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Health guide

Childcare Exclusion Periods in NSW

This page lists the childcare exclusion periods NSW Health recommends for common infections, from gastro and chickenpox to impetigo, flu and measles. Each period is the minimum time a child should stay away from care to stop an infection spreading. Use the table below to check any condition quickly, then read the detail on the ones families meet most.

21Conditions listed
48 hrsGastro, from last episode
3Need no exclusion
A small table and toy basket at Lead, cleaned and ready as families check childcare exclusion periods nsw
Back when it is safe

Childcare exclusion periods NSW families follow can feel strict when you are juggling work and a child who seems fine, but they are the reason a single case of gastro does not become a room of twenty. This guide sets out the NSW list in full. For day-to-day judgement calls, see the sick-day and illness guidance on our parent pages.

General information only. Your doctor or local public health unit (1300 066 055) can advise on your child's situation.

The basics

What exclusion periods are and who sets them

Childcare exclusion periods in NSW are published by NSW Health and apply to schools, preschools and education and care services. They are drawn from Staying Healthy, the NHMRC's national guide for early childhood services. Centres build them into their illness policies, and the nominated supervisor applies them day to day.

Most exclusions are based on symptoms, such as diarrhoea or weeping blisters, rather than a formal diagnosis.

Some apply to children who are sick. A few also apply to healthy children who have been in contact with a case and are not immunised.

During an outbreak of certain vaccine-preventable diseases, a public health officer can direct a centre to exclude children.

Centres may add their own policies, such as waiting until a child has been fever free for a day.

Who is involved

NSW Health
Publishes the list
NHMRC
Staying Healthy guidelines
Centre
Applies it daily
Public health unit
Steps in for outbreaks
A child's drawing of a flowerShared rules
Look it up

The full exclusion table, illness by illness

The table below covers every condition on the NSW Health list, in alphabetical order. Filter it to see only the conditions that need time at home, or only those that do not. Where the rule is "until well", your child should be back to their usual self and able to manage a full day before returning.

NSW Health exclusion periods for education and care services
ConditionMinimum exclusion
ChickenpoxUntil every blister has dried, normally five days or more after spots first show
ConjunctivitisUntil eye discharge has stopped
COVID-19Until recovered
GastroenteritisUntil 48 hours with no loose bowel motion
Glandular feverNone, unless the child is unwell
Hand, foot and mouthUntil the last blister has dried
Head liceNone, if effective treatment starts before the next day of attendance
Hepatitis AMedical certificate of recovery, and at least 7 days after jaundice starts (or 2 weeks after other symptoms if no jaundice)
ImpetigoUntil antibiotics have started; cover exposed sores
InfluenzaUntil well again
MeaslesFour days or more from when the rash shows; unimmunised contacts two weeks or more
Meningococcal diseaseUrgent medical attention; public health unit advises
Molluscum contagiosumNot required
Mumps9 days, or until swelling goes down, whichever is sooner
RSVUntil back to full health
RingwormUntil the day after antifungal treatment starts
Rubella7 days after the rash starts, or until fully recovered, whichever is longer
ScabiesUntil the day after treatment starts
Scarlet feverUntil the day after antibiotics start and the child feels better
Slapped cheekNo exclusion
Whooping cough21 days from the start of symptoms, or after at least 5 days of the right antibiotic

Source: NSW Health, school and childcare exclusion periods. Glandular fever, molluscum and slapped cheek need no exclusion; head lice need none if treatment starts promptly.

The big one

Gastro: the 48-hour rule

Gastroenteritis is the exclusion families meet most often. Children stay home until they have gone 48 hours without a loose bowel motion. The clock restarts with every episode, so a child who has diarrhoea on Monday evening can return on Thursday morning at the earliest if nothing further happens.

Gastro viruses survive on surfaces and spread through tiny amounts of vomit or faeces, which is why young children in care pass it around so easily.

Vomiting counts too. If your child vomits with a tummy bug, the same 48-hour wait applies.

Watch for dehydration: fewer wet nappies, a dry mouth, or unusual sleepiness mean a trip to the GP.

Spots

Chicken pox

Chickenpox causes itchy red spots that turn into fluid-filled blisters, then crust over. Children stay home until all the blisters have dried, which is usually at least five days after the rash first appears. Most children in NSW are vaccinated against chickenpox at 18 months, so cases in care are far less common than they once were.

Vaccinated children can still get a milder form, with fewer spots. The same exclusion applies.

Tell the centre if your child has chickenpox. Pregnant staff and parents, and children with weakened immune systems, may need to speak to their doctor.

Trim nails and use cool baths or calamine to ease itching, and ask your GP or pharmacist about anything else.

Eyes

Conjunctivitis

For conjunctivitis, the NSW exclusion is simple: children remain home until their eyes stop producing discharge. There is no fixed number of days. Bacterial conjunctivitis may clear faster with antibiotic drops, while viral conjunctivitis usually runs its course over several days.

Allergic conjunctivitis is not infectious and does not need exclusion. A doctor can tell the difference.

A clear, watery eye with a cold is different from thick, sticky discharge.

Clean hands and separate towels help stop it spreading through the family.

Home until

  • No more discharge
  • Eyes no longer crusted
  • Child is comfortable
Crayon butterflies drawn by a childNo fixed days
Skin

Impetigo and school sores

Impetigo, often called school sores, is a bacterial skin infection that starts as red, weepy sores and forms honey-coloured crusts, often around the nose and mouth. Children can return once appropriate antibiotic treatment has started, and any sores on exposed skin must be covered with a watertight dressing.

Impetigo spreads through touch, so keep your child's nails short and wash hands often.

Use separate towels and wash bedding and clothes in hot water.

If sores keep spreading after a few days of treatment, go back to your doctor.

Viruses

Influenza and COVID

For influenza, COVID-19 and RSV, NSW Health's advice is simply to keep children home until they have recovered, however long that takes. A child who is still coughing a little but is fever free, eating and full of energy is usually ready to come back.

Flu is more serious than a cold and can make young children very unwell. Annual flu vaccines are free in NSW for children aged six months to under five years.

Family members and staff being up to date with COVID-19 vaccinations helps protect the youngest children.

Get medical help for laboured breathing, unusual drowsiness, or a child who refuses drinks.

Paperwork

Medical clearance: when it is needed

For most conditions on the NSW list, children can return once the exclusion period has passed and they are well, without a doctor's certificate. Hepatitis A is the clear exception: NSW Health requires a medical certificate of recovery. Your local public health unit may also set conditions after serious diseases such as measles or whooping cough.

A doctor's diagnosis is still helpful for rashes and eye infections, so the right exclusion is applied.

If your child was excluded as an unimmunised contact during an outbreak, the public health unit tells the centre when they can return.

Questions about returning after illness? Call us on (02) 7238 8668, or read about immunisation requirements.

Common questions

Exclusions, answered

Are these rules or guidelines?+

They are NSW Health recommendations, based on national guidelines, that centres build into their own policies, so in practice they work as rules at your centre. During outbreaks of some vaccine-preventable diseases, public health officers also have legal power to exclude children.

Can a doctor override them?+

Generally no. A doctor can confirm a diagnosis or that a condition is not infectious, such as allergic conjunctivitis, which may mean no exclusion applies. But a doctor's note does not shorten a minimum exclusion period, like the 48 hours after gastro.

What about unimmunised contacts?+

Children who are not immunised against a disease may be asked to stay home if there is a case of it at the centre. For measles, NSW Health excludes unimmunised contacts for at least two weeks after exposure. The public health unit decides who is excluded and for how long.

Not sure if an exclusion applies? Ring our St Ives centre before drop-off.

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