Please visit the updated post February 2018
There is so much stuff going around right now that it may be useful to update this post from last winter.
When is your child contagious? (In other words, can they go back to school or daycare?)
Some
of my most common questions revolve around when kids are contagious and
when are they ready to go back to nanny-share, daycare or school. There
is not always a simple answer. On one hand, of course we want to be
responsible parents and not expose others to our sick child. On the
other hand we want to protect our own recovering child from going back
too quickly where they may come down with something new. In order to
logically best make these decisions there are many issues that we need
to consider.
Some
parents have an easy time taking time off and others simply can't
afford to. It is naive to think that these aren't real factors. What
makes this so tricky is that most viral syndromes can be spread a day or
two before the kids show clear signs that they are ill. Many kids may
be a little fussier than usual. Perhaps they don't eat quite as much. It
is also usually a big "Ruh Roh" when your normally active child tells
you that they think they will go take a nap now. Your antenna might be
up that something is brewing, but are those reasons to miss work and
keep your child at home??? Of course not!
The
fact is, if you child comes home from school in the afternoon and is
sick that evening, most likely everyone they were with earlier that day
has already been exposed and I am going to take that into consideration
when we try to come up with the most sensible plan on when they can
return. Frankly, more than likely they got exposed there in the first
place.
If
you are in a small share care situation, it is essential to have a talk
with the nanny and the other families involved to make sure you are all
on the same page. I would suggest that you create a "sibling"
relationship. This simply means that you all accept that the kids are
most likely going to get each others mild illnesses. Seriously, if you
plan on staying at home until your little toddler is free from a runny
nose, you will be waiting a very long time before you leave the house.
Remember
that some clear runny noses are not contagious. Teething as well as
some allergies can be the cause. As far as common colds go, the average
child under 2 years of age has EIGHT colds a year. While I would like to
keep my youngest and most vulnerable patients free from viral syndromes
and colds as long as possible, exposure to these common viruses is in
fact developing their immune system. At some point they are going to
have to deal with some mild illnesses. Think of it as a rite of passage.
Typically
if I have a child with a fever over 101, a new case of diarrhea, or a
brand new green mucous producing cough or cold, it is worth keeping them
home for at least a day to see what is coming next. If your child has
an infection that is being treated with antibiotics, we generally
consider them no longer contagious after they have been on the
medication for at least 24 hours. Bacterial conjunctivitis is also
usually given the all clear after 24 hours of eye drops (of course you
need to finish the course.)
There
is never any complete assurance that can be given that your little one
is "not contagious." Use your best common sense. When in doubt avoid
contact with anyone who is vulnerable. This would include newborns, or
someone with a compromised immune system.
If
you are questioning whether or not to go on an upcoming play date,
explain your situation to the other parents. They may be perfectly fine
hanging out with you and your snotty nosed child, or perhaps they have
an important event coming up and want to be more cautious. Let them
decide. Full disclosure ahead of time is the best practice.
Unfortunately
this week I have spoken to many parents who are ill. Of course careful
hand washing is essential, but quarantining yourself from your child is
not usually realistic unless you have a way above average support
system. If you are a breast feeding mom we are usually going to have you
to continue to nurse. Do make sure you are taking care to drink extra
fluids and rest as much as possible.
Spring will be here before we know it!
