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Serving the Susquehanna Region

Too Sick to Go to School?

by Olufunke Oladejo, MD, MPH

If your child isn’t feeling his or her best, should you definitely keep him or her home from school? After an illness, when is it okay for your child to return to school? As a parent, you know your children best. You also likely have a sense about when your child just doesn’t feel well enough to actively participate in school. Trust your instincts. But, also consider that there are times when it’s not a clear cut decision. What are some basic guidelines?

The American Academy of Pediatrics recommends that you answer a few basic questions before you send a child who doesn’t feel well to school.

  1. Does your child have a fever? A fever is a temperature of 101ᵒ F and above, and indicates that the child should stay home.  
  2. Does your child feel well enough to participate in classroom activities and instruction? If he or she seems too sick, too tired or has symptoms that would be distracting to either themselves or others in the class, her or she should stay home.
  3. Do you think your child could be contagious to other children?  If he or she has symptoms of pink eye, flu, strep throat, vomiting, diarrhea or other illnesses associated with a fever, you should keep the child at home.

Minor illnesses, such as a runny nose, occasional cough, mild sore throat, mild tummy aches or a slight headache, usually are not enough to keep your child home as long as you do not answer yes to any of the three questions above. Lice is another common problem that does not require that the child be kept home, provided that he or she is has received an appropriate treatment. If you do send your child to school with a minor illness, make sure the school has a contact number so that administrators can reach you if there are concerns about his or her condition.

After you’ve kept a child home from school, your next decision is when to allow him or her to return.  Generally, your child may go back to school after he or she is free of a fever for more than 24 hours as long as he or she is feeling well enough to participate in classroom activities. Also, ensure that he or she is free of the fever without the assistance of fever-reducing medicines, like ibuprofen and acetaminophen. Do not give aspirin to your child unless directed to do so by your health care provider.

More specific criteria for returning to school include:

  1. If your child is taking an antibiotic for an infection, it is usually okay to return 24 hours after the first dose. This includes treatments for strep throat and pink eye.
  2. If your child had diarrhea, he can return when stools are starting to be formed, or your healthcare provider says it is okay.
  3. If your child has been vomitting, he or she can return if the child is able to eat breakfast that morning and is without a fever or diarrhea.
  4. A child with an ear infection can return to school when he or she is without a fever for greater than 24 hours and not complaining of moderate-to-severe pain. Ear infections are generally not contagious.

Always check with officials at your child’s school to see if the administrators have any specific criteria for returning to the classroom. 

Remind your child that the best way to prevent illness from spreading is with good hand washing habits after playing, before eating, after using the bathroom and after sneezing or coughing. Even with everyone’s best efforts of hand washing and keeping children at home who are contagious, most viral illnesses are spread before a child shows any symptoms.

If you have any questions or concerns about when your child should return to school or may need treatment, call your healthcare provider for advice. 

To schedule an appointment with SH Pediatrics, call 570-321-2810.