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Allergies vs. colds in children
Between colds, coughs and stomach bugs, kids get sick frequently. When symptoms like a runny nose or stomach pain hit, it may be hard to decide when you should keep your child home from daycare or school.
"Sometimes it's obvious when kids need to stay home, like when they have a fever," says Stormee Williams, M.D., Chief Health Equity Officer at Children's Health℠. "But many times, children's symptoms fall into a gray area that gives parents pause."
Most schools and daycares have their own sick policies about when to keep a child home. You should become familiar with your school's fever and sick day policy as it may be narrower than what physicians recommend. While school and daycare rules may not always feel convenient, it's important to remember that they are in place to keep your child healthy.
In general, you should keep your child home from school or daycare when they have any of the following symptoms or illnesses:
Vomiting
Certain illnesses and rashes like chickenpox, measles or hand, foot and mouth disease
A health care provider or school nurse can help you know if your child has one of those illnesses and when your child is no longer contagious. Parents might be surprised to learn that a diagnosis of head lice is not a reason to stay home from school. We encourage you to reference your specific school's or daycare’s policies for more guidelines.
Colds, coughs, runny noses and sore throats are common in kids and do not require that children stay home from school or daycare, especially if symptoms are mild. However, if cold symptoms include fever or a cough that is excessive enough to disrupt their learning, you should keep your child home to rest and get them tested for COVID‑19.
"With colds, as long as there is no fever and the child feels well enough to participate in class, they can go to school," says Dr. Williams. "But if a child is lethargic or will not eat, it's best to keep them home until they feel better."
Dr. Williams also suggests that if your child needs help controlling their symptoms, like if the teacher will need to constantly wipe their nose or your child does not cover their coughs, these might be reasons to stay home from school.
When your child can go back to school will vary depending on what symptoms or type of illness your child experienced.
A child should stay home with a fever, which is a temperature of 100.4 or higher. Many schools require that children be fever free for 24 hours before returning to school. Dr. Williams cautions that treating a fever with fever-reducing medications and sending your child to school is not a good idea. Most likely, the fever will return while they are at school, and you'll receive a call to pick them up early.
Children can return to school after vomiting when they can drink liquids and eat solid food. A child may go hours without vomiting if they haven't eaten, but as soon as they eat or drink, they can get sick again. Dr. Williams advises waiting an hour after a child vomits to let the stomach calm down and then give them sips of water. If they can hold water down after an hour, progress to more liquids or something bland to eat, like a cracker or piece of toast. If they can eat without vomiting, children are fine to return to school. See more remedies for a stomach flu or bug.
Having diarrhea in the classroom can be disruptive to your child’s learning, not to mention extremely uncomfortable for your child. Children can return to school when they have not had diarrhea for 24 hours. You may need to keep your child home longer if they have an infection like norovirus, which is highly contagious.
Children can return to school after the flu when they are fever free (without fever-reducing medication) for 24 hours and feel well enough to participate in class. Because the flu can cause a variety of symptoms, a child may not be ready for school even if they are fever free. Parents should use their best judgment to determine if their child is close to being back to their normal level of activity before returning to school.
According to the Center for Disease Control and Prevention (CDC), the guidance on when to keep your child home with a respiratory virus like COVID-19 and RSV is the same. You may also consider having your child wear a mask and avoid close contact with others for up to five days after being sick.
To help prevent the spread of illness, remind your child to:
Wash their hands frequently, especially before eating, after using the bathroom, after blowing their nose or touching doorknobs.
Cough into their elbow
Cover their nose and mouth with a tissue before a sneeze.
Not share food or utensils with classmates
Wearing a mask can also prevent the spread of respiratory diseases like COVID-19, colds and the flu.
Children's Health is here to support all of your child's health needs. Learn more about Primary Care at Children's Health and find a doctor.
You can also videoconference with a health care provider 24 hours a day, 7 days a week with Virtual Visit by Children's Health Virtual Care. Learn more and download the Virtual Visit app today.
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