It is no secret that doctor’s offices and Emergency Departments are extremely busy these days. It is the “cold and flu” season, and RSV season, and that makes for a lot of sick kids. In other columns and blog entries, I have discussed which kids do not need to be brought to the Emergency Department, when they don’t have an urgent condition. It is even more disappointing when a parent brings a kid in who is not terribly sick, but needs a form filled out to return to school or daycare. The parent is not happy either- they often know their child is okay, but are missing work and pay, and can’t get into their doctor that day to get the child back into class.
The American Academy of Pediatrics has published guidelines about when kids can be kept in school and daycare. Rashes without fever, coughs and colds, and “pink eye” can be kept in school. However, a recent study in the AAP journal Pediatrics surveyed day care directors about knowledge of these guidelines. The study showed that the vast majority of directors would keep out kids who could have stayed. Teachers in public schools do not fare much better. I have seen too many kids in the Emergency Department with notes required for things like rashes and pink eye.
Here is a basic list of the conditions that DO NOT have to be kept out of school or daycare:
-Rashes, including scabies, ringworm, and poison ivy (NOT CONTAGIOUS!)
-Coughs and colds
-Fevers that have gone in 24 hours and the child is acting well
- Conjunctivitis, or “pink eye”
-Non bloody diarrhea that the child can control, or that is contained in the diaper
What should be kept out of school? Any condition with fever and the child acting sick, and vomiting. In the study in Pediatrics, vomiting was about the only guideline that daycare directors got right.
To be fair, the American Academy of Pediatrics has not done a great job of making these guidelines accessible to schools, day cares, daycare licensing agencies, and the public. They can only be found in two expensive books, one of which is a textbook for pediatricians. If you go to the AAP website, you can’t find these guidelines. A general internet search will bring up one AAP school guideline which is not very clear, and a lot of individual county and government guidelines which often conflict with the AAP guidelines. In Lafayette, day cares are bound by licensing requirements that also might keep more kids out than necessary. Therefore, school and daycare guidelines are often written with no expert input. Then teachers must follow these guidelines, because that is all they have to go on.
So, teachers, daycares, governments, and schools! Please revisit your policies on what kids to keep out of school, and when to take them back. At least keep the note requirements to a minimum! Doctor’s offices and Emergency Departments could use a break. Working parents could use a break. The kids DON’T need a break- keep them where they can continue to play and learn.