Common Childhood Illnesses in Child Care: What Parents and Providers Should Know

Young children commonly develop runny noses, coughs, fevers, vomiting, diarrhea, rashes, sore throats, eye drainage, and ear pain. These symptoms do not always identify a specific illness.

Parents and child care providers should avoid trying to diagnose a child based only on a symptom list. Their practical responsibilities are to notice changes, follow the program’s written illness policy, communicate promptly, reduce avoidable exposure, seek medical advice when appropriate, and respond quickly to emergency warning signs.

Why Illnesses Spread in Child Care

Group child care creates many opportunities for germs to move between people. Young children often play close together, share toys, touch their faces, put objects in their mouths, need help with toileting, and are still learning how to cover coughs and wash their hands.

Some infections can spread before symptoms appear, while symptoms are mild, through respiratory droplets, contaminated hands or objects, stool during diapering, direct skin contact, or food and water.

A well-run program cannot prevent every illness. It can reduce risk through hand hygiene, cleaning and sanitizing, ventilation, vaccination policies, safe diapering, food safety, appropriate exclusion, and prompt communication.

A Practical Symptom Guide

The table below is a general communication tool. It does not replace the program’s illness policy, state licensing rules, public-health instructions, medical advice, or outbreak-specific requirements.

A child may also need to stay home when the child cannot participate comfortably, needs more care than staff can safely provide, or the program’s policy, licensing agency, health department, or clinician requires exclusion.

Common Viral Illnesses

Viruses cause many illnesses seen in child care. Antibiotics do not treat viral infections. Only a qualified medical professional should diagnose the cause.

Common cold

A cold may involve a runny or stuffy nose, cough, sneezing, mild sore throat, mild fever, or reduced appetite. A mild runny nose alone does not always require exclusion if the child can participate and the program’s policy permits attendance.

Influenza

Influenza may cause fever, chills, cough, sore throat, headache, body aches, fatigue, and sometimes vomiting or diarrhea. It can be more serious for young children and children with certain medical conditions.

Respiratory syncytial virus

RSV may look like a cold in some children but can cause more serious breathing illness, particularly in infants, premature babies, and children with certain heart, lung, or immune conditions.

COVID-19

COVID-19 may cause fever, cough, sore throat, runny nose, fatigue, headache, vomiting, or diarrhea. Programs should follow current public-health and licensing guidance rather than outdated pandemic-era rules.

Norovirus and other stomach viruses

Norovirus commonly causes vomiting, diarrhea, nausea, and stomach pain. CDC guidance emphasizes soap-and-water handwashing, correct cleaning, and keeping sick people away from food preparation and care duties. Hand sanitizer alone does not work as well against norovirus.

Hand, foot, and mouth disease

This illness may involve fever, mouth sores, and a rash or blisters on the hands and feet. Exclusion depends on fever, ability to participate, open or draining lesions, program policy, and health-department guidance.

Fifth disease

Fifth disease may begin with mild symptoms and later produce a “slapped-cheek” appearance. Pregnant people and people with certain blood or immune conditions should seek professional guidance after exposure.

Roseola

Roseola often involves fever followed by a rash. Because several illnesses can cause fever and rash, parents should not assume the cause without appropriate evaluation.

Chickenpox

Chickenpox is less common where vaccination rates are high, but cases still occur. Programs should follow current health-department and exclusion guidance.

Common Bacterial Illnesses

Bacterial infections may require medical evaluation. Antibiotics should only be used when prescribed.

Strep throat and scarlet fever

Possible symptoms include sore throat, fever, swollen glands, headache, and a rash with scarlet fever. A clinician may test for group A strep. Return depends on treatment, fever, participation, policy, and public-health guidance.

Pertussis

Pertussis, or whooping cough, may cause severe coughing spells, vomiting after coughing, difficulty catching breath, or a “whoop.” Infants may not have the classic cough and can become seriously ill. Suspected cases need prompt evaluation.

Impetigo

Impetigo may cause red sores, blisters, or honey-colored crusts. Children may need evaluation and treatment. Open or draining lesions should be managed according to medical and program guidance.

Bacterial conjunctivitis

Eye redness or drainage can have several causes. Not every red eye is bacterial or needs antibiotics. Pain, severe swelling, fever, vision changes, or worsening symptoms warrant professional evaluation.

Ear infections

Middle ear infections often follow respiratory illnesses and are not generally spread directly from child to child. Whether a child can attend depends on comfort, fever, participation, and other symptoms.

When Children Should Stay Home

A child generally should stay home when the child:

• Has symptoms requiring exclusion under program policy
• Cannot participate comfortably
• Needs care beyond what staff can safely provide
• Has vomiting or significant persistent diarrhea
• Has fever with concerning symptoms
• Has a rash with fever until appropriately evaluated
• Has breathing difficulty
• Has an illness subject to health-department exclusion
• Has been instructed to stay home by a health professional

HealthyChildren.org notes that mild colds or runny noses without fever do not always require exclusion when the child feels well enough to participate and staff can provide appropriate care.

Fever

Fever rules vary by the child’s age, temperature, other symptoms, program policy, and medical guidance. A very young infant with fever requires prompt professional advice. Parents should not use fever-reducing medicine simply to conceal a fever before drop-off.

Vomiting

Vomiting can raise concerns about dehydration, infection spread, participation, and the need for close monitoring. Many programs exclude children after repeated vomiting until symptoms have resolved according to policy.

Diarrhea

Diarrhea may require exclusion when stool cannot be contained, toilet-trained children have accidents, frequency is substantially above normal, blood or mucus is present, the child shows dehydration signs, or policy requires exclusion.

Rash

A rash alone does not identify the cause. A rash with fever or behavior change should generally be evaluated before return. Providers should avoid announcing a diagnosis unless it has been appropriately confirmed.

Returning to Child Care

Return criteria may depend on improving symptoms, fever resolution, participation, treatment timing, covered lesions, public-health direction, and written policy. A doctor’s note does not always override licensing or public-health rules.

Helping Prevent the Spread of Illness

Handwashing

Children and adults should wash hands:

• On arrival
• Before eating or preparing food
• After toileting or diapering
• After wiping a nose
• After contact with body fluids
• After outdoor play
• Before and after caring for someone who is sick

Use soap and clean running water.

Respiratory hygiene

Teach children to cough or sneeze into a tissue, use the elbow when a tissue is unavailable, discard tissues, and wash hands afterward.

Cleaning, sanitizing, and disinfecting

These terms are not interchangeable. Programs should follow product labels, licensing rules, public-health guidance, safe-storage requirements, and correct contact times. Never mix cleaning chemicals.

Diapering and toileting

Programs should use designated diapering areas, careful handwashing, gloves where required, safe disposal, correct surface cleaning, and separation from food areas.

Ventilation

Programs may improve airflow through HVAC maintenance, outdoor activities, safely opened windows, and appropriate filtration.

Vaccination

Families and staff should follow current recommendations from qualified health professionals and public-health agencies. Requirements and exemptions vary by jurisdiction.

Keep sick staff home

Ill employees can spread infection and may be unable to care safely for children. Programs need staffing plans that do not pressure sick employees to work.

Communicating With Families

Clear communication protects privacy and helps families respond.

Providers should report:

• The symptom observed
• When it began
• Whether the child could participate
• Temperature, if measured
• Vomiting or diarrhea episodes
• Comfort or first aid provided
• When pickup is required
• What return policy applies

Avoid diagnosing. Say:

Your child vomited twice this afternoon and appears tired.

Do not say:

Your child definitely has norovirus.

Exposure notices

When appropriate or required, exposure notices may explain:

• Confirmed or suspected illness
• Classroom or date of possible exposure
• Symptoms families should monitor
• Program response
• Reliable sources for more information

Do not identify the sick child.

What parents should report

Parents should tell the provider about symptoms, relevant diagnoses, required positive test results, medication affecting care, exposure to a reportable disease, health-department instructions, and expected absence.

Protecting health information

Medical information should be shared only with staff who need it. Avoid hallway discussions, naming a child in an exposure notice, group-chat disclosures, public posts, and speculation about a family.

When Emergency Care May Be Needed

Call 911 or seek emergency care for signs such as:

• Severe difficulty breathing
• Blue, gray, or very pale lips or skin
• Loss of consciousness
• A seizure beyond the child’s emergency plan
• Severe allergic reaction
• Inability to wake or unusual unresponsiveness
• Signs of shock
• Severe dehydration
• Stiff neck with serious illness
• Sudden weakness or confusion
• A rapidly worsening condition

Providers should follow the child’s emergency plan when one exists.

Possible dehydration warning signs

Possible warning signs include:

• Very little urine
• Dry mouth
• No tears
• Sunken eyes
• Unusual sleepiness
• Weakness

Young children can become dehydrated more quickly than adults. Seek professional guidance when concerned.

Emergency readiness in child care

Programs should maintain:

• Current emergency contacts
• Child health and allergy information
• Staff trained in first aid and CPR
• Medication and action plans
• Clear 911 procedures
• Documentation practices
• Backup communication methods

Common Mistakes to Avoid

Parents and providers should avoid:

• Diagnosing from a rash photo
• Sending a child who cannot participate
• Hiding fever with medication
• Using antibiotics without medical direction
• Assuming every red eye needs antibiotics
• Posting a child’s diagnosis publicly
• Relying on hand sanitizer alone for stomach illness
• Using the same exclusion rule for every illness
• Ignoring the program’s policy
• Waiting during breathing difficulty or severe dehydration
• Assuming every ear infection is contagious
• Excluding every child with a mild runny nose regardless of policy or participation

Frequently Asked Questions

Related Resources

• Foods Home Daycare Providers Should Never Serve Toddlers

Sources

• CDC: Preventing Infectious Diseases in Early Care and Education
• CDC: Protecting Against Infections in Early Care and Education Programs
• CDC: When Students or Staff Are Sick
• CDC: About Handwashing
• CDC: How to Prevent Norovirus
• CDC: Respiratory Illnesses
• CDC: Preventing Group A Strep Infection
• HealthyChildren.org: When to Keep Your Child Home From Child Care
• HealthyChildren.org: Fever—When to Call the Pediatrician
• HealthyChildren.org: Diarrhea in Children

ChildCareCenter.us is an independent directory and educational resource. Illness exclusion, vaccination, medication, reporting, testing, outbreak response, and return-to-care requirements vary by program, jurisdiction, public-health conditions, and individual child. This article is not medical, diagnostic, treatment, licensing, or emergency advice. Follow the child care program’s written policy and consult qualified health professionals and public-health authorities when appropriate.