When is a child too sick for day care?

November 25, 2005|By BLOOMBERG NEWS SERVICE

If your child has a temperature of 100 degrees, do you keep him home from day care?

A survey of more than 250 U.S. parents, pediatricians and day-care providers found that about one-third of the time respondents were wrong about this and other questions regarding when to keep young kids home because of illness.

Pediatricians were inaccurate most often, failing 39 percent of the time to identify the right reasons as described in guidelines accepted by the American medical profession.

Parents needlessly are taking time off from work to stay at home with children they think are too sick to attend day care, according to the study led by Kristen Copeland, a pediatrician at Cincinnati Children's Hospital Medical Center.

American workers spend about 25 percent of sick-leave days taking care of an ill child or other relative, according to a 2000 U.S. Department of Labor report.

"The most surprising finding is that pediatricians did no better than child-care providers and parents" in assessing which conditions required children to be kept out of day care, said Copeland. Her results appear in the November-December issue of Ambulatory Pediatrics.

Copeland's study was based on surveys completed in 2000 by 80 child-care providers, 142 parents and 36 pediatricians. To evaluate their answers, the study relied upon the guidelines adopted jointly by the American Academy of Pediatrics, the American Public Health Association, and the U.S. government's Maternal and Child Health Bureau.

Given a list of 12 common symptoms, the pediatricians gave the wrong advice 39 percent of the time, including 37 percent of the time in cases where they should have advised the parent to let the child attend day care. Child-care providers gave wrong answers, as measured by the joint guidelines, 37 percent of the time, and the parents were wrong 36 percent of the time.

The joint guidelines indicate that three of the 12 symptoms described in Copeland's survey do not require children to be kept home: a new rash without other symptoms, five days of green or yellow discharge from the nose and redness of the eyes with watery discharge.

A majority of the pediatricians, 53 percent, incorrectly cited the eye redness as sufficient to keep children home, the study found. The guidelines recommend keeping children home if their temperature is 101 degrees or higher if measured in the mouth or 100 degrees or higher if taken under the arm. Pediatricians knew the former correctly 86 percent of the time, and the latter only 60 percent of the time, according to the study.

The high rate of incorrect responses among physicians could be due to several possible factors, including disagreement with the guidelines and variations in the types of patients seen by those participating in the survey, Copeland said.

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