Too Sick for Care

The Keep Me Home If… poster helps parents decide when to keep their sick child home from child care or school.

Most children with mild illnesses can safely attend child care. However, a child may be too sick to attend if:

• The child does not feel well enough to participate comfortably in the program’s activities.
• The staff cannot adequately care for the sick child without compromising the care of the other children.
• The child has any of the following symptoms, until a health care provider determines that the child is well enough to attend and that the illness is not contagious:
  • Fever (above 100°F axillary or above 101°F orally) accompanied by behavioral changes and other signs or symptoms of illness (e.g., the child looks and acts sick).
  • Signs or symptoms of possibly severe illness (e.g., persistent crying, extreme irritability, uncontrolled coughing, difficulty breathing, wheezing, lethargy).
  • Diarrhea: Changes from the child’s usual stool pattern – increased frequency of stools, looser or watery stools, stools that run out of the diaper, or inability of the child to get to the bathroom in time.
  • Vomiting more than once in the previous 24 hours.
  • Mouth sores with drooling.
  • Rash with a fever or behavioral change.
• The child has received any of the following diagnoses from a health care provider, until treated and/or no longer contagious:
  • Infectious conjunctivitis (pinkeye with eye discharge) – until 24 hours after treatment started.
  • Scabies, head lice, or other infestation – until 24 hours after treatment and the child is free of nits.
  • Impetigo – until 24 hours after treatment started.
  • Strep throat, scarlet fever, or other strep infection – until 24 hours after treatment started and the child is free of fever.
  • Pertussis – until 5 days after treatment started.
  • Tuberculosis (TB) – until a health care provider determines that the disease is not contagious.
  • Chicken Pox – until 6 days after start of rash or until all sores have crusted over.
  • Mumps – until 9 days after start of symptoms (swelling of cheeks).
  • Hepatitis A – until 7 days after start of symptoms (e.g., jaundice).
  • Measles – until 6 days after start of rash.
  • Rubella (German measles) – until 6 days after start of rash.
  • Oral herpes (if child is drooling or lesions cannot be covered) – until lesions heal.
  • Shingles (if lesions cannot be covered) – until lesions are dry.

Adapted from Caring for Our Children, American Academy of Pediatrics and American Public Health Association, 1992