When to keep your sick kid home

Your child wakes up and doesn't feel well. Their forehead feels hot and they have the sniffles. They are also complaining of a tummy ache and have had diarrhea. You're faced with the difficult decision - should you keep him home from school?

"Yes! For the benefit of the child as well as their peers in school or in daycare," says Dr. Ann Nunez, co-chair of the Pediatric Department at CareMount Medical in Hopewell Junction. "Most daycare facilities and schools have policies regarding fever, but a child does not have to have a fever to be ill."

Major symptoms
Kristina Santos, family medicine nurse practitioner at Modena's Health Quest Medical Practice lists fever, vomiting, strep throat, rash with fever, diarrhea and nausea as true indicators of a child that needs to stay home.  She also says, "Children must stay home if they have any vaccine-preventable diseases such as chicken pox (varicella), measles and rubella."

Santos says that children with these contagious symptoms will compromise the health of every other child at the school. "As parents, we have to be responsible not just for the health of our children but also the health of others," she says. "We should ensure that we keep children at home so that they can recuperate quickly and properly."

Leah Byrons has three sons - 10-year-old Liam, 8-year-old Case and 5-year-old Kian - and says that she doesn't want to be the parent of the kid who gets the whole class sick. She does admit, however, that she has sent her children to school with some sniffling, but never with a fever or cough.

In most cases, parents know exactly when they need to keep their child home.

"My kids aren't sick very often - even if they have colds they're over them in a day or two - so when they're lethargic I know they're sick enough to stay home," says Byrons, whose children attend school in the Washingtonville School District. "I wouldn't send my kids to school with a fever or if they're sneezing a lot and have a runny nose."

READ MORE: 7 ways to entertain a sick kid when you are sick too

The struggle for working moms
Byrons also understands that as a stay-at-home mom it's easier for her to keep her kids home when they are not feeling well. "Even though I get annoyed with parents who send in kids who are coughing and sneezing and obviously should be home, I do understand why working parents feel torn about sending a sick child to school," says Byrons. "That must be a difficult decision when you have a limited number of days to take off from work."

Lisa Johnson has a special compassion for those parents who are raising their children solo and who have no choice but to send their sick child to school. "Single parents have it especially rough because they need the salary to support their kids and pay bills," says Johnson, who was once a single parent. Today, she is raising her 15-year-old grandchild, Angel, who attends Middletown High School.

"Sniffles are not really serious, like fevers and viruses are," says Johnson. "Many kids have sniffles a lot during the school year and would miss too much school work if they stayed home every time they caught a cold."

Know the facts
Children are exposed to a lot of infections as they age. According to the American Academy of Pediatrics (AAP), children of any age will be exposed to a lot of infections in their first year of group child care. However, if a first year of child care is during infancy, a child may have as many as 8 to 12 more colds than a child would have if cared for at home without exposure to siblings or other children. During the second year of child care attendance, the number of respiratory illnesses begins to decrease because exposure to so many germs causes rapid development of the immune system. Diarrhea occurs once or twice a year in the typical child.

The AAP states that the primary reasons for exclusion from child care or school are that the condition prevents the child from participating comfortably in activities, results in a need for care that is greater than staff members can provide without compromising the health and safety of other children and poses a risk of spread of harmful disease to others.

READ MORE: Tips to combat cold and flu season

Pressure from the schools
According to Elizabeth Mullins, mother of 18-year-old twins Alison and Kristen, 17-year-old John and 13-year-old Kevin, the school districts are also making it harder on parents because of the amount of unexcused and excused absences that a child can have. "In my district if a student has more than 10 unexcused absences, the districts are legally required to report the student to PINS (person in need of suspension)," says Mullins. "Even though a parent knows their child is sick, they are reluctant to keep them home. Many will send them in, tell them to go to the school nurse and pick them up so that it is not recorded as an absence."

Mullins remembers when, a few years ago, one of her children was hospitalized with a virus. "I kept my youngest home who started to show symptoms and received a phone call from the school nurse regarding my children's excessive absences," she says. "I was livid. In my mind I was doing the right thing so as not to expose any other student's and risk them having to be hospitalized."

READ MORE: Tips to keep kids healthy and hydrated

What is the right choice?
Santos advises parents to trust their instincts on whether or not their child is well enough to be in a classroom setting.

Unfortunately, if a parent feels like they made the right decision sending their child to school, other parents may often complain when they hear that their child's classmates were sent to school while they were sick.

Santos says, "A lot of parents don't understand the specifics of certain sicknesses, so they worry about their children's health. Their reaction is warranted based on the fact that viruses are transmitted easily."

Santos sees this especially when it comes to lice. "They don't know that a child can be in school once he or she has had treatment with a lice shampoo," says Santos.

Nunez says that parents of school-aged children should make sure that the child's immunizations are up to date to avoid illness from preventable diseases. "Also, consider that the time spent home early in an illness may promote healing and prevent a longer duration of illness," she says.

Lisa Iannucci is a freelance writer based in Poughkeepsie, New York. Her latest book, On Location: A Film & TV Lover's Travel Guide, will be published February, 2018 by Globe Pequot Press.