Joseph Kahn portrait doctor

linda c mueller

It’s that time of year again. School buses are back on the streets. The kids may or may not be bummed out about summer being over. Nonetheless, moms and dads are probably celebrating about getting some ‘me’ time back. This also is the brief time of the year when pediatric offices are not so busy. The summer rush of school and sports physicals is over, and the children in school have not yet generously shared their germs with each other. However, it’s only a matter of time.

So how can Mom and Dad determine when their child is too sick to go to school and it’s better to keep him or her at home?

First, ask yourself these four basic questions: Will my child be safe at school? Will his classmates be safe from catching something from him at school? Will she be able to learn anything today? Is there adequate care at school, especially if her condition worsens during the day? If the answer to any of these is ‘no,’ then your child should stay home.

If your child has what seems like a common cold (sniffles, mild cough and a mild sore throat) with no fever, he should be well enough to attend school and participate in classroom activities. If he has just vague, non-specific complaints of aches, pains, just doesn’t feel well, stomach ache without vomiting or diarrhea and no fever, he should be able to go to school. Your child also can go to school if he has head lice, scabies or ringworm and has been treated. Likewise, she can return to school when she feels like it, has no fever and has had her strep throat treated for 24 hours.

There are specific signs and symptoms of illness you should look for to keep your child home from school, including if she just looks sick to you. As a pediatrician, I know that moms know! Other symptoms include:

  • A fever of 100.4 degrees or higher.
  • Thick drainage from the eyes or eye pain.
  • Thick, green nasal drainage or a significant cough present, especially if it lasts more than seven to 10 days. These aren’t necessarily indications of a bacterial infection, but should be evaluated. Remember, the common cold lasts up to two weeks. Usually only the first day or two are really uncomfortable and children are most infectious during that time. Coughing and sniffling that don’t interfere with activity aren’t dangerous.
  • Sore throat, especially if there also are swollen glands in the neck, fever or a fine rash that feels like sandpaper.
  • Vomiting or diarrhea, especially through the night.
  • Rash associated with fever.
  • An active case of the chicken pox. Your child can return to school when all lesions are fully crusted. (Remember that the chicken pox vaccine works and your child can avoid this illness!)
  • Difficulty breathing or shortness of breath.

School attendance is important. Kids can’t learn if they’re not there and it can be hard to catch up after an absence. Some children may actually exaggerate symptoms in an attempt to stay home—imagine that. Sometimes decisions about whether a child should stay home or go to school can be complicated by mom’s or dad’s work responsibilities. Regardless, trust your instincts, follow these guidelines, and make the right decision for your child, his classmates and his teachers.

Dr. Joseph Kahn is president of Mercy Children’s Hospital Services,