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The cough & cold conundrum - Should they stay home?

Posted Feb 25 2009 4:24pm

Girl's eyes
Every parent, has struggled with this problem at some time, do I send my marginally sick kid to daycare or school or should I keep them home? The boogery truth about this is most of us parents have probably dropped off our dosed kid to school wondering if they were going to be able to make it through the day or would we get a call from the school nurse saying that we need to pick up our feverish kid.

Most adults are likely to have a common cold two to four times a year. Children, especially preschoolers, may have a common cold as many as six to 10 times annually.” ~ Common Cold, Mayo Clinic

We all know the symptoms, it plays out like a NyQuil commercial; runny or stuffy nose, itchy or sore throat, cough, congestion, slight body aches or a mild headache, sneezing, watery eyes, low-grade fever (up to 102 F, or 39 C) and mild fatigue. In lieu of the recent trend by pediatricians and toxicologists to put pressure on the F.D.A. to clear over the counter cough & cold medicines from the shelves, what are we left to do when un-medicated kids have symptoms that linger for days and sometimes weeks?

Illness can occur throughout the year, but tends to cluster in the winter due to flu season. These illnesses can seem to spread like wild fire affecting other students, teachers, and family members. Families and schools need to balance the child’s school attendance with the risk of spreading the illness to others in the school. Sometimes even minor illnesses require the child to stay home just to prevent the further spread of a contagious disease.” ~ Gwenn Schurgin O’Keeffe, MD, FAAP, Pediatrics Now | When to keep kids home

So what symptoms are worthy of missing a day of school? Here’s an at-a-glance list of the deal-breakers:

  • Fever: indicative an infection elsewhere in their body. A child with a fever greater than 100.5 degrees Fahrenheit needs to stay home from school until the fever is gone for at least 24 hours. If the fever does not resolve in 2 to 3 days, or if your child appears sick with any fever, call your doctor.
  • Rash: many rashes will resolve spontaneously and are not reason alone to keep a child home from school. Any rash associated with symptoms such as trouble breathing or swallowing, fever, or ill appearance, should be evaluated by your physician. Rashes that are itchy or scaly may be contagious and should be evaluated before sending a child back to school.
  • Cough alone may not be a deal breaker, unless it is deemed contagious or is interfering with sleep or is frequent enough to interfere with their day. If the cough is productive and has phlegm or is associated with fever or trouble breathing, keep your child home from school and call their pediatrician for an appointment.
  • Diarrhea: where the stool frequency is often many times an hour. Diarrhea that is bloody or associated with fever, abdominal pain, or vomiting should be evaluated by your doctor.
  • Vomiting: with or without diarrhea, needs to stay home from school. Your child can return to school when the symptoms have stopped and the child has eased back to their regular diet.
  • Sore Throat: children can attend school with mild sore throats if no other symptoms are occurring. Any child with a sore throat associated with fever, vomiting, abdominal pain, or difficulty swallowing should be evaluated by a doctor before returning to school. Call your child’s school to see if strep throat is going through the school population; if so, they should be evaluated by their doctor. A child with a diagnosis of strep throat needs to stay out of school until on antibiotics for 24 hours.
  • Lethargy: if your child appears really sick, keep your child home and arrange an evaluation by your doctor that day. If you can’t get through to your doctor and you are really concerned, either call 911 or bring your child to the nearest emergency room for evaluation.

And of all the popular opinions I found they all mention enthusiastically the best deterrent of spreading germs and disease is to consistently and routinely wash your hands and practice go hygiene.

Sited & Related Links:
Mayo Clinic | Common Cold Symptoms
NY Times Health | The Cough-and-sniffle Question; When to Keep a Child Home
Pediatrics Now | When to Keep Kids Home

meta-DAD | Wash your hands
meta-DAD | How cough and cold medicine can adversely affect your child
meta-DAD | Use with caution - cough and cold medicine not for the young ones

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