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How to know when a child is too sick for school

From fevers and stomachaches to colds and sore throats, a lot of illnesses peak in the fall and winter. Parents often ask me how to know if they should send their kids to school or keep them home.

As a pediatrician for Children’s Hospital of Wisconsin, here are some guidelines I offer parents:

Fever

Children who have a temperature below 100.4 degrees Fahrenheit and are drinking fluids can go to school. If the temperature rises above that, however, kids should stay home. They are contagious, and are not feeling well enough to learn or participate. Keep children home until they are fever-free for 24 hours and back to feeling like themselves.

Vomiting

Kids who have only thrown up once in 24 hours can go to school. It’s not likely they have an infection or are at risk for dehydration. If they have vomited two or more times in 24 hours, they should stay home. Watch for signs of dehydration and offer small amounts of fluid frequently, increasing the amount as tolerated.

Diarrhea

School is in session for children whose stools are only slightly loose and who are acting normally. Kids should miss school if they are having diarrhea more than three times a day. They likely have an infection that can be spread. See a doctor if blood or mucus is in the stool. As with vomiting, watch for signs of dehydration and offer fluids frequently.

Sore throat

A sore throat accompanied by a runny nose is often just due to simple irritation from the draining mucus. As long as children are fever-free, they can go to school. Kids should skip school and see a doctor for a strep test if their achy throat is accompanied by swollen glands, a fever, headache or stomachache. Children with strep throat should be on antibiotics for at least a full day before heading back to class.

Stomachache

Children can go to school if their only symptom is a stomachache. It could just be constipation or nerves. Kids who have stomachaches associated with vomiting, diarrhea or fever should see a doctor. Sharp stomach pain and a rigid belly can be signs of severe constipation, appendicitis or a bowel obstruction.

Colds

Kids should go to school if they are fever-free and are not coughing heavily. Those with persistent, phlegmy coughs and who seem cranky or lethargic should stay home, particularly if they have a fever and are wheezing.