Sick Child? When to keep them home.
Back-to-school season already! Every day parents are faced with deciding whether they should keep their sick children at home or send them off to school? Often the way a child looks and acts can make the decision an obvious one and it can be worthwhile keeping a child at home at the beginning of an illness to prevent it worsening.
If your child has a mild cold, or cough they can go to school with plenty of tissues, water and instructions to wash hands often to help prevent spreading germs to other people. Staying at home won’t prevent the spread to other children, because most illnesses are contagious before a child is obviously ill. Coughs and colds can last for quite a long time too!
Consider the following guidelines when making a decision:
Fevers are common in young children. Keep your child at home if they have a temperature greater than 38°C (100.4°F). Ensure they get plenty of rest and stay hydrated. Consult a paediatrician if the fever lasts more than 4 days. Children can return to school once they have been fever-free for 24 hours without the use of fever-reducing medicine. While febrile seizures can be alarming, they are often harmless and are not linked to epilepsy or brain abnormalities.
Respiratory illnesses are common in children and are the main reason children miss school. They are usually caused by viruses and clear up on their own within a few days. Antibiotics are rarely necessary unless a paediatrician diagnoses a bacterial infection, such as strep throat. Offer soothing foods and lots of fluids. Ice cream helps! Provide pain relief with age-appropriate dosages of paracetamol or ibuprofen. Clean the nose out with isotonic saline, yucky but effective. Consult a pediatrician if symptoms don’t improve in 2-3 days.
Influenza (Flu) is more severe than the common cold and can lead to serious complications. The onset is usually sudden, and symptoms include fever, chills, muscle aches, cough, congestion, runny nose, headaches, and fatigue. Children should stay home until they are fever-free for at least 24 hours without medication. Really err on the side of caution with flu. I usually recommend easing back on sporting activities in the week or so after a bout of flu as the body can take time to recover and won’t be ready to restart sports. Restarting too early can prolong the recovery. Keep them hydrated and rested. Provide fever and pain relief with appropriate medications. Consult a paediatrician if symptoms worsen or persist.
Ear Infections, (otitis media) are also very common and are often the result of a viral disease. They rarely require treatment with an antibiotic. The unjustified use of antibiotics leads to various undesirable side effects such as allergies, the development of resistance, diarrhoea or other complications. Many middle ear infections heal on their own during the course of the disease. If your child is in severe pain, give painkillers such as paracetamol or ibuprofen. Clean the nose with isotonic saline. Consult the paediatrician after 2-3 days if the condition does not improve.
Coughing is generally a normal defence mechanism of the body but it can be a tricky one. Look at their behaviour, if they are running around, eating well and seem happy send them to school reminding them to cough into their sleeve to prevent spreading their germs. If they have been coughing all night, are groggy, don’t want to get out of bed, let them stay there. Herbal and chemical cough medicines are not really effective against coughs and can be dangerous for children, as they often consist of several active ingredients. Keep them hydrated. Avoid exposing the child to cigarette smoke. Maintain a good indoor climate with a humidity of 50-60% and a room temperature of 18°C. Raise the head end of the bed to elevate the child's upper body. See a doctor if they have other symptoms such as difficulty breathing or have a fever.
Bronchiolitis is a common viral infection of the lungs in infants and young children, that is in the news a lot these days. This begins with a cold and after a few days, the infection affects the small airways (inflammation and mucus formation), and the child may have trouble breathing. They breathe faster and cough, are tired, irritable and no longer feel like drinking and eating. In most cases, the children can stay at home and recover within 7-10 days. Treat as for a cold or respiratory infection and consult a paediatrician if the condition deteriorates or the child is struggling to breathe.
Meningitis often comes to mind when a child is ill but is now less common due to vaccination. It is a serious condition, with many causes that may start with flu-like symptoms and progress to any or all of the following which signal urgent medical consultation:·
Stiff neck or stiff body
Confusion or trouble concentrating·
Seizures
Sensitivity to light
Skin rashes in some cases
Severe headache
Treatment depends on the cause. If you are worried about meningitis, particularly if your child has been in contact with someone with meningitis please see your doctor.
Diarrhoea/Vomiting. A child with diarrhoea and /or vomiting should stay at home and return to school only after being symptom-free for 24 hours without medication.
Conjunctivitis (Pink eye) often follows a respiratory infection. This is highly contagious which is why it is so common. It is often viral so needs to run its course, which can be about a week. Following a diagnosis of conjunctivitis, the child may return to school 24 hours after the first dose of prescribed medication or when the doctor gives the ok, usually when there is no discharge from the eye. Encourage clean hands and no sharing of towels.
Rashes are very common in young children and are tricky. They can occur for many reasons including eczema, warts, viral, fungal and bacterial infections. Rashes from infectious diseases are most contagious early on. A child with a suspicious rash should only return to school after a doctor has diagnosed the rash and cleared them to return.
Fifth disease (Slapped cheek syndrome) is a common viral disease that causes a bright red rash on the cheeks and sometimes a lacy rash on the legs and arms. Children often have a short-lived fever and other nonspecific symptoms. Treat as for a respiratory infection.
Hand, Foot, and Mouth Disease (HFMD) another common disease is a contagious viral illness. Symptoms include fever, sores in the mouth, and a rash on the hands and feet. Children with HFMD should stay home until 24 hours after the fever without medication and mouth sores have healed.
Bacterial infections such as Scarlet Fever usually starts with a very sore throat and a headache followed by a red sandpaper like rash on the neck and upper chest which may spread out to other areas of the body. Treatment for this is as for a respiratory infection but this does need antibiotics. Children should remain at home until fully recovered. As with flu, restart sports slowly to ensure a good recovery.
Urticaria (Hives ) are itchy pink pale or red bumps on the skin. They may be small or different shaped raised welts. They can appear anywhere on the body and can keep showing up for days or weeks. They are often caused by viral infections but can also be caused by allergic reactions, stress and cold temperatures as well as for no known reason. Finding out the cause if possible is a first step and then antihistamines can be used. Children can be in school with hives unless they are really bothersome. They are not contagious.
A sick child cannot learn effectively or participate meaningfully in class. Keeping a sick child at home not only helps them recover but also prevents the spread of illness within the school community. Research has proven again and again that the biggest influence on the prevention of illness is good hand washing practice. Teaching the importance of hand washing begins early and constant reminders help this practice become a good habit.
Tip - Get to know your school nurse if there is one and find out what the school policies are regarding health and sickness.
Here’s to a healthy new school year.