Some daycare centers too quick to send kids home

I got the dreaded call a week ago. It's one I've been getting a lot lately. My youngest daughter had a fever. I needed to pick her up from daycare within an hour. My wife had an important work meeting and couldn't do it. And here's the kicker: The daycare center said my 7-month-old's breathing was "labored."

That scared me. A fever is one thing. Trouble breathing sounded like I would be making a trip to the hospital or at least the doctor. Turned out she is teething – that explained the fever – and has another in a seemingly constant stream of colds –  hence the congestion.

So, I got her home and got the fever under control with acetaminophen. She went back to sleep and I was able to do some work. Her fever had been over 101 degrees and daycare center rules required she be sent home. I have no problem with that.

But, for me, it did raise a question of whether children in daycare are sent home or kept at home – forcing parents to jump through logistical hoops and miss work - with fevers and other problems that aren't contagious and don't require such exclusions?

A recent study published in the medical journal Pediatrics found that daycare centers in the Milwaukee area would unnecessarily exclude children 57 percent of the time based on a survey of directors using five scenarios of sick children.

The study by researchers from the Medical College of Wisconsin, the Mayo Clinic, and Cincinnati Children's Hospital Medical Center noted that child care exclusions create significant economic burdens for parents and businesses. The researchers noted that "mild acute illness accounts for the majority of child care exclusions, many of which have been described as not medically indicated."

None of the five vignettes used for the survey – including a fever of 101 without other symptoms, a scalp rash, and a runny nose and cough – warranted immediate exclusion from daycare, according to the guidelines developed by national pediatric groups.

"The overall high rates of unnecessary exclusion decisions suggest that all directors, especially inexperienced directors, may need initial and ongoing training regarding … guidelines to reduce the high rates of unnecessary exclusion," the researchers concluded.