’s Health found that 75 percent of the parents they asked had kept kids home from school at least one day in the last year. Most cited their child’s health as the reason, though about half worried about their child infecting another child.

They also weighed other non-illness related worries when deciding whether to keep a kid home from school or day care: 37 percent of parents worried about what their child would be missing if she didn’t go to school, though that was typically parents of older children. 11 percent of parents worried about missing work and 18 percent worried about not having someone to watch their sick child.

When it came to illness, parents said they would not send a child to school with these symptoms:

Diarrhea (80 percent agreed)

Threw up once (58 percent)

Slight fever (49 percent)

Red watery eyes, no fever (16 percent)

Runny nose, dry cough, no fever (12 percent)

So, what are good rules of thumb about when kids are too sick to attend school?

Dr. Danielle Glade is the medical director at St. David's Children's Hospital.

Dr. Danielle Glade is the medical director at St. David’s Children’s Hospital.

We asked Dr. Danielle Glade, the medical director at St. David’s Children’s Hospital when you should keep kids home.

The three biggest factors are:

  1. Fever
  2. Whether or not your child is contagious
  3.  Whether or not he can participate

We’ve all heard that we should never send a child with a fever to school. Where does that come from? Viruses are most contagious when there is a fever. “Also a fever is miserable,” Glade says. “It’s hard on the kids to do anything with a fever.”

Don’t give your kid with a fever Ibuprofen or Tylenol and then send him to school when the fever is gone. He probably is still contagious and the fever will come back.

If your child has thicker nasal secretions, it could be a sinus infection. That would be a reason to see a doctor, but often nasal secretions or cough is not a reason to miss school unless it is severe. Don’t forget to teach kids how to cough into their sleeve, though.

What about a rash? Well, that depends on what is causing it. If it’s poison ivy, then yes, it’s spreadable, and you’ll want to get that under control to not share it. Often a rash is an indication of an illness and it’s the illness to worry about, not the rash itself. Now is also the time that kids get a lot of eczema. That is not a reason to stay at home.

And lice? Treat it immediately, to lessen the chance of spreading it, but chances are, your child has already shared it. See you at school.

With all symptoms, you’re looking at the big picture, Glade says. “Does the kid have a reason to have a nervous stomach? Was there a disagreement with friends? It’s about context and severity.

“If anything, parents feel the need to keep kids out of school longer than necessary,” Glade says.

If your kid is fever-free for 24 hours, send them. Don’t wait for the cough and runny nose to go away because that could take weeks.

Right now Glade is seeing a lot of respiratory viruses, rhinovirus, coronaviruses and parainfluenza (but not the flu itself). They all are similar: runny nose and cough.