Signs your child if too sick for school

Was your little one sick on the weekend, but seems bouncy and happy come Monday morning? We chat with paediatrician, Dr Judy Rothberg, who gives advice on when to send your child to school and when to keep them at home.

Should parents err on the side of caution?

In light of the coronavirus pandemic, many schools are encouraging parents to keep their children at home at the first sign of illness. But, how you can tell if your child is well enough to go to school and when it’s better to keep him at home? Have you ever been in a situation where your little one complained about a fever or stomach ache the night before, but seems perfectly fine the next morning, which left you feeling conflicted about whether or not she’s well enough to go to school? Paediatrician, Dr Judy Rothberg gives advice.

“The below are general guidelines only. Each child may be different and while there are no hard and fast rules, I advise the following as a paediatrician and mom,” says Dr Rothberg.

Fever

• A fever is a temperature over 37.5°C. The severity of the illness doesn’t always correspond with the height of the fever. You shouldn’t measure the fever neurotically. The important question is why your child has a fever – not how high it is.
• Fever usually means something’s up. Don’t send a child with a fever to school as they can be infectious to others.
• When you give your child an anti-fever medication like Panado, she might look and feel much better and can go to school if there’s no one else to look after them, but don’t be surprised if the school phones later when the fever comes back!
• It’s best to keep a child with a fever at home if possible, especially if they’re miserable and look sick too.

Good to know: If your child is on antibiotics, she should ideally have been taking them for 24 to 48 hours before returning to school. If she still has a fever or not feeling well after this period, wait a little longer before sending her to school.

Vomiting

“I don’t think any child who is vomiting should go to school,” says Dr Rothberg. If your little one vomited during the night and has since eaten breakfast, kept it down, and feels ok, she can go to school. However, repeated episodes of vomiting during the night, or a recent vomit during the last few hours before school, should be a warning sign that your child is not well.

Diarrhoea

Keep your child at home for the following reasons:

• Teachers/ caregivers at school would probably not appreciate having to deal with a child with diarrhoea.
• If it’s gastroenteritis which is usually due to a virus, it will spread unless strict hygiene is practiced.
• If the child is toilet-trained but messes themselves, this is potentially embarrassing for the child.
• If the child has cramps, fever, and/or vomiting, they should definitely stay at home.
• If your little one shows signs of dehydration or isn’t keeping fluids down, she should see a doctor.

When it’s ok to send your child to school:

• If it’s just occasional loose stools (two to three per day) due to antibiotics. This is quite common.
• If she’s having diarrhoea less than four times a day, not more than once every four to five hours. These cases are likely not very severe if they’re not accompanied by other symptoms like fever, vomiting, and generally feeling miserable.

Sore throat

• A sore throat usually means the start of a cold. This is pretty common and you probably can’t keep your kids home every time they have a sore throat.
• The sore throat could also be due to other viruses like glandular fever or hand foot and mouth disease.
• If your child has a fever or other symptoms of concern that indicate she’s not feeling well (loss of appetite, drooling, inability or reluctance to eat or drink), keep her at home.

Good to know: Tonsillitis sparks fear in many parents. It’s not necessarily more infectious or dangerous than a simple sore throat. Some parents diagnose it themselves and many doctors over-diagnose this. The tonsils may just be red but not actually infected. If your child has a fever and large tonsils with pus on them it’s likely that she may have tonsillitis and should stay at home. She might also need antibiotics.

Stomach ache

This is a tricky one because it’s a very common complaint among children. They often interpret any feeling of illness like a sore tummy. They may also use this as an excuse to avoid school. Though I tend to believe children don’t fake illness often and most want to go to school.

• If your little one isn’t eating or looks “off-colour”; accompanied by vomiting, diarrhoea, or fever, she should stay at home.
• A recurring complaint of a sore stomach should be dealt with to ensure there isn’t an underlying illness causing the problem.

Cold symptoms

Cold symptoms are very common. It usually starts with a runny nose and sneezing.
Unfortunately, this is pretty contagious, especially in younger kids who sneeze openly and touch their mucus a lot.

A cold is usually not a serious illness, but if your child has a fever or a headache and is feeling sick, she should stay at home.
If your little one has a high fever and feeling sore and achy, it’s likely that she has flu. This can be more serious than a cold.

Allergies

• An on-going blocked or runny nose and a cough can be mistaken for cold symptoms.
• An on-going blocked or runny nose may be due to allergies, especially if there’s a family history. The nose is itchy often, and there may be other signs like itchy, red eyes, and asthma. This isn’t a reason to stay home, but your child should see a doctor at some point as these symptoms can be annoying and they can be treated.
• During winter, some children cough for weeks. This doesn’t necessarily mean they have a serious infection or bronchitis (if your little one doesn’t have a fever and is otherwise well).
• Usually, a viral cough takes a while to resolve. These usually don’t need antibiotics unless there’s something else of concern.

Good to know: A prolonged cough (longer than two weeks) doesn’t necessarily require antibiotics unless your child has a fever, chest pain, and/or the cough is worsening. See your doctor if you are concerned.