Daycare Sick Policies: When to Keep Your Child Home

One of the biggest challenges of daycare: the constant illness. Understanding sick policies helps you plan for the inevitable and know when your child can return.

Standard Daycare Sick Policy Guidelines

Most daycares follow similar exclusion guidelines based on CDC and American Academy of Pediatrics recommendations.

Must Stay Home: Key Symptoms

| Symptom | Exclusion Required | Return When | |---------|-------------------|-------------| | Fever (100.4°F+) | Yes | Fever-free 24 hours without medication | | Vomiting | Yes | 24-48 hours after last episode | | Diarrhea | Yes | 24 hours after last loose stool | | Undiagnosed rash | Yes | Diagnosed as non-contagious OR cleared | | Pink eye (with discharge) | Yes | 24 hours on antibiotics OR no discharge | | Strep throat | Yes | 24 hours on antibiotics + fever-free | | Head lice | Usually yes | After treatment, no live lice | | Impetigo | Yes | 24 hours on antibiotics |

Usually Okay to Attend

• Clear runny nose (no fever)
• Mild cough (no fever)
• Ear infection (on treatment, no fever)
• Teething fussiness
• Rash diagnosed as non-contagious
• After 24 hours on antibiotics for bacterial infections

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Common Illnesses and Exclusion Periods

Respiratory Illnesses

Common Cold

• Exclude if: Fever, excessive coughing interfering with activities, very lethargic
• Return: When fever-free and able to participate

Flu (Influenza)

• Exclude: Yes
• Return: Fever-free 24 hours, able to participate (typically 5-7 days)

RSV

• Exclude: Yes, especially for infant rooms
• Return: Fever-free, respiratory symptoms improving

COVID-19

• Exclude: Yes
• Return: Per current CDC guidelines (typically 5 days isolation if improving)

Croup

• Exclude: If fever or severe coughing
• Return: When fever-free and cough manageable

Gastrointestinal Illnesses

Stomach Bug (Gastroenteritis)

• Exclude: Yes
• Return: 24-48 hours after last vomiting/diarrhea episode

Norovirus

• Exclude: Yes
• Return: 48 hours after symptoms end (highly contagious)

Food Poisoning

• Exclude: If symptoms present
• Return: When symptoms resolve

Skin Conditions

Hand, Foot, and Mouth Disease (HFMD)

• Exclude: While fever present or if unable to control drooling
• Return: Fever-free, blisters drying, able to participate
• Note: Remains contagious after symptoms—policies vary

Chickenpox

• Exclude: Yes
• Return: All lesions crusted over (usually 5-7 days)

Ringworm

• Exclude: Usually no (if covered)
• Return: N/A if treated and covered

Fifth Disease

• Exclude: No (contagious before rash appears)
• Note: By the time rash appears, no longer contagious

Eye and Ear

Pink Eye (Conjunctivitis)

• Bacterial (with discharge): Exclude 24 hours after starting drops
• Viral: May exclude until discharge stops
• Allergic: No exclusion

Ear Infection

• Exclude: Only if fever present
• Return: Fever-free (pain doesn't require exclusion)

Other Conditions

Strep Throat

• Exclude: Yes
• Return: 24 hours on antibiotics + fever-free

Head Lice

• Exclude: Varies—some same-day, some allow return after treatment
• Return: After treatment, no live lice visible

Pinworms

• Exclude: Usually no (if treated)
• Return: N/A

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Why Kids Get Sick So Often at Daycare

The Numbers

• Average: 8-12 illnesses per year in first years of daycare
• Peak: First 6-12 months of group care
• Improvement: Fewer illnesses in later preschool/kindergarten years

Contributing Factors

1. Immature Immune Systems

Young children haven't built immunity to common viruses yet. Each illness builds protection.

2. Close Contact

Daycares = lots of touching, sharing, and breathing in enclosed spaces.

3. Hand-to-Mouth Behavior

Toddlers touch everything, then their faces. Constantly.

4. Sharing Everything

Toys, cups (accidentally), and germs.

5. Pre-symptomatic Contagion

Many illnesses are contagious before symptoms appear.

The Silver Lining

Research shows daycare children have fewer illnesses in elementary school—they've built immunity earlier.

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How to Handle Constant Sickness

Build Your Backup Care System

Options to have ready:

• Family members who can help
• Backup babysitter roster
• Employer backup care benefit
• Sick child care centers (if available in your area)

Read our backup care guide →

Know Your Work Options

Talk to your employer about:

• Sick leave policies for child illness
• Work-from-home flexibility
• Dependent care backup programs

Stock Up on Supplies

Keep on hand:

• Fever reducers (ibuprofen, acetaminophen)
• Electrolyte drinks (Pedialyte)
• Easy foods for sick days
• Thermometer
• Saline spray
• Humidifier

Track Patterns

Note which illnesses spread through daycare to anticipate and prepare.

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Reducing Illness at Daycare

What Parents Can Do

1. Hand Hygiene

Wash hands (yours and child's) immediately after pickup. Every time.

2. Boost Immunity

• Ensure adequate sleep
• Healthy diet
• Outdoor play and exercise
• Keep vaccinations current

3. Change Clothes After Daycare

Reduce germ spread to home environment.

4. Keep Sick Kids Home

Even when it's inconvenient. This protects everyone.

What to Look for in Daycare Policies

Good signs:

• Strict handwashing requirements
• Regular toy sanitizing
• Adequate ventilation
• Staff trained on illness protocols
• Quick communication about outbreaks

Red flags:

• Lax enforcement of sick policies
• Same toys used without cleaning
• Crowded classrooms
• Staff coming to work sick

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Navigating Sick Policy Conflicts

When You Disagree with the Policy

Common frustrations:

• "It's just a cold!"
• "The fever was from teething!"
• "We can't keep missing work!"

Reality check:

Policies exist to protect all children, especially those with weaker immune systems. Even if your child seems fine, they may be contagious.

When Policy Seems Unfair

If you believe daycare is being overly strict:

1. Ask for specific policy in writing
2. Get doctor's note if appropriate
3. Discuss calmly with director
4. Understand their liability concerns

If you believe they're not strict enough:

1. Document concerns
2. Raise with director
3. Review state licensing requirements
4. Consider if it's right fit for your family

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Doctor's Notes and Return-to-Care

When You Might Need a Note

• Diagnosis confirming non-contagious condition
• Confirming treatment has begun
• Clearing child for return after significant illness
• When daycare requires it for specific conditions

Getting Notes Efficiently

• Use patient portal for simple requests
• Ask at sick visit before leaving
• Telehealth visits often sufficient
• Some daycares accept pharmacy prescription printouts

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Sick Child Care Options

In-Home Sick Care

Some areas have sick-child nanny services. Expect to pay premium rates ($20-35/hour).

Sick Child Care Centers

Some hospitals and childcare centers offer sick-child care rooms. Check:

• Your local children's hospital
• Large childcare chains
• Employer partnerships

Employer Backup Care

Many employers partner with services like Bright Horizons for backup care, including:

• In-home sick care
• Sick child center access
• Subsidized rates

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FAQ

Q: My child has a runny nose but no fever. Do they have to stay home?

A: Usually no. Clear runny nose without fever typically doesn't require exclusion. Green/yellow mucus alone isn't a reason to stay home unless accompanied by fever or other symptoms.

Q: How do I know if fever is from teething or illness?

A: Teething may cause low-grade fever (under 100.4°F). Higher fevers are typically from illness. When in doubt, keep home—daycares can't distinguish either.

Q: Can I give Tylenol and send my child anyway?

A: No. If your child needs fever reducer to be fever-free, they should stay home. Masking fever puts other children at risk and may mean your child is too sick to enjoy the day.

Q: What if I'll lose my job for calling in sick?

A: This is a real concern. Build backup care, talk to HR about FMLA protections, and consider whether your current childcare/work situation is sustainable.

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More childcare guidance:

• Backup Child Care Guide →
• Signs of Quality Childcare →
• Questions to Ask Daycare →
• Communicating with Childcare Providers →