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When should you keep sick kids home from school?

Deciding whether a sick child should miss valuable class time can be a struggle for any parent - especially when the symptoms seem borderline and a trip to the doctor means missing work.

In its book Caring for Your School-Age Child, the American Academy of Pediatrics suggests keeping a child home if he/she has a fever, is not well enough to participate in class or may be contagious to others.

Nancy W. Dickey, M.D., editor-in-chief of the e-health network Medem, said common symptoms that should keep a child home include: 1) fever at the onset of illness or a fever over 101 degrees Fahrenheit, 2) a rash, and 3) feeling sick.

If your child begins to feel mildly sick and a low fever is discovered, keep him/her home for the day to see how the symptoms develop, Dr. Dickey said. If your child has been on antibiotics for at least two days and feels fine but a low fever remains, it's probably okay to send him/her to school.

Sometimes your child might have few outwards symptoms of illness (no cough, no fever, etc.), but still feels sick. If your child doesn't feel well enough to concentrate in class, then let him/her stay home where the child is more comfortable and can get some rest.

Finally, if you suspect your child is contagious, it's best to find out before you send him/her to school. Sometimes children feel fine, but still shouldn't be exposing the whole class. For example, if your child has an unexplained rash, have her pediatrician take a look before letting your child return to school.

Other symptoms that may man an illness is contagious are:

  • repeated diarrhea, vomiting, or fever (above 100.4 degrees Fahrenheit) within the past 24 hours;
  • thick mucus or pus draining from the eye;
  • sore throat, especially if combined with fever or swollen neck glands; and
  • unusual fatigue, paleness, lack of appetite, confusion, or irritability.

Ear infections are not contagious, so don't let one keep your child home unless the condition will affect your child's ability to learn.

The next time you're indecisive about sending your child to school, consult your pediatrician. The well-being of your child, and possibly others, is at stake.

-Greg McConnell
2004 American Academy of Pediatrics