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If your child has any of these 5 symptoms, you might want to keep them home from day care

Was that just a sneeze or was it a 'sick' sneeze?

Sometimes it's hard to tell when "Mama, I'm sick" means you should keep your child home from day care and it's not always an easy decision for working parents to make.

Don't worry; you're not alone if you're having this conversation with yourself. "How sick, is too sick" is a question that plagues many parents as they head off to work for the day. A sniffle here or a cough there is no big deal, but according to the experts there are a few symptoms that should serve as red flags to parents.

If your child has one of these symptoms, they probably shouldn't go to day care today:

1. Fever

One of the clearest sign that your child should be kept home is if a temperature over 100.4° Fahrenheit is present, signaling a fever. Not only are fevers a sign of infection, it could also mean that your child could spread germs to their other children, explains pediatrician Dr. Claire McCarthy, an Assistant Professor of Pediatrics at Harvard Medical School and faculty editor for Harvard Health Publishing,

"There's just no way you can know whether things will get better or worse—and while giving them medicine might bring the fever down, it won't stop them from being contagious," she writes for Harvard Health. Experts and most schools agree that a child should be fever-free (without medication) for 24 hours before going back.

If your child is close but not quite at the fever point, it's always good to err on the side of caution and perhaps keep them at home in their cozy pjs.

2. Vomiting or diarrhea

It's not only messy, but vomiting or suffering from diarrhea is one of the most uncomfortable and unpleasant symptoms of being sick and it's not fun for anyone—especially your child—if they go to day care with these symptoms. In fact, they will likely be sent home if they present these symptoms once at day care, which would be even harder to plan for.

The U.S. Department of Health and Human Services Administration for Children and Families has clear guidelines for children suffering these symptoms to be removed from education settings as soon as possible. This is not only to care for the child but to prevent further spread of the illness in a group setting. This is also a symptom that could require a trip to the doctor to rule out a virus—especially the norovirus, which is highly contagious.

3. Incessant coughing

A few coughs here and there aren't too concerning but the coughs that simply keep persisting are the ones to watch out for. According to Stanford Children's Hospital "uncontrolled coughing" is a very good reason to keep your child home (and we agree).

There is a difference between a mild cough and a persistent cough and the latter is usually a sign of a more serious illness, especially if paired with a sore throat, irregular breathing or chest pain and these symptoms combined could warrant a trip to the family doctor.

4. Pain or sores

Pain level is a tough symptom to gauge since you can't feel your child's pain level. It's one thing to have a mild headache and some light body aches but anything worse makes it very hard for your child to concentrate or feel very good at day care. The American Academy of Pediatrics encourages parents to especially watch for abdominal pain that lasts more than two hours or intermittent abdominal pain associated with fever or other signs or symptoms.

But that's not the only kind of pain to watch for, the AAP notes. "Mouth sores with drooling that the child cannot control" or "skin sores that are weeping fluid and are on an exposed body surface that cannot be covered with a waterproof dressing" are all very good reasons to not only stay home but get your child to the doctor right away.

5. Constant crying that doesn't stop

Crying can be one of the hardest symptoms to decipher, especially in younger kids. Are they crying because they want to stay home or are they crying because they're feeling awful? Sometimes it's both. if your child is crying to the point that it would keep them from participating in activities at day care, you might want to keep them home and figure out why.

The American Academy of Pediatrics guidelines point to keeping the child home if they "need more care than the staff can provide without a risk to the health and safety of other children" and if the illness "would keep the child from joining in activities." If a child is crying and can't be distracted by fun activities, staying home (and calling the doctor) is your best bet.

If at all in doubt, just trust your motherly gut. It did after all, get you this far.

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    Tips parents need to know about poor air quality and caring for kids with asthma

    There are steps parents can take to keep their children as healthy as possible.

    When wildfires struck the West Coast in September 2020, there was a lot for parents to worry about. For parents of children with asthma, though, the danger could be even greater. "There are more than 400 toxins that are present in wildfire smoke. That can activate the immune system in ways that aren't helpful by both causing an inflammatory response and distracting the immune system from fighting infection," says Amy Oro, MD, a pediatrician at Stanford Children's Health. "When smoke enters into the lungs, it causes irritation and muscle spasms of the smooth muscle that is around the small breathing tubes in the lungs. This can lead to difficulty with breathing and wheezing. It's really difficult on the lungs."

    With the added concern of COVID-19 and the effect it can have on breathing, many parents feel unsure about how to keep their children protected. The good news is that there are steps parents can take to keep their children as healthy as possible.

    Here are tips parents need to know about how to deal with poor air quality when your child has asthma.

    Minimize smoke exposure.

    Especially when the air quality index reaches dangerous levels, it's best to stay indoors as much as possible. You can find out your area's AQI at AirNow.gov. An under 50 rating is the safest, but between 100-150 is considered unhealthy for sensitive groups, such as children with asthma. "If you're being told to stay indoors, listen. If you can, keep the windows and doors closed," Oro says.

    Do your best to filter the air.

    According to Oro, a HEPA filter is your best bet to effectively clean pollutants from the air. Many homes are equipped with a built-in HEPA filter in their air conditioning systems, but you can also get a canister filter. Oro says her family (her husband and children all suffer from asthma) also made use of a hack from the New York Times and built their own filter by duct taping a HEPA furnace filter to the front of a box fan. "It was pretty disgusting what we accumulated in the first 20 hours in our fan," she says.

    Avoid letting your child play outside or overly exert themselves in open air.

    "Unfortunately, cloth masks don't do very much [to protect you from the smoke pollution]," Oro says. "You really need an N95 mask, and most of those have been allocated toward essential workers." To keep at-risk children safer, Oro recommends avoiding brisk exercise outdoors. Instead, set up an indoor obstacle course or challenge your family to jumping jacks periodically to keep everyone moving safely.

    Know the difference between smoke exposure and COVID-19.

    "COVID-19 can have a lot of the same symptoms—dry cough, sore throat, shortness of breath and chest pain could overlap. But what COVID and other viruses generally cause are fever, chills, vomiting, diarrhea and body aches. Those would tell you it's not just smoke exposure," Oro says. When a child has been exposed to smoke, they often complain of a "scrape" in their throat, burning eyes, cough, shortness of breath, chest pain or wheezing. If the child has asthma, parents should watch for a flare of symptoms, such as coughing, wheezing or a tight sensation in their chest.

    Unfortunately, not much is known about long-term exposure to wildfire smoke on a healthy or compromised immune system, but elevated levels of air pollution have been associated with increased COVID-19 rates. That's because whenever there's an issue with your immune system, it distracts your immune system from fighting infections and you have a harder time fighting off viruses. Limiting your exposure to wildfire smoke is your best bet to keep immune systems strong.

    Have a plan in place if you think your child is suffering from smoke exposure.

    Whatever type of medication your child takes for asthma, make sure you have it on-hand and that your child is keeping up with regular doses. Contact your child's pediatrician, especially if your area has a hazardous air quality—they may want to adjust your child's medication schedule or dosage to prevent an attack. Oro also recommends that, if your child has asthma, it might be helpful to have a stethoscope or even a pulse oximeter at home to help diagnose issues with your pediatrician through telehealth.

    Most importantly, don't panic.

    In some cases, social distancing and distance learning due to COVID may be helping to keep sensitive groups like children with asthma safer. Oro says wildfires in past years have generally resulted in more ER visits for children, but the most recent fires haven't seen the same results. "A lot of what we've seen is that the smoke really adversely affects adults, especially older adults over 65," Oro says. "Children tend to be really resilient."

    This article was sponsored by Stanford Children's Health. Thank you for supporting the brands that support Motherly and mamas.

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