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August 21, 2020

When to Keep Your Child Home From School

When to Keep Your Child Home From School

Part of back to school this year means parents will need to do some at-home health screening to ensure their children are healthy enough to attend school in-person. It can be tough to know, especially with younger children, whether you really are dealing with a sick child, which poses a significant challenge for parents in the age of COVID-19. Dr. Daniel Cohen, pediatrician at Westmed Medical Group, provides advice for parents to determine if their child should stay home from school or not during the COVID-19 pandemic.

How to Tell If Your Child Is Sick or Not

Of course, symptoms play a big role in parents’ decision-making process. It is best not to send a child to school who has a fever, is nauseated or vomiting, or has abdominal pain or diarrhea. Children who lose their appetite, are clingy or lethargic, complain of pain, are drooling with mouth sores, or who just do not seem like themselves should also take a sick day. If your child will need more care than the teacher can provide, it is only fair to the other kids that your child stays home.

How to Identify Symptoms of Pain in Children

Pain is an objective sensation with subjective reporting. We all know our own children have different tolerances to discomfort, but how do we know when pain is a signal we cannot simply observe? Increasing or unremitting pain should always be communicated to your physician immediately. Otherwise, pain in children can often be evaluated by how much it takes away from normal activity. Good advice for parents is not to ask, but rather to watch if something hurts. Is your child playing, eating, running and jumping in-between reporting the pain? If the pain makes your young child alter their activity – limp, not sleep, not eat or avoid contact with friends – this deserves a call to your pediatrician.

How Children Can Describe the Severity of Their Pain

As far as severity, especially in the pre-school/elementary age group, asking for a pain level can be like leading the witness. Verbal children can be asked to grade pain so it can be tracked over time. Whether utilizing a scale from 1 to 10 or by moving their hands closer or further apart, the more important factor is the trend of the pain rather than simply the degree. If it is worsening over time or persisting, it should be evaluated even if the change is from 1 to 3.

Issues to Consider When Deciding to Send Your Children to School or Not

    • Will they be safe at school? What happens if symptoms worsen? Will they be able to function and learn? Rest and observation at home allows for flexibility in care in case symptoms change rapidly. The availability of fluids/food and access to expeditious care makes the option of observing from home much safer for your child in an evolving situation.


    • What is the risk to others? Going to school when sick can open up a world of problems. While it is easy to give some Tylenol to make the fever go away, the illness your child has may treat another family very differently. In the current pandemic, this issue is only intensified. Infections in different settings can have vastly different outcomes. As a community, we must think of others as a means of protecting ourselves and promoting our children’s well-being.

How do you know when to call for help?

It’s always recommended that a parent calls with a concern rather than waiting. In many circumstances, there are actions pediatricians can prescribe that will alleviate symptoms and allow time to be assessed in person. The best advice to give a parent is: if they are nervous, then their doctor should be nervous too.

When pediatricians answer a call from a parent, we think in terms of issues being EMERGENT, URGENT or SELF-RESOLVING. The important symptoms are the ones that need immediate assessment.

Emergent issues – call immediately and direct to care:

      • Altered consciousness – difficulty awakening or disoriented
      • Seizure
      • Difficulty breathing – rapid and shallow or labored
      • Rapidly progressive rashes
      • Testicular pain
      • Increasing or unremitting pain
      • Persistent bleeding lasting longer than 5 minutes
      • Ingestion
      • Stiff neck with fever

*Note this is not an exhaustive list but the above are the most common “red flag” symptoms.

Parents are the best detectives because they know how their own child typically behaves. However, if you consider your child’s symptoms as well as any rules their school has and you are still struggling to decide, consult with your pediatrician. No worry is too small to reach out. Dr. Cohen always tells parents that if they are nervous, he should be too. The only call that is wrong is the unmade call.