Your Child: Too Sick for School?

A little sniffle. A slight cough. "I don't feel good," says your child. But how do you really know: Should this kid stay home, or go to school?

With cold symptoms, fever (or lack of it) helps determine the answer, says Steven Parker, MD, director of the division of behavioral and developmental pediatrics at Boston Medical Center, and an expert moderator for WebMD's message boards.

"If there's no fever, it's generally OK to send the child to school," Parker tells WebMD. "It's likely a cold, and school is probably where your child got it in the first place. If your child feels pretty good otherwise, then it's fine to send the child to school."

But when in doubt, Parker says you should always call your pediatric provider for advice.

Also, if your child frequently claims to be "sick" but is fine on weekends, that's a sign of other issues. "There may be trouble at school," he notes.

Symptom by symptom, here are Parker's guidelines to help you decide whether your child should stay home from school:

Fever
If your child's temperature is 100.4 degrees or higher, keep your kid at home. While at home, encourage your child to drink plenty of liquids. Your child should be fever-free for 24 hours (without medicine) before returning to school.

Mild Cough/Runny Nose
If there's no fever, and the child feels fairly good, school is fine.

Bad Cough/Cold Symptoms
Children with bad coughs need to stay home, and possibly see a doctor. It could be a severe cold or possibly bronchitis, flu, or pneumonia. But when the cough improves, and the child is feeling better, then it's back to school. Don't wait for the cough to disappear entirely -- that could take a week or longer!

Diarrhea or Vomiting
Keep your child home until the illness is over, and for 24 hours after the last episode (without medicine).

Sore Throat
A minor sore throat is usually not a problem, but a severe sore throat could be strep throat even if there is no fever. Other symptoms of strep throat in children are headache and stomach upset. Keep your child home from school, and contact a doctor. Your child needs a special test to determine if it is strep throat. He or she can return to school 24 hours after antibiotic treatment begins.

Earache
The child needs to see a doctor.

Pink Eye (Conjunctivitis)
Keep the child home until a doctor has given the OK to return to school. Pink eye is highly contagious and most cases are caused by a virus, which will not respond to an antibiotic. Bacterial conjunctivitis will require an antibiotic; your doctor will be able to determine if this is the case.

Rash
Children with a skin rash should see a doctor, as this could be one of several infectious diseases. One possibility is impetigo, a bacterial skin infection that is very contagious and requires antibiotic treatment. Also, fifth disease is a contagious viral illness spread by coughs and sneezes; it's no longer contagious by the time rash appears.