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December 6, 2018

Health Topics: When to Keep Kids Home

Sick baby

Health and safety for kids in shared spaces

Should your child stay home from child care or school? Many parents ask themselves this question during the cold and flu season. Opinions vary too. Parents may disagree with their child care or the school’s temporary exclusion policy. That’s especially true because keeping children home means that parents must take time off work or other commitments.

But regardless of opinions, you and your child care provider both want what is best for your child. Keeping them home so they can rest and heal — and keep germs and viruses away from classmates — is always a good call.

We’ve researched what different health organizations and child care providers have to say. Here is where most of them agree on times to keep your little one home.

Health & Safety for kids in share spaces

Vomiting or diarrhea

With vomiting and diarrhea, many policies ask that children stay home until they are symptom-free for 24 hours. There are some viruses that are still active after the symptoms are gone, like in the case of norovirus. It is always worth it to check with your doctor to see if your child is ready to go back to school. Some exceptions apply. For example, if the parent is sure that the vomiting or diarrhea is a one-time episode.

Bad pain

A mild headache or soreness from a bump on the knee can be remedied with a little bit of love and sweet words. But when the pain is more than mild, it is best to keep an eye on it. Keep your little one home and call your doctor.

Coughing that won’t stop

Tis’ the season for *cough cough*. And with a few preventive pointers like, “cover your mouth when you cough” and “make sure you wash your hands,” there is no reason why your child can’t join in their class. But if the cough doesn’t go away or if you notice the cough is paired with some breathing difficulty, it is time to call the doctor.

Difficulty breathing

Wheezing or flaring nostrils each show that a child is having breathing problems.

Unless your child has a history of wheezing, it is not something that will go away on its own. And waiting can have serious consequences. Wheezing can progress quickly, and your child’s oxygen levels can become dangerously low. Call your health provider right away.

Nasal flaring is common in children with colds, but it can also be a sign of breathing problems. If you notice your infant’s nostrils flaring, try suctioning the nose out with saline drops and a bulb syringe. If your child is old enough, have them blow their nose. If their congestion does not clear, reach out to your health provider.

Is it a cold or the flu? Flu season begins in the fall and lasts through February. Lots of kids miss school, and parents have to care for their little ones every step of the way. But how do you know how serious it is? Read more…


When your child is sick with an infection, it is normal to have a fever. A fever will not hurt your child. Usually, it goes away after 3 days. Most schools and child care providers consider anything above 100°F a fever and ask that children stay home until they are fever free for at least 24 hours.

Babies younger than 6 months old should see a doctor when they have a fever. Older children can be treated at home, as long as they get enough liquids and seem well otherwise. Always call your health provider if you have concerns about a fever.

There are several ways to take your child’s temperature:

  • Rectal method (by the rectum)
  • Oral method (through the mouth)
  • Axillary method (under the armpit)
  • Tympanic method (in the ear).

What is the right method for my child?

It depends on your child’s age. And it’s important that the measurement is accurate. For example, taking a rectal temperature is the best way to get an exact reading for children under 2 years of age. But most children don’t like to have their temperature taken this way. Although taking a temperature under the armpit isn’t perfect, it will let you know if your child has a fever.

Pro parent tip: Label the thermometer you use for rectum temperature so no one gets confused. Write “tushy temps” or “rectal reader” to keep everyone safe. Also, use soap and water after each use.

The following will help you decide which method to use:

Age | Recommendation

Birth to 2 years | First choice: Rectum (for an exact reading), Second choice: Armpit (to check for fever)

Between 2 and 5 years | First choice: Rectum, Second choice: Ear, Third choice: Armpit

Older than 5 years | First choice: Mouth, Second choice: Ear, Third choice: Armpit

What is a normal temperature?

Now that you’ve taken the temperature, check the following chart to see whether your child has a fever. The normal temperature range varies, depending on what method you used.

Measurement method | Normal temperature range

Rectum | 97.9°F to 100.4°F

Mouth | 95.9°F to 99.5°F

Armpit | 94.5°F to 99.1°F

Ear | 96.4°F to 100.4°F

Other symptoms included in your child care’s exclusion policy

An exclusion policy is a document where child care providers tell parents when to keep kids home due to illness. This document exists so that all children in a classroom can share in learning without sharing viruses or other contagious illnesses.

FACT: Child care centers and programs on Paths to QUALITY™ are the only types of care required to have exclusion policies in Indiana. This means that other child care arrangements might include children who are experiencing a seasonal illness. Talk to your provider and be sure to be on the same page as them when it comes to their exclusion policy or when kids are asked to stay home. Being on the same page ensures your child will receive all the support they need, no matter how they feel.

Learn more about how Indiana’s quality rating improvement rating system, Paths to QUALITY™ can help you find a child care provider that is right for you.

Want to learn more about your child’s health? Check out these blog posts:

Information via the National Institute of Health (NIH), the American Academy of Pediatrics recommendations for school exclusion and Harvard Medical School – Harvard Health Publishing.

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