Great, article about sending kids to DC

iVillage Member
Registered: 05-16-2006
Great, article about sending kids to DC
Wed, 05-05-2010 - 7:29pm

with symptoms.

Your 'Sick' Kid May Be Well Enough for Day Care

By Nancy Shute,

When a child has a runny nose but is nonetheless perky, most parents would ship him off to school or day care. But day care directors would send that kid home about 60 percent of the time, despite the fact that guidelines from the American Academy of Pediatrics say otherwise.

The day care exclusion guidelines make clear that in most cases, there's no point in keeping kids home once they're symptomatic: Children generally spread germs for a few days before signs of colds or other bugs appear. That's something directors of child care centers are supposed to be up to speed on. Apparently many are not. The new survey, published online in Pediatrics, found that 57 percent of the 307 day care center directors who responded would exclude children from day care with symptoms allowed under the medical guidelines. For instance:

* 8 percent would exclude children with a cold.
* 60 percent exclude children with conjuncitivitis (pinkeye).
* 65 percent exclude children with an upset stomach or mild diarrhea.
* 67 percent exclude children with a mild fever and no other symptoms.
* 84 percent exclude children with ringworm of the scalp, a fungal infection.

Yep, your child can go to day care with all those symptoms, according to the pediatricians. "There's a lot of phobia regarding pinkeye and colds," which isn't justified, says study lead author Andrew Hashikawa, a pediatrician at the Medical College of Wisconsin in Milwaukee. "A lot of these illnesses spread before there are symptoms." As a result, he says, the doctors' guidelines have been shifting away from having parents quarantine kids with mild symptoms. But waving this new study in front of a day care director who is booting out your kid will probably not do much good. Day care directors need better education on the guidelines, he says, and few states offer them training in dealing with contagious illnesses.

Although the stay-or-go verdict is ultimately up to the day care director, the AAP suggests these three tests for deciding if your child is well enough to attend. They put your child's interests first, just like you do:

1. Does the child's illness keep him or her from comfortably taking part in activities?
2. Does the sick child need more care than the staff can give without affecting the health and safety of other children?

If the answer to either of these questions is "yes," then it's time for a sick day. (I'm writing this at the dining room table while my 6-year-old is home sick, so I feel your pain.)

The third question is trickier:

3. Could other children get sick from being near your child?

The pediatrician's guidelines say children should stay home with an oral fever of 101 degrees or more, and/or if they have a long list of contagious diseases like measles, mumps, and chickenpox. Children with strep throat should stay home for 24 hours after they've started antibiotics. (If my daughter's strep test is positive, she'll have to miss the school field trip to the zoo tomorrow, poor thing.) You can find the whole list of illnesses that should keep a child at home at the AAP's website

Ultimately, it's a judgment call. We've all sent kids to day care or school hoping they'd be OK, only to have to come pick them up an hour later. But if more day care centers got up to speed on the reality of kids and germs, perhaps there would be fewer days of work lost for parents, and more days for children to have fun with their friends at day care. Hashikawa urges parents to talk to their center's director about exclusion policies to make sure that everyone is on the same page.

iVillage Member
Registered: 05-16-2006
Wed, 05-05-2010 - 7:45pm
Last time I checked, it was up to the daycare provider. Not the AAP, the pediatrician, or the parent. After all, WE are the ones caring for them during daycare hours.
iVillage Member
Registered: 04-29-2003
Fri, 05-07-2010 - 6:04pm

Major assumptions by the article:

#1 The sick child is with the same children & caretakers every day.

****I have mostly PT'ers and I can effectively stop the pread of illness by excluding the I do. Just b/c Junior exposed everyone on Mon, Sally wasn't here Mon, only Tues/Fri, and she will only get sick if Piper gets sick bc Piper is here Mon/Tues. Not to mention I am very particular about sanitizing when there is an illness.

#2 When the sick child is exposes everyone prior to being sick, that there is the same risk of infection spreading, regardless if he attends then next day(s).

***Exposure does NOT equal illness. The more one is exposed to an ill child, it increases the chances of infection. Neither is 100%. I can effectively keep a 'kinda sick' away, and take extra precautions for a day & separating from the group/separate toys, etc...but after that, it is more difficult to keep the sick child at arms length (so to speak). And if *I* get sick, the majority of the kids will, too. This is b/c I interact more with each child than the children interact with each other. More exposure = more chance of illness.

#3 Every illness has the same risk of exposure & transmission.

Ringworm of the scalp is VERY DIFFICULT to treat and lasts a long time. It doesn't spread as easily as a cold/flu/pick eye...BUT the child has it for weeks (if your lucky), and contagious for at least the first week, and it cannot be covered like athlete's foot can. Silly to NOT exclude. While not life threatening, it does cause hair loss and lasts seemingly forever...Don't even get me started on the diarrhea thing....that can be passed around & around, and will never stop if you don't exclude for it. RSV, rotovirus? Often starts with diarrhea & sends many, many kids to the hospital yearly.

THe article is a bunch of Bull poop designed to make parents feel less guilty about sending their children to daycare when ill, so that they don't have to use vacation time for sick days. The AAP also states that a 'no nit' policy is silly and causes parents to miss work unnecessarily, too. *big raspberries*.