Sick Day or School Day? A Parent’s Guide to Making the Call

It’s 6:45 a.m. Your child says their stomach hurts or they woke up coughing. And now you have a decision to make: Do they stay home, go to school, or need to see the doctor?

There isn’t always a simple answer, but a few guidelines can help you decide.

When Should I Keep My Child Home?

In general, your child should stay home when they’re sick enough so that they can’t comfortably participate in a normal school day, or when they may be contagious. Consider keeping your child home if they have:

A fever. Keep them home until they’ve been fever-free for at least 24 hours without fever-reducing medicine.
Vomiting or diarrhea. Keep your child home if vomiting or diarrhea is frequent, ongoing, or makes it difficult for them to comfortably participate in their usual activities. In general, they should be able to keep food and fluids down and have symptoms under control before returning to school.
Significant coughing or respiratory symptoms. A mild lingering cough may not require a sick day, but frequent or severe coughing that interferes with normal activities is a reason to stay home.
A new or unexplained rash, especially with a fever or other symptoms.
Eye redness with significant drainage. Some eye infections can be contagious and may need treatment.
Extreme tiredness or discomfort. If your child doesn’t have the energy to make it through a normal school day, rest may be what they need most.

A helpful question to ask yourself: Would my child be able to comfortably learn, play, eat, drink, and participate in their usual activities today? If the answer is no, home is probably the right place.

When Should I Call My Pediatrician?

Not every illness requires a trip to the pediatrician, but if something doesn’t seem right, it’s always appropriate to call your pediatrician to ask for help.

Contact your child’s pediatrician if:

A fever is unusually high, lasts several days, or concerns you.
Symptoms are getting worse instead of better.
Your child has persistent vomiting or diarrhea or is having trouble staying hydrated.
A cough is severe, persistent, or accompanied by wheezing or difficulty breathing.
Your child has significant ear pain, throat pain, or other persistent pain.
You notice an unexplained rash, particularly one accompanied by fever or other symptoms.
Your child seems unusually sleepy, weak, irritable, or simply “not themselves.”
You’re unsure if your child is ready to return to school, daycare, or childcare.
You need advice about school attendance, return-to-school recommendations, or a school excuse/note.

For babies and young children, illness can sometimes require more prompt attention. Call your pediatrician for guidance if you have concerns about symptoms in an infant.

Seek immediate medical care for serious symptoms such as difficulty breathing, severe dehydration, a seizure, blue or gray lips or skin, severe lethargy, or if your child is difficult to wake.

When Is It Ok to Go Back to School?

A runny nose or lingering cough doesn’t necessarily mean your child needs to stay home. Generally, your child may be ready to return to school when:

They’ve been fever-free for at least 24 hours without fever-reducing medicine.
Vomiting and diarrhea have stopped for at least 24 hours.
Their symptoms are improving.
They’re eating and drinking reasonably well.
They have enough energy to participate in a normal school day.
They meet any specific return-to-school guidelines for a diagnosed contagious illness.

Keep in mind that schools and childcare centers may have their own illness policies, so it’s always a good idea to check their requirements, too.

How Should I Handle “Almost Sick” Days?

This is where things get tricky. A stuffy nose? A small cough? A complaint of a stomachache with no other symptoms? Not every symptom requires a sick day. Pay attention to the whole child, not just one symptom.

Ask yourself:

Are they acting like themselves?
Can they eat and drink normally?
Do they have enough energy for school?
Are their symptoms manageable without constant attention from a teacher or school nurse?

If so, school may be perfectly reasonable.

When in Doubt, Call Your Pediatrician

Parents make these judgment calls all the time, and you don’t have to make them alone. Your child’s UPMC Children's Community Pediatrics care team can help you determine whether symptoms can be cared for at home, need an appointment with your pediatrician, or require more immediate care like a trip to the emergency room. We can also answer questions about school attendance, return-to-school timing, and when a school excuse or note may be needed.

Need help after hours? Your neighborhood UPMC Children's Express Care location is here for you when your pediatrician's office is closed. And for added convenience, they offer 24/7 pediatric video visits – even on holidays.

Because sometimes the most important part of deciding between a sick day and a school day is simply knowing who to ask.