Sick Kids Can Be Costly. Here’s How to Decide What Care They Actually Need

Mom measuring fever to sick daughter with digital thermometer.
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When my daughter started preschool for the first time last month, I was aware it’d be an adjustment and that I’d incur new child care expenses.

What I wasn’t quite prepared for was how my kid’s body would need to adjust to the onslaught of germs she’d come into contact with — and the costs I’d encounter with her being sick on and off for weeks.

I’m lucky in many ways. My daughter hasn’t contracted anything serious. I have a job that provides me with great medical insurance, unlimited sick days and the ability to work from home when needed. My daughter’s grandmothers are usually able to watch her on days I can’t.

But less than a month into the school year, my kid has already been to the doctor twice and missed 2 1/2 days of preschool I still had to pay for. We’re running low on over-the-counter fever reducer, and the $10 bottle of honey-based throat soother I recently purchased is likely going to get thrown out since my child and I both concluded it tastes completely gross.

Having a sick child is tough enough without all the financial considerations. But the reality is many parents have no options but to miss work and forgo pay if their child is sick. Other parents shell out money for a baby sitter or a sick-child care facility.

And that’s on top of copays at the doctor’s office and pharmacy. Parents without medical insurance may have even greater financial expenses.

All that being said, not all illnesses are created equal. Everything doesn’t have to shut down due to a case of the sniffles. So before you pull your kid out from school to see a doctor, here is what the American Academy of Pediatrics wants you to know about children, school and sickness.

When Your Child Should Miss School

Sometimes it’ll be obvious when you need to keep your sick kid home from school. Other times, it may not be so simple, like when your kid complains of a stomachache the morning of a big test.

You should certainly check the sick-child policy at your kid’s school or child care center when deciding whether to keep a child home. The American Academy of Pediatrics also offers advice on the matter.

The organization states children should stay home from a school or child care facility if their condition:

  • Prevents them from comfortably taking part in activities.
  • Puts others at risk of contracting harmful diseases.
  • Requires care greater than teachers or staff can provide without compromising the health or safety of other children in the class.

The pediatricians’ group outlines which symptoms indicate a child should be excluded from school, such as a fever over 101°F, vomiting more than once in the past 24 hours or a quickly spreading rash. It also describes which symptoms are acceptable in group settings, like runny noses, coughs, eye discharge and common colds.

“In general, a child with a little bit of a runny nose who doesn’t have a fever, can play, can concentrate, can eat, can drink — that child is fine to be at school,” said Dr. Jaime Friedman, a San Diego pediatrician, mother of two and American Academy of Pediatrics spokeswoman. “I think a missed day of work and a missed day of school isn’t necessary for a child who’s otherwise very well. Obviously, with a fever, they’re going to stay home.”

She said most schools advise parents to keep ill children home from school until they’ve been fever-free for 24 hours.

The academy has specific guidelines on how long children with conditions such as strep throat, lice, scabies, ringworm and chicken pox should remain home from school.

Check with your child’s pediatrician or read the academy’s recommendations for guidance on how long your kid may need to be out.

If your kid is in the first year of school, don’t be alarmed if it seems he or she catches one virus after another. Friedman said pediatricians typically see young children, especially those who are new to school, encounter six to eight colds on average during the fall and winter. Symptoms from a cold may last up to two weeks before the child feels entirely better, she said.

When An Illness Warrants a Trip to the Pediatrician

No parent wants to see their child sick and suffering, so scheduling a doctor’s appointment is a natural response when your kid gets sick. But before you fork over a copay, you should know that a pediatrician won’t be able to prescribe medication for all illnesses.

The upper respiratory infection folks call “the common cold” is caused by a virus. Antibiotics are used to treat bacterial infections. “Colds don’t require antibiotics,” Friedman said.

She also said parents don’t need to bring their children to the doctor at the first sign of a fever.

“Fever is very normal with colds,” she said. “It doesn’t necessarily mean — if the child is otherwise healthy [with] no underlying conditions — that they need to run in to the doctor.”

The American Academy of Pediatrics advises parents that children with a cold don’t need to see a doctor unless they’re 3 months old or younger, or they have one of the following symptoms:

  • Nasal mucus lasting longer than two weeks
  • A cough lasting longer than one week
  • Ear pain
  • Fever above 102°F
  • Excessive sleepiness or crankiness
  • Trouble breathing, fast breathing or breathing where the nostrils get larger with each breath or the skin above or below the ribs retracts with each breath
  • Lips or nails turning blue

Friedman said parents should simply call their pediatrician’s office if they’re questioning whether they need to schedule an appointment.

The best course of treatment for a cold is to keep your children comfortable, have them get plenty of rest and encourage them to drink lots of fluids, according to the pediatricians’ academy.

Friedman doesn’t recommend parents buy over-the-counter cold or cough medicine to help their little ones.

Saline spray or drops, a room humidifier and tea (with honey for children over 1 year old) are preferred aids for children suffering from a cold, she said.

What Parents Should Know About Prevention

The ideal situation, obviously, is to avoid getting sick in the first place. Though sometimes it seems as though kids are germ magnets, the academy says practicing the following measures can help reduce your kid’s risk of contracting colds.

  • Wash hands with soap and water or use an alcohol-based hand sanitizer.
  • Have your kid cover his or her mouth and nose with a tissue when sneezing or coughing and then dispose of the tissue immediately.
  • Try to avoid contact with people who are infected with a virus.

“Nothing will replace good hand washing,” Friedman said. “There’s no amount of echinacea [an herbal remedy] or whatever the parents want to spend all their money on that’s going to replace good hand washing.”

She also recommends parents remind their kids not to share things like juice boxes or water bottles.

Friedman said children 6 months and older to should get an annual flu shot before the end of October.

While the immunization may not protect against all strains of the flu virus, she said some protection is better than nothing.

Nicole Dow is a senior writer at The Penny Hoarder. She feels so bad when her daughter is sick.