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.