How Sick Is Too Sick for School or Daycare?

With new clothes, backpacks and classrooms comes a whole new dilemma for parents. After all, school and daycares are synonymous with “germ sharing.” If it hasn’t happened yet, it won’t be too long before you’re awakened to the whiny chorus of, “I don’t feel so good,” and the dreaded conundrum of whether or not to send your child to school or daycare.

When faced with this, it’s always useful to rely on a few trusted instincts. In general, facing it with a healthy dose of common sense and a genuine concern for the well-being of your child will generally lead to the right decision. The American Academy of Pediatrics suggests using these guidelines to keep your child home:

  1. A fever
  2. Is not well enough to participate in activities
  3. May be contagious to others

Let’s review a few common scenarios.


If your child has a temperature of 100.5 F, or greater, they are considered contagious and should remain home. With a fever, they are most likely pretty uncomfortable and won’t be able to learn or participate in class (just think how you feel with a fever). Your child should remain home until he’s been fever free for 24 hours.

Cough and Cold Symptoms

Most of the time, upper respiratory infection symptoms are more of a nuisance and don’t necessitate your child staying home (otherwise, schools would be empty!). Colds typically last three to seven days, and the age-old adage of “Tincture of Time” is all we can prescribe. If symptoms interfere with their ability to participate in school, such as a cough keeping them up all night, then keep them home for some TLC.

Diarrhea and Vomiting

This seems like a no brainer, right? If your child is actively having symptoms, then they are too sick and contagious to go to school. A good rule of thumb is to keep them home until they have had no more episodes of vomiting or diarrhea for 24 hours. The tricky part comes when they have the persistent, lingering soft stool. Consult your doctor and use his comfort level in deciding.

Sore Throat

If they don’t have a fever and can tolerate eating and drinking, they are more likely okay for school. However, if they have been diagnosed with strep throat, they will need 24-hours’ worth of antibiotics before returning to school.

Pink (Red) Eyes

If their eyes are red, covered in – or oozing – yellow/green discharge, then you’re likely dealing with a contagious case of conjunctivitis (the dreaded pink eye). Again, they will need 24 hours of antibiotics before returning to school. On the other hand, slightly pink eyes with clear/watery discharge is likely allergic and they are okay to be at school.


We have saved the best for last. Rashes are dependent on diagnosis and may require a doctor’s aid in identifying the cause and contagiousness. Some are contagious before the rash appears. Others, like chickenpox and hand, foot and mouth disease, need to be crusted over before your child can return to school.

Parents, remember to simply trust your instincts. I know that it may wreak havoc on your already hectic schedules, but your child’s well being comes first. If all else fails, your Mercy pediatrician is always only a phone call away to help you navigate these difficult decisions.

Diana M. Roukoz, D.O. is a Mercy Kids pediatrician with Mercy Children’s Hospital St. Louis.

Our Providers

Diana M. Roukoz, DO, Mercy
Mercy Clinic