When your child is sick, and when they can go back

Every family starting daycare meets this sooner than they expect. A child entering group care for the first time encounters a large number of new viruses in a short period, and a run of minor illnesses through the first months is the ordinary pattern rather than a sign that anything is wrong.

Knowing the rule in advance makes the morning decision faster, and the rule in British Columbia is simpler than most families assume.

The test is participation

The current provincial guidance for child care settings is the BC Centre for Disease Control's Supporting Child Wellness, published 13 September 2023. It sets one practical test.

Staff, children, or other people in the child care setting who are showing symptoms of illness should stay home until they are well enough to take part in regular activities, or until a health care provider advises otherwise.

The same test governs the return. A person can attend child care if their symptoms have improved enough to return to regular activities, or where a health care provider says so.

This is a functional standard rather than a numeric one, and that is deliberate. The question is not what the thermometer says. It is whether this child, this morning, can do the things the day contains: join a group activity, play outside, eat lunch, manage a transition, rest.

A child with a mild runny nose who is otherwise their usual self passes. A child with no measurable fever who is limp on the sofa and refusing breakfast does not.

The guidance also describes a health check as a person regularly checking that they or their child are not experiencing symptoms that would limit their ability to participate fully, done before coming to child care. It notes that child care facilities do not need to monitor children or staff for symptoms. The check happens at home.

The exceptions worth knowing

Some illnesses run longer. The BCCDC guidance notes that those experiencing certain illnesses, such as gastrointestinal illness caused by norovirus, may be advised to stay home for longer than the general test would suggest. Vomiting and diarrhea are the category where the participation test alone is not sufficient, because a child can feel well again while still shedding an organism that spreads readily in a room of young children. For a specific case, ask a health care provider or call 8-1-1.

A known condition is not an illness. The guidance is explicit that a person can attend if their symptoms are consistent with a previously diagnosed health condition, and gives seasonal allergies as the example. A child with diagnosed hay fever does not stay home in April for a runny nose.

That exception only works if the centre knows about the diagnosis. Section 57 of the Child Care Licensing Regulation requires the centre to record any illness, allergy or medical disability disclosed by the child or parent, and this is exactly the situation that record is for. An educator who knows about the allergy sees a known symptom. An educator who does not see a new illness.

What happens if a child falls ill at the centre

Two things, one operational and one legal.

Operationally, a child who develops symptoms and cannot take part in regular activities is supported to go home. The BCCDC guidance directs that appropriate infection control precautions be taken while the person prepares to leave, including hand hygiene and the cleaning or disinfection of surfaces soiled with bodily fluids. A child over two experiencing respiratory symptoms may wear a mask; infants under two should not, because a mask may make breathing difficult and can become a choking hazard.

Legally, section 55 of the Child Care Licensing Regulation requires a licensee to immediately notify a parent or the emergency contact if a child becomes ill or is injured while under the centre's care or supervision.

That word immediately is the part worth carrying away. A parent is not told at pick-up about an illness that appeared at ten in the morning. This is also the concrete reason the contact details in the child's section 57 record have to be current, and why a changed mobile number is worth reporting the same week it changes rather than the next time somebody asks.

Medication, if any is needed

Where a licensee has agreed with a parent to give a child medication prescribed by a medical practitioner or provided by the parent, section 53 of the regulation requires the licensee and its employees to ensure the medication is administered in the amount and at the times specified. Section 57 requires any medication administered to be recorded in the child's file.

Practically, this means medication is handed directly to an educator with the required authorization and instructions, and never sent in the child's bag. A centre cannot administer something in an amount and at a time nobody established in advance.

How a centre limits the spread

Hand hygiene does most of the work.

The BCCDC guidance states that rigorous handwashing with plain soap and water, or an effective hand sanitizer, reduces the spread of illness, and that child care facilities should provide regular opportunities for staff and children to wash their hands. Children should be supervised or assisted in using hand sanitizer; it should not be used on infants; and labels should be read carefully, because some sanitizers are unsuitable for children.

The guidance also sets out routine respiratory etiquette: coughing or sneezing into an elbow or a tissue, discarding used tissues and washing hands immediately afterward, avoiding touching eyes, nose and mouth with unwashed hands, and not sharing food, drinks or unwashed utensils.

Section 46 of the Child Care Licensing Regulation adds a legal layer on top: the licensee must establish a program to instruct children in and practise the rules of health and hygiene, and no surface used for food preparation, storage or consumption may be used for changing diapers.

On ventilation, the guidance directs operators to keep heating, ventilation and air conditioning systems designed, operated and maintained to standard and working properly, and notes that windows may be opened when weather permits if this does not affect the ventilation system.

Masks, and what the guidance actually says

The BCCDC guidance treats masking beyond what public health recommends as a personal decision based on individual preference. Some children over two and some staff may choose to wear a non-medical mask throughout the day or for particular activities, and the guidance says that choice should be respected.

The one firm limit is age. Infants under two years should not wear masks, because a mask may make it difficult for them to breathe and may become a choking hazard.

A mask is not an alternative to staying home. The participation test comes first.

Telling the centre, and why it helps other families

A centre that knows what is going around can act on it. A centre that does not is managing each case as an isolated event.

When you keep a child home, say what the symptoms are rather than only that the child is unwell. The difference matters because a cluster of similar illnesses in one group is information: it changes what an educator watches for, what gets cleaned more often, and whether the centre needs advice from public health. Several unexplained absences in a week look like coincidence. Several reported cases of the same thing do not.

If a diagnosis arrives afterward, pass it on. This is particularly true for gastrointestinal illness, where the BCCDC guidance flags a potentially longer stay-home period, and for anything a clinician describes as notifiable or highly contagious.

The same applies to a new diagnosis of a chronic condition. Section 57 requires the centre to record any illness, allergy or medical disability disclosed by the child or parent, so the disclosure has a place to go and a purpose once it arrives.

The first year, in perspective

The frequency of illness in the first months is the single most common source of doubt about a daycare decision, and it is worth naming plainly.

A child who has spent their life in a household of two or three people has met comparatively few of the viruses that circulate among young children. Group care changes that quickly. The result is a run of colds and stomach upsets concentrated into the early months, which feels like evidence that something is wrong with the centre and is instead a feature of meeting a new set of people.

The pattern typically eases as a child encounters more of the common infections. What families notice is that a second year looks different from a first, in a way that has nothing to do with anything the centre changed.

None of that makes the missed work easier, which is why the planning below is worth doing early rather than during the first phone call.

Planning for the absences

The practical consequence of all this, for a working family, is that the first months of daycare include more days at home than the schedule assumed.

It is worth arranging the backup before it is needed rather than during the first phone call: who can collect at short notice, who can stay home, and whether either employer needs advance notice for that. The frequency does typically fall as a child meets more of the common viruses, but planning for the early pattern is easier than improvising through it.

If you are ever unsure whether a specific set of symptoms means staying home, the guidance is direct about where to go. Connect with your health care provider, or call 8-1-1. The centre can tell you its own policy; a clinical judgement about your child's symptoms belongs with a clinician.

Next

The disclosures that make the known-condition exception work are covered in before the first day. Food handling and the nut-free policy are in what to pack. For the health and hygiene rules a licence commits a centre to more broadly, see licensed child care in British Columbia.