Understanding Daycare Sick Policies: What to Expect and How to Plan

It's 7 AM. Your child has a runny nose. You have a meeting at 9. Can they go to daycare?

This scenario plays out in households across America every morning. Daycare sick policies exist to protect all the children in care—but they can also disrupt your work life significantly.

Understanding these policies before you enroll helps you plan for the inevitable: your child will get sick, probably a lot, especially in the first year of daycare.

Why Daycares Have Sick Policies

Before getting frustrated with strict policies, understand why they exist:

Protecting other children: Young children have developing immune systems. Illnesses spread rapidly in group settings, and some children (immunocompromised, infants) are especially vulnerable.

Protecting staff: Caregivers get sick too, and when they do, it affects everyone.

Protecting your sick child: A sick child needs rest and extra care that's hard to provide in a group setting.

State regulations: Many exclusion policies are mandated by state licensing requirements, not daycare choice.

Common Exclusion Criteria

Most daycares exclude children with:

Fever

Typical policy: Temperature of 100.4°F (38°C) or higher

Exclusion period: Must be fever-free for 24 hours without medication before returning

Why: Fever indicates active infection and contagiousness

What to know:

• "Fever-free without medication" means no Tylenol or Motrin masking symptoms
• Many parents are caught by the 24-hour rule—plan for at least one extra day home after fever breaks

Vomiting

Typical policy: Any vomiting

Exclusion period: 24-48 hours after last vomiting episode

Why: Stomach bugs spread explosively through daycares

What to know:

• One spit-up incident usually doesn't count
• True vomiting (multiple episodes, accompanying symptoms) always does

Diarrhea

Typical policy: Two or more loose stools beyond normal for the child, or stools that can't be contained by diaper

Exclusion period: 24-48 hours after stools normalize

Why: GI illnesses are highly contagious and require frequent diaper changes

What to know:

• Teething or diet changes can cause loose stools without illness
• If your child has chronic loose stools, get documentation from your pediatrician

Contagious Illnesses

| Illness | Typical Exclusion | |---------|------------------| | COVID-19 | Per current guidelines (varies) | | Flu | Until fever-free 24 hours and symptoms improving | | Strep throat | Until 24 hours on antibiotics and fever-free | | Pink eye (bacterial) | Until 24 hours on treatment | | Hand-foot-mouth | Until fever-free and blisters are not oozing | | Chickenpox | Until all lesions are crusted over (usually 5-7 days) | | RSV | Often based on symptoms (varies by center) | | Ringworm | Until treatment begins (may need to cover affected area) | | Head lice | Until treated and nit-free (policies vary widely) | | Impetigo | Until 24 hours on treatment and lesions covered |

Other Symptoms

Excessive coughing/congestion:

• Some centers exclude for persistent cough that disrupts activities
• Others allow if child is otherwise well
• Ask your specific center's policy

Rash:

• Unexplained rash often requires doctor's clearance
• Known conditions (eczema, allergies) usually don't require exclusion

Behavior changes:

• "Not acting like themselves," unusually fussy, or lethargic
• Caregivers often call parents for this before other symptoms appear

What You'll Need for Return

After exclusion, daycares typically require:

Always:

• 24 hours symptom-free (or as specified)
• Child acting normally

Sometimes:

• Doctor's note clearing return
• Proof of treatment start (for strep, pink eye, etc.)
• Clearance after specific illnesses (COVID, whooping cough)

Good practice:

• Keep your pediatrician's number handy for quick notes
• Know which conditions require documentation at your center
• Have templates ready for chronic conditions

The Reality: Your Child Will Get Sick A Lot

First-year daycare stats that surprise many parents:

| Metric | Average | |--------|---------| | Colds per year (first year) | 8-12 | | Days with cold symptoms | 60-90 per year | | GI illnesses per year | 2-4 | | Ear infections | 2-3 (varies greatly) | | Days home due to illness | 10-20 per year |

The good news: This decreases significantly after the first year. By kindergarten, daycare kids often have stronger immune systems than those who weren't in group care.

Planning for Sick Days

Before You Need Them

Know your options:

1. Your sick leave/PTO situation
2. Your partner's sick leave/PTO
3. Family members who can help
4. Backup care services
5. Your employer's flexibility policies

Budget for backup care:

• Some employers offer backup care benefits (Bright Horizons, etc.)
• Sick child daycare services exist in some areas ($75-150/day)
• Nanny agencies sometimes place last-minute sitters

Communicate with your employer:

• Some jobs are more flexible than others
• Working from home while caring for a sick child may be possible
• Having the conversation before you need it helps

Creating a Backup Plan

Tier 1: Minor illnesses (runny nose, mild cold)

• May be able to work from home while caring for child
• Partner can sometimes cover part of day
• Lowest-stress option

Tier 2: Moderate illness (fever, vomiting)

• Child needs more attention and rest
• One parent typically needs to stay home
• May need multiple days

Tier 3: Longer illness or quarantine

• May need to alternate days between parents
• May need to call in family support
• May need backup care service

Sample Backup Care Rotation

Many two-parent families alternate:

• Monday: Parent A stays home
• Tuesday: Parent B stays home
• Wednesday: Grandparent or backup sitter
• Thursday: Parent A works from home
• Friday: Child (hopefully) returns

Dealing with the Daycare Call

When daycare calls that your child is sick:

What to expect:

• They'll describe symptoms
• They'll tell you the exclusion policy
• They'll ask how soon you can pick up (typically within 30-60 minutes)

What to say:

• Confirm you understand
• Give a realistic pickup time
• Ask for details about symptoms and when they started
• Ask what you'll need for return

What not to do:

• Argue about whether symptoms are "really" sick
• Send a visibly ill child hoping they won't call
• Consistently be last to pick up (strains relationships)

Strategies for Minimizing Sick Days

Preventive Measures

At home:

• Thorough handwashing routines
• Good sleep schedules (tired kids get sick more)
• Healthy nutrition
• Keep sick siblings separated when possible
• Stay up to date on vaccinations

At daycare:

• Ask about their illness prevention practices
• Look for handwashing compliance
• Notice cleanliness of toys and surfaces

Building Immunity Takes Time

The first year is worst because:

• Exposure to many new germs at once
• Immune system still developing
• Everything goes in mouths

By year two:

• Illnesses decrease significantly
• Duration of illness often shorter
• Child has built immunity to common daycare bugs

Timing Considerations

Some parents:

• Start daycare in summer (fewer respiratory illnesses circulating)
• Start part-time to gradually expose to germs
• Start when child is slightly older (12+ months) if possible

These may reduce (but won't eliminate) first-year illness.

Special Situations

Chronic Conditions

If your child has a chronic condition (asthma, eczema, allergies, etc.):

• Get documentation from your doctor
• Share with daycare to prevent unnecessary exclusions
• Update as needed
• Know the difference between chronic symptoms and new illness

Immunocompromised Children

If your child or a family member is immunocompromised:

• Discuss with your pediatrician before starting daycare
• Consider smaller care settings (family daycare, nanny)
• Ask about the center's vaccination policies
• Know outbreak notification policies

Infant-Specific Concerns

Infants in daycare face unique issues:

• More vulnerable to serious illness
• May need more conservative exclusion policies
• RSV and other respiratory illnesses are more concerning
• Discuss with pediatrician about risk factors

Understanding "Daycaritis"

Some parents call the constant stream of illness "daycaritis." It's real, but perspective helps:

This is normal:

• All children get sick; daycare kids just front-load it
• Non-daycare kids get these same illnesses later
• Early exposure may have long-term immune benefits

This is temporary:

• First 3-6 months are often worst
• Year one is significantly worse than year two
• By preschool age, illness rate drops dramatically

This is manageable:

• Build your backup care network
• Communicate with your employer
• Accept that some disruption is inevitable
• Take care of yourself too

Questions to Ask Before Enrolling

Add these to your tour questions:

1. "What is your sick policy? What symptoms require staying home?"
2. "How quickly do I need to pick up if you call?"
3. "What do you need for my child to return after illness?"
4. "Do you require doctor's notes? For what conditions?"
5. "How do you handle outbreaks of contagious illness?"
6. "What's your policy on mild symptoms like runny nose?"
7. "Do you offer any sick child care options?"
8. "What are your cleaning and sanitizing practices?"
9. "How do you notify parents of illness exposure?"

The Policy in Writing

Request and keep a copy of the written sick policy. It should include:

• Specific exclusion criteria
• Return requirements
• Pickup time expectations
• Outbreak procedures
• Medication administration policies
• Emergency contact requirements

Having this in writing prevents misunderstandings and helps you plan.

Medication Administration Policies

Understanding how daycares handle medication is crucial for managing illness:

Over-the-Counter Medications

Most daycares require:

• Written parental authorization
• Original medication in labeled container
• Specific dosing instructions
• Limited duration (usually 3 days without doctor's note)

Common restrictions:

• No fever reducers (this masks symptoms that would otherwise exclude)
• No cough suppressants without doctor's note
• Sunscreen and diaper cream often require separate authorization

Prescription Medications

For prescribed medications:

• Doctor's note with exact dosing instructions
• Medication in pharmacy-labeled container
• First dose given at home to watch for reactions
• Specific trained staff administers medications

Allergies and EpiPens

If your child has allergies:

• Provide allergy action plan from allergist
• EpiPen stored in accessible location
• All classroom staff trained on administration
• Regular updates as child grows (dosing changes)

Communicating with Your Employer

Having proactive conversations about sick child scenarios:

Before Issues Arise

• Discuss your backup care arrangements during onboarding
• Understand remote work policies for caregiving situations
• Know how sick days and PTO apply to child illness
• Clarify whether "family sick days" differ from personal sick days

When You Need to Call In

Effective communication:

• Call early—as soon as you know
• Be specific about expected duration
• Offer solutions (work from home, shift meetings)
• Follow up on critical items

What to avoid:

• Excessive apologizing (you're entitled to care for your child)
• Providing too many details (a simple "my child is ill" suffices)
• Promising to return before you're sure

Long-Term Strategies

If illness is frequent:

• Consider whether your current job allows needed flexibility
• Explore remote work options
• Discuss job-share or flex-time arrangements
• Evaluate backup care benefits in job searches

Common Scenarios and How to Handle Them

Scenario 1: The Morning Dilemma

Situation: Child has runny nose but seems fine otherwise. You have an important meeting.

Decision factors:

• Clear vs. colored nasal discharge (clear often okay, colored may indicate infection)
• Other symptoms present (cough, fever, behavior changes)
• Your center's specific policy on runny noses
• How child acted overnight

Best practice: When in doubt, call the center before leaving home. Describe symptoms and ask if they'd accept the child today.

Scenario 2: Symptoms Develop at Daycare

Situation: Center calls at 2 PM saying child has 100.2°F temperature.

Decision factors:

• Temperature is just under typical 100.4°F exclusion threshold
• But trending up suggests fever is coming
• Getting ahead of rush hour pickup may be wise

Best practice: Pick up promptly even if temperature isn't technically exclusionary. Child likely won't feel well enough for care tomorrow anyway.

Scenario 3: The Multi-Day Illness

Situation: Child has stomach bug. Multiple days home needed.

Decision factors:

• 24-48 hour symptom-free return policy means 2-3 days minimum
• Need to coordinate with partner and/or backup care
• Work responsibilities that can't wait

Best practice: Immediately activate backup plan and communicate realistic timeline to employer. Plan for 3 days minimum.

Scenario 4: Chronic Condition Flare-Up

Situation: Child with asthma has increased coughing but no other symptoms.

Decision factors:

• Is this chronic condition management or new illness?
• Does daycare have documentation of condition?
• Are symptoms controlled with current treatment?

Best practice: Have standing documentation from pediatrician distinguishing chronic symptoms from acute illness. Communicate with daycare about normal management.

The Financial Impact of Sick Days

Sick days have real financial consequences:

Direct Costs

• Lost wages if no PTO available
• Backup care expenses ($75-200/day)
• Doctor visit copays
• Medications and supplies
• Full tuition still due while child is out

Indirect Costs

• Career impact from missed work
• Stress on partner relationship
• Using vacation days for illness
• Guilt affecting work performance

Planning Strategies

Build an illness fund:

• Set aside $50-100/month for sick day expenses
• Cover backup care, copays, and lost wages
• Reduces financial stress when illness hits

Maximize benefits:

• Use all available PTO strategically
• Understand FMLA protections for extended illness
• Check for employer backup care benefits

Frequently Asked Questions

Can I send my child with a runny nose?

It depends on your center's policy and the nature of the discharge. Clear runny nose with no other symptoms is often allowed. Colored (green/yellow) discharge, thick congestion, or runny nose with other symptoms (cough, fever, lethargy) typically requires staying home. Call your center to confirm their specific policy.

What counts as "fever-free for 24 hours"?

Your child must have no fever (typically defined as under 100.4°F) for 24 consecutive hours without fever-reducing medication. This means no Tylenol, Motrin, or Advil during that period. If you give medication and the fever stays down, the 24-hour clock restarts when medication wears off.

My child vomited once but seems fine now. Do they have to stay home?

Usually yes. Most centers require 24-48 hours after the last vomiting episode before return. One isolated spit-up (especially in infants) may be different—ask your center. But true vomiting, even once, typically means staying home to ensure it wasn't the start of a stomach bug.

Can I give my child Tylenol before drop-off to get through the day?

This is strongly discouraged and often explicitly prohibited. Masking a fever means a contagious child is around other children. The medication wears off mid-day, daycare calls you anyway, and now pickup is more disruptive. It also means your sick child isn't getting the rest they need.

What if I can't pick up my child within the required time?

Most centers understand emergencies happen. If you truly cannot leave work immediately, communicate honestly about your timeline. Have your emergency contacts (partner, grandparents, trusted friends) authorized for pickup so they can respond instead. Consistently delayed pickups, however, will strain your relationship with the center.

How many sick days should I expect in the first year?

Plan for 10-20 days home due to illness in the first year of daycare. Some children have fewer; some have more. The number drops significantly in year two and beyond as immunity builds.

My child keeps getting sick right after recovering. Is something wrong?

This is normal in the first year. Children in group care are exposed to many new viruses sequentially. Each illness builds immunity, but it can feel relentless. If you're concerned about the frequency or severity, consult your pediatrician, but know that 8-12 colds in the first year is typical.

Does my center have to notify me of illness outbreaks?

Most states require notification of certain communicable diseases (chickenpox, measles, COVID, etc.). Many centers also voluntarily notify about common illness outbreaks (stomach bugs, hand-foot-mouth). Ask your center about their notification policy during enrollment.

What if my child's illness keeps recurring?

Some children are more susceptible to certain illnesses (ear infections, respiratory issues). Work with your pediatrician to understand if underlying factors exist. Consider whether your childcare environment contributes (poor ventilation, crowded conditions). Some children simply need to build more immunity.

Can I get a refund for sick days?

Most daycares do not refund or credit tuition for sick days—you pay regardless of attendance. This is because the center's costs (staff, rent, utilities) don't decrease when your child is absent. Some centers offer a small number of vacation/sick day credits; check your contract.

Bottom Line

Daycare sick policies are a fact of life. They protect everyone's children—including yours.

Accept the reality:

• Your child will get sick, especially in year one
• You will get calls to pick up early
• You will miss work
• This will get better

Plan ahead:

• Build your backup care network now
• Communicate with your employer
• Know your center's specific policies
• Keep your pediatrician's number handy

Keep perspective:

• This phase is temporary
• Immune system building is happening
• You're not doing anything wrong
• Millions of families navigate this every year

The first time you get that 10 AM phone call, take a deep breath. It's not a crisis—it's just parenthood.

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Related Resources:

• First Day at Daycare Guide - Starting smoothly
• What to Pack for Daycare - Be prepared
• Choosing a Daycare Guide - Questions to ask
• Infant Daycare Guide - Infant-specific concerns