Little boy getting his temperature taken.


Sick Day?

When to keep a sniffling child at home

Your child wakes up feeling miserable. They’re complaining of a stuffy nose and a sore throat but they don’t have a fever. Should you keep them home or send them off to school?

It’s an everyday dilemma for millions of moms, dads and caregivers as they struggle to weigh what’s best for their children against scrambling to find – and possibly find the money to pay for – last-minute care. 

Sniffles alone are not a reason to keep your child at home. The common cold is just that, common, and you can expect a certain amount of sneezes and coughs from your kids. In fact, say experts, plan on your youngster coming down with anywhere from three to 12 (!) this year. That’s because your child’s immune system is still developing, making them a magnet for 200 plus cold-causing viruses. Kids also pass germs on easily because they constantly have their hands in their mouths, on other children and on toys.

So, how can you tell if it’s a cold or something else? In the absence of a fever, you need to rely on your instincts and knowledge of your child. Are they eating well? Having trouble falling asleep? Did they wake up last night complaining of a scratchy throat? Obviously, a kid who’s feeling lousy isn’t going to get much out of school, so keeping them home as a precaution is never a bad idea, especially if you can keep an eye on them to watch for additional symptoms. 

Painful earaches, heavy coughs accompanied by a steady stream of mucus, and rapid and/or labored breathing, however, are all red flags that warrant an immediate call to your child’s doctor. For less alarming common cold-like symptoms, the following tips – culled from pediatricians and other medical experts – offer advice on how to react.

Keep Your Child Home...
And call a doctor if:
• They have a temperature of more than 100 degrees.
• They’re experiencing dizziness, weakness or flu-like symptoms.
• They have a runny nose and are discharging thick green or yellow mucus.
• They’re experiencing a cough or congestion that interferes with their breathing. 
• They have a severe headache.
• They’re experiencing diarrhea or vomiting.
• They have a rash of unknown origin.
• There’s thick mucus draining from their eye(s).

Forget what you’ve heard about sitting in a drafty room or going outside with wet hair. Colds are caused by viral infections and typically go away on their own after about a week or so. For that reason, antibiotics won’t provide relief. 

What you can do: offer your child plenty of fluids (chicken soup really does help!); loosen congestion with a cool mist humidifier or a steamy bathroom; try a saline (salt water) nasal solution or a bulb syringe (for little ones); teach them to blow their nose by closing one nostril with a finger and blowing with the other; and try to get them to rest, even if it’s just lying on the sofa watching TV. An age-appropriate dose of acetaminophen may be used to reduce fever and achiness.

Be prepared for the fact that colds can sometimes get worse before they get better and that complications occasionally may lead to such ailments as bronchitis, pneumonia, or sinus or ear infection. Suspect a secondary infection if your child starts running a fever after the first day, has a thick, greenish or yellow nasal discharge, a wheezing cough, continued sore throat or earache, or seems lethargic.

Sore Throat
A mild sore throat accompanying a cold does not require specific medical treatment. Since the sore throat is a symptom, your goal is provide as much relief as you can. Warm and cool liquids can be soothing options. Try hot water with lemon or ice cubes made out of Gatorade. Children ages 8 and up can gargle with warm salt water. If the sore throat is accompanied by a fever or continues for several days, consult your doctor.

The flu is often confused with the common cold. While both are viral infections involving the upper respiratory tract, the flu – otherwise known as influenza – is more serious, involving a higher fever, cough, sore throat, stuffy or runny nose, headache, loss of appetite, muscle aches and fatigue. Over-the-counter medications may help, though generally, you need to let it run its course. The flu vaccine is recommended for those over 6 months of age with chronic conditions. Miami-Dade County Public Schools offers its students free flu shots with parental consent (contact your child’s school directly for details); the Florida Department of Health in Miami-Dade County also provides free flu shots at various locations (call 786.845.0550 to make an appointment). 

Strep Throat
Strep throat is a contagious bacterial infection. Left untreated, it can lead to rheumatic or scarlet fever. Be on the lookout for white spots on a red throat, difficulty swallowing, swollen glands, fever and general malaise. If you know strep has been going around your child’s school or daycare center, you should take them to the doctor for a strep test. If it’s positive they’ll need an antibiotic and won’t be allowed to return to school until they’ve been on the medicine for at least 24 hours.

Ear infection
Ear infections – basically an inflammation of the middle ear – often come on the heels of an upper respiratory infection. Telltale signs include fever, ear pain, tugging and pulling on ear, drainage and irritability. Medical care and an antibiotic are a must.

Sinus Infection
You can suspect a sinus infection if your child has had a cold for 10 days or more. Signs include a constant runny nose that doesn’t get better; coughing that worsens at night; tenderness of the face (those swollen sinuses!) and a headache. Call your doctor: your child will need an antibiotic.