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Inclusion and Exclusion Guidelines for Child Care
school girl
State Guidelines
Different states have different rules about when a sick child should be kept out of child care or school. Child care centers or homes within the state may have additional rules. Sadly, most of the state guidelines are not very detailed and may not be based on medical facts.

When deciding whether to keep your sick child out of child care, the two most important things to think about are:
  1. Does the child’s illness keep him/her from comfortably taking part in activities? 
  2. Does the sick child need more care than the staff can give without affecting the health and safety of other children?

    If the answer to either of these questions is yes, then the child should not go to child care or school. If he/she is sent to child care or school, then the caregiver or teacher may not let the child stay.

A third question to ask is:

  1. Could other children get sick from being near your child?

Most common illnesses, like a cold, are not really harmful. Other children can catch illnesses before, during, or after your child is sick. Making a sick child stay home may not really prevent other children from getting sick.

Keep in Mind
The family should ask questions 1 and 2 above and make a decision based on what they see at the time. Keep in mind that uncertain tummy aches could be the beginning of vomiting and diarrhea (for which a child should not attend school). Tummy aches can also mean that a child is nervous about school. (If a child is nervous about school, experts suggest that the child go to school and the family talk to a doctor or teacher about what is making the child nervous.)

Caregivers and teachers should also ask questions 1 and 2. A common cold is not a reason for exclusion if neither of the first two things on the list is met. The infection can be spread to others but is not a harmful illness. In fact, it probably helps a child to be exposed to cold germs because it makes their immune system stronger.

Deciding if a child who is only mildly sick should go to child care or school can be hard. In some cases the parent may have very little time to watch the child before he or she has to arrive at school or child care. Parents usually make good decisions but it can be complicated. For example, parents may lose pay from their jobs if they have to stay home for a sick child. Other parents may have a hard time getting a promotion if they have a child who is sick a lot. In addition, the child’s illness can change during the day. Parents make decisions, but the child care and school personnel also have a say in the matter about whether a child sent to child care or school is allowed to stay there through the day.

Read more about when sick children should stay home:

For Parents

For Caregivers and Teachers

Managing Infectious Diseases

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