There’s a decision parents will face this school year and it will be more challenging than assisting with complex homework assignments: Is your child sick enough to stay home from school or well enough to make it through a day of class work?

Unfortunately, there is no easy answer to this debate. On one hand, moms and dads don’t want to take their child to the doctor for every sniffle and booger. On the other, no one wants to wait so long that an illness becomes serious or progresses into a health crisis.

Caretakers must consider how taking time off to care for a sick child might affect their job, whether the illness might ease or exacerbate during the day, and how the child’s school might handle the situation.

So what’s a parent or school administrator to do?

First, you should have an idea about the rules, whether from the perspective of the state, district or individual school. The American Academy of Pediatrics also offers tips for families on their website According to the AAP, “Different states have different rules about when a sick child should be kept out of child care or school. Child care centers or homes within the state may have additional rules. Sadly, most of the state guidelines are not very detailed and may not be based on medical facts.”

The AAP suggests that parents keep two questions in mind: “Does the child’s illness keep him or her from comfortably taking part in activities?” Or, “does the sick child need more care than the staff can give without affecting the health and safety of other children?”

“If the answer to either of these questions is “yes,” then your kiddo should not go to child care or school,” the website says.

Caregivers and teachers should also consider these questions. If a parent sends a sick kid to child care or school, the caregiver or teacher may not let the child stay.

A third question the AAP asks: “Could other children get sick from being near my child?”

“Most common illnesses, like a cold, are not really harmful,” says the site. “Other children can catch illnesses before, during or after your child is sick. Making a sick child stay home may not really prevent other children from getting sick.”

“The family should ask questions like those above and make a decision based on what they see at the time. For example, a tummy ache could be the beginning of vomiting and diarrhea (for which a child should not attend school). Tummy aches can also mean that a child is nervous about school, which shouldn’t prevent attendance. If a child is nervous about school, experts suggest that the child go to school, and the family talk to a doctor or teacher about what is making the child nervous.”

With a little guidance and the following two checklists, the sick kid decisions may be just a little bit easier this fall.

If my child stays home from school, do they have to see the doctor?

It depends. From a mom or dad’s perspective, follow your gut. Pediatricians and the AAP will tell you that the biggest things to watch out for are:

  • Whether the child is acting like himself or herself
  • If he or she is able to keep up normal fluid intake and having normal urine output
  • Vomiting and diarrhea that lasts for more than a 24 hours in a child of any age, or bloody diarrhea
  • Rash, especially if there is also a fever
  • Any cough or cold that does not get better in several days, or a cold that gets worse and is accompanied by a fever
  • Cuts that might need stitches
  • Limping or inability to move an arm or leg
  • Ear pain with fever, lack of sleeping or acting ill, or ear drainage
  • Severe sore throat or problems swallowing
  • Sharp or persistent pains in the abdomen or stomach
  • Pain that gets worse or does not go away after several hours
  • Fever and repeated vomiting at the same time
  • Blood in the urine

When do I seek emergency care?

Arkansas Children’s Hospital advises that parents call 911 or the appropriate local emergency number for any severely ill or injured child, or if an infant or child has any of the following:

  • Bleeding that does not stop with direct pressure over the wound
  • Suspected poisoning (Call the Poison Help line at 1-800-222-1222)
  • Seizures (rhythmic jerking and loss of consciousness)
  • Trouble breathing
  • Skin or lips that look blue, purple or gray
  • Neck stiffness or rash with fever
  • Head injury with loss of consciousness, confusion, vomiting, or poor skin color
  • Sudden lack of energy or inability to move
  • Unconsciousness or lack of response
  • Acting strangely or becoming more withdrawn and less alert
  • A cut or burn that is large, deep or involves the head, chest, abdomen, hands, groin or face

For more information, visit

Susan Sullivan Demirel is an MD with Arkansas Children’s Hospital and University of Arkansas for Medical Sciences.