When to Keep Your Child Home from School

The morning dilemma every parent knows: Your child says they don't feel well. Are they truly sick enough to miss school, or is this a case of the "I-don't-want-to-go" blues? And if they are sick, when are they well enough to go back?

Making the right call helps your child recover, protects other students from contagious illness, and keeps you from unnecessary stress. This guide will help you navigate these decisions with confidence.

The Basic Rule AAP

When in doubt, ask yourself two questions:

1. Is my child well enough to participate in school activities?

• Can they focus and learn?
• Can they handle the physical demands of the day?
• Would they be miserable at school?

2. Could my child spread illness to others?

• Are they contagious?
• Would being at school put other children at risk?

If the answer to either question suggests keeping them home, keep them home.

Definite Stay-Home Situations AAP

Keep your child home if they have:

### Fever

• Temperature of 100.4°F (38°C) or higher
• Stay home until fever-free for 24 hours WITHOUT fever-reducing medication
• This is one of the clearest rules

### Vomiting or diarrhea

• Stay home until symptom-free for 24 hours
• Even if they feel better between episodes
• Highly contagious and miserable for the child

### Contagious illness

• Strep throat: Stay home until 12-24 hours on antibiotics AND fever-free
• Flu: Stay home until fever-free 24 hours and symptoms improving
• COVID-19: Follow current CDC guidelines (typically 5 days isolation, then mask)
• Pink eye (bacterial): Stay home until 24 hours on treatment
• Ringworm, impetigo: Stay home until treatment started
• Chickenpox: Stay home until all blisters have crusted over (usually 5-7 days)
• Head lice: Most schools allow return after treatment; check your school policy

### Too sick to function

• Extremely fatigued
• In significant pain
• Unable to participate in activities
• Would be miserable all day

When It's Usually Okay to Go to School AAP

Your child can likely attend if they have:

### Common cold symptoms (no fever)

• Runny nose
• Mild cough
• Sneezing
• As long as they feel well enough to participate

### Mild symptoms

• Slight headache that improves with medication
• Minor sore throat without other symptoms
• Allergies (not contagious)
• Rash that's been cleared by a doctor
• Mild stomachache (no vomiting/diarrhea)

### After treatment

• 24 hours on antibiotics for strep or bacterial infections
• Fever-free for 24 hours
• Pink eye after 24 hours of treatment
• Head lice after initial treatment (per school policy)

The Grey Zone: How to Decide

Some situations aren't clear-cut. Here's how to think through them:

Ask yourself:

• Does my child have the energy to get through the school day?
• Can they manage their symptoms well enough to learn?
• Will they get worse as the day goes on?
• Could they make other children sick?
• What does my gut say?

When you're unsure:

• Take their temperature
• Give them breakfast and observe for 30 minutes
• If they perk up, they might be okay
• If symptoms worsen, keep them home
• When truly uncertain, err on the side of keeping them home one more day

Trust your instincts: You know your child. If something feels off even without obvious symptoms, pay attention.

What About "I Don't Feel Good" Without Symptoms?

Kids sometimes say they're sick when they're not—or at least not physically sick. Before assuming they're faking, consider:

Check for hidden issues:

• Is something stressful happening at school?
• Social problems, bullying, academic struggles?
• Anxiety about a test or event?
• Problems with a teacher or classmate?
• General school avoidance?

How to respond:

• Take complaints seriously (don't dismiss)
• Look for patterns (always Monday? Before tests?)
• Check for physical symptoms
• Have a conversation: "I've noticed you feel sick on school days. Is something happening at school?"
• If school avoidance is a pattern, address the underlying issue

If no physical symptoms and no underlying issue:

• "You need to go to school unless you have specific symptoms"
• "Let's see how you feel after breakfast"
• Explain that staying home means resting (not screen time)
• Contact the school if the pattern continues

Communicating With School

When your child stays home:

• Report the absence per school policy (phone, app, email)
• Mention the illness type if relevant (helps with outbreak tracking)
• Ask about makeup work
• Keep the school updated on extended absences

When your child should return:

• Know your school's return policies
• Some require doctor's notes for extended absences
• Communicate if your child needs accommodation (asthma acting up, etc.)

When to Call the Doctor AAP

Not every illness needs a doctor visit, but some do:

Call your pediatrician if:

• Fever lasts more than 3 days
• Symptoms worsen instead of improve
• Signs of dehydration (no urination for 8+ hours, no tears, very tired)
• Severe sore throat or difficulty swallowing
• Ear pain
• Persistent vomiting or diarrhea
• Rash you can't explain
• Breathing difficulties
• Your child seems unusually ill
• You're not sure what's wrong

Seek immediate care for:

• Difficulty breathing
• Signs of severe dehydration
• Lethargy, difficult to wake
• Severe headache with fever and stiff neck
• Any emergency symptoms

Staying Home vs. Doctor's Appointment

Stay home and monitor:

• Mild cold symptoms
• Stomach bug (unless severe)
• General "under the weather" feeling
• Recovery from known illness

See the doctor:

• Need diagnosis (strep, ear infection, etc.)
• Symptoms aren't improving
• Need treatment (antibiotics, etc.)
• You're concerned or uncertain

Recovery and Return to School

When to go back:

• Fever-free for 24 hours (without medication)
• 24 hours without vomiting or diarrhea
• 24 hours on antibiotics for bacterial infections
• Able to participate in activities
• Appetite returning
• Energy improved

Don't rush return:

• Going back too soon often means getting sick again
• They may still be contagious
• They won't learn effectively if they feel terrible

Easing back:

• First day back might be tiring
• Pack easy-to-eat snacks
• Communicate with teacher about energy level
• Plan a quiet evening

Preventing Illness AAP

The best sick day is one you never need to take:

Teach your child:

• Handwashing (properly—20 seconds, with soap)
• Not touching face
• Covering coughs and sneezes
• Not sharing drinks or utensils
• Staying away from visibly sick classmates

At home:

• Adequate sleep (huge for immune function)
• Nutritious meals
• Regular exercise
• Up-to-date vaccinations
• Teaching kids to tell you when they feel unwell

Planning for Sick Days

Since sick days happen, plan ahead:

Have a sick day plan:

• Who stays home with the child?
• Backup care options
• How to communicate with work
• Keep sick day supplies on hand (thermometer, electrolyte drinks, soup, etc.)

Make sick days boring (in a good way):

• Rest should actually happen
• Limit screen time so staying home isn't more fun than school
• Quiet activities: reading, puzzles, drawing
• The goal is recovery, not a vacation

The Bottom Line

Deciding whether to send your child to school when they're not feeling well comes down to two things:

1. Can they participate and learn? (Are they well enough?)
2. Could they spread illness? (Are they contagious?)

When in doubt, keep them home. One extra day of rest usually leads to faster recovery and protects other kids.

Trust your parental instincts, check for symptoms, and don't hesitate to call your pediatrician when you're uncertain.

Clara is here to help you make these daily decisions about your child's health.