It’s back to school time and 6 o’clock in the morning. Your child feels ill. Is it back to bed or bound for school?
In case of doubt, there is no place like home for a sick person, adult or child. The sense of security that well-known surroundings engender in a sick person increases disease-fighting hormones and cells in the body, and shortens many diseases.
Do not be surprised that the sickly child of the morning has made a miraculous recovery when you return home in the evening. The presence of a mother increases the same hormones and cells. Of course, how convenient is it for her to take a day off from work?
You also have to be aware of the malingerer. Fortunately, children are not very good at pretending they are ill until they are about 10 or 11. Be suspicious, however, of solo symptoms, like isolated headaches or stomach aches without fever, diarrhoea, vomiting or other signs of illness. Vague symptoms or imprecise location of pain (circling the hand around the abdomen) are usually clues that there is nothing really wrong. The kid wants to stay home to avoid a spelling exam. This is another kind of problem that you deal with in a different way, and I do not mean physically.
Diarrhoeal illnesses are very contagious. Frequent, watery, mucousy and sometimes bloody diarrhoea is a definite reason to stay home, both for your child’s sake and to prevent an outbreak in class. Add vomiting and the possibility of dehydration becomes real. Home treatment consists of rest (never try to force a child to lie in bed, it does not work) and slowly drinking lots of fluids like water, young coconut water or fresh, diluted orange juice.
There is seldom a need to go to the pharmacy for oral rehydration fluids. These are only needed for young children or for the dehydrated child. Your plan is to prevent the child from dehydrating by encouraging them to slowly drink lots of fluids. Within two to three hours, you can start the BRAT diet (Bananas, Rice, Apples and Toast). Actually, you can give the child anything boiled, carrots, pumpkin or potato. An excellent energising as well as hydrating food is clear chicken soup. Do not make it too thick. You are not trying to make the child gain weight. You just want to keep them hydrated until their body defences fight off the invading virus and they return to their usual active self. If the child begins to show signs of dehydration (thirst, dry mouth, sunken eyes and especially increasing lethargy or weakness), or if the vomiting has not stopped within two or three hours, then call your doctor immediately. But there is certainly no need to run off to the doctor at the first sign of illness.
As soon as the vomiting is over, the stools are no longer explosive and watery and your child feels well again, they may return to school. That takes about three days. Be prepared, however, for the stools to remain a bit frequent and loose for another five days. During this convalescent stage, your child is not contagious.
Colds are a different bag of germs and children with a runny nose and mild cough can go to school. Excluding children from school when they come down with a cold does not diminish the spread. Children are most contagious a day or two before they are symptomatic. They have already exposed their classmates before they feel sick. This is so for most childhood diseases, chickenpox and hand foot and mouth included.
Some colds do need home care. It comes down to how the child is feeling and what other symptoms there are. If your child is happy and playful, if their nasal secretions are clear and watery and if they have no pain and no fever, there is no need to call the doctor or keep them home. This is a “nuisance cold” that will resolve with extra fluids, some tincture of time and lots of “tender loving care” or TLC.
But if the child has a fever and earache, or gets up frequently at night, or is looking peaked, then this is a “stay at home and call the doctor cold”. I cannot emphasise the importance of keeping the child at home if they have a fever. Schools should refuse to admit a child with a fever. Schools are not babysitters, although too many parents attempt to treat their school as such. The children invariably get sicker during the course of the day and end up in the doctor’s office or the hospital casualty in the evening. Time, money and worry would all be saved if the child had been kept home that morning.