When to Keep Your Child Home

If your child has been ill with fever, vomiting, or diarrhea, please keep him or her at home for at least a full day (24 hours) to allow time for a full recovery. Similarly, if a child complains of feeling ill during the night, it is probably not a good idea to bring that child in to the Center the next day.  Children who are on medication may attend the Center if the child’s physician approves.  Generally, it is a good idea for children to have been on medication for at least 24 hours before returning to the Center.

If a child has been exposed to a communicable disease, the Center should be notified at once. If appropriate, the Center will notify the parents of all children known to have been exposed during attendance at the program.  Children who are ill with a communicable disease should be kept home until they are no longer contagious.  Exclusion policies are specific to the various infectious diseases.  All exclusion policies are consistent with state recommendations and with the standards of the Centers for Disease Control, the American Academy of Pediatricians, and the American Public Health Association.

Children who have head lice or nits must be treated and all nits removed before returning to the Center.  We have to maintain a firm “no-nits” policy in order to keep head lice from spreading, and we do make periodic informal checks for lice if we hear of local cases or if a child appears to be showing symptoms.  If a child has been sent home with lice or nits, he/she may not return until we confirm through a visual check that all the lice and nits have been removed.

In the event that your child suffers an accident or injury requiring medical care, or has surgery, we would appreciate your talking with us before he/she returns to the Center so that we can be sure that we follow the physician’s advice regarding your child’s diet, participation in activities, etc.

Criteria for Excluding an Ill or Infected Child From an Early Childhood Program

Exclude children and adults with these illnesses or symptoms:

  • Temperature: oral temperature 100 degrees or greater, rectal temperature 102 degrees or greater, auxiliary (armpit) temperature 100 degrees or greater, accompanied by behavior changes or other signs or symptoms of illness, until medical evaluation indicates inclusion in the facility.
  • Signs of possible severe illnesses: unusual lethargy, irritability, persistent crying, difficulty breathing, and uncontrolled coughing
  • Uncontrolled diarrhea: defined as an increased number of stools compared with the child’s normal pattern, with increased stool water and/or decreased form that is not contained by the diaper or toilet use.
  • Vomiting: two or more times in the previous 24 hours unless the vomiting is determined (by a physician) to be due to a noncommunicable condition and the child is not in danger of dehydration
  • Mouth sores:  with drooling unless the child’s physician or local health department authority states the child is non-infectious.
  • Rash: with fever or behavior change until a physician has determined the illness not to be a communicable disease.
  • Purulent conjunctivitis: defined as pink or red conjunctiva with white or yellow eye discharge, often with matted eyelids after sleep, and including a child with eye pain or redness of the eyelids or skin surrounding the eye, until 24 hours after treatment has begun and/or a note from the child’s physician stating he/she may return to school.
  • Infestation: (e.g., scabies), until 24 hours after treatment has begun
  • Tuberculosis: until the child’s physician or local health department authority states the child is noninfectious
  • Impetigo: until 24 hours after treatment was begun
  • Streptococcal pharyngitis: until 24 hours after treatment has been initiated, and until the child has been afebrile for 24 hours
  • Ringworm infection: until 24 hours after treatment was begun
  • Varicella/Chicken Pox: until 6 days after onset of rash and until lesions have dried and crusted
  • Shingles: only if sores cannot be covered by clothing or a dressing, until the sores have crusted
  • Pertussis: which is laboratory confirmed, or suspected based on symptoms of the illness, or suspected because of cough onset within 14 days after having face-to-face contact with a laboratory-confirmed case or pertussis in a household or classroom, until 5 days of appropriate chemoprophylaxis (currently erythromycin) has been completed
  • Mumps: until 9 days after onset of parotid gland swelling
  • Hepatitis A Virus Infection: until 1 week after onset of illness or until after immune serum globulin has been given to appropriate children and staff in the program, as directed by the responsible health department
  • Measles: until 6 days after the rash appears
  • Rubella: until 6 days after the rash appears

Source: American Academy of Pediatrics, & American Public Health Association. (1992).  Caring for our child-National health and safety performance standards:  Guidelines for out-of-home child care programs.

Please note that in the case of a flu pandemic, the Center will follow the response guidelines as recommended by NH Health and Human Services.  If you would like to review these guidelines, please see the director.

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