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Too Sick to Attend Daycare?

How sick is enough to miss daycare? This decision affects two parties: Does your baby feel too sick to attend daycare? Is she contagious to the other children?

Here are some practical guidelines on what germs are the most catchy.

DIARRHEA ILLNESSES Here is one set of germs that all doctors agree are very contagious. Frequent, watery, mucousy, and sometime bloody diarrhea is a sure indication to stay home, both for your child’s sake & to prevent an outbreak in the center. Add vomiting and your baby is certainly too weak and too upset to leave home. As soon as the vomiting is over, the stools are no longer explosive and watery and your child feels better, she may return to daycare. COLDS AND FEVER While diarrhea illnesses merit quarantine, respiratory and febrile illnesses are a different bag of germs. Most cold germs do not threaten an outbreak in the daycare center as much as diarrhea. Children are most contagious a day or two before they act sick.

When you send your child to daycare with a cold, this is one time to teach her not to share. Show her how to cover her nose and mouth with a tissue when she sneezes or coughs and to turn her head away from others. Young children may be able to learn this sanitation gesture but are likely to forget.

If your child has a persistent fever it is prudent to keep her out of daycare until she has been fever free for 24 hours without the use of fever reducing medications like Tylenol or Ibuprofen.

SORE THROATS Sore throats, especially those associated with fever and throat spots are very contagious and are a red light for day-care attendance until the fever and the throat spots are gone — usually around five days.

EYE DRAINAGE The nose is not the only thing that runs when baby gets a cold. Eye drainage is often associated with an underlying cold, especially a sinus infection. These eyes are not contagious, and usually neither is the rest of the baby. This type of goopy eye drainage does, however, merit a doctor visit.

Some runny eyes are due to conjunctivitis (often called pinkeye), a contagious infection.  If the eyes are bloodshot in addition to draining, this is contagious pinkeye, which is quickly treated and made noncontagious by an antibiotic eye ointment or drops. The child may attend daycare as long as treatment has begun. If the eyes are not bloodshot, this is seldom contagious conjunctivitis, and your child may still attend daycare.

COLD VERSUS ALLERGIES How to tell a cold from an allergy?

Back to the telltale nasal secretions. Allergic noses are clear and watery, they run and drip, and are accompanied by other allergic signs: watery eyes, wheezing, a past history of allergies.

The nasal drainage from a cold is too thick to run; it dangles. Also, with a cold there are other signs of infection such as fever. In general, allergic children are noisy (sneezy and wheezy), yet they don’t act sick. They may attend daycare and are not contagious. Children with colds act sluggish, mopey, or cranky and may be contagious.

COUGHS While most colds end the cough still lingers –  but all coughs are not automatically stay-home illnesses.

A dry, hacking cough that neither awakens baby nor is associated with fever, pain, difficulty breathing, or other cold signs is not a reason for quarantine. These nuisance-type coughs linger on for a couple weeks, are rarely contagious, and seldom bother the child or her friends, who themselves may also be coughing.

Then there’s the child who coughs a lot at night but seems well during the day except for throat-clearing sounds and may have several similar episodes during the allergy season. This child suffers from postnasal drip, she is noncontagious, and this seldom is a reason to stay home from daycare.

Of course, any cough accompanied by fever, chills, and coughing up of green or yellow mucus warrants medical attention and absence from daycare. Your child can return to daycare when the fever subsides & has been gone for 24hrs, and she feels better (usually in a few days), though the cough itself may linger for a week or two.

WHEN TO STAY HOME WITH A COLD If your child’s nasal secretions are clear and watery, and your baby is happy and playful, pain & fever free, there is no need to keep your baby home from daycare.

If the nasal secretions become thicker, yellow, and green, especially if accompanied by a fever, an earache, frequent night waking, or a peaked look — in mother jargon, a sick-looking-face — this is a stay-home-and-call-the-doctor cold. Your baby may have an ear or sinus infection.

RASHES:

IMPETIGO A bacterial infection in the skin, impetigo begins as tiny red spots resembling picked at pimples that enlarge to coin-sized blisters which rupture and produce oozy, sticky, honey-colored crust. These circular spots may be as small as a dime or as large as a quarter. They tend to occur in patches where babies scratch, such as beneath the nose and on the diaper area, but may occur anywhere on the skin. Scratching spreads these eruptions. You can cover the infected areas with the prescribed antibiotic ointment and a square bandage. More severe cases may require oral antibiotics and a longer stay-at-home break.

RINGWORM A circular rash with red, raised borders; ringworm is caused by a fungus and is even less contagious than impetigo. Cover the area with an over-the-counter antifungal cream (or a prescription cream if necessary).

CHICKENPOX Unlike the rashes just mentioned, chickenpox is one of the most contagious of all childhood infections and a sure prescription to stay home. It begins as a flu-like illness (low-grade fever and tiredness), and the spots usually appear a day later. Initially, they resemble tiny bites over the back, chest, abdomen and face.  Baby can return to daycare once all the spots are scabbed over, about a week after they first appear.

HEAD LICE Where there are lots of children in a crowded place, expect little parasites to tag along. Lice don’t carry disease and are more of a nuisance than a medical problem. They reside deep in the hair, most commonly around the nape of the neck and around the ears. In return for a warm, fuzzy place to live, they often don’t bother the host, except for an irritating itch.

———————- Mahalo & Aloha, Ka Hana Pono Daycare

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