By: Shanna McGinnis, MD
Back to school time means new school supplies, new clothes, and unfortunately, new germs. School attendance is important for success, but sometimes kids are just too sick to go. There are some rules of thumb to follow when you are trying to decide if your kids should stay home or if they should go to school.
First, let’s explore some general guidelines for parents to follow when determining whether to send their kids to school. If your child has a fever or had one in the last 24 hours, they should stay home. More specifically, your child should be fever-free for 24 hours without taking any fever reducers. This provides more confidence that the fever has truly resolved and is unlikely to recur once the child returns to school. Next, if your child is too sick to participate in class or will be a distraction to classmates, they should stay home. Parents should use common sense and good judgment when determining what is best for their child and classmates.
One critical point to highlight is the importance of using a thermometer to measure your child’s temperature. Although the back of mom’s hand on the forehead is a fast and easy technique, it is not the most accurate way. An oral thermometer is the recommended method of measuring a temperature in school-aged children. An axillary, or underarm, measurement is often obtained in schools since it is more hygienic in that setting; however, this method of measurement is less reliable and should be considered a screening tool. Most pediatricians consider a temperature to be a fever at 100.4°F or higher. All fevers do not need to be treated with fever-reducing medicines like acetaminophen (Tylenol) or ibuprofen. If the child is acting normally, eating and drinking, and does not appear to have discomfort, it may be best to monitor the child for improvement. A fever is one of our body’s best defenses against infections. Viruses and bacteria do not thrive at elevated temperatures. When we bring the body temperature down to normal with fever-reducing medications, we are actually creating a more ideal environment for germs. Some studies have shown that children who are not treated with fever-reducing medications are sick for a shorter time than children who are. Many parents express concern about the fever hurting their child. It is extremely rare that a child’s temperature will exceed 105°F and their temperature would have to exceed 106°F before any serious harm is done.
Vomiting and diarrhea can be a challenge in terms of when to return to school. Sometimes these symptoms will wax and wane for several days. In most instances, when a child develops a stomach bug, the vomiting is the initial symptom, followed by diarrhea. When the symptoms resolve, the same is typically true – vomiting stops first, then diarrhea. This is a situation where the parent must use their judgment regarding return to school. All kids should be kept home until they are able to tolerate fluids and at least some foods. However, older children may be okay to return even prior to resolution of diarrhea symptoms. Younger children who are more prone to “accidents” should probably wait until all symptoms have ceased. It is also important to understand the school’s policy on bathroom breaks when making a decision.
Head lice is a topic that tends to emerge when discussing school illness policy. Both Owensboro City and Daviess County School systems have a policy statement regarding head lice. Parents should be aware that prophylactic treatment of non-household contacts (i.e. classmates) is not recommended. You can review the policy statement specific to your school for more information.
From a parenting standpoint, it is imperative that kids who are home from school due to illness “play the sick role.” Video games, computers, and television should be limited on sick days. The goal is for the child to rest so they can return to school as soon as possible. With a few exceptions, if they are well enough to participate in these activities, they should be able to participate in school.
Prevention should be taught and practiced so sick days can be kept to a minimum. Proper hand hygiene decreases spread of most germs. Teaching kids to cover their cough or sneeze with a tissue or to cough or sneeze into their upper sleeve helps cut down on hand contamination. Advise your children against sharing food or drinks with others at the lunch table. Model this at home by not even sharing with siblings or parents. If your child suffers from a chronic disease like asthma or diabetes, comply with follow-up visits with their doctor so your child can avoid long stretches of absence due to complications from their illness. Finally, ensure that your children stay up to date on their immunizations, including an annual flu vaccine.
Occasional illness is part of every school year, but practicing prevention and using good judgment can help minimize absences. Have a happy and healthy school year!