Parents are often frustrated by how often their children are sick, especially if they are in day care. It is normal for young children to have six to eight upper respiratory tract infections and two or three gastrointestinal infections each year. Children in day care can often have more (often called
day care syndrome).
To prevent infections, you should teach your children and care providers to practice
frequent handwashing, especially after using the bathroom (including diaper changes) and before eating. You should also frequently wash toys and other objects that your children put in their mouth and all other surfaces and dispose of tissues after wiping or blowing your child's nose.
Other tips to help avoid catching infections include avoiding close contact with other people who are sick. Make sure that your day care has a strict policy about excluding children with contagious illnesses. This does not always help though, because most illnesses are contagious for a day or two before you even have symptoms. Once your child develops symptoms, he has probably already infected other people he has been in contact with.
Although children with contagious illnesses do need to be excluded from day care settings or school, most children with mild illnesses can still attend. Excluding children with mild illnesses when it isn't necessary, or requiring a visit to the child's Pediatrician, can result in parents missing work and children being treated with antibiotics unnecessarily.
It is sometimes hard to know when you should keep your children home from day care or school. Reasons for excluding or keeping your child home from school or day care (and usually taking your child to see your Pediatrician) if he isn't able to participate in regular activities or having any of the following symptoms:
- fever
- lethargy or a very decreased activity
- irritability or persistent crying. Even if your child is consolable when held, it may not be possible for someone at the day care to devote all of their time trying to console your child.
- trouble breathing
- rash, if it is associated with a fever.
- diarrhea that has blood or mucus in it.
- vomiting more than two times in a twenty four hour period.
- mouth sores (like from gingivostomatitis and hand foot and mouth disease) in younger children that are still drooling a lot.
- eye infections (conjunctivitis or pink eye)
With many bacterial infections, it is safe to go back to day care or school after appropriate treatments, including:
- twenty four hours of antibiotic therapy for strep throat and impetigo
- a single treatment for scabies and head lice
- five days of antibiotics for pertussis infections
Viral infections, which usually do not have any treatments are usually contagious until after a certain period of time, including:
- chickenpox is contagious until all of the lesions have dried and are crusted over (usually six or seven days after the infection began).
- Hepatitis A is contagious until at least a week after the infection and jaundice began
Children do not need to be excluded if they have a mild upper respiratory tract infection, even if it is associated with green or yellow nasal discharge, as long as the child does not have a fever or any of the other symptoms described above.
Also children do not need to be excluded if they have fifth disease (Parvovirus B19 infection), because they are no longer contagious once the rash appears, and you usually don't know they have it until the rash appears, a rash without a fever, a red eye without a yellow or green discharge, fever or matting, warts, or ringworm.
Other infections include prolonged exclusion from school, including tuberculosis (children should be excluded until properly treated and the health dept. says they are no long contagious), and E. coli and Shigella infections (until diarrhea resolves and the child has two stool cultures that don't show an infection).
