It happened when I was dropping my three kids off at school one morning. My four-year-old looked at me and said the words every working mom dreads, “I don’t feel good. My tummy hurts.” I had a moment of panic because my next stop was supposed to be work. I was a lactation consultant in a hospital. There were moms waiting to see me at that very moment.
Then I remembered I didn’t have to choose between telling my sick child to suck it up and go to daycare or taking him home and not going in to work. The hospital where I worked offered sick childcare to its employees. If the pediatrics unit wasn’t busy, they’d take care of him.
This benefit is no longer available at that hospital. Sick childcare is a benefit offered by very few employers. A survey conducted by Care.com revealed only 15% of parents reported their employer offered back-up childcare benefits.
The most recent National Study of Employers reported only 10% of employers with 1,000 or more employees provided sick childcare. Employers with 50-99 employees were even less likely to provide this benefit, with a mere 3% offering it.
The Parental Dilemma
A reality of being a parent is kids get sick. Another reality is sometimes parents make the decision to send their sick child to daycare or school.
Silvia M tells Parentology she sends her child to daycare when she knows that’s where he got the illness. “[When]I’ve heard the cough going around,” she gives as an example. She says she never sends him if he has a fever, though.
Jo from The Moms At Odds confesses to Parentology, “I’m not proud of the fact, but I’ve definitely sent my kids to daycare a few times against the ‘sick rules.’” She admits that it’s “A truly selfish move on our part, but sometimes when you’re a working, sleep-deprived parent, you may not make the best decisions.”
The Daycare’s Point of View
Tina M. Pascoe, RN, MHA, JD, co-founder of Nurses for Day Care, a nurse-owned and operated, medical training/consulting firm servicing the unique needs of childcare providers. When it comes to protocol for sick children, Nurses for Day Care follows the American Academy’s Caring for Our Children, Fourth Edition.
What Pascoe most often hears from parents, “The main reason that parents have given me for sending in sick children is that they’ve been fever-free for 24 hours off fever-reducing medication and safe to return.”
Pascoe tells Parentology many parents bring a Primary Care Provider (PCP) note to giving the okay for kids to return. “However, we know they’re still contagious and unable to stay.”
Reasons for bringing sick kids to Nurses for Day Care run the gamut, Pascoe reports. “Some parents say they can’t take any more time off, or they risk losing their jobs. Other weren’t aware their child was sick. Some kids are under the weather on arrival and get sicker during the day.”
Gauging Symptoms, Weighing Options
So when, exactly, do you know you won’t be infecting anyone when you send a sick child back to day-care?
Sanjaya Senanayake is an infectious diseases physician and a lecturer at the Australian National University Medical School. In an article for Stuff.com, Senanayake said you can’t always tell. “It varies depending on the type of infection. Kids tend to excrete a bit longer than adults.” While adults and children with common colds and flu are most infectious during the first five days of the illness, kids will often “continue excreting it” for two weeks, even after they seem well.
As a general rule, Senanayake said, if it’s the first few days of the illness and they have symptoms, like a runny nose, they’re probably going to infect people. He advised, “If they’ve got a bad cold and cough and you can, keep them home for four days to help them fully recover and take them through the most infectious period for other kids.”
With gastrointestinal issues, Senanayake said determining a course of action depends on the virus. “Usually by the time the diarrhea has settled, the amount of infection is very low and if there’s good hygiene practice, it shouldn’t really spread.”
On the rash front, Senanayake said, “While they are typically not infectious in themselves, they represent an infectious process in the body. In a sense, it’s literally a red flag, so the rash may not be infectious but everything else about that child is.”
This is all good information to have, though the reality for many working parents, myself included, is we quite literally can’t afford to take five days off work every time our child is sick.
Senanayake acknowledged the different pressures influencing the decisions we make. It’s trying to use common sense and, as much as we can, trying not to perpetuate the petri dish spread.
When we can’t, though, we shouldn’t feel too bad, Senanayake said. He points out, regardless, children are going to be exposed to infections at daycare and school and, for the most part, it ultimately will help to develop their immune system.