When to keep your child home sick from school

These illnesses require a day off from school to help kids recover—and avoid spreading germs

By Cheryl Maguire | Sep. 7, 2021 Medically reviewed by Gerardo Sison, Pharm.D.

As a parent, you are often faced with difficult decisions. When your kids wake up feeling sick, it can be hard to know when to keep kids home from school. You don’t want them missing out on important lessons, but you also don’t want your child to get anyone else sick—or to become even more ill from toughing it out. Now with COVID-19 complicating the issue even more, you may be wondering: How do you know when to keep your child home from school?

9 signs you should keep your child home from school

“This year, infections like common colds and RSV are circulating much sooner than before and are perhaps causing symptoms that are stronger,” says Sumana Reddy, MD, a physician at Acacia Family Medical Group in Salinas, California. There are some symptoms that all providers agree would warrant keeping your child home from school. The American Academy of Pediatrics and other experts recommend that you keep your child home sick if they are experiencing the following symptoms:

Fever—any temperature of 100.4 degrees Fahrenheit (F) or greater
Vomiting
Diarrhea
Persistent cough or difficulty breathing
Severe pain (like a migraine headache or severe earache)
Severe sore throat that lasts more than 48 hours, especially when accompanied by a fever
A significant rash, especially when other symptoms are present
Large amounts of discolored nasal discharge
Pink eye

These could be signs of a contagious illness, like strep throat, the flu, or even COVID-19.

Which illnesses require a sick day?

Before the pandemic, it was common to go about normal life with a mild virus. The easy transmissibility of COVID-19 called attention to the fact that sometimes it’s better to stay home to avoid spreading illness to others. Yet, you don’t want to make kids miss class unnecessarily at the first sign of the sniffles. These are the types of illnesses when it’s okay to be out and about—and when to stay home from school.

Stay home from school for…

Influenza

“A child with flu symptoms may actually have COVID-19 and should be tested,” says Pierrette Mimi Poinsett, MD, a medical consultant at Mom Loves Best.

Your child’s temperature can determine when to return to school after the flu. When your child has the flu, they should stay home for at least 24 hours after their fever is gone. They are contagious one day before they show symptoms until five to seven days after they first show symptoms.

Pink eye

Pink eye, also known as conjunctivitis, is nicknamed for its hallmark symptom: eyes that are red or pink in color—often along with itching or swelling. This condition spreads easily from person to person, so children should stay home until they are no longer contagious.

For viral pink eye, the contagious period can last for up to two weeks. For bacterial pink eye, kids are contagious for 24 to 48 hours after beginning antibiotics. Your child may need a letter from your pediatrician to return to school if symptoms aren’t completely gone after starting treatment.

Fifth disease

Fifth disease, also known as parvo, is often signaled by a bright red rash across the cheeks, with a low-grade fever. Children can be contagious up to five days before symptoms appear. Once the tell-tale rash appears, kids are no longer contagious and can return to school if they are feeling well enough.

Strep throat

Strep throat is another infection that’s highly contagious and usually warrants time off from school. Common symptoms include severe sore throat, fever, headache, and nausea. You can even catch it from your kids, so make sure to take precautions if your child is diagnosed. Once a pediatrician confirms the infection with a strep test, kids are only contagious for 24 hours after treatment with antibiotics. Then they can head back to class.

Stomach bug

A stomach bug—and the unpleasant vomiting, diarrhea, and stomach pain it brings—can last up to two weeks. Though, vomiting and diarrhea usually subside after 48 hours. Kids can be contagious until symptoms stop, and should stay home from school until 24 hours after the last bout of tummy troubles.

Hand, foot, and mouth disease

Hand, foot, and mouth disease gets its name from the sores that appear on the hands, feet, and in the mouth—though they can also appear in other areas. Children are contagious for the first week of experiencing symptoms, and it is possible to be contagious for longer depending on the case.

It may be okay to go to school with…

The common cold

If your child only has minor symptoms of a cold, then in most cases, they can go to school. Just make sure to get a negative COVID-19 test first. Some symptoms can mirror the coronavirus.

But, if your child feels like they can’t focus or learn then it probably makes sense to keep them home. Children can be contagious two to three days before showing symptoms and for as long as symptoms remain present.

Ear infection

If your child has an ear infection, you may notice symptoms like ear pain, fever, and sometimes nasal congestion. Ear infections are not contagious, so as soon as the fever has subsided and your child is feeling up to it, it’s okay to return to school. However, ear infections usually develop as a result of a bacterial or viral respiratory infection, which can be contagious.

Why it’s important to keep sick children home from school

Even if your child’s symptoms aren’t severe, sometimes it’s good to take a day off for some rest and rejuvenation. Why?

Your child won’t learn: If a child is feeling sick, they are unlikely to be able to focus and learn if they are sent to school.
It could spread the illness to others: Your child could infect other children or teachers if they are still contagious. If some of these people are immunocompromised, then your child may be putting them at risk for severe illness or other complications.
Too much activity slows your child’s recovery: If your child goes to school when they are sick, they may lose out on time to recover, which could increase the time that they are sick.

In other words, when in doubt, keep your child home! It will speed recovery and avoid risking infecting others.

How to avoid illnesses in school and daycare

Luckily, there are some easy preventive measures your child can take to avoid illness in the future. “We’ve learned all about it with COVID: handwashing, not rubbing eyes, nose, and mouth, avoiding getting too close to others, and now we can even wear masks to not spread what we have,” Dr. Reddy says. Parents and caregivers can take the following steps:

Encourage hand washing: According to the CDC, hand washing can prevent about 30% of diarrhea-related illnesses and about 20% of respiratory infections.
Recommend a good night’s sleep: The CDC recommends that school-age kids get between nine to 12 hours of sleep at night. The proper amount of sleep can help maintain a strong immune system, which fights off infections.
Provide a healthy diet: Eating a healthy diet can also support the immune system’s ability to fight off sickness. TCertain foods, like ones with vitamin C, may help boost immunity.
Schedule vaccinations: The CDC recommends routine vaccines to provide immunity against certain infections, like the flu or COVID-19.