Pediatrics

How sick is too sick for school?

Another school year has begun, so it’s only a matter of time before your child brings home a cold, sore throat or other illness that will cause some missed school time. Here are some tips on a few common illnesses along with advice on how to tell when a child is well enough to return to the classroom.

Colds and flu. The flu usually strikes with a sudden, high fever accompanied by body aches. Cold symptoms – such as a runny nose or sore throat – will appear gradually. Children with colds can attend school unless their symptoms would keep them from participating in normal classroom activities. Children with the flu should stay home, get plenty of rest and drink lots of fluids. The federal government recommends that all school-aged children receive flu vaccines every year. Cough. Expect some coughing with a cold, but a cough that continues beyond a few days, or one that accompanies a fever, warrants a call to your child’s pediatrician.

Fevers. Fevers often accompany respiratory illnesses, so look for other symptoms when a child has a low-grade (99 to 100 degree) fever. Keep any child home whose temperature is above 100.4 degrees. Encourage the child to drink lots of fluids and avoid feeding fatty, fried or other foods that are hard to digest. Acetaminophen or ibuprofen can be given to control fevers, but never use ibuprofen when the child is dehydrated or vomiting continuously. Call your pediatrician if a high fever lasts more than 24 hours or if the child’s condition worsens.

Tummy aches. Upset stomachs are caused by a variety of viruses or bacteria. Two to three hours after a child vomits, encourage small drinks of water, then gradually introduce clear liquids in small volumes at a time. If fluids are tolerated for eight hours, progress to bland foods throughout the day. Contact your pediatrician if vomiting persists beyond 24 hours, includes worsening pain at the belly button or lower right abdomen, or if the child vomits blood or green or yellow bile.

Pink eye. Conjunctivitis (pink eye) causes red, weeping eyes and a thick discharge that could become crusty when sleeping. Pink eye can be highly contagious. Your child’s physician can prescribe the appropriate treatment, depending on whether the condition was caused by a virus or a bacteria.

Rotavirus. The most common cause of severe gastroenteritis (inflammation of the stomach and intestines) in young children, rotavirus causes a sudden onset of diarrhea and a fever that can exceed 102 degrees. Symptoms usually subside within a few days. Use nonaspirin medications to control fever and provide plenty of liquids to avoid dehydration.

Medications. If your pediatrician has prescribed an antibiotic, make sure the child takes all of it according to directions. Read labels carefully when giving over-the-counter medications. Many cold remedies already contain acetaminophen to control fever and achy muscles. Consult your pediatrician before combining over-the-counter and prescribed medications.

Back to school. Never send to school a child who has been vomiting or who has a fever that’s above 100.4 degrees. Generally, it’s safe to send a child back to school when the symptoms that caused the child to stay home have subsided for at least 12 hours, and fever has subsided for 24 hours. With these or any illnesses, remember to contact your child’s physician with any questions or concerns.

Originally Published in The University Doctors' MedicaLink - 09/08

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