How long should I keep my child home from school when he or she is sick?

In many ways, taking a common sense approach will be very helpful in making this decision. Also, many schools and daycare facilities will have specific guidelines to help you decide when returning is a good idea.

In general, your child should be fever free for at least 24 hours without a fever-reducing medicine (acetaminophen or ibuprofen) before returning to school or daycare—this helps ensure that your child will not make others sick, as well as be sure that they are ready to return. If they are started on an antibiotic (for strep throat for example), they should take that medication for 24 hours before returning to school or daycare. If they have a severe cough, it may be difficult for them to return to school before the cough improves, and they may still be contagious to others. Children who have had bad intestinal symptoms may need an extra day or two after the vomiting or diarrhea stops before they can function normally at school or daycare. Finally, make sure they have enough energy to last the full day at school if they have been absent for several days.  

My children want to do all sorts of outdoor winter sports. How do we prepare for and avoid injuries?

Encouraging children and teens to be active outdoors during the winter months is an excellent idea to promote. Among its many benefits, active play outside will contribute to a healthier weight through those long winter months. Depending upon where your child’s interest lies, playing outside can be as simple as building a snowman or as physical as a game of ice hockey on a nearby pond or skating rink. 

Being outdoors can be very fun and safe if just a little preparation is done before your kids head outside. Exposed skin—face, ears, and so on—can develop frostbite quickly if there is a significant wind chill being reported. Hypothermia can develop more quickly in young children as compared with older children or adults, so paying attention to comfort levels or signs of shivering are important. Dressing in multiple layers will help to retain warmth close to the body. Wearing clothing that can help “wick away” moisture/sweat from right next to the body will also help your child stay warmer longer. A good-fitting set of warm, dry boots will help keep the feet warm and help to prevent frostbitten toes. Finally, since much of the body’s heat loss occurs from the head and face, wearing a hat and a scarf will go a long way to keep kids comfortable in the snow and on the ice. 

We are having “sleep opinion wars” in our household. How much sleep do our kids need? My husband and I are at significant differences in terms of how much sleep we believe our 8-, 10-, and 13-year-old should get.

 As in everything, each child’s particular sleep need may be more or less than the average for his or her age. Some typical sleep amounts include:

Age three to five years – 11 to 13 hours per night

Age five to 12 years – 10 to 11 hours per night

Younger teens – nine to 10 hours per night

Older teens – 8.5 to 9.5 hours per night

A common pattern with teenagers is that they will go along on six or seven hours of sleep each night during the school week, going to bed about midnight and getting up at 6:00 a.m. The weekend comes along and they end up sleeping until 10:00 a.m. or even noon on Saturday and Sunday. This is a sign that they are likely sleep deprived during the week and their body is trying to make up for it on the weekend. For some teenagers this can work okay, but for many teens this much change in their sleeping schedule can really adversely impact them. They go through the whole school week chronically tired and consequently, do not perform at their best. These kids sometimes get home from school, crash for a few hours, wake up and then are unable to fall asleep when they try to go to bed at a more reasonable time. As parents, consider establishing a consistent sleep routine bedtime and time to get up in the morning—even on the weekends—to help to lessen these problems. 

This column is intended to provide general information only and not medical advice. Contact your health care provider with questions about your child. Dr. Peter Dehnel is a board-certified pediatrician and medical director with Blue Cross Blue Shield of Minnesota. Send questions to [email protected].

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