When Children Are Sick: A Parent's Guide to Staying Home and Recovery

It’s 7 a.m. Your daughter wakes up with a scratchy throat and a runny nose, and she insists she feels “fine” because today is the field trip. You hear a small cough and wonder: is she contagious? Should she go?

Young children often catch about 6 to 8 colds a year, more in their first years of daycare or school. A few clear rules make the decision easier.

In one minute

• Keep your child home with a fever of 100.4°F (38°C) or higher, with vomiting or diarrhea, or when they’re too unwell to join normal activities. Many schools want 24 hours without fever, without fever-reducing medicine, before a child returns.
• At home, aim for comfort: rest, plenty of fluids, simple food when they’re hungry, and calm company. How your child acts tells you more than the number on the thermometer.
• Call your pediatrician for trouble breathing, signs of dehydration, a fever that lasts, any fever in a baby under 3 months, or whenever your instinct says something isn’t right.

When should children stay home?

Staying home is about your child’s recovery, and about not spreading illness to classmates, teachers and their families.

The 24-hour rule. Many schools and daycares, and the CDC for common illnesses like colds and flu, say children can go back once they’ve had no fever for 24 hours without fever-reducing medicine and are feeling better overall. Check your school’s own policy, since rules differ.

Clear signs your child should stay home

• Fever: 100.4°F (38°C) or higher, until 24 hours without fever, without medicine.
• Vomiting: two or more times in the past 24 hours. Many schools also ask for 24 hours without vomiting or diarrhea.
• Diarrhea or stomach pain: diarrhea that’s frequent or hard to control, or stomach pain that stops normal play.
• Breathing: a constant cough that disrupts the day, wheezing or chest tightness. Any trouble breathing also means a call to the doctor.
• Too unwell to take part: unusual tiredness or weakness, or a big change in behavior.

The gray areas

• A slightly raised temperature (about 99 to 100.3°F): not a fever by the usual definition. Look at energy, appetite and other symptoms, and check again later.
• A new cold: colds spread most easily in the first few days. Strong symptoms may call for a day at home; a mild runny nose alone usually doesn’t.
• “Not quite themselves”: if your child seems to be fighting something off, a quiet day may be right.
• Complaints of feeling unwell: take them seriously, especially from a child who usually loves school. But if stomachaches come every school morning and vanish by 10 a.m., it may be worry rather than a bug. Talk with your pediatrician and the teacher.

Rest gives the body energy to recover, and a child sent back too soon often has a miserable day and shares more germs.

Understanding your child’s temperature

• About 97 to 99°F (36.1 to 37.2°C): the usual range, shifting a little through the day. With no other symptoms, school is usually fine.
• About 99 to 100.3°F: a little warm, maybe the start of an illness. Watch energy and other symptoms.
• 100.4°F (38°C) or higher: a fever. Your child stays home and rests.

Readings depend on the kind of thermometer, so ask your pediatrician which one suits your child’s age. A fever itself is a sign the body is fighting an infection. A child who drinks, plays a little when the fever comes down and wakes easily is usually doing okay. One firm rule: for a baby younger than 3 months, 100.4°F (38°C) or higher means calling the pediatrician right away, even if the baby seems fine.

Caring for your sick child at home

• Rest: more sleep than usual, and quiet days.
• Fluids: frequent small sips of water, milk, broth or ice pops. For vomiting or diarrhea, ask your pediatrician about an oral rehydration solution from the pharmacy; it usually works better than juice or sports drinks.
• Comfort: a comfortable room temperature, light clothes, a favorite blanket.
• Food: a smaller appetite for a day or two is normal. Offer simple foods when your child is hungry.

Easing common symptoms

Fever: light, breathable clothes, cool (not cold) drinks and rest. Ask your pediatrician before giving any medicine, including fever reducers, so you know which one and how much suits your child’s age and weight. Medicine is for comfort, not for reaching a normal number. Never give aspirin to a child unless a doctor tells you to.

Stuffy nose: a cool-mist humidifier, or sitting with your child in a steamy bathroom while a warm shower runs. Saline drops can help clear stuffy noses in younger children. An older child may sleep better with an extra pillow; babies always sleep flat on their back.

Cough: for children over 1 year, honey can soothe a cough. Never give honey to a baby under 1. Fluids and a cool-mist humidifier help at night. Don’t give over-the-counter cough and cold medicines to young children unless your pediatrician says so.

Upset stomach: small sips often. Once fluids stay down, offer small amounts of usual foods. Toast, rice or bananas are fine to start, but pediatricians no longer recommend a strict bland diet for days, and most children don’t need to stop milk. Ask your pediatrician if you’re unsure.

Teaching children about being sick

Ages 3 to 5: “Your body is working hard to feel better.” “Rest helps your body get strong again.” “Staying home keeps your friends from getting sick too.”

Ages 6 to 8: “Your body has an army of helpers that fight germs. Rest gives them energy.” Explain why certain symptoms mean staying home. As children grow, they learn to notice their own symptoms and not to push through.

Make it safe to say “I feel sick.” Children hide being sick because “sick” means missing out. Say: “Thank you for telling me you feel sick. That was the right thing to do.” Keep sick days cozy, never a punishment, so speaking up doesn’t feel like losing.

Healthy habits: wash hands with soap for 20 seconds (sing “Happy Birthday” twice), especially before eating and after the bathroom; cough and sneeze into the elbow; keep water bottles, cups, forks and tissues personal; and tell a grown-up early, when “my throat feels scratchy.”

Making sick days restful

Choose low-energy activities: audiobooks or gentle music, simple coloring, picture books, quiet puzzles or building blocks, a calm show or a nature documentary. Fast, exciting games can keep a tired child wound up, so pick calm screens and turn them off well before sleep.

Sick days also teach patience with the body. Recovery takes time, and rushing back to running and climbing can make a child feel worse.

Planning ahead for sick days

Sick days are hard on working parents, and every family’s situation is different. Line up backup care (family, a friend, a neighbor, a sitter), know your workplace’s sick leave rules, ask about flexible or remote work, and trade help with other parents. Keep a sick-day kit: a thermometer, your pediatrician’s number, tissues, a few easy foods, any medicine your pediatrician has told you to keep, and a box of special sick-day toys.

Tell your child’s school or daycare when your child is sick. It helps them spot outbreaks, and they’ll explain their rules for coming back. Help your child see that staying home when sick is a kindness to classmates, teachers and their families.

When to get help

Call your pediatrician if:

• a fever lasts more than 3 days in a child 2 or older, or more than 24 hours in a child under 2
• a baby younger than 3 months has a temperature of 100.4°F (38°C) or higher
• a fever keeps rising above 104°F (40°C)
• symptoms get worse instead of slowly better, or a fever comes back after it had gone
• you see signs of dehydration: peeing much less, a dry mouth, no tears when crying, unusual sleepiness
• your child has a severe headache, a stiff neck or chest pain
• your instinct tells you something isn’t right

Call 911 if your child is struggling to breathe, has blue or gray lips, is very hard to wake, has a seizure, or has a rash of small purple or dark red spots that don’t fade when you press on them.

Read together

In Being Sick, Whyia and Phoebe meet Ethan and Tom at the playground, where Tom has a new remote-controlled car. When Tom has to go home, Ethan runs off, and the friends climb onto the roof of the playhouse. Ethan’s coordination is poor: he falls, hurts his hand, and his head aches. Crying, he admits: “My mom said I can’t go out when I’m sick. But I didn’t want to stay in bed, so I didn’t tell her how I felt.” Whyia turns into a puppy and runs to Luna, the doctor’s dog. Luna explains that poor coordination can be a symptom of illness, that rest lets the body focus on fighting infection, and that some infections spread through coughing, sneezing and touching, which is why we stay home, wash our hands and cover our mouths and noses. Phoebe’s mom, Mrs. Ronalds, walks the children to Ethan’s house and says hot tea can soothe a scratchy throat and help the body stay hydrated, “like giving your body a warm, cozy hug.” Phoebe says staying in bed is boring but toys can help, and Whyia adds that toys put aside for a special occasion can come out now: “Well, now your special occasion has arrived!”

After reading, make a sick-day box. Let your child choose a few toys and books to put aside for sick days only, and add a drawing of Luna with the words “Tell a grown-up.” On the next sick day, make a warm drink together the way Mrs. Ronalds suggests: a grown-up makes it, it’s warm rather than hot, and for young children it’s caffeine free.