When is your child too sick for school?

Deciding when to keep your child away from school is tricky. Every parent knows how it feels to have a child saying they feel unwell first thing in the morning on a school day.

They might have a slightly sore throat, a tummy ache, be sneezing or have a headache. If you're dashing to work yourself, it's a hard call to know what to do. Do you keep your child away from school only to find they are full of beans an hour later? Or, send them to school and risk being called to collect them if they feel worse?

Schools do provide guidance on illnesses such as diarrhoea and vomiting. Children should stay at home for 48 hours after the last episode even if they feel well. But the decision is harder with other conditions, especially over the winter when more bugs are common. No parent wants their child to miss a lot of school for very minor illnesses. But what about infecting others?

GP Julie Coffey fully understand this. "It's a tough call for a parent in the morning. One thing they should do is go easy on themselves if they decide to send their child to school and they are then sent home. Things can change very quickly and parents can only deal with what they see at the time."

What you need to look for

Coffey advises: "If your child is properly awake, alert, has a normal appetite, playfulness and chattiness, they are probably going to cope at school even if they have a cold, sore throat or cough. These are the normal run of things for children and getting them actually helps build up their immune system."

However, she suggests: "If your child has other symptoms, such as pain, drowsiness or sleepiness, no appetite or they are unusually quiet, it's best to keep your child away from school, even if they make a dramatic recovery in two hours' time. You know your child best and what for them is normal behaviour."

Schools are likely to be hypervigilant when a child turns up with spots or a rash, points out Coffey.

"They tend to exclude them immediately, although in many cases a rash such as small, pink spots that disappear under the pressure of a glass, are often linked to a viral infection."

Varicella, although also caused by a virus, produces a different type of rash from most other common viruses which affect the skin. These spots, which can be few or numerous, are blistery.

Although chickenpox is infectious, Coffey says: "The infectious stage would have been there a week before the spots appeared. However, your child should stay at home until the spots have crusted over."

Some rashes, such as impetigine, are infectious, as is conjunctivitis. Children with impetigo should be kept away from school until there is no more blistering or crusting, or until 48 hours after antibiotic treatment has started.

Public Health England (PHE) advises that children with conjunctivitis still attend school, as it is usually a very mild infection which often clears up quickly on its own. However, some nurseries and childcare providers do ask that young children, who are in close contact with others, remain at home until it clears up, so check out what applies to your child.

If you are unsure whether your child is really ill or not, it's worth speaking to your pharmacist for advice. Pharmacies are able to offer advice without the need for an appointment, unlike a GP.

Shirin Alwash, spokesperson for the Royal Pharmaceutical Society says: "We often have parents contacting the pharmacy first thing in the morning to ask if their child should go to school. We can recommend certain products at the pharmacy that can be given to children, such as decongestants and eye drops for conjunctivitis. It is important to remind children to use a good hand-washing technique to stop germs spreading."

Each school has their own policy on giving children medicine during the school day. Your child may be able to cope with school if they need a single dose of medications such as mild painkillers, decongestants or an antibiotic during the school day. Some schools will administer these and have a process for managing it, whereas others will ask for the parent to go into school to give medicines to their child, usually at lunchtime. Check with your child's school on their policy.

Both parents and teachers want children to be at school as much as possible if they are well enough. Following a few guidelines will help with that early morning, tricky decision.