The staff at child care centres are often too quick to send toddlers home for mild illnesses, doctors note in a new study.
In a new survey, a number of daycare centre directors in the U.S. said they would choose to exclude kids more than half the time for minor ailments such as:
- pink eye (conjunctivitis)
- mild fever
- colds
- ringworm (a scalp infection)
- loose bowel movements
But to do so would be medically unnecessary and runs counter to long-standing professional guidelines, doctors say.
The researchers note that by the time children show symptoms for such ailments, they've already been contagious. So to send the children home does nothing to reduce the chances of spreading infection.
Researchers led by Dr. Andrew Hashikawa, a pediatrician at the Medical College of Wisconsin, interviewed the directors of more than 300 daycare centres in Milwaukee, Wisconsin.
They asked them what their policies were for children who become sick with pink eye and the other infections.
All the infections were those that the American Academy of Pediatrics (AAP) and the American Public Health Association (APHA) have said do not require that children be immediately sent home.
They found almost one-third of the directors chose to exclude the kids in four or all five of the symptom scenarios. Overall, they ended up sending 57 per cent of kids home unnecessarily, the researchers report in the journal Pediatrics.
Hashikawa says while many day cares have the attitude that it's better to be safe than sorry when deciding whether to send children home, there's no good medical reason for excluding the children. What's more, he notes, asking parents to leave or skip work to care for their children at home can be burdensome to parents, particularly those who are paid by the hour.
"If every time a child with a cold who's otherwise well had to be sent home, parents would have to take an enormous amount of time off from work. If you can imagine a single parent who has no backup day care, a job that does not provide paid sick leave, it can be a significant problem for them," Hashikawa told WUVM, Milwaukee public radio.
The AAP and the APHA have issued illness exclusion guidelines for child care centres, listing which symptoms necessitate sending a child home and which do not.
Though Wisconsin endorsed the guidelines more than a decade ago, the researchers found that only a minority of daycare centre directors were familiar with the guidelines.
Hashikawa notes there are no training programs in Wisconsin for day care centre directors to learn about appropriate exclusion guidelines.
"The next step," Hashikawa suggests, "is to develop formalized state training programs that child care directors could use to learn about appropriate exclusion guidelines for mild illness."
