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Head Lice Is No Reason to Miss School, Report Says
Filed under: In The News, Day Care & Education, Research Reveals: Toddlers & Preschoolers, Education: Big Kids, Research Reveals: Big Kids, Education: Tweens, Research Reveals: Tweens, Expert Advice: Health
Experts say kids with lice can stay in school. Credit: Sharon Gekoski-Kimmel, Philadelphia Inquirer / MCT
A.) Call you to come pick up your child.
B.) Ask the nurse to confirm her diagnosis of lice.
C.) Let the child finish the school day, but tell you not to bring her back until you are sure the infestation has cleared.
According to a revised clinical report issued by the American Academy of Pediatrics, the only correct answer is B. There is no need to send a child home from school because he or she has been found to have head lice, the report states.
The reason? They've probably had the lice for ages, anyway. Lice can live on a child's head for six to eight weeks before itching starts, Cynthia Devore, a pediatrician, chair elect of the Council on School Health for the American Academy of Pediatrics and a co-author of the revised report, tells ParentDish.
"Children usually have head lice for weeks before we know it," she says.
That isn't to say lice shouldn't be treated promptly -- it should -- there's just no reason to make a child miss school, Devore says. And policies that require kids to be nit-free before they return to the classroom should be abandoned, the report says.
Outbreaks of head lice can cause parental emotions to rise to the surface, but should be kept in perspective, Devore says.
"People should take a deep breath and not forget to exhale, and try to understand the life cycle of the insect coupled with the civil liberties of children," she tells ParentDish, citing cases where kids have been forced to miss months of school because of recurrent head lice.
While annoying, the pests don't carry any health risks, so a child's right to attend school should not be compromised because of them.
If your child does have a confirmed case of lice, there are many viable options, but the report recommends one percent permethrin lotion as the initial treatment. Whatever shampoo parents choose to use, they should "follow the instructions to the letter, including timing the clock," Devore says, adding that the treatment should be repeated seven to 10 days later, with the ninth day being the ideal day to do so.
After that, parents should monitor their child for signs of recurrence. When examining your child, be sure to do so in good light and focus on the nape of the neck and behind the ears. Lice are roughly the size and shape of a sesame seed and can vary in shade from translucent or white to amber. The difference between a nit and, say, a fleck of dandruff, is that the nit is "cemented to the hair shaft" and you need to use a fingernail to dislodge it, Devore says.
If the lice come back, a third treatment should be applied seven to 10 days after the second, with the ninth day again being the ideal time to treat. If that doesn't clear the lice up, contact your doctor because there may be resistance to the medication, Devore says.
Head lice have nothing to do with poor hygiene, Devore stresses, and while they are contagious, they are not highly contagious.
"It's not like a flea -- it doesn't jump, it doesn't have wings; it moves by grasping a shaft of hair and moving up," she explains.
And, finally, remember it's not your child's fault he or she has lice.
"What we encourage is that parents use this opportunity to have some close physical contact with their child and some good close conversation with their child rather than being angry and tugging at the child's hair," Devore says.
Related: How to Get Rid of Head Lice












ReaderComments (Page 4 of 4)
7-27-2010 @ 1:48AM
Tess said...My children got lice so many times, it was like a revolving door for the nurse's office. The one thing that really solved it was when I started homeschooling. But most people can't do that. If the kids are getting it from school (it could also be the emergency room, a bus, your own car, whatever) there are many ways it is transmitted that we don't even think about. The younger kids have story time and lay on a carpet on the floor. If they sit down and rest their head somewhere (on their desk) where another kid had lice, they can pick it up. We always remember to run all the bedding and stuffed animals through the laundry, but you can't run through the couch or the carpet, and then there's the vehicle you're driving.
Kids pass it with hats, combs, scarves, and maybe even all the clothes they play dress-up with at school.
Clean heads are more likely to have lice because the bugs can readily get to the scalp to suck blood. If you think hygiene or race has anything to do with it, check your statistics.
And the absolute best sure-fire method to get lice of the children (doesn't help if you don't disinefect everything else) is to glop either Mayonaise or Olive oil all over their head and put a shower cap over that for several hours. Then wash it out and do a final rinse with white vinegar. The lice can't breathe when they are covered with these things. But you can't rinse it away too soon, the longer the better, because lice can hold their breath for a very long time.
Recurrence of lice has less to do with a child not being clean and more to do with not completely getting rid of the vermin from every part of your home and vehicles and pets and even parents. Because if you have a child and you actually give them a hug once in a while, you are going to get the lice too, and you don't even realize it.
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7-28-2010 @ 6:34AM
scott said...Ms. El-Faizy is putting out an irresponsible post. Why would anyone condone the spread lice to other children in school? The only way to stop it is to have the child stay home until successfully treated. The main reason there is a lice problem in schools every year is due to this kind of thinking. If your kids have lice and you are to lazy , irresponsible, or don't care, then keep the lice in your household!
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7-27-2010 @ 2:22AM
gram said...When My children were young they seemed to get head lice each year. Well really only my daughter, My son did not seem to attarct them. I also would become their blood donor. Because of this I was always checking them to be sure we did not have any unwanted guests. Sure enough one year I found them before the yearly school letter came with a warning. I treated the kids and called the school. Only to have my children signaled out but the school everytime any other child had lice. Their heads were checked in front of other students and only THEIR heads. When I found out and asked why i was told that because our family did not have the same shall we say budgets of most of the people in the school area. My children may have worn others hand me downs but they were always clean, bathed and shampooed. Just blowing off a resentment that I guess was still festering.
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7-27-2010 @ 3:42AM
Helene Goldman said...To those who have stated that lice cause disease/infection/anemia - check the facts on cdc.gov, because you have not checked your facts. Why is is that you aren't freaking out more when little kids cough or sneeze without covering their mouth and nose? How come people don't demand that a whole classroom has their temperature taken when one student is sent home with a fever? People can die from the flu, but they don't die from head lice, yet people get more frantic about a case of head lice. To those who talk about teachers getting lice from the kids, I question what kind of physical contact the teacher would need to have with the student in order to get lice from them. I have had 5 schools for the last 10 years, done thousands of head checks, and I have never found "a classroom full of kids with active head lice." In fact, many people will say that a child has lice, when what they really have are nits. I had actually done head checks for several years before I finally saw a live louse crawling on someone's head. I agree that parents can, and should be proactive about reducing the potential for their children to get lice by educating them about not sharing combs, brushes, and other personal items, by checking their hair for lice/nits on a regular basis, and by reading about preventive measures from good resources, such as cdc.gov. A challenge for parents is that young kids have a lot of close contact while playing with each other, and while socializing. Re: African American hair - it depends on the texture of the individual child's hair, so don't assume that African Americans can't get lice.
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7-27-2010 @ 4:50AM
Mery said...I am a school nurse and I strongly disagree with the author of this article. She is making lice sound innocuous and is giving parents, that are not motivated to take care of the problem, a free "Get Out of Jail Pass". Lice can cause Typhus which killed many people in years past. That was the reason for many of the deaths in the concentration camps. The inmates got lice and then Typhus. Diphtheria and Pertussis are making comebacks thanks to people refusing to immunize their children. Lice easily spread from child to child. What will be worse is when Typhus spreads from child to child. Don't think it can't happen.
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7-27-2010 @ 7:43AM
Mike Ingenito said...Now that D.D.T. has been banned for over a Quarter Century, more pests & parasites are re appearing even bed bugs are making a comeback!cc
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7-27-2010 @ 10:17AM
Olive Mankiewicz said...NEVER PUT PERMITHRIN SHAMPOO ON YOUR CHILD'S HEAD. This is an insecticide that is probably found in Rid, Nix and the other lice shampoos you can find at Wal-mart, etc. If you do a little reading on the subject, you will find that there are parents who think it caused leukemia in their children. I know from personal experience that, following the directions to the letter, it would give my daughter a headache within half an hour.
There is a companion article to this in which a camp nurse or counselor suggests completely covering your child's hair in Crisco for six hours, then using conditioner and a fine-toothed comb ... and lots of patience and hard looking through the hair -- to first get rid of the live lice, and then pick off the eggs on the strands.
There is a shampoo in health food stores called Hair Clean 1-2-3 (or it might have to be ordered online) that is a combination of extracts like anise in alcohol that we found to be extremely effective and gentle. I have to warn you ... it is more expensive, like about $25, and your doctor won't give you a prescription for it. But you can call the company and they will tell you the ingredients over the phone if you want to buy them and make it yourself. They include extracts like anise mixed with alcohol, though I looked into it, and buying the ingredients myself wouldn't have saved much money, so I just bought the kit. It lasts for about two applications, and was the difference between night and day as compared to the commercial brands.
Apparently, the lice absolutely hate it, and let go of the hair shaft. I spread a big white sheet on the floor and put my daughter in the middle of it. If I remember correctly, we shampooed my daughter's hair regularly, then put this stuff on her hair and combed it through. The kit contained the best nit comb I have ever used ... really close teeth. I don't understand the combs I've seen in commercial kits in which there are spaces between the tines. You have to have a really fine-toothed comb, as the saying goes -- apparently parents have been fighting lice for centuries.
We got all kinds of live lice which we then dumped into alcohol -- not very nice of us, but we did want to kill them. We actually then looked at them under the microscope. It was kind of fun. We then went through her hair with the comb and got oodles of eggs -- as I said, the comb was extremely effective. We repeated the whole process about three days later, and found a few live lice that probably had since hatched and more eggs, and after that she was louse-free.
Recently, my daughter, who is now 20, got lice from a coworker at a deli and got rid of them herself just by hard shampooing and using the comb. I think she may have tried the mayonnaise treatment, which is the same as the Crisco one and makes the hair soft and shiny. Of course, you're supposed to wash your linens and clothes, and vacuum, and any pillows and stuff you can't wash, you can bag for several weeks. I'm not sure if that is completely effective in killing lice, though; I don't know how long they can go without a meal, you could probably find that online. As far as the smothering the hair in Crisco, etc., I did research on it and discovered lice can shut down and not breathe for about 12 hours, so, actually, theoretically, a mayonnaise or Crisco treatment should go for at least 12 hours. But who has the time? I think what it mainly does is gets rid of the lice you have on the hair so you can concentrate on the nits with the comb.
The other thing is that lice don't like to be too close to the head -- that is why you will usually find the eggs on the hair shaft about an inch or two out from the scalp. If you shave a little boy's hair close to the scalp, you can pretty much guarantee he will not get lice. You might not wish to do that to a girl (!), but if you give her a short summer haircut, it at least makes it easier to find and get rid of the nits (eggs). Some girls have absolutely glorious heads of hair, though, so a really good nit comb and diligent shampooing are the answer, I would think. I actually think the saying about lice having nothing to do with hygiene is hooey. I think it's just to make people feel better about themselves if their child gets lice. Anyone can get lice. But I have never known any of my daughter's friends who shampooed their hair on a daily basis to get them. I think daily shampooing gets rid of them before they have a chance to take hold.
One other possibility ... if your child has a head of beautiful hair and your treatment and comb are ineffective, perhaps you can just cut out the hairs that have the eggs on them just below the egg. Your child's hair will be a little thinner, but it will still look wonderful and one thing we know about hair is it grows back. I have no idea though if that might cause hair on a head of beautifully curly hair to grow back straight or not. But it you're at your wit's end because of the dumb nits, it might be worth a try.
The biggest lesson from this is, I would say is ... even if you don't have the money for a really good lice treatment, invest in a really good comb. There are combs out there with metal tines so close together, you wonder how they can go through hair. You can probably find them at the pharmacist's or go online.
Good luck!
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7-27-2010 @ 3:15PM
lauren said...All children have this civil liberties that the article talks about. Both those with lice and without lice. So why is it that they feel those with lice aren't affecting the civil liberties of the other child without the lice? They have the right to be lice free. Just saying.....
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7-27-2010 @ 3:43PM
Marit Londeaux said...My son, grand-daughter, and grandson, who live in L.A., came to visit me in San Diego on Memorial Day weekend. He is a single father. My grand-daughter, who is seven, wanted to sleep with me so we could watch "girly" movies together. By that I mean Barbie, Cinderella, etc. Living with two males she is always stuck watching Spiderman and the like. My son called me the evening after they returned home. He said that the school had sent my grand-daughter home, as well as other children, because the nurse had checked her after finding lice in another kid's hair. I was terrified that she had given me lice, having slept in the same bed together. I immediately went to the store and bought the shampoo, furniture spray, and comb. After checking my hair thoroughly with a magnifying glass, (bugs give me the creeps, especially ones that live on the body) I found that I didn't have any lice. I agree that the kids should be sent home, which would ensure that parents take care of the problem. Why should the majority of families have to deal with this problem just because a few don't make it a priority to get rid of the little critters? And I do believe that the beginning of the "epidemic" starts with uncleanliness. Not the kids who get it from someone else, but the person who initially started the mess in the first place. If you keep your home and kids clean, then you shouldn't get lice, unless some other kids brought it to school.
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7-28-2010 @ 12:43AM
Michelle said...I can still remember this poem from junior high:
Share a toy, share a ride,
Share the feelings deep inside;
But never share a hat or comb,
Or lice could make your head their home!
Shared cubbies, costumes for the school play, nap time mats/towels, all these things help to spread lice. It's important to teach kids what their responsibilities are in preventing head lice. I don't let my kids take combs or brushes to school, and I make sure to tell them not to share hats or other clothing. If an item has been sitting in the lost and found, where clothing is often stacked, I tell my kids to bring it home and have me wash it before wearing it again. I'm not saying it will completely prevent lice, but it helps. There is also a brand of shampoo and leave-in spray conditioner at my salon that is supposed to prevent lice in kids, is called Lice Free Zone by Circle of Friends. Smells like lavender, too :) Is anyone else's head itching after reading this article???
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7-28-2010 @ 12:46AM
Michelle said...fyi--I guess the shampoo has been renamed "Lice Defense", and there is styling gel and hair spray now, too.
8-03-2010 @ 3:35PM
Jenna said...A family of darling students were sent home numerous times this past year with lice. The students were shunned by other students and their families who did not want the itching, shampooing, "nitpicking", housecleaning, time spent and costs associated with lice. It is hard for a teacher to work with a student who itches her hair and lice falls onto desks or work papers. One of the students developed a staph infections from the scratching. Another student who sat behind her developed lice and then ringworm of the scalp. Students with lice should be sent home for treatment and checked often. Students should be checked confidentially at school.
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8-15-2010 @ 1:51AM
Spin Dr said...For heaven's sake, why are the kids not being taught in their health class about preventing the spread of lice? Lice do not jump or fly. If you saw a bug jump from a child's head, it was a flea from a dog or cat. Fleas will not reside for long on humans and will jump off. Therefore, teach the kids NOT to hug or use other's combs or hats. Schools should not have children's jackets hanging in close proximity. Desks should not be crammed close together or children work closely around a table. A few precautions will eliminate a lot of this hysteria surrounding lice as there will be fewer infestations. Repeatedly ingesting pesticides transdermally with treatments is more harmful to your child that having head lice.
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