Children's illnesses and child care

The last thing a parent needs before she's even had her first cup of coffee is a call at work from a child care provider who says her child is sick. The last thing a child care provider needs is to discover an ill child in her care who may have exposed other children in the program or center.

But illness, young children, and child care are facts of life. Young children get sick more frequently than adults because their immune systems can not fight disease as well. Considering the large number of children in child care, both parents and child care providers must learn to recognize whether children should attend child care, or stay at home.

Our first instinct may be to exclude children from early childhood programs when they demonstrate signs of a common cold, but children who are sneezing or sniffling may actually have exposed others before seeming ill. And, many illnesses stop being contagious shortly after treatment is started.

All adults should learn to identify the signs of serious illness in children, and when to seek immediate medical attention. Up-to-date immunizations and frequent, proper handwashing help prevent illness in centers and homes. As for whether mildly ill children should attend early childhood programs or stay at home, the basic question to ask is whether or not the child can participate comfortably and receive adequate, appropriate care without interfering with the care of other children.

Parents:

• Be familiar with your child care program's policies that address excluding ill children. Well-informed and regularly-implemented policies help programs provide appropriate care for ill children as well as a healthy environment for all children and staff.
• Notify caregivers about illness that occurred the night before. We've all seen children go to bed with a fever, then wake up well and eager to attend their program or center.
• Never pressure a caregiver to include an ill child or place an ill child in care without notifying the program. Remember programs have a responsibility to maintain a healthy environment for all children, staff, and families.
• Plan alternate arrangements ahead of time for care of your child when he is too ill to attend child care.

Programs:

• Maintain written program policies on inclusion/exclusion of children, carefully evaluating what the program can handle adequately. Make sure these policies are communicated to parents at the time of enrollment or orientation and shared at other times as needed.
• Use proper prevention such as frequent handwashing by both caregivers and children; and adopt universal precautions to handle potential exposure to blood and blood-containing body fluids. Wash and disinfect equipment (such as toys and items mouthed by infants) on a frequent, regularly-scheduled basis.
• Be sensitive to the needs of parents who may have limited leave time at their own places of employment. Lost work in many cases means lowered income or even the loss of a job. Make the situation work best for all parties involved.

The information above complements, but is not a substitute for the advice of a child's health provider. If you are uncertain about the nature or management of an illness, call or consult a pediatric professional to help you determine how sick the child is and what care the child needs.

Other resources available for the care of mildly ill children

American Academy of Pediatrics, Pennsylvania Chapter. 1993. Model child care health policies. Washington, DC:NAEYC. #716/$5.

American Academy of Pediatrics, Pennsylvania Chapter. 1996. Preparing for illness: A joint responsibility for parents and caregivers. Washington, DC:NAEYC. #707/$2.

Kendrick, A.S., R. Kaufmann & K.P. Messenger, Eds. 1995. Healthy young children: A manual for programs. Washington, DC:NAEYC. #704/$15.

NAEYC. 1995. Keeping healthy: Parents, teachers, and children. Washington, DC: NAEYC. #777/$.50 each or 100 for $10.