From the Guidelines
A child can generally return to daycare after a contagious illness when they are no longer contagious and feeling well enough to participate in activities, with specific conditions having different guidelines as outlined by local health authorities and the Infectious Diseases Society of America 1.
General Guidelines
For most common illnesses, children should be fever-free for at least 24 hours without fever-reducing medications like acetaminophen or ibuprofen before returning.
- Children with strep throat can typically return after 24 hours on antibiotics like amoxicillin.
- Those with pink eye can return after 24 hours of antibiotic eye drops.
- Children with gastrointestinal illnesses should stay home until diarrhea and vomiting have stopped for at least 24 hours.
Specific Conditions
For non-contagious conditions like ear infections, children can return when they feel well enough and any prescribed antibiotics have been started.
- Rashes may require a doctor's note confirming they're not contagious.
- According to the 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea, children with certain infections like Salmonella or STEC may need to provide negative stool cultures before returning to daycare 1.
Importance of Waiting Periods
These waiting periods are important because they allow the child's immune system to fight the infection and reduce the risk of spreading illness to other children and staff.
- Always check your specific daycare's illness policy, as some facilities may have stricter requirements for certain conditions.
- It is also recommended to collaborate with local public health authorities to adhere to policies regarding return to settings in which transmission is a consideration 1.
From the Research
General Guidelines for Returning to Daycare
- The decision to send a child back to daycare after recovering from a contagious illness or non-contagious condition depends on various factors, including the type of illness, the child's overall health, and the daycare's policies 2.
- There is no consensus on the exact criteria for excluding children from daycare, as opinions differ among daycare staff, mothers, and pediatricians 2.
Contagious Illnesses
- Children in daycare settings are at a higher risk of contracting infectious diseases, with some studies suggesting a two to four times greater risk compared to children cared for at home 3.
- The risk of respiratory illness is particularly high for children in daycare, especially those under the age of 3 years 4.
- Daycare attendance has been linked to an increased risk of respiratory illness, although this risk decreases with longer duration of exposure to daycare 4.
Non-Contagious Conditions
- There is limited research on the specific guidelines for returning to daycare after recovering from non-contagious conditions.
- However, it is generally recommended that children should be free from symptoms and no longer require medical attention before returning to daycare.
Prevention and Intervention
- Improving microbiological hygiene and training daycare staff on proper hygiene practices can help reduce the spread of infections in daycare settings 5.
- Increasing outdoor time and space for children in daycare can also help reduce the risk of infection 5.
- A study found that children in daycare who remained in the same childcare arrangement for 3 years had a trend toward stabilized or decreased rates of infection, duration of illness, and risk of hospitalization 6.