Health & wellness


When to keep your child home from school

Adapted from the MD Mama blog on

These days, with all the sickness going around, and with all the fright about the flu, it’s a question parents regularly face: When should you keep your child home from school? It’s not usually a straightforward question, either. For most families (mine included), keeping a kid home means missing work — and, although our families are of course our first priority, missing work can be hard. Missing school isn’t great for learning, either.

What makes the keeping-home decision even more complicated is the fact that it’s not just about your kid — it’s about other kids too. Children are really good at spreading germs. I talk about this a lot with parents. For me, there are some clear-cut guidelines — and some judgment calls. First, the clear-cut ones:

If they’ve got any symptom you’d want to take them to the doctor urgently for, they shouldn’t go to school. For example, any trouble breathing, or bad pain, or a new limp. Sometimes people send the kids to school and then call the doctor, figuring they’ll pick them up or take them after school. Please don’t.


Fever. You can’t send your kid to school with a fever. Not only will they feel miserable, but people are usually at their most infectious when they are febrile. The definition of a fever is 100.4, but chances are the school nurse will call for 100 or higher — and your kid will feel yucky at that temperature too. Besides, a temp of 100 often has a way of going up in an hour or two.

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Please resist the temptation to give your child acetaminophen or ibuprofen, send them off, and cross your fingers. You might decrease their fever, but you wont decrease their contagiousness.

Vomiting or diarrhea. Reasonably obvious. It’s mean to send a kid off with either one, but I’ve seen it happen. Usually it’s a hopeful parent who thinks that just because the kid feels better after vomiting, they are better. Unless they’ve gone many hours without vomiting, they aren’t better — and with vomiting, diarrhea, and fever you should wait until your child has gone 24 hours without symptoms.

OK, now for the judgment calls:

Cough and runny nose. Usually, if kids don’t have a fever and don’t have trouble breathing, they can go to school. However, if they are really hacking away, or covered in snots, keep them home a day or so.


Headache and other pains (assuming they aren’t severe). Take their temperature, ask about any other signs of illness, ask about injury, look them over (do your Dr. Mom exam). If you don’t find anything, ask yourself: How uncomfortable are they? If they really seem uncomfortable, keep them home — and check in with the doctor. If they don’t seem so bad, try some acetaminophen or ibuprofen and tell them to go to the nurse (or let the teacher know) if they get any worse.

“I don’t feel so good.” We all hear this from our kids some mornings — usually when we’ve got an important meeting or they’ve got a test. My advice is the same as above: Check ’em out, and if you don’t find anything, and they seem basically OK, send them with instructions to call if they need you. I’ve also found that reminding them that if they are sick they need to stay in bed all day and not watch TV sometimes makes them feel better.

Remember, too, that even if your doctor’s office isn’t open yet, there should be someone on call that can help you figure out the best thing to do.

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