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Reducing the Spread of Illness in Child Care

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​Whenever children are together, there is a chance of spreading infections. This is especially true among infants and toddlers who are likely to use their hands to wipe their noses or rub their eyes and then handle toys or touch other children. These children then touch their noses and rub their eyes so the virus goes from the nose or eyes of one child by way of hands or toys to the next child who then rubs his own eyes or nose. And children get sick a lot in the first several years of life as their bodies are building immunity to infections.

In many child care facilities, the staff simply cannot care for a sick child due to space or staff limitations, although in others, the child can be kept comfortable and allowed to rest as needed in a separate area of the room where they have already exposed the other children. When waiting to be picked up, an ill child who is being excluded should be in a location when no contact occurs with those who have not already been exposed to their infection. Often, it is best for the child not to be moved to another space to prevent their illness from spreading throughout the facility and to maintain good supervision of the child. In some programs, a staff member who knows the child well and who is trained to care for ill children may care for the child to a space set aside for such care and where others will not be exposed. If the child requires minimal care for a condition that doesn't require exclusion, there may a place for the child to lie down while remaining within sight of a staff member when the child needs to rest. In some communities, special sick child care centers have been established for children with mild illnesses who cannot participate or need more care than the staff can provide in the child's usual care setting.

Even with all these prevention 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. Be sure to wash your and your child's hands frequently. You never know when your child or another child is passing a virus or bacteria. 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 them up. 

Fortunately, not all illnesses are contagious (like ear infections). In these cases, there's no need to separate your sick child from the other children. Most medications can be scheduled to be given only at home. If your child needs medication during the day, be sure that the facility has clear procedures and staff who have training to give medication. Ask what they do to be sure they have the right child, receiving the right medication, at the right time, by the right route and in the right dose–-and document each dose.

Measures to Promote Good Hygiene in Child Care:

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

  • 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 child 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 all doors and cabinet handles, drinking fountains, all surfaces in the toileting and diapering areas cleaned and disinfected at the end of every day?

  • Are all changing tables and any potty chairs cleaned and disinfected after each use?

  • Are staff and other children fully immunized, especially against the flu?​​
  • Is food brought in from home properly stored? Is food prepared on site properly handled?

  • 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 surfaces should be disinfected.)

    • 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 child

    • 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.

  • Is health consultation available to deal with outbreaks or to review policies?

Additional Information & Resources:

Last Updated
Council on Early Childhood (Copyright © 2017 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.
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