As any parent or caregiver knows all too well, almost every child has his or her fair share of colds and coughs, stomach aches, and other illnesses that are a normal part of childhood. But knowing whether a child is too sick to go to daycare or school can be a tough call. Some illnesses or symptoms may be too minor to let a child stay home, including a sore throat, minor cough, or mild congestion. On the other hand, many other conditions are usually a good sign to let your child take an official sick day.

When to Stay Home

The American Association of Pediatricians recommends that a child should stay home from child care or school if a particular illness or condition prevents the child from taking part comfortably in daycare or school activities; if the need for care is greater than staff members can provide; or if there is a risk of spreading a harmful disease to others (such as rubella, whooping cough, mumps, measles, and hepatitis A).

Common Medical Symptoms/Conditions

According to medical experts, here are some of the most common medical symptoms/conditions that mean a child should stay home from school:

• Fever: If a child has a temperature of 100.4° Fahrenheit (38° Centigrade), it is considered to be a fever and that means you should keep them out of school. Fevers are a sign of infection and it usually means a child is shedding germs and is most likely contagious. Parents and caregivers have no way of knowing whether a child will get better or worse during  the day so a sick day at home is the best course of action. Most daycares and schools also have rules that a child should be fever-free for 24 hours before going back to school. If a child has a temperature of 99.9 or 100, technically it’s not a fever—but it may signal the beginning of an illness. In this case, if you’re on the fence about whether to send a child to school, just keep an eye on them to see if they are acting sluggish or sickly. If they are, it’s a good idea to go ahead and let them stay home for the day.
• Strep throat: Kids who have a sore throat along with a positive strep test should stay out of school until they have been on antibiotics for 24 hours. Treatment with antibiotics limits the spread of strep and reduces the risk of an extremely rare complication called rheumatic heart disease.
• Constant Coughing or breathing difficulties: No matter the season, many kids will exhibit coughing due to allergies or minor colds. But constant coughing or breathing that sounds or looks different than normal usually means a trip to the doctor—and time out from school.
• Vomiting or diarrhea: If a child is vomiting or has diarrhea, make sure they stay home—even if they appear to be well beyond those symptoms (your daycare worker will thank you!). If a child is symptom-free after 24 hours, they should be good for school but it’s always a good idea to check with your doctor or healthcare worker before doing so. Some viruses, including the norovirus, can make someone contagious for an extra day or so.
• Bad pain:  If a child has a sore knee or a mild headache that causes pain—but is otherwise acting okay—it’s fine to give some child-level pain medicine and send them off to school. But if the pain is more than mild, keep the child home. Parents and caregivers should always keep an eye on a child with pain and be sure and call the family doctor if the pain persists.
• Conjunctivitis/pink eye: Conjunctivitis is simply an inflammation of the eye, and it can be caused by a lot of different things: viruses, allergies, and (rarely) bacteria. Many of these cases are viral and don’t require treatment. For children that have conjunctivitis/pinkeye cases caused by bacteria, they should stay home, only returning to school after antibiotic drops are started.
• Hand, foot, and mouth disease: A common outbreak in day-care facilities, this disease can cause some painful mouth ulcers and a rash. Kids should be kept at home if they have a fever or if they are unable to control their drooling.

Remember that most childcare facilities, preschools, and grade schools have rules about when to keep kids home. But when it comes to your child’s health and the health of all the other children at school or daycare, it’s better to be safe than sorry. And remember, if you are in doubt, always consult a physician or other healthcare worker for guidance on all medical issues related to your child.