How Sick Is Too Sick for School

The first rounds of seasonal colds struck our household last week. I try not to be a worrier when it comes to colds, but one son is prone to ear infections and the other to asthma-like breathing problems, so we are no strangers at the doctor’s office.

This time, although our nurse practitioner confirmed that my 7-year-old had indeed brought home a viral cold, there was no ear infection, and she was ambivalent about whether he should stay home from school the rest of the day. That response seemed a little peculiar until I looked into it, and it turns out the medical community is pretty much in agreement that kids are going to get colds, so if they are energetic enough to follow through with the normal school day, a sniffle or a cough need not keep them home.

“It’s OK to go to school, but if the teacher or school nurse is concerned, or your child complains, you may get a call asking you to return him/her home,” said Dr. Robert W. Smith, the market medical director for United Healthcare of the Midwest in Maryland Heights.

A fever, on the other hand, is a one-way ticket to the couch.

“Absent a fever, blowing the nose and TLC go a long way to help comfort a child with a cold,” Smith continued via e-mail. “Also, it’s important to note that many of the cold medicines we used in the past are no longer considered appropriate for younger children.”

Instead, Smith suggested, “use a vaporizer and push fluid intake. Offering smooth liquids may help. Use cough drops for children over the age of 6, but not younger to prevent choking.” Sometimes a spoonful of honey can reduce coughing –  and it’s a “medicine” kids won’t mind swallowing! However, Smith cautioned, “Don’t offer honey to children under 1 year of age.”

Cold symptoms can vary from person to person, but in general they include a sore throat, congested nose, hoarseness, ear congestion, croup, and watery eyes. In some cases, children could run a fever for three days and have lingering symptoms like a sore throat (up to five days), stuffy nose (up to two weeks) and cough (up to three weeks). All of those symptoms are pretty normal and don’t necessarily require medical attention.

If your child is clearly too sick to go to school, Smith said it’s probably a good idea to stay home – which means staying away from the doctor’s office, too. Colds are one of the most common reasons parents bring their kids to the doctor or hospital, and usually there’s not much a healthcare providers can do. “Going to the emergency room is not always the best idea,” Smith said. “Parents should consider if the ailment is a true emergency, the prospect of a long wait, exposure to other illnesses and effects on sleep needed by the child (and parents) to expedite recovery.”

It’s better to “ask your physician what he or she advises about cold care when your child is in the office for a well visit,” Smith said. For example, colds can trigger asthma attacks, so doctors may want to keep a closer eye on their young patients with asthma.

Of course, there are plenty of bugs worse than cold viruses out there. And sometimes kids do need medical attention. “When it comes to deciding if you are facing a medical emergency, monitor your child’s cues,” Smith said. “Some kids will whine and complain when feeling bad, and others will carry on more normal levels of activity. Stay in tune with your children.”

If the complaint involves a stomachache, “it’s best to keep your child at home and monitor him or her for 24 hours,” Smith said. “If something is serious, the ache or complaint will get worse. As a practical matter, children who are vomiting or have diarrhea should not go to school.”

There are many online resources to check into your child’s symptoms, including this one from the American Academy of Pediatrics. Locally, St. Louis Children’s Hospital has a cell phone app for checking symptoms.

Both my kids are fine now – and I’m the one sniffling!  I’m taking Dr. Smith’s advice: rest, fluids and a bit of TLC.

By Amy De La Hunt, Health Blogger for SmartParenting