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Health Issues

In today’s world of two-income families and single parents, many young children spend a lot of their time in child care.

When choosing a child care setting for your child, do not forget to take into account this crucial factor — what is the policy concerning sick children? Wherever children are together, the risk of spreading infectious diseases exists, especially among infants and toddlers who are likely to put their hands and toys into their mouths and then share their toys.

To reduce the risk of becoming sick, your child, the child care providers, and all the children being cared for must be up-to-date with the recommended immunizations against diseases such as measles, mumps, rubella, chickenpox, diphtheria, tetanus, pertussis, polio, hepatitis B, Haemophilus influenzae type b, pneumococcus, hepatitis A, and the flu if eligible for the vaccine.

Even though your child has had his immunizations, he can get other infectious diseases common in youngsters such as colds, sore throats, coughs, vomiting, and diarrhea. For example, the viruses responsible for colds or the flu cause the most common sicknesses in child care facilities and schools. In fact, most children in child care and school settings have as many as 8 to 12 colds a year. Diarrheal episodes occur once or twice a year in the typical child.

Make sure you get answers to questions like

  • When your child becomes sick, either at school or in a child care program, will you be notified in a timely manner?
  • What plans are in place to lower the chances that your child will get sick from another youngster who is sneezing or sniffling, has diarrhea, or is vomiting?

Reducing Disease Transmission

In many child care programs, as well as public and private schools, parents are contacted right away when their child shows signs of even a mild illness, like a cold. In others, a child is allowed to stay at the facility as long as he doesn’t have a fever and can take part in most activities. Either way, be certain that the school or caregiver has a way to reach you at all times—make your phone numbers at home and work available, as well as your cell phone number.

In many child care facilities and schools, the staff simply cannot care for a sick child, although in others, the child is kept comfortable in a separate area so a cold, a cough, or diarrhea doesn’t spread throughout the facility. In these programs, a staff member is trained to care for ill children, often in a “get-well room” where they won’t pass the disease to others. There may also be a place to lie down while remaining within sight of a staff member if a youngster needs to rest. In some communities, special sick child care centers have been established for children with mild illnesses who should be kept apart from healthy youngsters.

You can help prevent the spread of infectious diseases by keeping your contagious child home from school or child care until he can no longer spread his illness to others. Children should be kept home when they have

  • Diarrhea or stools that contain blood or mucus
  • An illness that caused vomiting 2 or more times during the previous 24 hours, unless the vomiting is known to be caused by a condition that’s not contagious
  • Mouth sores with drooling, unless caused by a noncontagious condition
  • Impetigo (a skin infection with erupting sores) until 24 hours after treatment has been started
  • Head lice (until after proper treatment has been given)
  • Scabies (an itchy skin condition caused by mites) until after treatment has been given
  • Conditions that suggest the possible presence of a more serious illness, including a fever, sluggishness, persistent crying, irritability, or difficulty breathing

Even with all these safety measures, it is likely that some infections will be spread in the child care center. For many of these infections, a child is contagious a day or more before he has symptoms. That is another reason why it is important to wash your and his hands frequently. You never know when your child or another child is passing a virus or bacteria.

Fortunately, not all illnesses are contagious (eg, ear infections). In these cases there’s no need to separate your sick youngster from the other children. If he’s feeling well enough to be at child care or school, he can attend as long as a staff member can give him any medication he’s taking. Sometimes your child will become sick while at child care and need to go home. You will need to have a plan so someone can pick him up.

Measures Promoting Good Hygiene

To reduce the risk of disease in child care settings as well as schools, the facility should meet certain criteria that promote good hygiene. For example

Are there sinks in every room, and are there separate sinks for preparing food and washing hands? Is food handled in areas separate from the toilets and diaper-changing tables?

  • Are the toilets and sinks clean and readily available for the children and staff? Are disposable paper towels used so each youngster will use only his own towel and not share with others?
  • Are toys that infants and toddlers put in their mouths sanitized before others can play with them?
  • Are the child care rooms and equipment cleaned and disinfected at least once a day?
  • Is breast milk labeled and stored correctly?
  • Are children and their caregivers or teachers instructed to wash their hands throughout the day, including
    • When they arrive at the facility
    • Before and after handling food, feeding a child, or eating
    • After using the toilet, changing a diaper, or helping a child use the bathroom (Following a diaper change, the caregiver’s and child’s hands should be washed and the diaper-changing area should be sanitized.)
    • After helping a child wipe his nose or mouth or tending to a cut or sore
    • After playing in sandboxes
    • Before and after playing in water that is used by other children
    • Before and after staff members give medicine to a youngster
    • After handling wastebaskets or garbage
    • After handling a pet or other animal

Make sure your own child understands good hygiene and the importance of hand washing after using the toilet and before and after eating.

 

Last Updated
5/11/2013
Source
Adapted from Immunizations & Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.