The Cough-and-Sniffle Question: When to Keep a Child Home?

There are moments when I feel I have spent large parts of my professional life dropping off my own marginally ill children at school (or at day care) and then hurrying to work to examine children who are notably less sick but have been kept home by their parents and brought to see the doctor.

I’m talking about the common cold, the winter crud, the lingering nasal drips and irritated coughs that mark our children’s passage through the varied mix of respiratory viruses — or perhaps mark the viruses’ passage through our children.

What I’m not talking about is childhood fever. I vigorously deny those vile rumors that I occasionally, in the distant deniable past, gave my warm-to-the-touch toddler a big dose of ibuprofen at day-care drop-off time — though we’re admittedly entering into the Deepest Secrets of the Working Parent Zone here. The child with fever clearly needs to stay home, as does the child who is vomiting or is just plain miserable.

On the other hand, I do remember getting several calls from day-care directors or school nurses to inform me that although my child seemed happy and active, there was in fact a lurking fever — and I remember biting back the question, what kind of zealot takes the temperature of a happy, active child?

http://www.nytimes.com/2009/02/10/health/10klas.html?th&emc=th

That's been my rule with my daughters so I agree with author. I also don't take them to the doctor unless they have a fever that persists. :hi:

they're vomiting or have fever.

presented with all the symptoms of flu or strep but without the fever. However, my dd really seemed sick, despite the lack of fever. I emailed my sister (a pediatrician; very convenient I must say) and she recommended taking her in to be checked. They had been seeing a lot of flu presenting in a similar way. Indeed, her own son had a really bad case of influenza b in which the fever didn't appear for 2-3 days into the illness.

With flu, I'd prefer not messing around because if they're going to benefit from tamiflu, it has to be within the first 72 hours. Of course, this year, the tamiflu isn't working that great it seems, but it's all we have.

actually dose a poor baby with Ibuprofen at daycare drop off time? I mean I have never gone back to share lunch with the teachers and kids on the mission of firing in a dose of Ibuprofen because I saw the nurse eyeing her on the way in and reaching for the thermometer. I deny that accusation even though her teacher was sworn to secrecy cause she may have seen something.

I actually keep my kids home when they are miserable and or contagious or show a real fever. Our daycare doesn't send them home unless the fever is significant. Nothing I hate more than to see co-workers who think they are so vital to the day to day operation of work that they have to show up to give the rest of us their damned cold or flu.

on edit: I'm lucky enough to work for a group and company that doesn't discourage you from staying home with your kids once in awhile.

dumped sick kids off at school. It's far more common than anyone wants to admit. And it makes it worse for the parents who DO keep their kids home when they are sick.

Viral infections can spread even if a child harboring the virus is not exhibiting symptoms. Conversely, a child with a runny nose and cough may not be infectious at all. Judgments are difficult to make on appearances.

So, it's more likely that your kid is catching something from their classmate who sits on one side of them who seems perfectly fine (and gets sick the next day) than from their classmate on the other side who is sneezing and has a runny nose.

I think trying to place blame as to why one's kid got sick is pretty pointless, to be honest. Last year, my older child left for school in the morning perfectly fine, and then was sick as a dog with flu by 5th period. She went to the nurse, but when the nurse wasn't in, she went back to class and proceeded to cough all over her neighbor. Two days later, she was diagnosed with flu a. Four days later, her neighbor in that class (a family friend) was diagnosed with flu a. Yep, she probably caught it from my kid. I felt awful, but you know, it happens. Kids get sick.

but remember, this is how he builds up his immune system so that the common cold doesn't kill him when he gets old and grey. He'll have had them all by then, and his immune system will swat them down before he knows he's got an infection.

Keeping your kid safe from all infection is not doing him a favor in the long run.

And yes, working parents do try to get away with dumping a sick kid at day care or school. Sometimes they even get away with it.

They claimed some ill-conceived notion that they had to come in because of too much work, not enough sick time, etc. And, predictably, half a dozen other people would be infected by the end of the week.

My son's Pre-K school has a general guideline that children should be kept home if they present a real threat of contagion: incessant coughing or sneezing; free-flowing nostrils; or anything else likely to give the illness to a child sitting nearby.

Of course, schools are breeding grounds for all sorts of microbial nasties, so the germs get through no matter how careful the guidelines might be...

then they go to school. If they're lethargic, just "out of sorts", not like themselves, they stay home. Of course, fever means they stay home. However, even in the absence of a fever, I've been known to keep them home if they're acting funny.

It's not always as easy to know when to keep them home and when not to, especially as the kids get older. I have a middle schooler, and sometimes it's hard to separate the times when she is really sick from the times when it's normal 12 year old angst about hating life in general.

We would stay home if:

1. We had thrown up in the last 24 hours;
2. Had a fever of 100 degrees or more in the last 24 hours;
3. Was coughing or sneezing frequently, or otherwise had an excess of snot.

My mom was careful to teach us about hygiene, how to blow our noses properly, wash our hands and the like, even at an early age. (We were poor and visits to the doctor meant a day off work plus the costs. Much cheaper to beat into us the importance of prevention.)

keep him home. When he gets to the green, drippy stage, it's probably OK to send him to school with plenty of tissues.

Once the temperature is down, the virus is no longer present in sufficient amount for him to be contagious.

People take the temperature of an active, happy kid when that kid feels warm to the touch, which he will when that dose of ibuprofen wears off in four hours, so just keep him home.