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How long should a child with a cold stay home?
Q: I am a full-time working mom, and I am wondering how long I should keep my child home from daycare when he develops a cold? How long is he considered contagious? I understand that anyone who is sick is actually more contagious a day or two before they even have any symptoms. Is that true?
A: It can be challenging taking off work to care for your child with every illness. It’s common for infants to have 10 to 12 illnesses in their first year of life including colds, ear infections and diarrhea. Over time, as children are exposed to more illnesses, their bodies develop immunity and they tend to get sick less frequently. Children in child care programs are typically exposed to more children and more germs, and often get sick more frequently in their first year in child care, but they also tend to develop immunity and stay healthier in subsequent years.

The American Academy of Pediatrics and American Public Health Association have collaborated with leaders of childcare associations to develop health guidelines for children in childcare. The guidelines, “Caring for Our Children,” (available through the National Resource Center for Health and Safety in Child Care, http://nrc.uchsc.edu) identify those illnesses for which children should stay home from childcare, and for how long.

In fact, they do not recommend that you keep your child home for a cold, as long as he’s comfortable and able to participate in the child care activities, and doesn’t have any other symptoms of a more serious illness such as high fever, severe cough, vomiting or diarrhea. The main reason why health authorities say it’s OK to send your child with a mild cold is what you pointed out—a child with a cold begins being contagious in the several days before the symptoms of runny nose are apparent, so keeping him home after he shows the symptoms won’t prevent the cold from spreading to other children. It would be like shutting the barn door after the horse has gotten loose.

On the other hand, if your son is feeling really sick with his cold and is unable to participate in the usual childcare activities, you should keep him home and allow him to rest and get more tender loving care for a couple of days, for his own health and well-being.

Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician