December 19, 2008

When Is Your Child Too Sick For School?

Children may complain of many ailments in an attempt to stay home from school, but pediatricians at Baylor College of Medicine in Houston can help parents with advice on how to make the decision to stay or go.

"If your child is not running fever or having significant respiratory distress, does not have an identified serious infectious disease, vomiting or diarrhea, and is able to be active, then he or she is OK to go back to school," said Dr. Sara Rizvi, assistant professor of pediatrics at BCM. "In most cases, we opt for them to go to school as soon as possible, rather than staying home. It is important they not miss out on a valuable educational experience."

Rizvi outlined a few common illnesses that may cause parents confusion when deciding whether to send their children to school.

Common cold and flu symptoms

Fever is the key factor when deciding to send your child back to school after coming down with the common cold or flu, Rizvi said.

"Once the fever resolves, your child is safe to go back," said Rizvi. "Coughing and a runny nose may persist for a week or more. There is no reason to continue keeping your child cooped up at home, unless the cough is chronic and complicated, which could indicate symptoms of pneumonia or bronchitis and should be evaluated by a physician."

Older children involved in competitive sports should wait until the cough goes away and they are feeling better before resuming those activities.

"Sometimes these children feel pressure to go back to competition too early," said Rizvi. "Doing so can place them at risk for dehydration or injury."

When children do return to school or activities, Rizvi advises them to wash their hands frequently and cover their mouth when they cough so they do not transmit their germs to classmates.

Diarrhea and/or vomiting

For diarrhea and/or vomiting, Rizvi said pediatricians recommend keeping children out of school until these symptoms stop.

"These conditions are usually short, self-limited and after the diarrhea and vomiting have completely stopped, children are able to go back," said Rizvi. "This may take as little as two to three days or up to a week.  Probiotics are sometimes helpful in shortening the duration of the diarrhea."

Probiotics are dietary supplements or foods that contain beneficial bacteria that assist with digestion and help protect against harmful bacteria. Probiotics can be found in yogurt, fermented and unfermented milk, miso and some juices and soy drinks.

Strep throat

Strep throat is highly contagious, Rizvi said. If your child is complaining of a sore throat, it's important he or she be evaluated by a physician who can advise the proper treatment.

"With strep, once the child has been on antibiotics for 24 hours he or she can go back to school," said Rizvi. "It's important not to go back before then."

Pink eye

Pink eye is another ailment that may keep your child out of school. "Pink eye is usually caused by a virus or bacterial infection and is very contagious, though usually not very serious," said Rizvi. "Most schools are reluctant to allow children to return until the eye is no longer pink, which takes an average of two to three days but can take a little longer."

It's always a good idea to have your child evaluated by a physician if you suspect pink eye, Rizvi said. "Other conditions, such as eye allergies, can contribute to pink eye-like symptoms. Your child may not need to stay home at all. He or she may just need an antihistamine eye drop."

Lice or ring worm of scalp

If your child is complaining of an itchy scalp, then he or she may have lice or tinea capitis (ring worm of the scalp) and must be treated immediately. "With lice and ring worm, once the children have started treatment (insecticides and wet combing for lice; oral antifungal medicine and topical selenium sulfate shampoo for ring worm), they can go back to school the next day," said Rizvi.

Children may also occasionally complain of belly pains or other symptoms of illness to avoid school. "It's important to recognize these symptoms and discuss how to address it with your pediatrician," said Rizvi.

Rizvi stresses the importance of allowing your children to continue to have an enriching educational experience, rather than keeping them home for longer than necessary after an illness.

"Stick to the advice of your pediatrician and do not hesitate to ask questions," said Rizvi. "In the vast majority of cases, as long as your child is recovering and/or not seriously ill or debilitated, it is important for him or her to return early to school and continue their valuable, educational career."


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