Daycare Mamas- Where Do You Draw the Line with Colds?

Updated on October 06, 2010
J.K. asks from Davis, CA
17 answers

HI Mamas,

I run a large home daycare and was hoping for some feedback about your practices or policies regarding colds. Let me begin by saying I know that colds happen and I have been on both sides of the daycare issue. I've had my own kids in care before and now I provide care for other people's kids. I am fully aware of how hard it is to balance work with daycare and sick kids. However...

I have a child in my daycare who has been sick for a month. He was the first to get a cold that everyone then essentially got at the same time. But since then, his nose has never cleared completely and his cough has never gone away. After the cold, Mom and Dad got sick and then Mom said he got sick again with another virus that my kids and a couple of others had. The week before last (before he got sick with the same symptoms my kids had), I asked the Mom if she had considered taking him to the Dr because his cough was getting worse. She said she hadn't noticed it being worse and it didn't seem to bother him. Then early this week she told me that she didn't think his cough was "that bad." THEN she told me they were going to take him to the Dr. on Thursday afternoon even though he seemed much better. Today (Monday) she told me the Dr. had said he was clear. He isn't coughing as much, but he still sounds like he's been smoking for 70 years when he coughs.

This little guy (2 1/2) has his fingers in his nose CONSTANTLY (even without a cold), doesn't cover his mouth, wipes his nose on his arm if I don't get to it fast enough. For the past 2 weeks his nose has run constantly. We literally wipe it every 10 minutes. Contagious or not it's just gross! And the mom never corrects his nose picking.

I revised my illness policy to state that the nose running can't be so excessive that it disrupts the daycare and interrupts the care of other children, and regarding cough, no hacking or persistent cough. She called me today to say that she doesn't know what she'll do when he gets a cold because his nose runs more than any of the other kids, and that she has read that it is not recommended to give any kind of cold medicines to children under 5. I told her that we could take it day by day, since he now seems to be on the mend from this last illness. There are other issues that contribute to her son getting sick, but I don't want to write a novel.

I feel like other people pay for care too and shouldn't have their kids be sick all the time. I also understand that she can't take time off work every time her child gets sick with a cold. What to do...?


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So What Happened?

HI Everyone,

Thanks for your thoughtful responses. I think the issue for me was that , yes, it appeared to be "just" a cold, but the symptoms seemed to be lasting way too long without concern or intervention; and then when I did suggest taking him to the Dr. (the CDC recommends taking kids to the Dr if symptoms last more than 10 days), it seemed to be a bother to the Mom. It didn't appear that it was because she would have to take time off work ( she works until 3pm each day and is off every Friday,) it just seemed like she wasn't aware how sick he seemed to be.

I have always had a pretty comprehensive illness policy with the main concerns being fever, vomiting and diarrhea. But I also have babies in my care though and the colds are very hard on them. Luckily most of my parents understand that kids get sick in daycare and it's actually good for their immune systems. I let parents know that if this is their child's first dip in the germ pool they can expect them to get sick at least once a month during cold and flu season.

We also practice good hygiene and have a basic schedule for hand washing. In the cold/flu season it increases. I like the suggestion that all kids wash hands upon entering and practice that already with my school aged kids. Makes sense that kids could also bring in illness from home... I do teach kids to cough into their elbows and to use a tissue instead of their fingers and I don't think that 2 is too young for them to learn that. Most of them are able to ask for a tissue and not use their hands or arms.

Thanks again for your responses. It is the nature of working with people to come across all kinds of personalities, and I feel lucky that there aren't a lot of occasions when I get troubled by my families. Your feedback gave me a good perspective from all sides!

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answers from Boston on

I agree a lot with Jane M. My youngest has a constantly runny nose he has allergy symptoms all year and the runny nose just gets 100x worse with a cold. He is 3.5 and knows how to blow his nose but he still needs to be reminded. I think you are expecting a little too much from a 2 yr old as far as hygiene goes.

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answers from St. Louis on

I've had the same problem, here's what I did. Ask the parent to bring a note from the Dr. stating the child can return to Daycare and is not contagious to the other children. Most Dr's don't have a problem with this and their not going to say it's ok if it's not. How do you know for sure mom has taken him in to the Dr's at all. If she's not willing to do so well maybe she needs to find a different arrangement.

4 moms found this helpful


answers from New York on

Simiar to Peg M, these are the guidelines from my daycare:
24 hours free of fever (without fever-reducing meds) before a child may return to school; mucus, if any, must be clear and colorless, and coughs and rashes, for example, must be cleared by doctors as non-contagious (allergic coughs and runny noses with clear mucus don't spread). No nausea or lethargy, no diarrhea. No returning to school with pink eye until it has been treated for at least 24 hours. There are also certain illnesses that require a doctor's note before the child may return.

I think these guidelines are clear and fair. Unfortunately, some kids just have perpetually runny noses and you can't keep them out for weeks as a time. My son, for example, had diarrhea for months when he was a baby - we did take him to the doctor, and she thought it was related to his teething and swallowing all that extra phlegm (he never drooled, at all) - so I did send him to daycare with diarrhea for that time. If I had kept him out that entire time, I would have been fired and I would not be paying for a daycare where my child was kept out for months!

I do think that you need to spend the time teaching the kids proper hygiene and self-care (such as sneezing into sleeves, frequent handwashing). I'll never forget the day my son said "She's getting her germs all over me!" when my friend's daughter sneezed and didn't cover her mouth - I think he was almost 3 at the time and it was too funny (and true!) One thing my daycare does and it has really made difference - as soon as each child or teacher enters the room (or is dropped off, whatever the case may be), s/he must immediately wash their hands - then no germs are coming from outside on your hands. So at drop-off, my husband has to take our son's coat off and take him right to the sink, wash and dry his hands and then he is ready for the day. All adults (like teachers and aids) must do the same. This practice has really cut down illness for students and teachers alike! It is such a simple thing but really makes a big difference.

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answers from Sacramento on

One of the great things about our in-home provider was that she wasn't overboard with sick rules. She just used common sense. In fact, she often let kids who didn't feel well stay, letting them rest in the family room (with other kids in the living room), where she could see the child and care for him/her. If a cough or sniffles persists, the child isn't infectious, so no reason to keep the child home. Yes, it's a hassle, but it's just part of life. If my childcare made me keep a child home for a month for sniffles and a cough, I'd be out of business (I'm self-employed). So many colds out there take ages to go away completely.

I think the fact that the family hasn't taught great hygiene practices is another issue entirely. You might give a hand-out for the fall cold season, something along the lines of "It's cold season! Here are some tips for keeping your child healthy." Then list some things like working on young kids to teach them to use tissues rather than shirts and arms, using hand sanitizer or teaching to wash hands regularly, etc. Also urge parents to take their kids to the doctor if colds persist -- and bring it up when it's time, not as an option but mandatory -- so they can give you the "all clear" from the doctor and ensure their child can stay. Give the handout to everyone in your care, so you're not singling out this one family.

Good luck! I can imagine this is awful to deal with. There's a girl in our daughter's pre-k whose nose is apparently like a faucet right now, but her teacher just mentioned it in passing and she's allowed to stay at school since she's not contagious. It's that fun time of year. :)

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answers from New York on

It seems like there may be something more than just a cold with this one child, maybe just with this illness or maybe in general. I say this because my almost 2 year old daughter has a very small opening between her nose and throat. It is not a big problem but she always has a runny nose because the congestion can't drain the way it does for most people. When she is sick it is is terrible, wiping her nose every few minutes. After discussing things with her doctor I do give her children's decongestant in an age/weight appropriate dose when she is sick. My friend has a daughter just a little older than mine with asthma so her colds and especially coughs are worse for her. I have known other kids with asthma to cough all the time in the winter even if they aren't sick. This is just a long winded way of saying this child may have some medical quirk that makes it much harder for him to shake the average cold. Hopefully the parent will follow up on it. There may be an easy fix like a humidifier in his bedroom or adjusting his bedtime a little earlier when he is sick.

I like the idea in one of the other posts of sending home a handout with tips to stay healthy and your sick child guidelines, including when a child has to be seen by a doctor before coming back to your daycare. You may have to be firm on the doctor visits policy until the parents are used to it. Definitely teach and reinforce your good hygiene habits with the kids when they are with you. Sid the Science Kid, a PBS show for preschoolers, has a great episode on "The Journey of a Germ" about colds and good hygiene. Maybe you can check the listings and show or record it to teach the kids a little about germs and colds. There is also a website with printable coloring pages and activities (they have things for the show but I haven't checked if covers the specific episode I mentioned.) My 4 year old son loves learning about science but we are still working on the good hygiene practices. I let him use use baby wipes and/or hand sanitizer if he is using tissues all the time so he is not washing his hands every 5 minutes.

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answers from Portland on

It certainly is a dilemma, J., balancing the needs of your clients individually against the needs of your clients as a group, and is further complicated by the fact that many of your kids will come into contact with extended family. Some of those family members will be especially vulnerable: babies with still-undeveloped immune systems, sick children and adults with compromised immune systems, and elders with complicating health problems.

I'm in the last group. In the last two years I have caught four "simple" colds via my grandson's daycare that have turned into raging secondary infections that required emergency medical care. Now THAT'S expensive, about $1000 out of pocket for me, because of terrible insurance and preexisting lung problems (lifelong asthma). And I lost days of work each time.

I've been the mom of the sick kid – in my case, I did keep her home if I knew she was coming down with something. Yes, it was tough on job and paycheck, but other kids getting sick because of my daughter could have been just as tough on other moms' jobs and paychecks. And every daycare situation had clear guidelines: 24 hours free of fever (without fever-reducing meds), mucus, if any, must be clear and colorless, and coughs must be cleared by doctors as non-contagious (allergic coughs and runny noses with clear mucus don't spread). No nausea or lethargy, no diarrhea. Any of these things would get children working mothers called and children sent home ASAP.

Good question. I hope you can come up with a policy that feels fair to all concerned.

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answers from Provo on

As a mom who takes her son to daycare and there is child with a runny nose since he started going there (July) I'm totally grossed out by it, and wonder if the snot that is on my son when I pick him up, is actually his or hers. I want to take my son out of the center (for many other reasons, not just the snotty nose) because of it (and I will take him out as soon as we have a problem cleared up with stuff). Not only do they let her in, but another child there had pink eye. So you drew a line, and she keeps crossing it. If you let her keep pushing she eventually will have him there while throwing up, fever, and she will keep asking you to take him in. Please keep up with your new rules. Occasionally you can be lenient, but after a month . . .that's WAY to long.

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answers from Modesto on's my 2 cents :O) I am a mom, not a provider.

I think it's perfectly acceptable to ask for a Dr's note in this situation. However, the runny nose thing is soooooo common, even for kids who are not that sick, so you might have to re-think that part of your policy.

I believe that infection lies with a fever. So perhaps you should update your policy noting that kids cannot come to daycare with a fever. And if a kid HAS been out for a few days with fever/cold, then they cannot return until they have been fever-free for 24hrs. This is a perfect time of year to do this because winter is almost here. "In an effort to try to keep our children healthy this winter, I am revising my health policy effective immediately..."

Yes, boogers and snot are gross.....especially from someone else's child :o) I can appreciate that!!!! I know most daycare's have even the simplest "routine's" throughout the day. Perhaps you could work in specific times to clean hands (even hand sanitizer)......after morning play....before we eat.....whatever.....this could eliminate some stress about all children's winter germs. At the same time to clean nose's.

The little guy in question is only 2........but even at 2 he can be taught to "cover his mouth" and wipe his nose. He should always have a kleenex in his little pocket........he may not cover and wipe all the time, but you can be a teacher to him to help him keep his germs to himself :O)

J., even with the most perfect policies in place, there will always be someone who tries to break your rules........parents are busy, and rely on daycare to help them........we parents don't always think about everyone else's children when WE need to get something done.........I mean, I do, but majority do not.....

You can only do the best you can do :o)

I hope something I've said can help you in some small way. This is really a tough one with our winter approaching. Kids are sick all the time, even when they are not in daycare. And I'm sure you're just trying to control your environment so when you are NOT a are a mommy with a clean house :O)

Good Luck!
~N. :o)

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answers from Seattle on

1- Requiring a doctor's note for readmission with a cough/runny nose etc is PERFECTLY reasonable.

2- When my son was sick, I kept him home OR took him to "Sick Child Daycare" through Virginia Mason if it was an emergency. (Many hospitals offer sick child daycare).

In our preschool it was LAW, any coughing or runny nose (that didn't accompany a doctor's note saying "allergies") was sent home. Ditto, any child with a fever.

I know parents who complain that they don't want to take their child to sick child daycare, because they don't want them to catch anything else. Bit of a double standard there; they don't care at ALL about infecting other people's children.

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answers from Redding on

Just throwing this out there any possibility it's allergies and not a true cold or other viral illness?
Yes, colds do happen and they can't be avoided really, but the consistant coughing and persistant running nose? I volunteer at a thrift store where all proceeds go to an animal sanctuary and my eyes and nose run so bad I can barely stand it. I'm not even around the's the dust and everything in the store that make me sick. I'm fine about 2 hours after I get home, take a shower and change my clothes. A half hour I get to the store, I look like I'm sick and my voice even goes hoarse. It's not anything I can "give" to someone else.
Maybe you can suggest, gently, that she have her child checked for allergies due to the nose running. See what she says.

Just about everyone I know had a terrible cold a couple months ago and I didn't catch it. It felt like I was the only one who didn't.
But, the dust at the thrift store kills me.

I'm just saying it could be allergies.

I hope you find what works for the situation.

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answers from San Francisco on

Greetings J., You seem to have at least 3 issues going here. But to adress the main one of picking the nose and runny nose here goes! I have done Day Care for many years. I have found most parents are wonderful about taking care of thier children when in fact they are sick. I do have a seperate room that sick children can stay in with toys and items that are washable or that the parents bring from home . I have a grandchild that has a horrible runny nose. It turned out after several doctor visits to be an allergic reaction to a plant at the daycare that cause it=no fault of th provider no one could have known. But at age 2 theya re able to learn simple things that are to be done like having kleenex or wet wipes in many areas so they can be used.
At this age it is also a power thing to pick thier nose. Some adults never out grow it I have learned. If the parents are not willing to work with oyu consider telling them theyneed a new care provider. It sounds as if you have become emeshed with this family since you state there are other things going on to write a novel, so it may be time to let the child go anyway.
Since I have been blessed with great children and parents I have only had a few odd ones that I figured was a business decision that I needed to balance out and make. If the parents can not afford to take the child to the doctors that may have an impact but if the child does not have asthma, which can have many of the same reactions you describe then find out where the local child health free clinic is for them.

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answers from Tulsa on

Well, I feel your pain, over 10 years in child care, owner/directer all the way through to every other job I can think of in child care. It depends on your state regulations. If they say runny nose you can say no runny nose, if they say fever over 100 degrees that's where you should too.

As hard as it seems, it's your job to teach this little guy his "cold" manners and it sounds like you do a good job of it. You need to just keep teaching him to cover his cough, not pick his nose, etc.... You know as well as I do that you may be the only person to ever tell him what to do.

I have had so many kids in this same situation that it seemed like all I did all day was wipe noses and clean up boogers. It is very distracting and when a teacher has spent considerable time planned a lesson and spent money on items to be used then not get to because her hands are busy wiping up stuff, it's very frustrating.

To me what you are describing in ongoing seasonal allergies and they really can't be treated until he's older. Our kids get them, I get them, lots of people get them.

She can try giving him allergy meds like Claritin but needs to start him out on 1/4 dose. Allergy meds dry out the sinus' and can over do it and cause pain and irritability in kids. I can't take even a half dose of Benadryl or Claritin due to this. I take 1 tsp. instead of 4 and that works for me on a regular basis, there are times it just doesn't do it and I take a bit more.

Good luck with this child and I hope he gets to feeling better as soon as the freezes start, well, if you have cold winters there in California.

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answers from New York on

I cant tell you what to do, dont run a daycare, but as a working mom, I think I wouldn't want my child to attend your daycare (no insult to you) because of this child, so keep in mind it could affect your business. You said there are other reasons this child is never healthy, whatever they are the parents need to deal with them. (and if they are smoking around this poor child you should not be feeling sorry for the mom!) I hope you hear from others who run daycares.

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answers from Portland on

It is not necessary to have a child stay home with a cold, unless a fever, vomiting, projectile coughing or diarrhea is present. You as the provider most likely spend the most time with this child every week, so it should be part of your curriculum to teach and model how to cough into your elbow, wash hands and assist with blowing noses. At 2 1/2 years old, it is quite appropriate for a child to have a runny nose for a long time, especially in colder weather. You are also just as free to help to teach him not to pick his nose while he is in your environment. Good luck!

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answers from Detroit on

I don't run a daycare but that child has been sick an awful long time. If that was my child it would absolutely drive me crazy. Maybe he has some type of allergy? Sounds like she should take some preventative measures to prevent the cold. I know it's difficult.
I have spoken to several Dr.'s when my youngest had a cold with coughing and none of them have or will recommend any type of cold medicine. Saying that the medicine is not really for children or was not designed for them and that it could bring on respiritory or ashmetha like conditions.
I no longer use cold medicine anymore because I have yet come across one that actually did any good. I now take preventative measures (vitimins/handwashing eating properly) and if my kids do get sick I just make them comfortable (plenty of liquids/saline drops) . I don't give medicine unless there is a fever.

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answers from Boston on

I think that some kids just take longer to fight infections than other kids. I think that your policy is reasonable, but I wouldn't keep my kids there - as a working mom I need the policy to be really clear and runny nose to the disruption of other children feels a little amorphous to me. Honestly, wiping a nose every 10 minutes just doesn't feel excessive - I mean, how many seconds does it take to bend over and wipe a nose? It can't keep you away from the other children for any significant period of time.

The other thing that you might want to think about is asthma - my son will often have a hacking/persistent cough, but that just means that he needs a nebulizer treatment, not that he's contagious at all.

Finally, I appreciate that you find his hygiene poor, but the kid is 2.5 years old. Of course his fingers are up his nose! He's just at the age where he's learning to cover his mouth, etc. And I still have to remind my 5 year old not to wipe her nose on her sleeve. Yes, it's gross, but she's a kid. Kids can be kind of gross. This surely can't be the first 2.5 year old who doesn't have the ins and outs of hygiene down.

Just my two cents. Good luck with whatever you decide to do.

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answers from Las Vegas on

Hi J.,

I am a parent, not a provider. My daughter has been in daycare since 6 months and since 6 months her nose is full of snot every winter. She is asthmatic and sometimes has a chronic cough/wheeze. We have to treat her for her asthma, not a cold. I have been told by the doctor and the pharmacy that there are no more cough medicines, you have to treat an infection if that is the case.

Does the little one mess with the ears? If there is an infection, often it goes right to the ears and you will see those signs by him rubbing or pulling his ears.

As for the nose picking, if he touches his eyes or others pick up the mucus germs and rub their eyes, they will get pink eye. Of course today it can be treated over the counter, but it hurts and is unnecessary. I think my daughter picked up her strongest sense of germ spreading at school. Not to say that we didn't teach her, but the school has done a wonderful job with all the students at an early age about the spread of germs. They wash their hands often and sneeze into their sleeve. I am certain it was an actual lesson, much like she learned to keep her hands to herself.

With that said, I think you are within your rights to ask her to return a slip from the doctor that says she is ready to return to school. My daughters PED gives one upon request.

Best wishes.

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