When your child wakes up with a runny nose or a cough, it can be hard to know whether to keep them home or send them to preschool. Most preschools follow clear, research-backed policies to reduce the spread of illness while supporting children’s social and learning routines. Understanding these guidelines helps you make confident decisions and partner effectively with your child’s school.
Common reasons to keep a child home
Preschool policies typically align with recommendations from pediatric health organizations. In general, a child should stay home if they have any of the following:
- Fever of 100.4°F (38°C) or higher within the past 24 hours without fever-reducing medication
- Vomiting or diarrhea two or more times in 24 hours
- Conjunctivitis (pink eye) with discharge or crusting until treated or cleared by a doctor
- Strep throat or other bacterial infections until at least 24 hours after starting antibiotics
- Severe cough or difficulty breathing not due to allergies or asthma
- Unexplained rash until a doctor confirms it is not contagious
When can a child return?
Most preschools require that a child be symptom-free for 24 hours without medication before returning. This includes no fever, vomiting, diarrhea, or other contagious signs. Some schools also ask for a doctor’s note after certain illnesses, especially for strep throat, chickenpox, or confirmed influenza.
What about mild symptoms like a runny nose?
Many preschoolers have constant mild cold symptoms, but a clear runny nose alone is not usually a reason to stay home if the child is otherwise active and comfortable. However, if the mucus is thick, yellow or green, or if the child has a fever or is unusually tired, it is best to keep them home.
How to prepare for sick days
Having a backup plan for sick days can make the decision easier. Consider these steps:
- Keep a list of local backup caregivers or family members.
- Stock children’s fever-reducing medicine (with pediatrician guidance).
- Post the preschool’s illness policy somewhere visible.
- Talk to your employer about flexible sick time options.
When to call the doctor
If your child has a fever that lasts more than 3 days, is very lethargic, has trouble breathing, or shows signs of dehydration (dry mouth, not urinating normally), contact your pediatrician. Trust your instincts. You know your child best.
Partner with your preschool
Each preschool may have slightly different policies. Review them at enrollment and ask questions at the beginning of the year. Let the teacher know if your child tests positive for a contagious illness, and follow the school’s guidelines for notifying other families (if required). This builds trust and keeps everyone healthier.
Remember: missing a few days of preschool for illness is normal and helps protect other children. By following clear, evidence-informed policies, you support your child’s recovery and your community’s well-being.