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When should children stay home from childcare?
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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 transmission 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 child at home?
Experience shows that strict rules to keep sick children out of childcare have a limited effect on transmission. This may be partly because the diseases are often contagious 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 mean they need to stay 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.
The child can return to childcare when the blisters have started to formed scabs.
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 guardians if they are in doubt. If treatment is prescribed, the child may return to childcare on the day after treatment is begun.
Diarrhoea with or without vomiting
Children with diarrhoea can return to childcare 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 unusual diarrhoea.
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.
Children who have been diagnosed with E.coli infection (EHEC), which can affect the kidneys, can return to nursery when the child is clinically well and has three negative control tests taken at 24-hour intervals. The first control sample is taken two to three days after being symptom-free, at the earliest.
Children who have been diagnosed with other types of EHEC than HUS-associated EHEC can return to the nursery 48 hours after the child no longer has diarrhoea or vomiting.
Ear infection (otitis)
Children can return to childcare when they feel well enough.
A child’s normal body temperature may vary. A rectal temperature higher than 38 °C is considered to be a fever. 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 potentially infectious disease.
If head lice are detected at childcare or school, it is not necessary to send the child home. When 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.
- Head lice - information about head lice
Children with impetigo can return to childcare when their blisters are under control. The decision must be based on that there is no longer a danger for transmission from infectious wound secretions to other children either directly or indirectly through touch points.
Children can return to childcare when they feel well enough, even if they have some residual symptoms (see section under colds). It may be necessary to keep children at home for longer during influenza pandemics.
Children can return to childcare no earlier than four days after the rash appears, if their general condition is otherwise good.
Children may return to childcare when the symptoms have passed. This also includes siblings or other close contacts who have been given prophylactic antibiotics.
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.
Norovirus is a common cause of gastroenteritis. 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.
Children can return to childcare once treatment has started.
RS virus, coronavirus and other respiratory tract infections
Colds are the most common infections among children. They can return to childcare when they feel well enough. This means that children with some residual symptoms after a cold, such as a runny nose/mucus or cough, can return to the nursery when the child is otherwise back to their normal form.
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.
Rubella (German measles)
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. Rubella is extremely rare in Norway.
Children can return to childcare the day after treatment has started.
Children can return to childcare the day after treatment has started.
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, or if it was considered too late to begin treatment.