Health Issues and Childcare

How sick must your child be to keep him home?


You make every effort to keep your child healthy at home—but what about at childcare?

Any time children congregate—church, school, family reunions—it is likely that they will exchange viruses and bacteria. The larger the number of children who are together, the more likely that someone will become ill from a virus or bacteria acquired from another child. Younger children are more likely to share their infections than are older children.

Policy on Sick Children

Your childcare provider should have a policy on how sick is too sick for childcare. Your child’s (and your provider’s) risk is lowered if the childcare provider’s policy resembles the CDC’s recommendations. These are mostly commonsense guidelines. Workers should be properly immunized and screened for health problems. Each childcare facility should have written criteria for excluding and readmitting children who are or have been ill. You should obtain a copy of these criteria from your childcare provider.

Who is at Risk?

Children who do not have chronic illness or immune system defects should not have serious problems. It is very important to keep your child’s immunizations current, especially if the child is in childcare. It is true that children who are in daycare situations acquire more infections than those who stay at home; however, children are likely to acquire many of these infections when they start school anyway. Children who may be at increased risk of serious infection from childcare exposures should receive care in a facility that minimizes their risks of exposure to infections. You might consider in-home childcare or small family childcare situations. It may be best to minimize exposures to other children for infants with special situations.

Premature Infants

Some premature infants are more susceptible to respiratory infections than infants born at term. Babies at greatest risk are those born at less than 32 weeks gestation. What might be a simple cold in other children can become a serious lung infection in these children. This risk is usually higher in winter than in summer and during the first 18 months of a child’s life. As these children grow and their immune systems mature, this risk decreases. Consult with your doctor about this risk if your child was born prematurely. Some babies may benefit from treatment that reduces the severity of a common viral infection, respiratory syncytial virus (RSV).


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