When Should You Keep Your Child at Home Instead of Sending Them to Childcare?

A sick child needs peace and rest at home

Starting daycare or preschool is a big change for both child and parent. It is natural for a young child’s immune system to gradually encounter new viruses in a group setting, and for parents to sometimes struggle to tell the difference between a mild symptom and a condition that means the child should stay home. A helpful starting point is to ask: Can my child manage a normal day in the group, and is it safe for the others?

If your child is tired, tearful, in pain, needs more sleep, refuses to drink or eat, and would not manage the usual routine, staying home will generally help. This is not a failure or an unnecessary absence. A few quiet days can help prevent the condition from worsening and avoid unnecessarily prolonging recovery.

We also protect other families. A group may include children with weakened immunity or chronic health conditions, young siblings or pregnant women. Making a considerate decision is therefore not only about the childcare centre’s rules, but also about caring for one another.

Every facility has its own operating rules and may require a doctor’s note or set conditions for returning. If you are unsure, follow its rules and consult your paediatrician.

Practical guide: if your child needs individual medical care during the day that the childcare centre cannot safely provide, they should stay at home for now.

Fever, vomiting and diarrhoea: clear reasons to stay home

Do not send a child with a raised temperature or fever to childcare. Do not give them medicine to lower their temperature before leaving just so they can attend preschool. The medicine may temporarily mask the symptom, but the cause of the problem remains and the child’s condition may worsen again during the day. Staff also need to know how the child really feels.

It is similarly best to stay home with vomiting, diarrhoea or significant nausea. There is a risk of rapid spread of a gastrointestinal infection and dehydration, while the child needs close supervision, fluids and rest. Only consider returning once the digestive symptoms have settled, the child can drink, eat appropriately and has regained their energy. The facility’s operating rules or a paediatrician’s recommendation may specify the exact time of return.

Contact your paediatrician especially if your child is urinating very little, refuses fluids, is unusually lethargic, has severe pain or their condition is getting worse. Extra caution is particularly important with young children.

• do not send your child with a current temperature or fever,
• do not mask symptoms with medicine before leaving in the morning,
• with vomiting or diarrhoea, prioritise hydration and rest at home,
• inform the childcare centre of the reason for the absence according to its rules.

Infections that spread easily in groups

Some illnesses or symptoms deserve special attention because they spread very easily through direct contact, droplets or shared objects. These include, for example, inflammation of the eyes with redness and discharge, often called conjunctivitis. Since there can be several causes and not all are equally contagious, consult your paediatrician about these symptoms and follow the preschool’s guidance.

Staying home is also appropriate with chickenpox, suspected flu or another more significant respiratory infection, and cold sores with weeping blisters. With cold sores, it is sensible to limit close contact until the lesion has healed and dried; discuss the exact approach with your doctor and the childcare centre.

With a cough and runny nose, consider the child’s overall condition carefully. A child with a mild, fading runny nose, no fever and good energy may sometimes manage the group, if the facility’s rules allow it. However, if the cough is exhausting, the child has a fever, breathing difficulties, significant nasal discharge or feels unwell, keep them at home and contact your paediatrician.

Do not assess skin symptoms solely from a photograph or online advice. A rash can have many different causes. If it is new, spreading quickly, oozing, itchy, associated with a fever or painful for the child, do not send them to childcare until you have discussed the situation with a doctor.

Head lice, parasites, warts and shared objects

Head lice are unpleasant but fairly common in children’s groups. If you find them, inform the facility discreetly and follow its rules. Your child should return only after effective treatment has begun and their hair has been checked carefully. Check other household members too, comb out the nits, and wash or treat items according to the product instructions.

Other parasitic problems that need to be addressed with a doctor include scabies and threadworms. Scabies can spread through close contact and requires a coordinated approach. With threadworms, thorough hand hygiene, short fingernails and the procedure recommended by your paediatrician are important. Always inform the preschool so it can take appropriate hygiene measures without stigmatising the child.

Viral warts can spread through skin-to-skin contact or shared items such as crayons or towels. On their own, however, they do not necessarily mean automatic exclusion from the group. It is advisable to cover the lesions, discourage scratching, avoid sharing personal items and consult a paediatrician or dermatologist, especially if the warts are numerous, inflamed or changing quickly.

Inform staff and allow time after vaccination too

Always tell the staff in advance about confirmed allergies, regularly used medicines, important health restrictions and potential risks. Agree on a clear plan: what the facility should monitor, whom to call and what steps to take if problems arise. In the case of a severe allergy or another significant health condition, establish the procedure together with your paediatrician and the facility’s management.

After vaccination, consider keeping your child at home at least on the day of the vaccination. They may need a quiet routine, and a parent can monitor them more easily. Vaccination does not mean that problems will necessarily occur, but your paediatrician is the best person to advise you about reactions or returning to the group.

It is not possible to catch every infection, and parents cannot control everything. However, they can respond promptly, communicate openly and put their child’s health before pressure to attend. If you are unsure whether your child is ready for preschool, one calm day at home and a consultation with your paediatrician are often a better choice than risking a worsening condition or infecting other children.