When to keep your child home sick from daycare, and what happens if they get ill here

It is quarter past six in the morning and your child is warm, quiet, and not themselves. You have a meeting at nine. This is the decision every family makes several times a winter, usually with bad information and no time.

Here is the good news: British Columbia publishes guidance for child care settings on exactly this, and it is more usable than most parents realise.

The one test that covers everything

Before the symptom list, learn this line, because it settles most mornings on its own.

The Province's guidance says a child must be kept at home, or taken home, when the child is suffering from one or more of the listed symptoms, or is not well enough to take part in the regular programs of the facility.

That second half is the useful part. It does not require you to diagnose anything. It asks a question you can answer from the kitchen: could my child do a normal day here? Circle time, outdoor play, lunch at a table with other children, a nap, an afternoon of activity.

If the honest answer is no, then the answer is no, whatever the thermometer says. A child who is well enough to be at a centre is well enough to do the day the centre is running. A centre is not a quieter version of home with a sofa free.

The symptom list

The Province's guidance advises parents to keep a child at home or make alternate arrangements for the following:

Any complaint of unexplained or undiagnosed pain.

A common cold with listlessness, runny nose and eyes, coughing and sore throat.

Difficulty breathing, meaning wheezing or a persistent cough.

Fever of 100 degrees Fahrenheit, 38.3 degrees Celsius, or more, accompanied by general symptoms such as listlessness or sluggishness, which the guidance notes may be an early sign of an illness needing a doctor's attention.

Sore throat or trouble swallowing.

Infected skin or eyes, or an undiagnosed rash.

Headache with a stiff neck, which the guidance says should be seen by a physician.

Unexplained diarrhea or loose stool, whether or not it comes with nausea, vomiting or stomach cramps.

Nausea and vomiting, which may be early signs of illness.

Severe itching or dry skin of the body or scalp caused by head or body lice, or scabies.

Any known or suspected communicable disease.

Two things about this list are worth noticing. Fever appears with a qualifier, "accompanied by general symptoms", rather than as a number on its own. And pain appears at the top, before anything measurable, which is a good reminder that the most reliable instrument here is a parent who knows what their child is normally like.

The exception most families do not know about

If the runny nose, watery eyes and cough are caused by a known allergy, hay fever or asthma for example, the guidance is explicit: the child is not contagious and does not have to be excluded.

This is worth knowing because it saves a lot of unnecessary days at home every spring. A child with diagnosed seasonal allergies who is streaming in April is not a child with a cold. Tell us about the diagnosis so we can tell the difference, rather than assessing the same symptoms from scratch each time.

Coming back

Two of the return rules are specific enough to quote.

After a cold. The guidance says that once the child's temperature, wellbeing and energy have returned to normal, the child may no longer be contagious and may be able to return even though coughing and a runny nose may persist. It also gives a rough infectious window: a person who catches a cold can spread it for about one day before symptoms appear and about five days after they begin.

That first part answers the most common question we get, which is whether a lingering cough is a barrier. Generally it is not, once energy and temperature are back.

After diarrhea or vomiting. Stricter. The guidance says the child should be kept home until all symptoms have stopped, and explains why: these symptoms may indicate a bacterial or viral gastrointestinal infection that passes very easily between children.

For anything else, or if you are unsure, your child's health care provider is the right call. A centre can tell you what our guidance says. It cannot tell you what your child has.

What we do when a child becomes ill here

This part is regulated, and the requirements are short.

Section 54 of the Child Care Licensing Regulation says that if a child becomes ill while in the care of the licensee, the centre must provide a quiet and clean resting area in the facility for the child, and ensure the child is under the close supervision of a responsible adult.

Section 55 says the centre must immediately notify a parent or emergency contact if a child becomes ill or is injured while in our care.

So the sequence is: your child rests somewhere quiet with an adult beside them, and you get a phone call while it is happening. Not a note at pick-up.

What we cannot do is run a sick room. A centre is staffed to ratios for a group of well children doing a full programme, and one child who needs continuous individual attention changes the arithmetic for everyone in the room. That is the honest reason we ask families to collect promptly, and it is worth saying plainly rather than dressing up as policy.

The Province's guidance makes the same point from the other direction: symptoms can appear very quickly, and even with strict exclusion policies a centre may have to care for an ill child while waiting for a parent to arrive. That is expected and educators do it without any fuss. What we ask families to keep short is the wait.

Telling us what it was

Section 56 requires a centre to keep a log of minor accidents, illnesses and unexpected events involving children that did not need medical attention and were not reportable incidents.

Section 55 goes further for the serious ones. A centre must notify the medical health officer within 24 hours after it comes to the licensee's attention that a child enrolled at the facility has a reportable communicable disease, as listed in Schedule A or B of the Health Act Communicable Disease Regulation.

That duty depends entirely on families telling us. A centre cannot report what it does not know, and the reporting exists so that public health can spot a cluster across several facilities before anyone at any one of them would notice it.

It also helps the families around you. When we know what is circulating, we can let other parents know what to watch for, which turns a surprise on Thursday into something they were half expecting.

The first winter

Nearly every family finds the first several months at a centre bring more illness than they are used to. It is not a sign that anything is wrong with the centre or the child. A group setting simply exposes a child to more of what is going around than a home does, and their immune system meets a lot of new things in a short time.

It does settle. Knowing it is coming is what makes it manageable, so plan for it rather than being caught out: work out in advance who can collect at short notice, keep a backup on the list, and use your sick days across the winter rather than spending them all in October.

What actually helps

Hand washing does most of the work here, which is why it happens on arrival, before eating, after the washroom and after outdoor play, every single day.

Immunisation status is part of each child's record under section 57 of the regulation, so keep us updated when your child has had something new.

And keep the emergency contact list current. The number that matters is the one that gets answered at 11 a.m. on a Tuesday. Families who list a contact who works out of town discover this at the worst possible moment. There is more on what we hold on file in what we need from you about allergies.

The morning decision, in short

Ask whether your child could do a full day here. Check the symptom list against what you are seeing. If it is diarrhea or vomiting, wait until it has fully stopped. If it is a cough that is left over from a cold that has otherwise passed, they are probably fine to come. If it is a rash you cannot explain, or pain you cannot explain, keep them home and ring your provider.

And if you are genuinely on the fence, call us before you drive over. A two-minute conversation is better than a decision made in a car park, and we would far rather have it than not.

Frequently asked questions

What symptoms mean my child should stay home from daycare?

British Columbia's guidance for child care settings lists unexplained pain, a cold with listlessness, difficulty breathing or a persistent cough, fever of 38.3 degrees Celsius or more with general symptoms, sore throat or trouble swallowing, infected skin or eyes or an undiagnosed rash, headache with a stiff neck, unexplained diarrhea, nausea and vomiting, severe itching from lice or scabies, and any known or suspected communicable disease.

Is there one simple test for whether my child is too sick for daycare?

Yes, and it covers the cases the symptom list does not. The Province's guidance says a child must be kept at home when they have one of those symptoms or when they are not well enough to take part in the regular programs of the facility. If your child cannot join in the day, the day is not the right place for them.

My child has a runny nose but seems fine. Can they come?

If the runny nose and cough come from a known allergy such as hay fever or asthma, the guidance is explicit that the child is not contagious and does not have to be excluded. A cold with listlessness and low energy is different, and that one stays home.

How long after a cold can my child come back?

The guidance says that once temperature, wellbeing and energy have returned to normal, a child may no longer be contagious and may be able to return even if a cough and runny nose persist. It also notes a cold generally spreads for about a day before symptoms appear and roughly five days after they begin.

When can my child return after vomiting or diarrhea?

The guidance is that a child with unexplained diarrhea or loose stool should be kept home until all symptoms have stopped. These infections pass between children very easily, which is why this one is stricter than most.

What does the centre do if my child becomes ill during the day?

British Columbia's rules require a licensed centre to provide a quiet, clean resting area and keep the child under close supervision by a responsible adult, and to notify a parent or emergency contact immediately. So you get a call while it is happening rather than a summary at pick-up.

How quickly do I have to collect my child?

As soon as you reasonably can. The centre can make your child comfortable and supervise them, and educators do that without complaint, but a room set up for a group cannot give a sick child what home gives them. If your child is seriously unwell we will ask you to come straight away.

Do I have to tell the centre what illness my child has?

Yes, and it matters more than parents expect. A centre has to notify the medical health officer within 24 hours of learning that an enrolled child has a reportable communicable disease, and it cannot do that if nobody told it. Your child's diagnosis also helps other families watch for the same thing.

Will my child be sick more often after starting daycare?

Most families find the first several months bring more colds than they are used to, simply because a group setting exposes children to more of what is going around. It settles. Knowing that in advance makes the first winter easier to plan for.

Coming to see us

We are at 1103 Confederation Drive in the Citadel neighbourhood of Port Coquitlam. Fraser Health inspects licensed facilities in this region and publishes what it finds, and there is a walkthrough of how to read those reports in how to check a daycare's licence. If you would like to see the rooms and ask about how we handle a sick day, you are welcome to book a visit.