How to Determine if you Should Keep Your Child Home from School

In the rush that is a weekday morning, it can be very difficult to decide in those scarce few moments if your child is well enough for school. Is it simply morning grogginess? A mild sniffle and sore throat?

Or, is it something more?

I’ve been led astray myself. I recall one particular cold winter morning. My son woke up saying that his tummy hurt. I, in my let’s get this show on the road hustle, shrugged it off as him being hungry. “You need to eat and you’ll feel better”, I promised.

I was wrong.

Not more than an hour had passed and I received the phone call. You know the one. It’s the number from school and in those brief seconds you imagine the worst has happened to your child. In this case, it was the school nurse. My son had vomited.

And his “tummy hurts.”

Total mom fail.

Such is life with little ones and the various viruses and infections that can potentially sideline them for a few days. So, while determining whether your child is too sick for school is not an exact science, there are some general guidelines to adhere to. That way, you can feel more confident calling it a sick day or forging on with the day’s plans.


If your child spent the night tossing and turning because of a fever (anything over 100.4 F), it’s probably best to keep her home until she’s fever free for 24 hours. Children are most contagious from whatever bug they’re fighting off while they have a fever.

Besides, children battling high fevers (102 F or higher) tend to feel pretty miserable. A sick day is in order indeed. Keep in mind that fever is actually a good thing. It means your child’s body is doing what it should be doing: Mobilizing the immune system to fight off an infection. An infant less than 6 months old with a fever (100.4 F or higher) should be seen by his pediatrician.

Vomiting and/or diarrhea

I think this is pretty self-explanatory. Like the situation with my son above, he was sidelined with a short bout of viral gastroenteritis for a couple of days. In general, any child who has vomited more than twice in the last 24 hours should be kept home. Same goes for frequent diarrhea.

Stay on top of their hydration and allow them to rest at home.

Severe cough

So you were up all night with your coughing child and spent the better part of it holding her in your lap near the cool-mist humidifier? Chances are both you and your child could use a sick day.

Any persistent, harsh cough or one that is making it difficult for your child to catch her breath, deserves a visit to the doctor. Otherwise, mild intermittent coughing from a run-of-the-mill cold should not keep your child from going to school.

Pink eye

Schools and day cares are extremely wary of any eye discharge because of the high contagion factor. The truth is, not all pink eyes are actually infectious. If the whites of your child’s eyes are red, there is yellow to green discharge, and he wakes up with his eyes sealed shut then you should keep him home and put a call in to the pediatrician. That signals a bacterial conjunctivitis and will need antibiotic eye drops to clear it up.

Clear, watery discharge from the eyes could be allergy or viral related and shouldn’t necessarily keep your child away from school.

Sore throat

Wintertime sore throats often throw me for a loop in the early morning rush. Kids (and adults too) will often wake up with sore throats from the dry indoor air. So if your child complains of a sore throat first thing in the morning, give it some time. See how she feels after breakfast.

A mild sore throat that accompanies a mild upper respiratory infection won’t keep your child from school.

On the other hand, a sore throat accompanied by a fever, headache, and red or white spots on the back of throat could signify a strep throat infection. In that case, yes to a sick day and yes to a doctor appointment. Your child should be all clear after 24 hours on antibiotics for a strep throat infection.

Other automatic sick days

Lice will keep your child home until treatment has been started and daily nit removal has begun. Any suspicious rash should be checked by a doctor as well (impetigo and chickenpox are contagious). Pain anywhere on your child’s body that is persistent and interferes with his daily activities requires some investigation and a sick day.

Even armed with this information, there will be some days that you just aren’t sure. In those cases, tune into and trust your gut instinct. Believe me, there isn’t a parent out there who hasn’t misjudged and either sent a sick kiddo off to school or spent a “sick day” trying to entertain a bored and energetic kindergartner.  Personally, I’ve been both of those parents at one time or another.

Dr. Melissa Arca is a pediatrician, mom of two, writer, blogger, and child advocate. She is author of the award winning blog, Confessions of a Dr. Mom and writes a weekly parenting/children’s health column for her local paper, The Sacramento Bee.  In her free time you can find her at the beach with her husband and two kids (ages 5 and 7), coffee in hand.