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Day Cares Send Sick Kids Home Too Quickly, Study Says
Filed under: In The News, Research Reveals: Toddlers & Preschoolers, Education: Big Kids, Research Reveals: Big Kids, Research Reveals: Tweens
Too sick for day care? Credit: Getty
You're crashing in on a deadline at work or in the middle of an intense conversation over lunch when the phone rings: It's the day care center calling to say your child is sick and needs to be picked up immediately, and you drop everything to rush out of the room to go get him. But a new study now says you probably didn't need to act so fast.
Researchers at the Medical College of Wisconsin and the Mayo Clinic presented more than 300 child care center directors with five scenarios featuring children who weren't acting sick but had the symptoms of mild illnesses, including a cold, pink eye, a mild stomach flu, fever and a ringworm of the scalp, and asked if the child should be sent home. In more than half of the cases -- 57 percent -- the directors would have sent the child home, according to the study, published in the May issue of Pediatrics.
The thing is, according to guidelines from both the American Academy of Pediatrics and the American Public Health Association, none of those cases warranted exclusion from group care, but 62 percent of the directors were unfamiliar with the guidelines.
"It appears that just endorsing them or having them as a guideline at the state level is not enough," the study's lead author, Dr. Andrew Hashikawa, tells ParentDish. "We need to incorporate training in addition to that."
A child being sent home places a significant economic burden not only on the child's parents but also on businesses and health care facilities. In 2005, more than two-thirds of children under the age of 5 were cared for by someone other than their parents, and most of those were in child care, the article says.
For parents worried that kids with runny noses or mild diarrhea will spread whatever illness they may have, "by the time you're seeing those symptoms they've already spread it," Hashikawa says. However, he adds, a child who isn't feeling well enough to participate should be sent home.
The rate of incorrect responses varied according to the situation, with only 8 percent of directors unnecessarily excluding a child with a cold, but 84 percent of directors doing so for a child with a scalp infection. Directors who had more experience, ran larger centers or worked in areas where more women are heads of households excluded fewer children unnecessarily, the study reports.
Related: Kids In Day Care Not Active Enough, Study Says
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ReaderComments (Page 1 of 1)
4-19-2010 @ 8:08PM
d_puso said...I work in day care, I wonder how the American Academy of Pediactrics members would feel about cleaning up the results of stomach flu( maybe for the 2nd or 3rd time) while keeping an eye on 7 other children or explaining to another parent why his/her child caught pink-eye or ring worm from another child at the center, and they caught it from the child right before a big business trip or presentation? The question is not if children are being sent home too quickly, but why sick children are being sent ot school to begin with? Pre-k 4 Teacher
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4-19-2010 @ 8:27PM
Childcare teacher said...The centers have state regulations to follow.
4-19-2010 @ 10:45PM
msjeanniehughes said...Yeah I totally agree with you. in my state our ratio is one to twelve with four year olds. Having a child who is vomiting or with the runs and trying to care properly fro the other eleven is complicated. Besides that you have to consider the health of the other children, the teachers and parents and other staff. If your child has a fever of over 100 or has had the runs in the last 24 hours you should keep them home. Instead of giving them meds to reduce the fever so you can bring them in anyway.
4-19-2010 @ 9:00PM
Sifrina said...Our son's home daycare provider NEVER sent home sick kids (even when she should have) and our preschool made pretty accurate calls in my view. But the oddest incident was this year in 2nd grade when I was called out of work to pick up my son with what the nurse called "an acute cold." No fever, just a really runny nose. When I picked him up his nose had totally stopped running and he was carrying on an animated conversation with the school nurse. Could I have pushed back? Probably, but I was still able to call into my afternoon meeting and I had a really good afternoon with my son at home. I just wish my boss would send me home one day with "an acute cold." :-)
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4-19-2010 @ 9:16PM
Daycare Teacher for 20+ years said...This is ridiculous!! Some parents seem to NOT want to be parents these days. Listen, I've been a teacher at a daycare for 20 plus years and I think I've seen everything. We've had children sent to school who were obviously sick, but when we try to contact the parent they either see the daycare's number on the caller ID and do not pick up or they give us an argument why they can't pick up their child. Parents, these are YOUR children we're talking about!! If your child is sick, please do NOT drop him/her off at daycare because he/she will be miserable all day AND whatever your poor child has, the rest of us is going to catch!! Parents NEED to start being parents and take care of their children!! Isn't YOUR child more important than your job or anything else? It doesn't seem that way sometimes!! We've had a lot of instances when a poor child who is sick is just dropped off obviously sick with a bad cold, throwing up, has pink eye, or the runs and then when we try to get in touch with the parent they either pretend NOT to hear the phone ring or give us an argument why they can't pick up their child! Again, Moms and Dads these are your children - please keep them and take care of them when they are sick!! Thank you!!
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4-19-2010 @ 9:33PM
Carrie-Lee said...This is pretty scary stuff to be saying here!
My mother has run a home day care for over 22 years. Growing up in and around the other children and helping with the daycare as I got older, I realized how little the parents actually wanted to parent.
My mother never would have called a childs parent for a slight temp, a little diarrhea, runny nose, etc. She always made the best calls possible and used her judgment which the parents always trusted. To put the thought that maybe you shouldn't take the providers word for it into the minds of parents, what does that cause in the parent/provider relationship?
What happens when the parent says, "No, I read a new study and you might be wrong so... see you at 5!"? The trust on both parties goes flying out the window.
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4-19-2010 @ 9:38PM
Daycare Teacher for 20+ years said...I just LOVE the parent who brings in an obviously sick child and then the parent announces they will be home all day, and if the child seems to feel worse then please call them! Hello? If you're going to be home all day, then please take your child home with you and take care of them! You're the parent, now please act like one!
Or the parent who sends their obviously sick child on the bus, but when we try to call the parent he/she won't answer their phone! Or when they do pick up their phone, they tell us they can't come pick up their child! Or they tell us they will come pick up their child, but then they don't come pick up the poor child until it's almost the child's normal time to go home!!
Or how about the lovely parent who brings their child in that morning and announces that their child now seems fine (YSR!), but threw up/had the runs/a fever. the night before or that morning? Of course the parent leaves and what happens? The child ends up throwing up or has the runs! He/She is NOT fine! If your child threw up/had the runs/a fever the night before or that morning, guess what?! Your child is still sick and probably contagious, and NEEDS to stay home that day with you, the parent!
Hello, parents? Please act like parents! If your child has a runny nose, threw up at home, has the runs, or a fever and had one the night before or that morning, PLEASE do NOT send your poor child to school! Your child is contagious, will be miserable all day, and will not have any fun! If your child is contagious, that means the whole school will catch what your child has and believe me, we don't want whatever your poor child has caught!!
Parents, please act like parents and keep your child home when your children are contagious!! Thank you!!
I disagree with this article! Daycares do NOT send sick kids home too quickly! There is a reason we send your kids home quickly! We send your child home when it is obviously your poor child is sick and contagious! Your sick child belongs at home with YOU, the parent! Believe me, none of the rest of us at the daycare want to catch what your child brought in!
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4-19-2010 @ 9:58PM
daycare teacher for 20+ years said...I also want to point out that every day care hands out a booklet on their rules and regulations to the parents when a new child is enrolled. At the daycare I work at we have policies specifically outlining when a child will be sent home. For example a child will most likely be sent home if he/she has a fever over 100, throws up twice or more, has the runs more than once, or is obviously contagious with something like ringworm or pink eye.
As a parent, if your child is not feeling well at day care, don't you want us to call you and let you know? If I was a parent, I would want to know! Wouldn't you?
And if your child was sick and we didn't call, of course we'd have the parent who would be upset and complain!
But like I mentioned before, I've had children who were obviously sick in my classroom and had to call the parent to please come get him, and guess what? Some of those parents have gotten very upset and complained about having to come and pick up their children (and I will mention that in some of those instances, the parents were at home and NOT working!)!
Can you imagine? Your poor child is sick at daycare and miserable and the parents complain about having to come pick up their children! Wow! This is YOUR child we're talking about!
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4-19-2010 @ 11:12PM
SKL said...My kids' daycare seems to be pretty good about not calling for every sniffle. I will take my kids to school with a cold, because they catch all their illnesses from school in the first place, so by the time they have it, it's too late to protect the other kids or the teacher.
They have rules about not letting your child into school until at least 24 hours after an episode of vomiting, and they send the kids home if their fever is, I think, 101 or so. Sometimes they will call and tell me my kid has a temperature that's going up, so be prepared in case it goes higher. And again, I can't take them back to school for another 24 hours if they get sent home with a fever. So if it looks like my kid is that sick, I will keep her home rather than have her be sent home and miss the next day too.
I always assumed they were following legal requirements, so I never tried to talk them out of it. And I couldn't imagine asking them to hang onto my kid longer when they have just vomited - knowing they will likely vomit some more. But, have I given my kids a little Tylenol in the morning when they seemed to be almost over something? Yes, a couple times. Bad mother!
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4-20-2010 @ 10:28PM
Sifrina said...I confess to "dosing up" my son once in preschool at the first sign of a very slight fever and then sending him to school if he was otherwise feeling great (and, no, I didn't tell the teachers I did that). Felt guilty about it but it was so borderline (not even a real fever, though I did suspect it would go up before it would go down) and I just needed to get through the a.m. meetings and then could pick him up after that. I know pediatrician parents who are guilty of the same crime.
4-20-2010 @ 4:08AM
Janusin said...This is one of the worst articles I have read for children. This is suppose to be our childrens' doctors and leading associations for our children. Children need to be taken care of properly and this is what the doctors and associations are saying to do...nothing. Fight to keep them in the school or daycare. And let your boss tell you don't have the right to pick up your child or child wasn't sick enough to go home and take care of child. Children do die of the flu. Will they say in the next study higher amount of kids dying from the flu. Need to get the flu shot. Think if your kid is sick be happy that you can take care of them and get them better. Be happy they don't get anything more severe and let them rest and eat properly. If you need to do work, ask to do it at home your child will be sleeping anyway. Be a good parent because look at the all the parents who listened to these doctors and associations and have sick kids for life. They believed in vaccinations and didn't know of trace of mercury, ethonal and a list of other things. They didn't realize how many toxic things in a small body they were putting. And then after the shot their children were autistic or not responding the same. The doctors and associations answers I don't know why? Couldn't be the shot. But it was right after the shot. And now they are sick. Be happy if you can get your child healthy in a day or two. And the doctors and associations should be looking at their "study" as preventive health care at that point. Not saying they should have stayed in school slighly sick. Or get your flu shot because that is what they are really selling next.
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4-20-2010 @ 6:44PM
marizza rogers said...I disagree with this article. A child needs their parent when they dont feel well. Also I think it is important to protect the other children from infection. In fact, I think is awful when other parents send a sick child to daycare.
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4-20-2010 @ 9:32AM
Heather said...Contagious illness is one thing. If your child has something that is going to get other kids sick, then yes they should not be in school. What drives me nuts is when my son is sent home for allergies. He isn't going to get anyone else sick, he is happy and getting along fine in school. Why should he go home. I do think that teachers need to use some common sense when looking at a child they think might be sick. And if there is a question then sure call the parents and ask, but don't force a child that you think might just have allergies home.
I also think that more parents need to use more common sense as well. If you know your child (and I know you do) is sick, then please don't send them to school, work from home that day, call out that day, find a friend or family member to stay with them. If you can't do any of that then maybe it is time to find a new job where you can. Kids wouldn't get as sick if parents would stop sending sick kids to school.
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4-20-2010 @ 2:24PM
CLM said...I agree with you about the allergies. The part-time program my children were enrolled in last year had a "no runny noses" policy, which would be ok, I guess, except that we were in HOUSTON, where, if you have allergies, it's pretty much a year-round problem.
4-28-2010 @ 5:08PM
Lisa said...Define "Sick"! I pay over $12,000 is day care expenses a year! If you’re going to call me out of work you better be sure my child is "go to the doctor" sick. The fact is I still have to pay you if you send him or her home! Daycare's should give sick day's for reasons like this then maybe it wouldn't irritate me so much when they call for a measly cold, cough or runny nose. Vomiting, consistent diarrhea, and temperature over 101 are all good signs to send a child home to get a little TLC from mommy or daddy. But seriously, the common cold is well common therefore they can get it from anywhere or anyone and it's going to spread no matter who you send home. To care for your children you have to provide for them so don’t treat a parent like they are neglecting or not loving their child because they have got work to do. Not all parents rush their kids to the emergency room for every little bump and bruise. And this one doesn’t rush hers to the doctor for every little sniffle!
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5-14-2010 @ 3:17PM
family child care provider 32 yrs said...Wow, Lisa! You're the 'I'm getting my money's worth' daycare parent! Sorry, quality programs are in great demand and usually cost more. I'm not sure exactly what the exclusion policies are at your child's care provider, but I exclude children who feel too bad to participate in activities. A peds dr at a national conference I attended called it "bottoms up" meaning the child only felt like lying down instead of playing. Those children should be at HOME. Child care is very difficult on good days and surely should not involve attempting to care for an ill child amongst the rest of the group of other children. Should what you pay for child care determine if your child is cared for at home when they are ill and feel terrible? Of course not! Licensed programs have a certain number of children we may care for and expenses that do not vary. The fees are based on your child taking up one of those available slots, not on attendance. To expect that we should make allowances for sick days is unrealistic and probably would involve raising child care fees to accomodate that policy. Our basic expenses do not vary according to which children are in attendance any certain day.
If you think we're getting rich in this business, come on over and I'll be glad to show you what I make after expenses for working 65 hours per week!
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5-14-2010 @ 5:48PM
highlandmg said...Wow you people are so good. Have you thought of other people?
If I get a simple cold I could die. If I go tcatch a cold I have to go to the er for treatment. If you must know why I have no adrenial glands and must take steroids for rest of my life. So thanks for bringing you children who are sick out into public. Such caring folks I am sure the job is more important to you I wonder why you have kids if you don't want to take care of them. Kids throwing up and messsing pants are not worth any worker who get low pay to clean up but what the heck your at work and don't have to deal with it. I hope kids will remember this when picking out a nursing home for you because you all ready taught them when your sick let someone else clean up after them
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10-05-2010 @ 6:36PM
Elyse said...i totally agree with you. as far as im concerned, if your children are sick, dont send them to day care to get other children sick. and if people cant handle their children being sick, then u shouldnt have had children in the first place.
as for people whinging about how much they pay for day care, well too bad, you choose to send your kids there, so quit whinging.
2-19-2011 @ 1:18PM
Practical Mom said...It's just silly to say that parents who don't want their *mildly* sick kids to stay at daycare are bad parents or don't care about their kids or shouldn't have had kids in the first place. There are many young families these days where both parents work. My husband and I both work and neither of us can take off tons of days to take care of our kids, no matter how much we would like to. It would be great if we could find jobs that would let us work from home or take a day off whenever either of our kids had a little cold or loose stool, but there aren't that many jobs that will let you do that.
When I was considering who would take care of my children while my husband and I worked, there were two obvious choices - nanny and daycare. I chose daycare for many reasons. Two of the main ones were that I wanted my kids to have structured activities and I wanted them to be around other kids. But another consideration was what everyone told me about kids getting sick. There seems to be general agreement that kids who go to daycare get sick a lot. At least for the first year that they are in daycare. Then they don't get sick much at all. Parents who chose nannies only delay this sick year until the point when their kids start school. Actually, it's getting sick that builds your immune system. So I figured we might as well get it over with and enrolled my kid in daycare. (By the way, my first kid did get sick A LOT from daycare that first year. After that he was fine.)
Sending kids home when they are just mildly ill, but still in good spirits doesn't make sense for a lot of reasons. First of all, as the article and other people have mentioned, the kid most likely got the germ from daycare and in any case has already spread the germ by the time they are showing symptoms. Second of all, as long as there aren't serious symptoms, what's so bad about exposing the other children? Either their immune systems are already strong and they won't get sick or they get sick and it strengthens their immune system.
This past week my second kid had diarrhea all week. We brought him to my mom (who, by the way, works the rest of the week) to take care of him Monday and I took a half day on Tuesday. For the rest of the week, he went to daycare. He was happy and played with the other kids and whenever he had a bm it was a little liquid-y.
I LOVE my kids' daycare. I spent a lot of time choosing it and I think the people there are kind, intelligent, knowledgeable. They teach my kids and guide my kids and love my kids. But if they had made me take a week off work for a mild, lingering case of diarrhea (and asked me to take off many days for similar mild illnesses), I wouldn't be able to keep my kid in daycare. It wouldn't be because I don't think that daycare is a better choice for child care. And it wouldn't be because I wouldn't LOVE to take care of my kids at home whenever they have a tiny cold. It would simply be because I don't get that much time off and I need to keep my job. I would be forced to get a nanny (which by the way costs about the same amount as daycare tuition for two kids) and would benefit from the fact that nannies never ask the parent to stay home to take care of a sick kid. I know a lot of parents who have been forced to go that route after daycares sent their kids home too often.
I think it's sad that daycare workers (and I'm sure it's only a few of you who feel so strongly about this) would have such negative opinions about the parents of the kids they take care of who are simply trying to keep their jobs. After all, if we didn't have our jobs we could take care of our kids all the time, and then you would be out of a job.
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