Is My Child Too Sick for Daycare?
Daycare sickness is one of the hardest calls parents make, usually at 6:30 in the morning with work looming. The short answer: a fever, vomiting or diarrhoea, or a condition NSW Health lists for exclusion all mean a day at home, and so does being too unwell to enjoy the day. This guide helps with the grey areas in between.
Most young children in care pick up a lot of bugs in their first year or two. Experience shows this settles down as their immune system matures, but in the meantime families face frequent judgement calls about whether a child is well enough to go in.
This guide explains how we think about illness, based on NSW Health exclusion periods and standard childcare practice. It is for families at our centre and anyone else trying to make sense of daycare illness rules. It does not replace medical advice. Worried? Your GP is the best first stop, and the free healthdirect line, 1800 022 222, answers around the clock.
For allergies, immunisation, medication and more, visit our childcare health and safety hub.
The quick decision guide
For most daycare sickness decisions, three questions do the job. Does your child have a fever, vomiting or diarrhoea? Do they have a condition with an exclusion period? Could they cope with a normal day of play, meals and rest in a group? If the answer to the first two is yes, or the last is no, keep them home.
A temperature of 38°C or higher is a fever. Keep your child home and watch them closely. Most centres, including ours, ask that children stay away until they have been well without fever for a full day.
Call 000 straight away if your child
- Has trouble breathing
- Is very drowsy or hard to wake
- Looks very pale, or their hands and feet feel cold or look blue
- Has a stiff neck, or a rash of purple spots with fever
Fever: the 24-hour rule
A fever is a temperature of 38°C or higher. A child with a fever should stay home. Many centres, ours included, ask that children are fever free for 24 hours before returning. That is a common centre policy rather than a NSW Health rule, and it gives children time to recover and lowers the chance of passing the illness on.
Fever is the body's normal response to infection, not an illness in itself.
Paracetamol or ibuprofen can make a child more comfortable, but masking a fever to send a child in only delays recovery and spreads the bug.
A baby under three months with a fever above 38°C needs to go to the nearest emergency department straight away.
See a doctor promptly for a fever above 40°C, a fever with a rash, or symptoms lasting more than two days.
Febrile seizures can happen with fevers in children aged six months to six years. They are frightening but usually brief. Call 000 if your child has one.
Fever facts
- Fever
- 38°C or higher
- Under 3 months
- Emergency department
- Back to care
- Usually 24 hours fever free
Rest it outMeasure temperature with a digital thermometer. Forehead strips and touch are not reliable enough to decide on care. Under the arm is fine for young children; write down the reading and the time.
Think about how your child is behaving, not just the number. A child with 38.2°C who is playing and drinking is less worrying than a child with 37.8°C who is floppy and will not drink. Both should stay home, but the second needs a doctor.
Why a full day without fever before returning? Children often seem better in the morning and spike again in the afternoon. A day of rest also means they come back with the energy for play, which makes for a happier return.
Vomiting and diarrhoea
Children with vomiting or diarrhoea must stay home. NSW Health guidance keeps a child with gastroenteritis away from care until two full days, 48 hours, have passed since their last loose bowel motion. Gastro spreads very easily in groups of young children, and this rule is one of the most important ones for keeping a whole room well.
The 48 hours starts from the last loose bowel motion or vomit, not from when your child first seemed better.
One vomit after a coughing fit or a big meal is different from a tummy bug. If you are unsure, keep them home and watch.
Small sips of fluid often help children stay hydrated. Babies and young children can become dehydrated quickly, so see a doctor if your child is not drinking, has far fewer wet nappies than usual, or seems floppy.
Handwashing with soap and water is the best way to stop gastro spreading through your household.
If several children in a room have gastro, we tell families so they can watch for symptoms, without naming anyone.
During an outbreak, our cleaning of toys, tables and nappy change areas steps up, and families may be asked to take extra care with the 48-hour rule so the bug does not bounce back through the room.
Adults in the house can catch it too. Anyone preparing food should be especially careful with handwashing until the whole family has been well for two days.
Coughs, colds and green noses
A child with a mild cold, a runny nose or a light cough can usually come to care if they are otherwise well, eating, and able to join in. Green or yellow mucus on its own does not mean a child needs antibiotics or must stay home. What matters most is how your child is coping, and whether they have a fever.
Young children catch a lot of colds, often one after another in their first year of care. Keeping every sniffle at home is not realistic, and it is not required.
Keep your child home if the cough is constant, keeps them up at night, or comes with fever, fast breathing or wheezing.
Flu, COVID-19 and RSV all need exclusion until your child is well again. Annual flu shots are free in NSW for children from six months to under five years.
Whooping cough is different. It needs medical assessment, and NSW Health excludes children for 21 days from when symptoms start, or until they have had at least five days of the right antibiotic.
Teach children to cough into their elbow, wipe noses often and wash hands afterwards.
Ear infections often follow colds in young children. Ear pulling, waking at night in pain, or fever after a cold are reasons to see your GP. An ear infection is not infectious in itself, so your child can return once they are comfortable and fever free.
Asthma can flare with colds. If your child has an asthma action plan, make sure we have an up-to-date copy and their reliever medication and spacer at the centre.
Rashes: which need a diagnosis
Any new rash you cannot explain should be checked by a doctor before your child comes to care, especially if it comes with fever. Some rashes are harmless, like heat rash or mild eczema. Others, like chickenpox, hand, foot and mouth or impetigo, have exclusion periods. A rash of purple spots with fever needs urgent medical care.
| Rash | Exclusion |
|---|---|
| Chickenpox | Until every blister has crusted and dried, which is normally five or more days from the first spots |
| Hand, foot and mouth | Until all blisters have dried |
| Impetigo (school sores) | Until antibiotics have started; cover sores with a watertight dressing |
| Measles | At least 4 days after the rash appears |
| Slapped cheek | No exclusion needed |
| Molluscum contagiosum | No exclusion needed |
A quick check for worrying rashes: press a clear glass against the spots. If they do not fade under the glass and your child has a fever or seems unwell, treat it as an emergency and call 000. Eczema flares and nappy rash are not infectious and do not need exclusion, though a very sore or weeping patch is worth showing your GP.
See our guide to hand, foot and mouth disease, a very common daycare rash, or the full NSW exclusion periods.
Conjunctivitis
Conjunctivitis makes the white of the eye red and swollen, often with a sticky discharge. Infectious conjunctivitis spreads easily. NSW Health says children should stay home until the discharge from their eyes has stopped. Allergic conjunctivitis, which is often itchy and watery in both eyes, is not infectious.
Wipe each eye with a fresh cotton ball or tissue, from the inner corner out.
Wash hands after touching the eyes, and keep face washers and towels separate.
See a doctor if your child's eye is very painful, they are sensitive to light, their vision seems affected, or the eyelid is very swollen.
If your doctor says it is allergic, let us know so educators do not send your child home.
Babies sometimes have a sticky eye from a blocked tear duct. This is not infectious and often clears as they grow. If your GP confirms a blocked duct, tell us so we can note it in your child's records.
Sticky eye tips
- Wipe inner to outer
- Fresh tissue each wipe
- Separate towels
- Home until discharge stops
Clean hands helpWhen we will call you to collect
We will call you to collect your child if they develop a fever, vomit or have diarrhoea, show signs of an infectious condition such as a new rash or sticky eyes, or are too unwell to take part in the day. While we wait for you, an educator stays with your child somewhere calm and comfortable.
Please keep your contact details up to date in KinderM8, and make sure an authorised person can collect promptly if we call.
We record the illness, what we observed and what we did, and share it with you at pick-up.
We will not give medication unless you have authorised it, except in an anaphylaxis or asthma emergency.
If your child seems seriously unwell, we call 000 first and then you.
We know a call from childcare in the middle of a meeting is stressful. We only call when we genuinely think your child needs to go home, and we will tell you what we have seen so you can decide whether a GP visit is needed on the way.
Questions about our illness policy? Call us on (02) 7238 8668.
Returning after illness
Your child can return once any exclusion period has passed, they have been free of fever for a full day, and they are well enough to enjoy a normal day of play, meals and rest. For most common illnesses, a doctor's certificate is not needed, but a few conditions, such as hepatitis A, require medical clearance.
A first day back after a long illness can be tiring. A shorter day, if your booking allows, can help.
Tell educators about any ongoing medication, and complete an authority form if we need to give it.
Absences for illness count towards your 42 Child Care Subsidy absence days per year. Additional absences can be approved with a medical certificate once those are used.
If a brother or sister is sick but your child is well, they can usually still come in, unless public health staff advise otherwise during an outbreak of a vaccine-preventable disease such as measles.
If your child is often unwell, it is worth a chat with your GP. Frequent infections are common in the first year of care, but a doctor can check nothing else is going on.
For the full rules, read the NSW Health page on exclusion periods for childhood illnesses.
Planning for sick days before they happen
The first year of care often brings more sick days than families expect. A little planning makes those mornings less stressful and makes it easier to keep a sick child home when that is the right call, rather than feeling forced to send them in.
Talk to your workplace early about carer's leave and working from home. Under the National Employment Standards, most employees can use personal leave to care for a sick child.
Line up a back-up carer, such as a grandparent, friend or neighbour, who can step in at short notice. Make sure they are listed as an authorised person if they may need to collect from the centre.
Share sick days between parents or carers where you can, so the load does not always fall on one person.
Keep a simple sick-day kit at home: a digital thermometer, oral rehydration solution, tissues, and a few quiet activities.
Save healthdirect's number, 1800 022 222, in your phone. Nurses answer around the clock and can help you decide whether your child needs a doctor tonight or can wait until morning.
How we protect the whole room
Keeping sick children home is only one part of stopping illness spreading. Everyday hygiene habits, at the centre and at home, make a real difference, and young children can learn them from very early on.
Children wash hands with soap and water before and after meals, after nappy changes and toileting, and after outdoor play.
Nappy change areas, tables and high-touch toys are cleaned regularly, with extra cleaning during outbreaks.
Each child has their own labelled bedding and drink bottle, and children learn not to share cups or food.
Immunisation protects your child and the babies in the room who are too young to be fully vaccinated.
At home, the same habits help: handwashing before meals and after the toilet, and covering coughs with an elbow.
Five mornings, five decisions
These everyday examples show how the guidance above plays out in practice. They are illustrations, not rules for every child, and your GP's advice always comes first.
The midnight vomit. Your toddler vomited once overnight and seems fine at breakfast. Because gastro often starts this way, keep them home and watch. If there is no more vomiting or diarrhoea for 48 hours, they can come back.
The green nose. Your preschooler has had a runny nose for a week, is eating well and wants to see friends. No fever, no exclusion needed. Send tissues-friendly clothes and let educators know.
The sticky eye. One eye is crusted shut on waking and red. Keep them home, clean the eye gently, and see your GP if it is painful or not improving. They can return once the discharge has stopped.
The Panadol morning. Your child had a fever last night, and paracetamol has brought it down. It is tempting to send them in, but the fever will likely return as the dose wears off. Keep them home until they have been fever free for a full day without medication.
The mystery spots. A few small red spots appear on your baby's hands and around the mouth. This could be hand, foot and mouth disease. See your GP for a diagnosis, and keep them home until all blisters have dried.
Sick days, answered
Can they attend with a runny nose?+
Usually yes, if your child is otherwise well, has no fever and can join in the day. A runny nose, even with green mucus, is very common in young children and is not a reason for exclusion on its own. Keep them home if they are miserable, feverish or struggling to breathe comfortably.
Who decides, us or you?+
Both of us, at different times. Families decide in the morning whether a child is well enough to come. During the day, the nominated supervisor decides whether a child needs to go home, guided by NSW Health exclusion periods and our illness policy. We will always explain why.
Why was my child sent home but another stayed?+
Every child is assessed on their own symptoms on the day, so two children with a cough can be very different. One may have a fever or be too unwell to join in, while the other is bright and playing. We also cannot share another child's health details, so the full picture is not always visible.
Still unsure about today? Call the team at our St Ives centre before you leave home.
Clear policies, calm mornings
Visit our centre and ask how we keep rooms healthy.