Daycare Illness Policy Guide 2026: When to Keep Kids Home

Understanding your daycare's illness policy is essential for every parent—knowing when to keep your child home, what symptoms require exclusion, and when they can return helps everyone stay healthy and reduces workplace disruptions. Quality illness policies protect all children while being reasonable for working families.

This guide covers everything about daycare illness policies in 2026: common exclusion symptoms, illness-specific guidelines, return-to-care requirements, and how to evaluate whether a program's policies are reasonable.

Table of Contents

• Understanding Illness Policies
• When to Keep Your Child Home
• Common Illness Guidelines
• Return-to-Care Requirements
• Evaluating Illness Policies
• Managing Sick Days
• Questions to Ask

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Understanding Illness Policies

Why they matter.

Purpose of Policies

Illness policies:

• Protect all children
• Protect staff
• Reduce spread of illness
• Maintain healthy environment
• Set clear expectations

Who Sets the Rules

Policies come from: | Source | Influence | |--------|-----------| | State licensing | Minimum requirements | | Health department | Medical guidance | | Program policies | Additional rules | | CDC guidelines | Best practices |

Variability Between Programs

Policies differ in:

• Specific symptoms
• Fever thresholds
• Exclusion length
• Return requirements
• Strictness

The Balancing Act

Programs balance:

• Child safety
• Family needs
• Staff health
• Legal requirements
• Practical considerations

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When to Keep Your Child Home

General guidelines.

Universal Exclusion Symptoms

Always keep home with:

• Fever (usually 100.4°F+ or 101°F+)
• Vomiting (within 24 hours)
• Diarrhea (within 24 hours)
• Unexplained rash
• Pink eye with discharge
• Head lice (until treated)

Respiratory Symptoms

Evaluate carefully: | Symptom | Exclude? | |---------|----------| | Runny nose (clear) | Usually no | | Green runny nose | Policies vary | | Persistent cough | Often yes | | Difficulty breathing | Yes | | COVID symptoms | Per policy |

The Fever Rule

Common thresholds:

• 100.4°F or higher: Most programs
• 101°F or higher: Some programs
• Fever-free period: 24 hours without medication

Behavioral Signs

Keep home if:

• Too sick to participate
• Unusually tired/fussy
• Needs more care than possible
• Would be miserable at daycare

Can Participate Test

Ask yourself:

• Can they play?
• Can they eat/drink?
• Can they rest normally?
• Do they need constant attention?
• Would I send them to a friend's?

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Common Illness Guidelines

Specific conditions.

Fever

Guidelines:

• Threshold: Usually 100.4°F or 101°F
• Exclusion: Until fever-free 24 hours
• Without medication
• No Tylenol to bring down before drop-off

Vomiting

Guidelines:

• Exclusion: Yes
• Return: 24 hours symptom-free
• Single incident: May vary
• Recurring: Definitely excluded

Diarrhea

Guidelines: | Type | Exclusion | |------|-----------| | Single loose stool | Usually no | | Multiple episodes | Yes | | Cannot be contained | Yes | | With other symptoms | Yes |

Return: 24 hours symptom-free

Pink Eye (Conjunctivitis)

Guidelines:

• Exclude if: Discharge present
• Return after: 24 hours on antibiotics (bacterial) or discharge resolves
• Viral: May not need antibiotics
• Doctor's note: Often required

Hand, Foot, and Mouth

Guidelines:

• Highly contagious
• Exclude until: Fever-free, blisters crusted
• May return with active rash: Policies vary
• Common in daycare settings

Strep Throat

Guidelines:

• Exclude: Yes
• Return: 24 hours on antibiotics
• Fever-free
• Doctor confirmation

Ear Infections

Usually NOT excluded unless:

• Fever present
• Too uncomfortable to participate
• Contagious symptoms

COVID-19

Current guidelines:

• Follow program policy
• May require testing
• Isolation period varies
• Check current recommendations

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Return-to-Care Requirements

Getting back to daycare.

General Return Rules

Typically need: | Requirement | Details | |-------------|---------| | Symptom-free period | 24 hours usually | | Fever-free | Without medication | | Can participate | Well enough for activities | | Not contagious | Per specific illness |

Doctor's Notes

When required:

• Some programs always require
• Others only for specific illnesses
• Some accept parent attestation
• Know your program's policy

Medication Requirements

May need to be on antibiotics for:

• 24 hours before return
• Specific to illness
• Varies by program

Grey Areas

What counts as "symptom-free":

• Lingering cough: Often allowed
• Runny nose: Usually allowed
• Low energy: Use judgment
• Still contagious but feeling better: Check policy

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Evaluating Illness Policies

Reasonable vs excessive.

Reasonable Policies

Good signs:

• Based on health guidelines
• Clear criteria
• Consistent application
• Practical for families
• Focused on contagious periods

Overly Strict Policies

Watch for: | Potentially Excessive | Concern | |----------------------|---------| | Exclude for any runny nose | Too restrictive | | 48+ hours for all illnesses | Beyond necessary | | Doctor note for everything | Burdensome | | No green runny nose ever | Not evidence-based |

Overly Lax Policies

Concerning if:

• No fever policy
• Sick children present
• No exclusion for vomiting
• Dismissive of illness
• Staff come to work sick

Questions About Policies

To understand:

• "What symptoms require exclusion?"
• "How long must my child be symptom-free?"
• "When is a doctor's note required?"
• "What's your fever threshold?"

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Managing Sick Days

When your child is sick.

Building Your Backup System

Options for sick child care: | Option | Pros | Cons | |--------|------|------| | Parent stays home | No coordination | Work impact | | Family member | Trust, free | Not always available | | Sick child care service | Designed for this | Cost, availability | | Work from home | Stay with child | May be hard to work |

Sick Child Care Services

May be available:

• Through employer benefits
• Specialized sick child centers
• Sick child nanny services
• Hospital-based programs

Work Coordination

Strategies:

• Split with partner
• Use sick leave
• Work from home if possible
• Flex schedule
• Have backup identified

Planning Ahead

Be ready:

• Know your work policies
• Identify backup care
• Stock comfort supplies
• Have pediatrician number
• Understand daycare policy

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Communication About Illness

When to Notify Daycare

Let them know:

• If keeping child home sick
• What the illness is
• Expected return
• If anything diagnosed

If Child Gets Sick at Daycare

Expect:

• Call to pick up
• Description of symptoms
• Timeline to pick up
• Information about when to return

Sharing Health Information

Appropriate to share:

• Contagious diagnoses
• Symptoms to watch for
• Care needs if returning
• Medication requirements

Privacy Considerations

Daycare should:

• Keep health info private
• Not share child's name in outbreak notices
• Protect your information
• Notify of exposure generally

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Questions to Ask

About General Policy

1. "What's your illness policy?"
2. "Can I see it in writing?"
3. "What symptoms require exclusion?"
4. "How long must my child be symptom-free?"

About Specific Situations

1. "What's your fever threshold?"
2. "What about runny noses?"
3. "When is a doctor's note required?"
4. "How do you handle COVID symptoms?"

About Notification

1. "How will I be notified if my child is sick?"
2. "How quickly must I pick up?"
3. "How do you notify parents of outbreaks?"
4. "What information do you need from me?"

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Illness Policy Checklist

Understanding the Policy

• [ ] Get policy in writing
• [ ] Know fever threshold
• [ ] Understand symptom-free requirements
• [ ] Know doctor's note requirements
• [ ] Understand specific illness rules

Preparation

• [ ] Backup care identified
• [ ] Work flexibility understood
• [ ] Pediatrician accessible
• [ ] Supplies at home
• [ ] Emergency contacts updated

When Illness Hits

• [ ] Notify daycare
• [ ] Follow exclusion requirements
• [ ] Get needed documentation
• [ ] Track symptom-free period
• [ ] Communicate return plan

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Quick Reference Chart

Common Exclusion Periods

| Illness | Exclude Until | |---------|---------------| | Fever | 24 hours fever-free | | Vomiting | 24 hours symptom-free | | Diarrhea | 24 hours symptom-free | | Pink eye | 24 hours on antibiotics or no discharge | | Strep | 24 hours on antibiotics | | HFM | Fever-free, blisters crusted | | Head lice | After treatment | | Flu | Per doctor guidance |

Always check your specific program's policy

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Resources

• Find Quality Daycare Near You
• CDC Childcare Guidance
• Daycare Health & Safety
• Backup Childcare Guide

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Last updated: December 2025