Pediatricians Urge Schools to Nix 'No Nit' Policies

Head lice shouldn't force healthy kids to stay home

TUESDAY, Sept. 3, 2002 (HealthDayNews) -- It's that time of year again, when children come skipping home from their first days of school with their little heads full of new friends' names, homework assignments, and -- all too often -- lice.

The dreaded little bugs may mean a trip to the drugstore, a few extra shampoos and sessions with a fine-toothed comb. In many school districts, though, it also means time off: So-called "no nit" policies prevent children from returning to school before all of the lice -- and the lice eggs, or nits -- are gone.

The nation's leading group of child doctors now says that's doing children a great disservice.

The American Academy of Pediatrics (AAP) strongly discourages such policies, saying "no healthy child should be excluded from or allowed to miss school because of head lice."

The recommendation appears in the September issue of Pediatrics.

The pediatricians estimate that between 6 million and 12 million will come down with a case of head lice this year. While there are no hard statistics on precisely how many schools have no-nit policies, the AAP describes numerous reports of children missing weeks of school due to head lice, and even in some cases being forced to repeat a grade because they were not allowed back into school with the problem.

There's no reason why head lice should cause children to miss even more than one day, argues Dr. Howard Taras, a professor of pediatrics at the University of California, San Diego, and chairman of the AAP's Committee on School Health.

"If you use the [lice treatment] in the morning, I frankly don't see why a child can't return to school that very afternoon," he asserts.

The lice treatment recommended by the AAP is a cream rinse called permethrin, which is sold as an over-the-counter product called Nix.

While the product should kill most head lice, many of the nits typically remain, clinging to the hair with a gluey substance scientists have yet to figure out how to dissolve.

That's where the controversy comes in: Although the nits are not infectious and may not even contain live eggs, some schools see them as harbingers of another infestation waiting to happen.

"The argument some give is that any nit can hatch at any moment," explains Dr. Barbara Frankowski, a professor of pediatrics at the Vermont Children's Hospital in Burlington. "But many of the nits that are seen are just the remaining casing and don't even contain eggs at all, or they contain dead eggs that were killed by the treatment."

"And even if they hatch, it's still two weeks before they matured to lay eggs and cause any kind of infestation," Frankowski adds.

In the meantime, if the treatment is used and followed by a fine-toothed comb through the hair, the problem can usually be resolved within a week or two.

The AAP says it's not necessary to try to manually remove nits after medication for lice to prevent their spread, but advises that parents may want to try to make an effort to pull out nits to further decrease the chance of a misdiagnosis.

But don't expect to remove all of those nits by hand in one sitting.

"It's simply unreasonable to expect that a 7-year-old is going to sit still for three hours while you try to pull out all of the nits," says Frankowski. "What we suggest is that you do short sessions every night for seven to 10 days, because by that time, any nits that are left would have hatched."

Another problem about lice that many parents dread is the laborious process of having to disinfect everything from couches and carpets to bedding and clothing with various lice-removal products.

But the effectiveness of such efforts has yet to be determined, experts say.

In most cases, transmission in fact occurs by direct contact with the head of another infested individual. That's why children's play, and their close contact with one another, makes them the group most susceptible to lice.

Lice cannot hop or fly -- they crawl, says the AAP. While indirect transmission through such means as the sharing of hats or hairbrushes is possible, it is much less likely than is commonly believed.

Many experts say don't bother turning your home inside out with those lice removal products.

"It makes sense to look around the house, take note of places in which your child's head is frequently in contact, and perhaps vacuum that area, if it's a couch," advises Frankowski. "But regarding use of the various products, your time is probably better spent just using the [permethrin] directly on your child's head and making sure you really use it correctly."

The many misconceptions about head lice transmission and control, combined with the sheer creepiness of having live bugs living in one's hair, gives head lice an understandably unique stigma. But that stigma shouldn't keep children from learning, says the AAP.

"People are both fascinated and horrified by lice, and since they don't want to get it themselves or want others to get it, they can do drastic things," says Taras. "But it's important to take a step back and ask why a child should miss any days of school when they're not really infectious."

What To Do

You can read more about head lice in this news release from the American Academy of Pediatrics. The Centers for Disease Control and Prevention also has a page devoted to the critters.

Related Stories

No stories found.
logo
www.healthday.com