Your 3-year-old is playing listlessly with her oatmeal. "My tummy hurts, Mommy," she says. There's no fever, no vomiting and no diarrhea, but she's not her normal bundle of energy.
Now comes the tough part. Do you send her to day care, or keep her home?
The American Academy of Pediatrics and the American Public Health Association have guidelines that can help you make up your mind. Drawn up in 1992 and revised in 2002, they cover kids in group care and school.
Kids should stay home if the illness:
Poses a risk of spreading a serious or harmful disease.
Needs more care than the staff can provide without a risk to the health and safety of other children.
Would keep the child from joining in activities.
These are specific examples of when to keep children home:
Diarrhea that is leaking from the diaper or that occurs more than 2 times over a child's normal number of bowel movements, or blood in stools that is not explained by medication, hard stools, or diet
Vomiting twice or more in 24 hours until a health care provider has determined that it is not contagious
Hand, foot, and mouth disease if there are sores in the mouth or drooling
Unexplained fever in a child younger than 4 months
Sluggishness, uncontrolled coughing, constant crying or other signs of possible severe illness
Children with colds, runny noses or mild fever may be able to go to school or day care depending on other factors.
Deciding whether a mildly ill child can go to child care or school is difficult. What may have been just a tummy ache in the morning could lead to vomiting and diarrhea later in the day. Parents usually make good decisions. However, work obligations sometimes do get in the way, making it hard for the parent to keep the child home. It can sometimes be a complicated decision. However, child care and school personnel also have the final say on whether the child is too sick to attend child care or school.