Working and Parenting – Part Four

Too Sick to Attend Day Care? How to Tell

It’s seven o’clock in the morning and family rush hour begins. The teakettle is whistling, the toaster’s popping, and the traffic report is the usual bad news. Enter a whine that will turn your already overbooked day upside down. By reflex you lay hands on your baby’s head. “On, no, a fever!” To day care or not to day care, that is the question. Suddenly you realize that it is not so easy to change jobs at the touch of a forehead.

How sick is sick enough to miss day care? This decision affects three parties: Does your baby feel too sick to attend day care? Is she contagious to the other children? How convenient is it for you to take a day off from work? Here are some practical guidelines on what germs are the most catchy.

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Diarrhea Illnesses
Here is one set of germs that all doctors agree are very contagious. Frequent, watery, mucousy, and sometimes bloody diarrhea is a sure indication to stay home, both for your baby’s sake and to prevent an outbreak in the center. Add vomiting — parents call this a double ender — and your baby is certainly too weak and too upset to leave home. As soon as the vomiting is over, the stools are no long explosive and watery, and your baby feels better, she may return to day care. Be prepared for the bowel movements to remain loose and frequent for weeks, as the intestines are notoriously slow to recover. During this convalescent state of diarrhea, your baby is not contagious.

Colds and Fevers
While diarrhea illnesses merit quarantine, respiratory and febrile illnesses are a different bag of germs. Most cold germs do not threaten an outbreak in the day-care center as much as diarrhea germs do. In fact, studies in school-age children have shown that excluding children from school does not diminish the spread of colds; admitting kids with colds to school does not increase their spread (the contagious period so variable, and babies are most contagious a day or two before they act sick). When you send your two-year-old to day care with a cold, this is one time to teach her not to share. Show her how to cover her nose and mouth with a tissue when she sneezes or coughs and to turn her head away from others. “Two-year-olds may be able to learn this sanitation gesture but are likely to forget. If your baby has a fever (persistent temperature of at least 101 degrees F/38.3 degrees C) it is prudent to keep her out of day care until you ask your doctor whether she is contagious.

Sore Throats
Sore throats, especially those associated with fever and throats’ sores (for example, hand, foot, and mouth disease, are very contagious and are a red light for day-care attendance until the fever and the throat sores are gone — usually around five days.

When to Stay Home with a Cold
If your baby’s nasal secretions are clear and watery, and your baby is happy and playful, pain free, and has only a low-grad fever (100 degrees F/37.8 degrees C) there is no need to keep your baby home from day care. If the nasal secretions become more think, yellow, and green, especially if accompanied by a fever, an earache, frequent night waking, or a peaked look — in mother jargon, a sick-looking face — this is a stay-home-and-call-the-doctor cold. Your baby may have and ear or sinus infection. In reality, a cold can be contagious for two or more weeks, yet is unrealistic to expect to miss work for that long. When to send only a mildly sick baby to day care depends a lot on the ability of the day care to separate potentially contagious children.

Before you jump to change your whole day, here’s a nasal secretions tip: The goop from the nose is always thicker upon awakening in the morning, since it has had a chance to stagnate during the night. To help assess the situation, squirt a few saline nose drops into each of your baby’s stuff nostrils and encourage a gentle nose blow, or remove the secretions with a nasal aspirator. If the remaining secretions are clear and your baby breathes better, you can breathe easier, and it’s off to day care.

Eye Drainage
The nose is not the only thing that runs when baby gets a cold. Eye drainage is often associated with an underlying cold, especially a sinus infection. These eyes are not contagious, and usually neither is the rest of the baby. This type of goopy eye drainage does, however, merit a doctor visit.

Some runny eyes are due to conjunctivitis (often called pinkeye), a contagious infection that will send day-care providers rushing to make a come-get-your-baby call. If the eyes are bloodshot in addition to draining, this is contagious pinkeye, which is quickly treated and made noncontagious by an antibiotic eye ointment or drops. The baby may attend day care as long as treatment has begun. If the eyes are not bloodshot, this is seldom contagious conjunctivitis, and your child may still attend day care.