It’s no surprise that when children start child care, they start to get sick. They’re exposed to other children and new environments, all with a weaker and less developed immune system to adults. Exposure to germs does help develop immunity, but no one wants to be exposed to unnecessary viruses and infections, so it’s wise to know how long to keep your child home when they are ill.
For parents, illness in their young children can be very worrying and frequent. According to GP and specialist in children’s health Dr Julia Driscoll, “The average school-age child can expect 3 to 8 colds a year and 2 to 3 bouts of viral gastroenteritis.”
Given that some families have more than one child, and that child may spread the bug to other siblings or parents, it may feel like sickness is an all too common occurrence. This frequency can also confuse parents as to when a child is just a bit “off colour” or seriously ill. According to Dr Driscoll, many parents panic and take their child to the doctor too soon for minor complaints, only to be told to take the child home to sleep and drink lots of fluids. It also quite common to assume that a child is suffering from a cold, but instead they have an allergy or a virus with symptoms that mimic the common cold. How do you tell what is ailing your child and whether they are safe to go to pre-school or care?
When to stay away
Nothing can make a parent more unpopular than the act of repeatedly bringing a sick child to child care. Not only is this bad for the child, but it exposes the rest of the children and carers to unnecessary bugs. All parents should clearly understand their child care facility’s policy on illnesses – and carers must communicate the policy clearly.
Clear signs that the child should not attend child care, and should seek medical attention:
- uncontrolled vomiting or diarrhoea;
- elevated temperature (over 39.5 degrees Celsius) that lasts more than 48 hours, accompanied by other mood or physical changes;
- respiratory illness such as asthma, coughing or sinus infection (different from a clear runny nose);
- obvious signs of influenza – fever, sore throat, coughing, sneezing, lethargy;
- mouth sores that cause drooling, e.g. hand, foot and mouth disease;
- difficulty breathing or dramatic wheezing;
- head lice (untreated);
- any presence of blood, either coughed up, vomited or appearing in a child’s urine that is more than a few dots, e.g. larger clots or a steady flow of blood;
- bacterial conjunctivitis with yellow discharge from the eyes;
- any rash, particularly when accompanied by fever or behavioural change such as lethargy or crying, e.g. slapped cheek syndrome, roseola.
Life-threatening, but rare diseases such as meningitis are also very concerning for parents, as they can also have symptoms that can mimic the common cough or cold. However, such serious illnesses are usually accompanied by several additional symptoms listed above. (E.g. meningitis would have not only cold and flu symptoms, but vomiting, stiffness and severe, persistent headache and more).
Below is a list of the more common illnesses regularly suffered by children in care:
- hand, foot and mouth disease
- ear infections
- coughs and colds
- slapped cheek syndrome (Parvovirus B19)
- upper respiratory tract infections
- urinary tract infections
- vomiting and diarrhoea
When is a child infectious?
For most illnesses, a child is most infectious before she or he develops symptoms. Therefore, it is essential to maintain good hygiene in the home and child care settings, particularly washing hands thoroughly and regularly. Fortunately, some infections are not contagious, such as ear infections and in these cases there is no need to remove the child from care unless the symptoms are severe.
Below is a list of common childhood illnesses and a guide to when a child should be safe to return to day care:
- chickenpox – six days after the rash has scabbed over and disappeared
- hand foot and mouth disease – wait until the child feels better and all blisters and mouth ulcers have gone
- head lice – a child can return after treatment
- slight cold with clear nasal secretions – if the child’s temperature is under 37.8° and the child is happy and pain-free, they may attend child care
- bacterial conjunctivitis – 24 hours after starting a course of antibiotics
- slapped cheek syndrome – once the red rash on the cheeks develops as they are no longer infectious
- roseola – after the fever subsides, usually within a week
- vomiting – wait 24 hours before returning to childcare
- fever – keep a child at home until the fever has completely subsided, generally three to five days
- cough with fever – wait for the fever to subside and child to feel better. The child may return to child care even if the cough is remaining.
Sage Institute of Child Care – it’s more than a job, it’s a rewarding career.
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