Should Sick Children Go To Group Care?

It’s a fact of life: children who attend group care will be sick children at some stage.

Increased exposure to other children, and shared play spaces and toys will increase the chances of sharing viruses and bacteria.

For many working parents whose children are in group care, the frequency of illnesses they experience can be frustrating.

Should Sick Children Go To Group Care?

Some children might not seem sick enough to need a day at home.

Others are unwell enough to stay home, but their parents are under pressure to go to work.

It makes sense to keep your children home when they are really unwell, but what if they only have mild symptoms or are at the tail end of a cold?

Why Do Kids In Group Care Get Sick So Often?

Before your children started attending group care, you could probably count on one hand how many times they had been sick.

Within a matter of months of leaving them in group care, you’ve lost count of the endless runny noses, coughs, fevers, bouts of vomiting and diarrhoea.

Research bears this out. Children who are cared for full time at home are less likely to experience the same number of infections and colds as those children who are in group care. It’s considered normal for children to get sick when they start group care – they have up to 12 colds in the first 12 months.

Research has revealed another interesting fact: children who attend group care settings before they are 2.5 years old are less likely to get sick at school, compared with their peers who didn’t attend group care.

Most children enter group care services at a time when their immune systems are still immature and their exposure to viruses and bacteria has been limited.

The group care centre is the perfect environment for the transmission of viruses and bacteria. Children are in close proximity to each other during regular play and other activities. Toys and objects such as pacifiers are often shared, particularly among younger children.

The typical illnesses include: the common cold; hand, foot and mouth disease; conjunctivitis; and various gastroenteritis viruses.

These germs are easily spread, through indirect and direct contact between children. Many viruses can survive outside the body for minutes, even hours.

Why Do Parents Send Sick Kids To Group Care?

There are numerous benefits of group care and preschool, including socialisation, cognitive development and, potentially, a better transition to school.

However, most children attend group care because families require two incomes to get by financially.

According to the Australian Institute of Family Studies, in 2011, 68% of women in a relationship and 57% of single mothers were in paid employment.

Keeping a sick child at home has quite an impact on your life. In Australia, child care is expensive and is paid for whether a child actually attends or not. You might need to take a day off work, and still have to pay for the day of care your child missed.

Taking a day off work might also mean you aren’t paid (if you’re a freelancer, for example). You might not have enough carer’s leave days left, or it could make things difficult if your absence need to be covered at work.

Should Sick Kids Be Allowed To Attend Group Care?

This is one of the most contentious questions among parents, especially during the winter months, when colds and viruses are rife. Should group care centres allow children to attend when they are sick?

At any given moment, social media is burning with righteous indignation because a child with a runny green nose has been spotted at child care or preschool. Or because a parent has been overheard mentioning the child who vomited once last night but is now fine.

What could possess parents to decide to send a sick child to group care, and potentially infect your child (not to mention your entire family)?

In Australia, each child care centre and preschool is encouraged to create a clear policy about exclusion, hand hygiene, and cough and sneeze etiquette.

This policy should state the minimum exclusion periods, according to guidelines in the National Research And Medical Council’s Staying healthy: Preventing infectious diseases in early childhood education and care services.

The advice and procedures in Staying Healthy are best practice, based on evidence and research. Group care centres and preschools are encouraged to adopt these practices but aren’t required to. They may choose to develop their own policies, which deviate from the recommendations of Staying Healthy.

In other words, your child’s group care centre might have a policy which excludes infectious diseases such as chicken pox, but which allows children who have the common cold. Other group care centres might have a policy stating children with high temperatures must be picked up from the service within an hour of the parent being contacted.

When you choose a group care service or preschool, ask for a copy of the health and hygiene protocols, as well as the policy on exclusion. This will help you plan ahead for the days when your child is sick, so you aren’t trying to figure out what to do at short notice.

Should Sick Kids Go To Group Care?

Even if your children don’t have an illness requiring exclusion, according to the group care or preschool policy, you might still wonder whether you should send them in?

Ideally, sick children should stay home and rest. This gives their immune systems a chance to fight off whatever bug is making them unwell.

Some parents prefer this approach – in case there’s more than one virus going around. Kids whose immune systems are already hard at work are often the ones who get every single bug going.

But what if your child only has a common garden-variety cold and isn’t really sick?

Most health experts these days agree it would be impossible to send children into group care or preschool if the common cold were an excuse for exclusion. During winter, most children regularly experience cold symptoms, including: runny nose, nasal congestion, cough, sneezing, mildly sore throat, and mild fever.

If your children have mild symptoms without fever, aren’t sneezing and coughing constantly, and are otherwise happy in themselves (eating, drinking and playing), then generally a group care centre or preschool will be fine about having them attend.

How Do You Decide Whether To Keep Children Home From Group Care?

If you’ve woken up in the morning (or been up during the night) to a sick child, and you’re wondering whether you should keep the child at home, ask yourself these questions:

• Is this illness likely to be something contagious and easily passed on to staff and other children?
• Will my child be well enough to enjoy being at group care, playing  and doing activities?

Sometimes, it’s wiser to keep your child at home. Seek medical advice, as necessary, if you notice the following symptoms:

• Raised temperature with lethargy
• Uncontrolled coughing, breathing difficulties, or wheezing
• Diarrhoea – generally, exclusion is for 24 hours after last loose bowel motion
• Vomiting – generally, exclusion is for a minimum of 24 hours
• Any sort of rash, especially with fever
• Mouth sores
• Bacterial conjunctivitis.

Sometimes children are out of sorts or unwell the night before, and wake up perfectly fine the next day.

In that case, with the exception of diarrhoea and vomiting, it’s usually ok to take your child to group care. Be sure to let the care providers know what has happened, though. Then they can keep an eye on your child in case symptoms return.

Your Child Is Sick And You Can’t Take A Day Off

Parents often have to balance the need to work against the need to care for a sick child. It can be difficult. In these situations, it helps to have a back up plan in place:

• Split the day with your partner
• Ask grandparents or other relatives to take over for a few hours
• Hire a nanny or babysitter
• Speak to your neighbours or friends who are stay at home parents. Ask whether they can take over for a few hours.

Your child’s group care centre or preschool has a responsibility to look after the wellbeing of its staff and the other children. It’s never appropriate to pressure the care provider to accept a child who is genuinely sick.

It might be tempting to resort to a dose of paracetamol and hope your child gets through the day. In the end, though, rest at home is the best medicine.