Nurses Weigh In: When Is It OK (and Not OK) to Send a Sick Kid to School

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"Mom, Dad... Can I stay home from school today?" Every parent is all too familiar with those words, asked sheepishly by a child who sometimes is legitimately sick - and who sometimes is just hoping for a day off from school. But how is a parent to tell when their child is pulling their leg? And how is a parent to tell when a child is actually sick enough to miss an entire day of class?

There are all kinds of reasons a kid would try to fudge an excuse to stay home. Maybe they forgot to finish their homework or there's a big test they're hoping to miss. Maybe they feel like watching TV all day instead of sitting in a classroom and listening to their teachers drone. As a parent, you know those are distinct possibilities. But you also would feel really guilty if your child really was sick and you sent them to school anyway.

Some symptoms are OK to power through. A slight stomachache, for instance, is probably fine to overlook. But where is the line drawn between a small symptom and one that might be serious? We asked three nurses what they thought were good rules of thumb for parents to make these types of judgment calls. Nurses see young patients nearly every day and are all too familiar with the typical ailments that children typically face. Here's the advice these nurses want parents to know.

Know Your School's Policy

"The first thing any parent should be aware of is their child's daycare or school's policy on illness," said Scott Topiol, a certified emergency nurse, public health nurse, and father of five. "Most schools have guidelines that can help simplify the decision." Each school has different policies; check in with your child's school administration before sending your child to school. Often, these policies are derived from the universal policies put in place by the American Academy of Pediatrics (AAP). And follow these simple tips for avoiding back-to-school germs as often as possible.

Common Cold

"According to the AAP, kids can go to school with the common cold," Topiol told The Active Times. The sniffles shouldn't keep a kid from sitting in the classroom. Topiol advised that you should, however, educate your child on common hygiene practices such as washing their hands after they blow their nose and after a sneeze. Topiol also says to teach your child to cough and sneeze into their arm, rather than their hands. However, if those cold symptoms are being caused by a more severe virus, staying home is warranted.

Fever Check

Not sure what constitutes a more severe virus? Check your child's temperature. "If your child has a fever greater than 101 degrees Fahrenheit, keep them home," advised Brandi Cavegn, registered nurse and medical director of women's health at Ascension St. Elizabeth Hospital. "There's some debate about what kind of temperature - under the tongue, the armpit, etcetera. But no matter where you got it, a 101 is enough to keep them home." For babies, she noted, the temperature cutoff is a bit lower. Anything above a 100.4 warrants a day home.

24-Hour Rule

With fevers, Cavegn notes that there is a 24-hour rule you should apply. Make sure your child's temperature has been below 101 for at least that long before sending them in. But there's one thing with this rule that parents sometimes get wrong. "This rule means without any medications to make it go down," she said. "Wait another 24 hours from that point, when the last medication was taken."

Runny Nose

"If the child has a runny nose, I recommend they stay home and rest," Cavegn said. With fluids leaking from your child's nose, they are putting other children in the vicinity at risk for getting sick. "But that's not always possible," she conceded. "Kids can have a consistent runny nose for weeks."


A slight cough is probably fine. But a wet cough is a sign of an infectious illness. Cavegn says that there are exceptions, however. Like a runny nose, a cough can last for weeks on end before it finally dissipates. In this case, parents might want to consider sending their child back to school after the illness is probably no longer contagious.


Both nurses said that a child with allergies is OK to go to class. Allergies can last all season, and there's not much you can do about them. These simple tips may help, as could over-the-counter medication. Talk to your doctor about ways you might be able to ease the discomfort that comes with seasonal allergies.


This symptom is enough of a reason to stay home from school - both because it could signal something serious and because your child will be intensely uncomfortable in class. "If they are having loose or frequent stool unrelated to a diet or medication change, it's best for them to stay home," said Cavegn. In toddlers it's more difficult to spot diarrhea, but it often characterizes itself as more frequent accidents.


Vomiting is what Cavegn calls a "wait and see situation." If it happens once, you're probably in the clear. Kids can vomit for all kinds of reasons, especially when they're young. It could happen if they're crying too hard, they've choked on something, or they're just really stressed out. But if they vomit two or more times in a 24-hour period, the nurse says it's probably best to keep them home. Unless, she noted, they're at risk for dehydration. In that case, one instance of vomiting is a sign they're in danger and need to rehydrate under your supervision ASAP.

Stomach Pain

Ah, every kid's favorite excuse: the stomachache. But how's a parent to tell when a halfhearted complaint of stomach pain becomes serious? If the pain lasts for more than a couple of hours, Cavegn says, that's when you should start to consider keeping your child at home. But most of the time, the pain is fleeting and could be gone by breakfast.

Distraction Test

A simple way to check if your child's stomach pain is legit or if it's being exaggerated at the hopes of a sick day on the couch is with a distraction test. Nurse Cavegn says that if you are able to distract your child from remembering they're in pain, it's a safe bet to send the child to school. Try to divert their attention with something simple like brushing their teeth, getting them ready, or serving a tasty breakfast. Are they still complaining? Do they refuse breakfast? If so, their pain might be something to take more seriously. Only a child truly in pain would deny a warm Pop-Tart.

Mouth Sores

A cold sore is contagious, but it's no reason to skip class. Just make sure you teach your child how to prevent these sores from spreading. No swapping spit! That means no kissing, no sharing food, and always making sure they wash their hands. The exception, nurses advised, is a case where the child is exceptionally drooly or the sore opens and bleeds. Then you might want to consult a doctor to see what else could be going on.

Cuts or Wounds

Between playgrounds and sports teams and raucous playdates with friends, it's normal for kids to get cuts and scrapes. How can you tell if a wound is severe enough to require your supervision or medical attention? "If the sore or cut is too big to cover with a bandage or if it's leaking fluid," Cavegn confirmed. "That's when you should keep them home. Fluids from the cut could be transferred to other children."

Contagious Diseases and Infections

Of course if your kid has caught something contagious, you should avoid exposing his or her classmates. Strep, ringworm, scabies, pink eye... No matter the infection, keep it quarantined. Schools usually have their own rules and regulations for the amount of time a child must keep their distance from the campus. Check in with your child's school administration to see when it's OK to return your child to class. Usually, the school will require a doctor's note or some other form of verification that you've treated whatever infection occurred.

Rule of Thumb?

Still not sure whether you should let your loved one stay home? Registered nurse Brandi Cavegn likes to live by one rule of thumb: If anything is oozing, keep them home. "This includes diarrhea, bleeding wounds, vomiting, runny eyes, runny nose," she explained. "Any of these. But if it isn't oozing, they're OK to go to school." Give them some moral support, tell them you love them, and send them on their way. Maybe sneak a treat in their lunchbox - it'll cheer them up later!

Mental Health

Though mental health problems certainly aren't contagious between peers, they should still be taken seriously. In some cases, Cavegn said, they are absolutely a good reason for a child to take a sick day. "We're seeing it more and more often - kids will want to stay home or be sent home from school for something that has to do with mental health, like anxiety, panic attacks, or depression," she said. "Those shouldn't be ignored, and should actually be a reason to consider keeping your kid home." If you start to see a recurring pattern of these behaviors, don't take it as a sign your child is pulling your leg - seek medical advice from a school counselor, mental health provider, or other professional. Mental health problems in children are very real. Some of these surprising signs of mood disorders could be your first clue that something serious is going on.
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