When to keep your sick kids home from school

HOUSTON – On average, children get eight viruses a year, and every year American kids are missing millions of school days.

The American Academy of Pediatrics (AAP) is actually very mindful that kids get sick and parents have to work. So, their guidelines on when to keep a child home from school are actually a little less strict than you may think.

AAP Child Care Recommendations for Exclusion:
The primary reasons for exclusion from child care or school are that the condition:
•    Prevents the child from participating comfortably in activities
•    Results in a need for care that is greater than staff members can provide without compromising the health and safety of other children
•    Poses a risk of spread of harmful disease to others 

Kids need to be free from a fever for 24 hours without medication before returning to school.

However, illnesses like diarrhea may not come with a fever and are still be a reason to stay home from school, according to Kelsey-Seybold pediatrician Dr. Jessica Lanerie.

“If they have major behavior changes, they're not eating, not drinking, complaining of severe pains to where they're going to be uncomfortable during the school day, parents want to keep them home,” Lanerie said.

Lanerie said it's important to be mindful of other families.

“There's kiddos at school who may have underlying medical problems and what just causes a cold or runny nose in one child, for a kid that has another underlying problem it could cause a very severe illness where they wind up in the hospital or worse. So we really need to think about and protect those kiddos as well,” she said.

On the other hand, there are some contagious illnesses that are not listed by the American Academy of Pediatrics as reasons to keep kids home.

When It's OK to Stay in Child Care/ School: 
Except during outbreaks of influenza, as long as the first two criteria are met, children do not need to be excluded for:
•    Common colds
•    Runny noses (regardless of color or consistency of nasal discharge)
•    Coughs
•    Yellow, green, white, or watery eye discharge without fever, even if the whites of the eyes are red (pinkeye)
•    Eye pain or eyelid redness
•    Fever in children older than 4 months above 101ºF (38.3ºC) from any site-(axillary, oral or rectal) without any signs or symptoms of illness
•    Rash without fever and without behavioral changes
•    Thrush
•    Fifth disease
•    All staphylococcal infections including Methicillin-resistant Staphylococcus aureus (MRSA) carriers or children with colonization of MRSA but without an illness that would otherwise require exclusion
•    Molluscum contagiosum
•    Cytomegalovirus infection
•    Hepatitis B virus infection
•    HIV infection
•    Children who have no symptoms but are known to have a germ in their stools that causes disease—except when they have an infection with a Shiga toxin–producing Escherichia coli (STEC), shigella, or salmonella serotype Typhi. In these types of bowel infections, follow health department guidelines for return to care.

“Once they're started on that first treatment, they're OK to go back to school,” Lanerie said about conditions like pink eye or lice. “So that first treatment can happen in the evening between school days.”

Remember, pediatricians may recommend one thing and your school could have rules against it. Be aware that if your school has rules against coming to class with certain conditions, they can call you to pick up your child if they’re showing symptoms.