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Oregon Family Magazine

When is Your Child Too Sick for School?

12/01/2019 ● By Sandy Kauten
During cold and flu season, children are frequently exposed to germs that cause illness, and it can be difficult for parents to know when to keep their child home from school.

The American Academy of Pediatrics’ (AAP) guidelines for school exclusion are based more on a child’s behaviors than on specific symptoms. The main criteria for exclusion include not being able to participate in activities, being so sick that the child requires more attention than staff can provide or spreading a harmful illness. 

Should you keep your child home if they have:

  • Fever: YES, if the fever is above 100.4. Children should stay home until they are fever-free, without fever-reducing medicine.
  • Common cold: NO. Exclusion is not recommended unless the child has a fever, significant behavior changes, looks or acts very ill, has difficulty breathing, has a severe cough, or has a blood-red or purple rash.
  • Mild cough: NO, unless it is severe, accompanied by rapid or difficult breathing, wheezing, or the child has a known respiratory illness, such as whooping cough.
  • Mild Diarrhea: NO, unless it causes the child to have accidents. Encourage hand-washing.

  • Vomiting: YES, if your child has thrown up two or more times in the previous 24 hours—unless it’s been determined that their vomiting was caused by a non-communicable/non-infectious condition, and your child is not in danger of dehydration. Keeping them home for 48 hours is preferred
  • Abdominal pain: YES, if it continues for more than two hours or they are experiencing intermittent pain associated with fever or other signs or symptoms.
  • Rash: YES, if accompanied by fever. If a child’s rash is caused by allergies, he or she can attend school.

To help lessen the spread of illness, ensure that your kids are up to date on their vaccinations and are immunized against influenza. Get more germ-prevention strategies at

By Emily Dalton, M.D., F.A.A.P.

Eugene Pediatric Associates