When to Keep Your Child Home From Preschool: Fever, Vomiting and Rashes

Keep your child home if they cannot comfortably join in with the day or need close care. Under AAP guidance, a child with fever and a cough, runny nose or sore throat stays home until they have been fever-free for at least 24 hours without fever-reducing medicine. Consider their symptoms, overall condition and the preschool’s written health rules together.

Looking well in the morning does not always mean they will manage a full day. Ask your doctor if you are unsure about symptoms, and check the school’s return requirements.

What to Check Before Deciding About Preschool

Start by watching your child. How alert are they, how do they respond to you, and are they behaving like themselves? Are they drinking? Are they struggling to breathe? Are they interested in playing, or do they just want to lie down? Add what happened during the night to the picture.

Then think about the preschool day. There’s eating, going to the toilet, playing, resting and time outdoors. Your child needs to be able to take part in all of this, and their needs have to be manageable within the group. Rather than telling the teacher “He’s a bit poorly,” describe the symptom, when it started and when it last happened.

We know it’s hard to rearrange work at short notice. If you can, have a back-up childcare plan ready for sick days in advance; it makes the morning decision feel much less pressured. The point of the plan is to make it easier for your child to rest and to see a doctor if they need to.

What If My Child Has a Temperature?

Take their temperature with a thermometer, and write down how you measured it and when. Your child feeling hot to the touch isn’t a substitute for a reading. When deciding about preschool, a fever means a temperature above 38.3°C, however you take it.

Feeling better after a dose of fever medicine doesn’t mean they’ve recovered. When the medicine wears off, the symptoms can come back. Don’t use medicine just to get them through the door, as that hides how unwell they are; if needed, tell the doctor and the preschool which medicine you gave and when.

Here’s what the American Academy of Pediatrics (AAP) says in its guidance on when to keep your child home from child care:

• A fever with a cough, runny nose or sore throat means staying home. Your child can go back once they’ve had no fever for at least 24 hours without any fever-reducing medicine.
• A fever with a change in behaviour, or with another symptom such as a rash, vomiting or diarrhoea, also means staying home.
• A fever on its own, in a child who has no other symptoms and is behaving normally, isn’t a reason to stay home. The exception is a child whose vaccinations aren’t complete.

Sun Preschool follows these rules. If the fever comes with listlessness, difficulty breathing or a rash, speak to your doctor as well.

Vomiting and Diarrhoea: What to Look For

The AAP says a child who has been sick twice or more in the last 24 hours should stay home. Being sick once, with no other symptoms, isn’t a reason on its own. With diarrhoea, the reasons to stay home are poo leaking out of the nappy, accidents in a child who’s out of nappies, more than two extra poos in 24 hours compared with what’s normal for them, or blood or mucus in the poo. Most diarrhoea gets better at home with plenty of fluids. In line with NHS advice and the AAP’s criteria, talk to your doctor if your child can’t keep fluids down, is weeing much less than usual, has blood in their poo, keeps being sick, is under one, or still has diarrhoea after a week.

When they were sick, whether it’s happened again, whether they can keep drinks down, and any change in how much they’re weeing are all things to tell the doctor.

Note any clear change from your child’s usual toilet pattern. “He went once this morning” and “She had frequent watery poos all night” are not the same information. Knowing when symptoms last occurred also helps when discussing a return to preschool.

Tummy ache that lasts more than two hours, or that comes and goes with a fever, is also a reason to stay home. If you suspect they’re dehydrated, or they’re in pain or still unwell, talk to your paediatrician.

Rashes and Coughs: Is Every Case the Same?

A new rash that comes with a fever or a clear change in behaviour means staying home until a doctor says it isn’t contagious. A rash without a fever or any change in behaviour isn’t a reason on its own. If your child has a diagnosed illness, don’t decide when they go back just by how the rash looks.

A cough or cold without a fever isn’t a reason to stay home, as long as your child can join in. A cough that stops them talking, sleeping or playing is a different matter. And if they’re struggling to breathe, forget about preschool for now and get medical advice straight away.

Is Green Snot on Its Own a Reason to Stay Home?

No. The AAP is clear that a runny nose isn’t a reason to stay home, whatever its colour or consistency. A child with no fever who feels well and can join in can go to preschool. Don’t use the colour to decide whether they need antibiotics or whether they’re contagious.

The same goes for red, sticky eyes when there’s no fever. Everyday habits matter too: handwashing, using tissues, and letting the preschool know if symptoms change.

The test for going back isn’t just that a symptom has gone. It’s that your child can get through the day comfortably.

How Sun Preschool Shares Health Information With Families

At Sun Preschool, updates from families about their child’s health, including any new diagnosis or change in medicine, help us provide everyday care. If your child becomes unwell at preschool, we let you know, keep them comfortable with an adult beside them, and arrange for them to be collected. A preschool isn’t a health service that diagnoses or treats illness.

Keeping your emergency contact numbers up to date matters, so we know who to call if we can’t reach you. You can keep your child’s health information up to date on Sun Portal, our parent app. We explain our wider safety arrangements in our guide to safety at preschool.

Sun Preschool’s Rules for Staying Home and Coming Back

Sun Preschool’s rules are based on the AAP’s recommendations. The main ones:

If your child has	They can come back
A fever above 38.3°C with a cough, runny nose or sore throat	After 24 hours with no fever, without fever-reducing medicine
A fever above 38.3°C with another symptom or a change in behaviour	When the fever or the other symptom has gone
Been sick twice or more in 24 hours	Once they’ve been sick fewer than twice in the last 24 hours
Diarrhoea that leaks from the nappy, causes accidents, means more than two extra poos in 24 hours, or has blood or mucus in it	When none of these applies
A rash with a fever or a change in behaviour	When a doctor says it isn’t contagious
Strep throat	12 hours after starting antibiotics
Head lice, scabies or ringworm	After the first treatment; we won’t send them home before the end of the day
Chickenpox	When all the blisters have dried or crusted over and no new ones have appeared for 24 hours
Too unwell to join in	When they can take part in the day

A cough, a cold, a runny nose or red eyes without a fever aren’t reasons to stay home. Nor is hand, foot and mouth, unless your child has mouth sores with constant drooling, a fever or other symptoms. For everyday meals and allergy arrangements, see our preschool nutrition guide.

What to Tell the Preschool Before Your Child Goes Back

Put together a short summary for the teacher:

• When did the symptom start, and when did it last happen?
• Has a doctor seen them, and is there a diagnosis or advice on going back?
• Are they taking any medicine?
• Are their eating, drinking and energy back to normal?
• Will they need any extra support during the day?

Sun’s return rules are in the table above; at any other preschool, finding out the written return rules in advance takes away a lot of uncertainty. Telling the preschool about a diagnosed infectious illness also helps it let other families know without identifying anyone. Our guides to daytime naps and picky eating address everyday routines outside periods of illness.

If you’d like to talk about everyday care and how we keep in touch with families, you can arrange a visit.

References & Further Reading

• American Academy of Pediatrics (HealthyChildren.org) — When to keep your child home from child care. Sun Preschool’s rules for staying home and coming back are based on this guidance.
• UK Health Security Agency — Exclusion periods in children and young people’s settings.
• NHS — Diarrhoea and vomiting.
• Robert Koch Institute — Hand, foot and mouth disease guidance (in German).
• US Centers for Disease Control and Prevention — Hand, foot and mouth disease.