FRIDAY, Jan. 30, 2004 (HealthDayNews) -- Your child is sniffling, sneezing and complaining of a scratchy throat, but his temperature is normal. Should you pack his lunch and send him off to school?

Parents make tough calls like that every day, often with little else to go on other than gut instinct.

Parents are "pretty clued in to their kids" and know when their child isn't feeling well, says Marilyn Kinne, a school nurse practitioner and school projects coordinator at the National Association of School Nurses.

"If, in their best judgment, the child is running a fever and has other symptoms, then it just seems prudent to give them a day at home resting [and to] give them extra fluids and keep an eye on them," she says.

Surely that's what June Cleaver, the fictional television mom from the early 1960s situation comedy "Leave It to Beaver" would have done. But in today's dual-income society, few moms -- or dads, for that matter -- have the luxury of taking a day off from work to serve chicken soup to their ailing child.

"There is pressure to send them even when they're sick," says Dr. Thomas L. Young, an associate professor of pediatrics at the University of Kentucky and a member of the American Academy of Pediatrics' Committee on School Health.

Some parents may be taking extra precautions in light of the recent news reports suggesting that this season's flu outbreak has been particularly harsh. Since the influenza season's onset, nearly 100 children in the United States have died due to flu-related causes, the U.S. Centers for Disease Control and Prevention reports.

Flu symptoms include fever, headache, extreme tiredness, dry cough, sore throat, runny or stuffy nose and muscle aches, according to the CDC. Children may have additional gastrointestinal symptoms, such as nausea, vomiting and diarrhea.

It's up to parents to separate true malady from truant behavior. A child who simply complains, "I don't feel good," could be cooking up a mild excuse to skip class.

So when should your youngster absolutely skip school?

A child with a fever should be kept home and nursed back to health, Young advises. If he or she is vomiting, it's also best to stay home, he adds.

Colds, obviously, are mildly contagious but not necessarily a reason for children to miss school. It may depend on how uncomfortable they are. Likewise, it's probably safe to send a child to school with a mild cough if unaccompanied by fever and other symptoms, Young says.

Strep throat is different, Young cautions. Even if your child is being treated with antibiotics, he or she is considered contagious during the first 24 hours, so keep your kid home for at least a day.

Diarrhea? If the child doesn't have a fever and is otherwise healthy, a "little bit of diarrhea is not a reason not to go to school," he says. The key with diarrhea is very good hand-washing to keep the infection from spreading to others.

Parents also need to check the school handbook for guidance, since many school districts have policies stating when a child cannot attend school. "Some are very specific," Kinne says. "Some will actually list a temperature."

Some schools also maintain a zero-tolerance policy with regard to children who have head lice, even though that prohibition is at odds with current medical guidance. The American Academy of Pediatrics discourages "no-nit" policies and says no healthy child should be excluded from school due to head lice. Likewise, the National Association of School Nurses says nit-free policies disrupt the education process and should not be considered an essential strategy for managing head lice.

Still unsure what to do? School nurses and school-based health centers often can help parents decide what's best for their child.

The bottom line: A good dose of common sense can go a long way toward getting your child back on her feet and in the classroom.

More information

The American Academy of Pediatrics has more on treating children for colds. Here's more details on the flu.

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