When is a child too sick to go to school?

DEAR DR.PAUL: I have a question that seems simple, but I feel is an important one. How do you know when your child is too sick to go to school? Thank you.

PEDIATRICIAN DR.PAUL Answers: This is a very basic question with a broad answer. In today’s society where often both parents work, what to do with a sick child at home during the day is an issue that complicates matters. I want to qualify my answer however by saying that parents know their child best and can eventually learn to judge when a child is too unwell to go to school.

Aside from the real social issue related to both parents or a parent (in a single-parent family) working without any readily available child care support, I have broken down the decision process to the following criteria:

  • Is the child contagious? Most children with a viral infection are contagious during the first few days. Children with chicken pox are contagious as long as the skin spots are still full of liquid, usually for about four days. Once the chicken pox lesions dry and become crusty, the child is no longer contagious. In the case of a bacterial infection such as a Strep Throat, a child is no longer considered contagious after a period of 48 hours if she has been on antibiotics. We do not consider a child with an ear infection (Otitis Media) to be contagious.
  • Is the child actively vomiting and/or having diarrhea? This, of course, is a reason not to send a child to school. The classroom is not a good place to be sick in. Additionally, in this situation, we want to keep an eye on the child to make sure he is not dehydrated, and to provide the necessary fluids at home to prevent dehydration.
  • How uncomfortable is the child? Is there any pain or other symptoms that are making the child uncomfortable? For example, is there a headache? Is the nose very stuffy? Does the throat hurt a lot? Does the child have ear pain? If the answer is yes and the pain makes the child uncomfortable, chances are the child will not be able to concentrate and perform well at school and should stay home, rest and take the necessary treatment, if any.
  • Is the child tired and/or listless? If so, the last thing she needs is to go to school. Rest in bed would be better.


What I described above is a general outline or checklist to run through that I think is useful in helping decide whether or not a child is too sick to go to school. Of course, if still unsure, your doctor can give you some specific advice.

Finally, here is a real common sense tip: when trying to make this decision, put yourself in your child’s position. If you had a particular symptom or illness, would you send yourself to school?

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Pediatrician DR.PAUL Roumeliotis is certified by the American Board of Pediatrics and Royal College of Physicians and Surgeons of Canada. The information provided above is designed to be an educational aid only. It is not intended to replace the advice and care of your child’s physician, nor is it intended to be used for medical diagnosis or treatment. If you suspect that your child has a medical condition always consult a physician.