Attendance: When Should I Send My Child To School?

Suggestions for children 5 to 18 years of age.

When students miss too many days of school, they fall behind and struggle to keep up with their classmates. Whether the days missed are due to illness, truancy, or for any other reason, the end result for the student is the same— learning time is lost. Children and adolescents will get sick at times and may need to stay at home, but we want to work with you to help minimize the number of days your child misses school.

Missed Days Add Up Quickly!

  • Just a few missed days a month add up to several school weeks missed in a year.

  • Both excused and unexcused absences can make it more difficult for your child to keep up with other students,especially in math and reading.

  • Kindergarten and first grade are critical for your child. Missing school during these early years makes it more difficult for children to learn in later years and they often have trouble reading by the end of third grade.

Work with Your Child and Your School

  • As the parent, be strong with your child and don’t let your child stay home when it is not necessary. This will help your child succeed.
  • If your child has a chronic disease, make sure that the School Public Health Nurse and school staff are aware of the disease so the staff can assist your child if he or she becomes ill. Information about your child’s chronic disease should be noted on the school Health Information Form and the Emergency Care Form. Please also be sure to alert the School Public Health Nurse of any changes to your child’s health care needs that could impact the school day.
  • Keep an open line of communication with your School Public Health Nurse, school staff, and teachers. The more the school knows about your child’s health, the better prepared everyone will be to work together for your child.

Helpful Ideas:

  • Make appointments with the doctor or dentist in the late afternoon so your child misses as little school as possible.
  • If your child must miss school, make sure you get his or her homework assignments and follow up to see if the work is completed and turned in.
  • Call the school as soon as you know your child will be absent and tell school staff why your child will be absent, the specific symptoms your child is having, and how long your child will be out of school.
  • Be prepared to get a doctor’s note when requested by school personnel.
  • If you need medical advice after business hours, most doctors’ offices have answering services 24 hours a day to assist you.
  • If your child has an emergency, call 911.
When Should I Send My Child To School?

The suggestions below are for children 5 to 18 years of age. Recommendations may be different for infants and younger children.

Health Concern Suggestion

Parent is Sick, Stressed, Hospitalized

YES - If you are sick, your child still needs to attend school. Your illness does not excuse your child from attending. We all are sick at times so plan ahead for these days.  Get a neighbor, relative, or spouse to take your child to school and pick him or her up.

Chronic Diseases (Asthma, Diabetes, Sickle Cell, Epilepsy, etc.) Chronic disease is a disease that lasts at least 3 months or longer. It often can be controlled, but may not be cured.

YES – Your child should attend school.  The School Public Health Nurse will train school personnel to assist your child with his or her chronic disease and associated needs.

Child Doesn’t Want to go to School
Frequent crying, fear, anger, not wanting to socialize, behavior change, stomach ache, nausea
(These can be signs of depression, anxiety, post-traumatic stress, or fear)

YES– You should keep your child in school, but try to determine what is causing the changes.  Talk to school personnel and consult a health care provider.  Your child may be experiencing bullying or trauma, may be behind in his or her school work, or not getting along with others. These and other issues may require your or school personnel’s attention.

Cold Symptoms
Stuffy nose/runny nose, sneezing, mild cough

YES - If your child is able to participate in school activities send him or her to school.

Conjunctivitis (Pink Eye)
The white of the eye is pink; there may or may not be a thick yellow/green discharge.

NO if there is discharge from the eye, your child must be evaluated by a healthcare provider before returning to school.

Head Lice
Intense itching of the head; may feel like something is moving

YES – Your child can be in school if he or she has had an initial treatment of shampooing of hair with a product approved for lice removal by the Food
& Drug Administration (FDA) and the school has received a Lice Treatment Verification form (available from School Health Room).

Strains, Sprains, and Pains

YES – If there is no known injury and your child is able to function (walk, talk, eat) he or she should be in school. If pain is severe or doesn’t stop, consult a health care provider.

Menstrual Issues

YES – Most of the time menstrual (periods) issues should not be a problem. If they are severe and interfering with your daughter attending school, consult with a health care provider.

Fever usually means illness, especially if your child has a fever of 100.4 or high-and is not feeling well with other symptoms such as behavior change, rash, sore throat, vomiting etc.

NO – If your child has a temperature of 100.4 or higher, keep him or her at home until his or her fever is below 100.4 for 24 hours without the use of fever reducing medication. If the fever does not go away after 2-3 days or is 102.0 or higher, you should consult a health care provider.

Frequent, loose, or watery stool may mean illness but can also be caused by food and medication

NO If, in addition to diarrhea, your child acts ill, or is vomiting, it is recommended to keep him or her at home for 24 hours. If stool is bloody, or if the child has abdominal pain, fever or vomiting, you should consult a health care provider.

Child has vomited.

NO – If your child shows other signs of illness, keep your child at home until the vomiting has stopped for 24 hours.  If vomiting continues, contact a health care provider.
YES- if vomiting is due to motion sickness, vigorous activity, overeating or eating too fast, or heat.

Severe, uncontrolled, rapid coughing, wheezing, or difficulty breathing

NO – Keep your child home and contact a health care provider. If symptoms are due to asthma, provide treatment according to your child’s physician/healthcare provider. When your child does not need to use his or her inhaler or medication more frequently than every 4 hours, or as  ordered, he or she may return to school.


NO –If a rash spreads quickly, is not healing, or has open weeping wounds you should keep your child at home and have him or her seen by a health care provider. Your child may return to school if health care provider states child is not contagious
YES -If the cause of the rash is known, please notify the School Public Health Nurse, School Health Aide and school staff.

Strep Throat
Sore throat, fever, stomach ache, and red, swollen tonsils

Strep throat should be diagnosed by the health care provider.
NO - If your child is diagnosed with strep throat, keep your child at home for the first 24 hours after an antibiotic is begun.

Vaccine Preventable Diseases
Chicken Pox - fever, headache, stomach ache or sore throat, then a red itchy skin rash develops on the stomach first then limbs and face.
Measles & Rubella (German Measles) – swollen glands, rash that starts behind ears followed by the face and the rest of the body, sore joints, mild fever and cough, red eyes
Mumps – fever, headache, muscle aches, loss of appetite, swollen tender salivary glands
Pertussis (Whooping Cough) – many rapid coughs followed by a high- pitched “whoop,” vomiting, very tired

NO – Keep your child at home until a health care provider has determined that your child is not contagious.

This information is based upon recommended guidelines from reliable sources to include the Centers for Disease Control (CDC), American Academy of Pediatrics, and Public Health Association.
Materials developed by the Alameda County Public Health Department.

Absences Add Up

Attending school regularly helps students feel better about school - and themselves.