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Information for parents

When should children stay home from childcare?

Children who attend centre-based childcare are exposed to more infections than other children. The child's general condition will usually dictate the need to stay at home for some days, but some diseases may require a longer absence to prevent the spread of infection to others.

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Colds, sore throats and ear infections are almost twice as common in children who attend childcare than those who do not, and gastrointestinal infections are almost three times as common. In addition, there may be frequent outbreaks of head lice, impetigo and other diseases with rashes.

Infections are usually spread through direct or indirect contact between children.

When can I send my child to childcare?

For some diseases there is no reason to keep children at home. This may be because the disease is often transmitted before symptoms appear or because the risk of infection is very small once the child has recovered, or because the disease is common and mild.

Examples of these diseases include the fifth disease (erythema infectiosum), cold sores, warts and hand, foot and mouth disease.

When should I keep my children at home?

Experience shows that strict rules to keep sick children out of childcare have a limited effect on the spread of infection. This may be partly because the diseases are often infectious before symptoms appear. Nevertheless, in many cases, a sick child should be kept at home for a period to prevent spreading the infection to other children.

With infectious diseases, the child's general condition will often require some time at home and the decision should be based on parental judgement. As a rule of thumb, a child should feel well enough to take part in normal activities in childcare and not have a fever.

For many diseases, such as impetigo, it is difficult to specify an exact time period after which the child can return to childcare. In such cases the treating physician or parent should assess the situation.

The following list covers the most common symptoms and diseases among children who attend childcare or the lower grades in school.

Fever

A child’s normal body temperature may vary. A raised temperature is considered to be higher than 37.5 °C in the morning and 38 °C at night. Children with fever should stay at home until the fever has gone, mainly for their own comfort but also to avoid the spread of a possible infectious disease.

Diarrhoea with or without vomiting

Children with diarrhoea can return to nursery two days after they have been symptom-free. This also applies to children who use nappies. Children who normally have loose stools do not need to be kept at home. The parents must decide if their child has an abnormal diarrhoeal condition.

For diarrhoea where contaminated food is suspected (such as after travelling abroad), the child should be examined by a doctor and the other children in childcare should be monitored for symptoms.

Conjunctivitis (pink eye)

There is no reason why children with mild to moderate conjunctivitis should be kept at home. Children who have severe conjunctivitis with abundant discharge should be kept home until the discharge has lessened, to avoid the risk of infecting other children. Severe conjunctivitis will often need to be checked by a physician and the child's general condition will also largely determine the need to stay at home.

The child's guardians should decide if the child has conjunctivitis symptoms that ought to be examined by a doctor. Childcare staff cannot insist that a child with conjunctivitis symptoms must be examined or treated with eye drops before they can return to childcare, but they can discuss this with the child's parents if they are in doubt. If treatment is prescribed, the child may return to childcare on the day after treatment is begun.

Colds

Colds are the most common infections among children. They can return to childcare when they feel well enough.

Influenza-like symptoms

Children can return to childcare when they feel well enough. It may be necessary to keep children at home for longer during influenza pandemics.

Coughs and other respiratory symptoms

Children can return to childcare if they have a cough without fever when they feel well enough. With prolonged or severe coughing, the child should be checked for whooping cough or other diseases.

Ear infection (otitis)

Children can return to childcare when they feel well enough.

Impetigo

Children with impetigo can return to childcare when their blisters are under control and there is no danger of other children directly or indirectly coming into contact with contagious pus.

Head lice

If head lice are detected at childcare or school, it is not necessary to send the child home. When the child The child comes home, the initial treatment should preferably begin that same evening. The child can return to childcare or school once treatment has begun. The childcare centre and contact network should be informed that lice have been detected so they can check for lice and avoid reinfection.

Whooping cough (pertussis)

If treatment begins early in the course of the disease, the child is usually not contagious five days after treatment begins, but the child should be kept home until then. If treatment begins later in the disease, they will be significantly less contagious, and may return to childcare the day after treatment began.

EHEC infection

Children who have been diagnosed with enterohaemorrhagic E.coli (EHEC) must have five negative control samples before the child can return to childcare. Any children with a household member who has been diagnosed with EHEC infection should stay away from childcare until they have had three negative stool samples.

Mumps

Children with a confirmed diagnosis can return to childcare nine days after the swelling appears. If all the other children are vaccinated, the general condition of the child will determine the return to childcare.

Rubella

Children can return to childcare no earlier than five days after the rash appears. If the child has been vaccinated, it is unlikely to be rubella.

Threadworms

Children can return to childcare once treatment has started.

Ringworm

Children can return to childcare once treatment has started.

Scabies

Children can return to childcare once treatment has started.

Meningococcal disease

Children may return to childcare after recovery. Siblings of a child with meningococcal disease should be suspected as possibly being infected with meningococcal bacteria and should stay at home for observation for a few days after carrier treatment has begun.

Measles

Children can return to childcare no earlier than four days after the rash appears, if their general condition is otherwise good.

Norovirus infection

The infection risk is highest when symptoms of vomiting and diarrhoea are present, so children should be kept at home during this period. Wait 48 hours until diarrhoea and vomiting have stopped before returning to childcare.