How Sick Is Too Sick

Winter: That time of year when children always seem to be sick. It's one runny nose after the other, one bout of non-stop coughing and wheezing followed by an endless array of fever inducing viruses.

For a lot of parents and caregivers there is also the endless debate about when a child is, and is not, too ill to attend daycare. Hopefully caregivers have clearly defined in their Policy Statement when they will not accept an ill child into care. "As a general rule, children need to be at home when they need more care than you can give them while meeting the needs of the other children," says the Canadian Paediatric Society in their book, Little Well Beings: A Handbook on Health in Family Day Care.

The CPA notes the following as the most reliable signs of sickness (usually too sick to be in care):

Behavioural Changes

    * Unusually sleepy or drowsy
    * Lack of Interest in other children or play
    * Unusually irritable, cranky, or fussy
    * Non-stop crying, especially high-pitched or weak or crying when cuddled
    * Rapid breathing
    * A change in behaviour with a rash or fever
    * Unusual drooling
    * Still neck (won't move head up and down)
    * Won't swallow liquids or won't eat.

Physical Signs

    * Vomiting more than two times during the day.
    * Diarrhea more than two times during the day
    * Dehydration as evident by a dry tongue and mouth, or if a baby's diaper stays dry longer than usual
    * Yellow eyes or skin
    * Rash with a fever or the child shows a change in behaviour along with the rash
    * Fever that is keeping the child from his/her normal playing and happy routine. (Rectal temperature is 101.3 oF or 38.5 oC - Oral temperature is 100.4 oF or 38 oC or higher.)

The best way to gauge a child's well-being throughout the day is to make a mental note of the child's health upon arrival and by talking with the parents before they leave about the any concerns they may have about their child. It only takes a minute for parents to answer three simple questions:

    * How did their child sleep during the night?
    * Has the child been eating or drinking?
    * What kind of a mood is the child in.

The best way to keep track of a child's health isto learn more about the signs of illness with regards to each child in your care. It is advisable that parents complete a Medical Information Form, available in our Forms Section. Other forms that would be of great use to caregivers and parents include:

    * Illness/Injury Report
    * Administering Medication Form
    * Permission slips for administering medication
    * Child Development Form
    * Daily Information Sheets for Infants


Little Well Beings: A Handbook on Health in Family Day Care
A project of the Canadian Paediatric Society