Bigger Kids

4 ways to know if you should send your sick kid to school

Is an ear infection, croup, sore throat, or other common childhood illness serious enough to warrant skipping school? Here's how to know.

By Cathryn Tobin, MD

Here's help to make those on-the-spot decisions when your little one wakes up on a weekday and isn’t feeling his best.

1. Your child woke up in the middle of the night screaming that her ear hurt. You settled her back to sleep and in the morning she says it feels better.

What could it be?

Ear infection (acute otitis media) Common during a cold, ear infections have an abrupt onset, and may be associated with a fever, nausea and vomiting. They are typically worse when the child is lying down, chewing or sucking, and may cause transient hearing problems. Ear infections often feel worse at night, but by morning the pain may be gone.

Fluid behind eardrum (serous otitis media) This usually occurs as a result of blockage in the Eustachian tube — the passageway that connects the middle ear to the throat. It causes a popping sound and a sense of fullness in the ear, much like the feeling you get on an airplane.

Sore throat or dental issues Pain can radiate, and a child with a sore throat may also complain of ear pain.


What should I do?

Send her to school? A school-aged child with ear pain should see a doctor sometime the same day to determine its cause. In the meantime, she can attend school if she’s feeling reasonably well, has no other health issues and is fever free, is eating and drinking, and her pain is well controlled with acetaminophen or ibuprofen.

Keep her home! If your little one still has an earache after taking pain medication, there’s no sense sending her to school because she won’t be able to concentrate. Take her to the doctor that day.

2. Your child refuses to eat breakfast and cries that she doesn’t want to go to school because her throat hurts.

What could it be?

Infection of the throat, tonsils and surrounding areas If your child is sneezing, and has watery eyes, a slight fever, aches or mild headache, her sore throat is likely caused by a virus and will resolve without medication. But if symptoms include a fever, stomach ache, headache, swollen glands and, possibly, a fine red rash, she may have a bacterial infection such as strep throat.


Allergies Itchy eyes, a scratchy throat and runny nose without a fever are most likely caused by allergies.

What should I do?

Send her to school? If your child is fever free, drinking and eating adequately, energetic and only mildly bothered by her throat, she doesn’t need to stay at home unless her symptoms persist or get worse.

Keep her home! If her glands are swollen, she’s having difficulty swallowing, has a headache or stomach ache and a rash or fever greater than 38.5ºC, keep her home from school and take her to the doctor that day. A trip to the ER is appropriate if your child can’t swallow or is having difficulty breathing.

3. Your son wakes up and his eyelids are stuck together. He complains that his eyes are itchy, but otherwise says he feels perfectly well.

What could it be?


Eye infection A common eye infection, conjunctivitis (pink eye) causes the whites of the eyes to appear red and feel itchy and eyelids to sometimes stick together after sleep because of discharge. One or both eyes may be affected. Viruses, bacteria and allergies (see below) are all common causes of pink eye.

Corneal abrasion A scrape or scratch on the surface of the eye associated with eye pain, tearing and redness.

Allergies If your child has itchy eyes, a scratchy feeling in his throat and a runny nose with clear mucus, he likely has environmental allergies. His eyes may look bloodshot, but he’s not contagious.

What should I do?

Send him to school? If your child has a cold and his eye is slightly red but there is no discharge, he likely has a viral eye infection that will go away without treatment. He can attend school in this case — likewise if his symptoms are allergy related.


Keep him home! See your doctor if he wakes up with eyelids that are stuck together, has a fever and itchy, pink eyes (often associated with ear infections), there’s redness or puffiness of upper or lower eyelids, there’s a rash or blister near the eye, or pain is present.

4. In the middle of the night, you heard a brassy cough coming from your child’s bedroom. Come morning, his cough has subsided but he’s complaining of a sore throat. He eats a good breakfast and doesn’t have a fever.

What could it be?

Croup A viral infection that causes swelling in the upper airway, croup is more common in kids under the age of five. It typically starts with cold symptoms followed by a barking seal-like cough that appears in the middle of the night. It may be accompanied by a low-grade fever, sore throat and loud squeaky noises when your child breathes in. Croup is usually a mild illness, but occasionally causes breathing difficulties. In older kids, croup often presents itself as a hoarse voice (laryngitis).

Common cold If he’s sneezing and has a runny nose and wet-sounding cough — with or without a low-grade fever — a cold is likely the cause.

What should I do?


Send him to school? If your child has a cold but no fever, he can attend school. Likewise with mild croup, as long as he feels well enough to participate at school and has no difficulty breathing.

Keep him home! If cold symptoms worsen after five days or a cough lasts longer than 10, head to the doctor. Go to the ER if symptoms include a high fever, difficulty breathing, severe sore throat, drooling (this implies difficulty swallowing) or rapid breathing.

Cuts and scrapes

Dirt and bacteria may cause cuts, scrapes and wounds to become infected. Once the bleeding stops, remove any foreign particles and wash the area with mild soap and tap water. Once the area is clean, apply an antibiotic ointment, such as Polysporin, and cover it with a bandage.

See a doctor if:

• the cut is deep or gaping, or edges are separated • your child has a gaping cut on her face • dirt can’t be removed • bleeding does not stop within several minutes after pressure has been applied • it's a puncture wound

Red alert:

If your child has a deep or dirty cut, such as a wound caused by stepping on a nail or an animal bite, a tetanus needle may be required if her immunizations are not up to date.

Bumps and bruises


Injuries to soft tissues produce pain, swelling and discoloration. If your little guy continues his activities without showing signs of pain, the injury is most likely mild and doesn’t require medical treatment. However, if he has severe pain, swelling or deformity, or avoids using the injured body part, a trip to the doctor is warranted.

This article was originally published in August 2007.

This article was originally published on Sep 12, 2016

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