Tuesday, February 10, 2009

The Cough-and-Sniffle Question - When to Keep a Child Home? - NYTimes.com

There are moments when I feel I have spent large parts of my professional life dropping off my own marginally ill children at school (or at day care) and then hurrying to work to examine children who are notably less sick but have been kept home by their parents and brought to see the doctor.

I'm talking about the common cold, the winter crud, the lingering nasal drips and irritated coughs that mark our children's passage through the varied mix of respiratory viruses — or perhaps mark the viruses' passage through our children.

What I'm not talking about is childhood fever. I vigorously deny those vile rumors that I occasionally, in the distant deniable past, gave my warm-to-the-touch toddler a big dose of ibuprofen at day-care drop-off time — though we're admittedly entering into the Deepest Secrets of the Working Parent Zone here. The child with fever clearly needs to stay home, as does the child who is vomiting or is just plain miserable.

On the other hand, I do remember getting several calls from day-care directors or school nurses to inform me that although my child seemed happy and active, there was in fact a lurking fever — and I remember biting back the question, what kind of zealot takes the temperature of a happy, active child?

But of course, they were worrying about the other children. And that is a fair question with any child who is borderline sick: who is infectious, what's the risk, and is there anything we can do to reduce it?

Doctors, as a group, are big believers in sending children to school. Every doctor I've talked to is more concerned about children unnecessarily missing school than about their posing an infection risk to their classmates.

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http://www.nytimes.com/2009/02/10/health/10klas.html?_r=1&pagewanted=print