Too Sick to Go to School? Ask These 3 Questions.

HYANNIS – Children get 10 to 12 viral illnesses per year, and each lasts at least a week. Given those statistics, it’s no wonder parents can’t keep their children home from school for every sniffle.

How do you decide when to send a sick child to school?

Pediatrician Kathryn M. Rudman, MD practices at Seaside Pediatrics, West Yarmouth, and is the Barnstable Public School Physician. As a Mom who toughs out the decision when her own daughters are ill, she brings exceptional expertise to the question!

“My daughters are 14 and 16, and sometimes they will fake being well so they can go to school. I see them becoming the kind of adults who will power through life,” Dr. Rudman said, noting that the way you handle sick days now lays the groundwork for adulthood.

“When you have to make the decision to send sick children to school or to keep them home, it’s one of those life moments for the family. The child sometimes needs to be part of the decision,” she said.

Study Shows Parents’ Mixed Views

A newly released University of Michigan C.S. Mott Children’s Hospital National Poll on Children’s Health offers some interesting insight on parents’ opinions, such as:

• The top factors in parents’ decisions to keep children home are concern that the illness will get worse or spread to classmates.
• Parents are more likely to keep a child home with diarrhea, vomiting or fever, but send a child to school with a cough or runny nose.

Perhaps the greatest value of the study is to bring the topic to the public agenda. It sparked Cape Cod Health News to seek expert answers to make parents’ lives a little easier.

Coincidentally, Dr. Rudman trained at the University of Michigan where the study was conducted. Hearing about the study, she quickly noted that her office always welcomes calls from parents. “If you are not sure whether to send your child to school, please talk with us. We are happy to help,” she said.

Three Questions to Guide Your Decision

The decision is easy when children are definitely too sick to go to school. Lethargy, severe abdominal pain, fevers over 100, and other symptoms leave you with no question.

Milder illnesses such as colds, Dr. Rudman noted, “are trickier.”

“These three questions will guide your decision about when to keep sick children home from school,” she said. “Remember that contagion risk is different with a preschool student versus a high school student. Younger children are still putting things in their mouths, they are sharing toys, passing things around, and they are not particularly adept yet at preventing the spread of germs.”

1. Can you participate in school?

Are you so sick that you cannot sit in class? Can you learn? Can you take the test? Are you going to be coughing so much that you need to leave the room? If you cannot participate, if you cannot learn, you should not be in school.

2. Will you need more care than your teacher can provide?

Younger children will need more care than older students. If children are crying or uncomfortable, they should not be in school.

3. Is there risk of contagion to others? Here’s how to tell.
   1. Ear infections and sinusitis are not contagious, so children can go to school.
   2. Strep throat, pneumonias and conjunctivitis are contagious.
   3. The flu is highly contagious. If you have the flu, stay home until you are fever-free for 24 hours.
   4. Stay home for at least 24 hours after starting an antibiotic for a contagious bacterial illness such as strep throat or pneumonia.
   5. If a fever is over 100 degrees, the student is likely to be contagious.
   6. Generally, staying home until you are fever-free for 24 hours is a good rule of thumb.

School Nurses are Valuable Resources!

The school nurse is a very important member of the healthcare team. Let your child know the nurse is there to help.

“Parents can ask if the nurse minds checking on the student during the day,” Dr. Rudman said. “This is especially useful early in an illness when a child might feel well enough to go to school, but the illness gets worse during the day.”

Dr. Rudman’s Top Tips

1. Be immunized. That’s the best way to prevent life-threatening illnesses.

2. Wash your hands with soap and water for 20 seconds. That’s even better than using hand sanitizer.

3. Cough into your elbow, not your hand, to stop the spread of germs.

Sniffles or fever, the nagging, unspoken concern for each parent is that no one wants to be remembered as the kid who threw up in third grade! Making the best choice for your child can be less stressful if you know the right questions to ask and count on caring doctors and nurses for support.

By BETH ANN LOMBARDI, Cape Cod Health News