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When Should Parents Keep Child Home From School?

Doctor's Cheat Sheet: When Should Child Stay Home From School, Part 2

Deciding whether to send your ailing child to class or keep them home can be a tough call for parents. While some schools have strict guidelines, others don't so we asked NYC-based pediatrician Dr. Anatoly Belilovsky who has been practicing for more than 20 years to help us compile a cheatsheet. Here is what he had to say:

Sore throat: A sore throat during a flu or strep epidemic is reason to stay home and a sore throat accompanied by fever is always reason to exclude. If it turns out that your child does have strep, he or she will be contagious until after 24 hours of antibiotics. Untreated strep throat may remain contagious for several weeks and sometimes indefinitely, so when in doubt, get a strep test.

Wheezing: If the wheezing is due to acute bronchitis or bronchiolitis, then your child is contagious and should stay away from school. Don’t wait for the wheezing to end before she resumes classes, though, because the wheezing can last longer than contagion. Asthma attacks are a common cause of wheezing, and they’re not contagious, but they need to be treated. Trouble breathing, turning blue, retractions, fast breaths or pain with breathing are all signs that your child needs to see a doctor as soon as possible.

Fatigue or aches and pains: These symptoms can be linked to any number of causes, so parents will have to make the call regarding how sick their son or daughter really is. Once again, my recommendation is that like a runny nose or sore throat, these symptoms could be the early signs of a flu, so if there’s an epidemic in your area, you should keep your child home for observation.

Keep reading for five more common ailments and the things parents should take into consideration.

Nausea or Vomiting: Nausea alone is very common and non-specific. It’s often due to anxiety, smells or unfamiliar food and shouldn’t be a reason to stay home. However, if the child vomits, it’s a good idea to keep him or her home.

Diarrhea: Fully continent, "accident-proof" children may attend school if diarrhea is mild. Since diarrhea is usually contagious by the hand-to-mouth route, teach your children to wash their hands after they use the bathroom and keep their fingers from their mouths. If you’ve heard of a salmonella, shigella or norwalk epidemic, that instance dictates more caution.

Constipation: Unless it’s accompanied by severe pain, constipation is rarely a reason to miss school.

Chest Pain: Pneumonia, pneumothorax and heartburn are common causes of chest pain, so if this is a complaint your child is making, take a visit to the doctor. Cardiac causes are rare, but another reason to get a doctor’s opinion.

Headache: By itself, a headache is no reason to stay home unless it’s very severe. It can be the first signs of flu, so it should be monitored. An urgent doctor visit is dictated if the headache is causing double or decreased vision, trouble thinking/ remembering/ orienting/ walking/ doing things with hands, or your child uses any of the following magic words: "light hurts my eyes,” " it hurts more lying down,” "the pain woke me up,” “I can’t move my head/neck,” “it’s bad and getting worse.”

Fortunately, between the vaccines available today and modern sanitation methods that ward off diseases such as cholera, plague, typhus, typhoid and dysentery, parents should not have to worry about their children picking up too many extremely dangerous transmittable illnesses. At this point, the contagious diseases we really want to avoid include to strep, pneumococcal disease (subtypes not included in the vaccine), flu (largely preventable, but few take advantage of it), and a bunch of rare and/or nonspecific infections (ones in which multiple bugs are implicated, such as URI, bronchitis, diarrhea).

Finally, when assessing your child’s symptoms, remember to take other factors into consideration:
• What are the ages of children affected?
• How many are in a group?
• Is there an epidemic going around?

To see what Dr. Belilovsky advises for five other common ailments, click here.