When should you keep your child home from daycare?
Ohio rules and the AAP say to keep your child home with a fever of 101°F or more plus another symptom, repeated vomiting, frequent diarrhea or untreated lice.
Published · 7 min read
Quick answer
- Under Ohio's rules for licensed centers, a child goes home with a temperature of 101°F or higher (100°F under the arm) plus another symptom. Other signs include 3 or more unexplained loose stools in 24 hours, vomiting more than once, and untreated lice.
- The American Academy of Pediatrics (AAP) counts a rectal temperature of 100.4°F (38°C) or higher as a fever. For child care, its line is a temperature above 101°F (38.3°C) with a change in behavior or other symptoms.
- After a fever with cold symptoms, the AAP says your child can return once they've gone 24 hours without a fever and without fever-reducing medicine. Your center may ask you to wait longer.
- Call your pediatrician right away about a fever of 100.4°F or higher in a baby 3 months or younger. Call 911 for trouble breathing, blue or gray lips, a seizure, a child who won't respond, or a fast-spreading purple or red rash.
What symptoms mean my child has to stay home?
A licensed Ohio center must send your child home for any sign on the list in appendix A to Ohio Administrative Code 5180:2-12-16, in effect since July 1, 2026. Staff keep your child apart from the group, under supervision, and call you right away to pick them up.
Along with the symptoms in the table below, Ohio's list includes:
- Severe coughing that turns the face red or blue or causes a whooping sound
- Hard or fast breathing
- A stiff neck with a raised temperature
- Yellow skin or eyes
- Unusually dark urine, or gray or white stool
Centers must also post and follow the DCY 08087 Communicable Disease Chart, which the Ohio Department of Health updated in 2025. A January 2026 state letter told programs to follow the Health Department's guidance on who stays out and when they return.
What temperature counts as a fever?
The AAP counts a rectal temperature of 100.4°F (38°C) or higher as a fever (AAP: Fever and Your Baby). It calls rectal readings the most accurate for babies and says underarm readings can use a lower cutoff.
For child care, the AAP's line is a temperature above 101°F (38.3°C) by any method plus a behavior change or other symptoms (AAP). Ohio's center rule also counts a temperature only when another sign of illness comes with it.
Babies under 2 months are different: the AAP says to get urgent medical advice for a temperature of 100.4°F or higher, with or without other symptoms. A child who hasn't finished the recommended vaccines may also be kept out with a fever until a vaccine-preventable illness is ruled out.
Which symptoms usually mean staying home, and which don't?
Fever with other symptoms, repeated vomiting, frequent or leaking diarrhea and untreated lice usually mean a day at home, but a cold without fever doesn't. The table pairs Ohio's list with the AAP's guidance, and your center's policy may be stricter.
| Symptom | Usually stay home | Usually OK to attend | When to return |
|---|---|---|---|
| Fever | 101°F or higher (100°F under the arm) with another symptom or behavior change | Above 101°F with no other symptoms, in a child over 4 months (AAP) | When symptoms are gone; after fever with a cold, 24 hours fever-free without fever reducers (AAP) |
| Cough, cold or runny nose | With fever, severe coughing with a whoop or color change, or hard or fast breathing | No fever; a runny nose of any color is fine (AAP) | 24 hours fever-free without fever reducers (AAP) |
| Vomiting | More than once, or once with another symptom (Ohio); 2 or more times in 24 hours (AAP) | Once, with no other symptoms, if your child feels well | When it has stopped and your center's policy is met |
| Diarrhea | 3 or more unexplained loose stools in 24 hours (Ohio); leaks from the diaper, accidents, more than 2 extra stools in 24 hours, or blood or mucus (AAP) | One or two loose stools that stay in the diaper, with no other symptoms | When there are fewer than 3 loose stools in 24 hours (Ohio) and stools stay in the diaper or accidents stop (AAP) |
| Rash | With fever or behavior change (AAP); unusual spots or rashes, or untreated infected skin (Ohio) | No fever or behavior change (AAP), unless the center finds it unusual | When a health care provider says it isn't contagious (AAP) |
| Pink eye | Red eyes or eyelids, thick pus, matted lashes, or burning, itching or pain (Ohio) | Discharge without fever (AAP), though Ohio centers send home the signs at left | When your center's policy is met; see your pediatrician if it lingers (AAP) |
| Sore throat | Sore throat or trouble swallowing (Ohio) | No exception in Ohio's list | Strep: at least 12 hours after starting antibiotics (AAP) |
| Lice or scabies | Untreated lice, scabies or other parasites (Ohio) | After the first treatment (AAP) | After the first treatment (AAP) |
The AAP's full guide for programs is Managing Infectious Diseases in Child Care and Schools, 7th edition (2026).
When can my child go back?
Most children can return once the symptoms that kept them home are gone and they feel well enough for regular activities. The AAP's 24-hour fever rule counts only time without fever-reducing medicine, so a morning dose doesn't shorten the wait.
Some illnesses have set timelines in the AAP's guidance:
- Chickenpox: when all sores have dried or crusted (usually about 6 days after the rash starts) and no new ones have appeared for 24 hours.
- Hepatitis A: 1 week after the illness or yellowing of the skin began, or as the health department directs.
- Ringworm: after the first treatment.
- Norovirus: children are less likely to spread it 48 hours after vomiting and diarrhea stop (AAP: Norovirus).
- STEC, Shigella or Salmonella Typhi: these bowel infections follow health department rules.
Will the center tell me if my child was exposed?
Yes: Ohio requires a licensed center to tell you when your child has been exposed to a communicable disease on the DCY 08087 chart (rule 5180:2-12-16). The deadline is the end of the next business day. If your child is very young or not fully vaccinated, ask your pediatrician what to watch for.
When should I call the pediatrician?
Call right away if your baby is 3 months or younger with a rectal temperature of 100.4°F or higher, even without other symptoms (AAP). Call at 101°F or higher for babies 3 to 6 months, and 103°F or higher after 6 months.
Also call if (AAP: When to Call the Pediatrician):
- Your child looks very ill, is unusually drowsy or is very fussy
- A fever comes with a stiff neck, severe headache, breathing trouble, an unexplained rash, or repeated vomiting or diarrhea
- A fever lasts more than 24 hours in a child under 2, or more than 3 days in a child 2 or older
- You see signs of dehydration, such as dark urine, a dry mouth or fewer wet diapers (AAP, AAP)
- Diarrhea comes with bloody stools, a swollen belly or severe belly pain
If you're unsure, the AAP suggests calling your pediatrician's office (AAP).
When should I call 911?
Call 911 for any of these signs, which the AAP lists as reasons to call emergency medical services (AAP: When to Call EMS):
- Trouble breathing, or skin or lips that look blue, purple or gray
- A seizure, or a child who is unresponsive or becoming less alert
- A purple or red rash that appears suddenly or spreads quickly
- A severe stiff neck, headache and fever together
- Serious dehydration, such as sunken eyes, no tears or no urine, with unusual tiredness
- Vomiting blood, or a lot of blood in the stool
Common questions
Does green or yellow snot mean my child should stay home?
According to the AAP, a runny nose of any color or thickness isn't a reason to stay home, as long as there's no fever and your child can join regular activities.
What happens if my child gets sick at daycare?
Under Ohio's rule, staff move your child to a separate room or area and keep watching them, with a cot, mat or crib to rest on. The center calls you right away to arrange pickup, so keep your phone numbers current.
Does my child need a doctor's note to go back?
It depends on the illness and your center's policy. In the AAP's guidance, a rash with fever or behavior changes needs a health care provider to say it isn't contagious. Ask your center what it needs.
Can the center give my child medicine while they recover?
Only with your written permission, which Ohio requires for prescription and over-the-counter medicines and for creams and lotions. Medicine must be in its original container with your child's name on it. Except for emergency medication, your child must have had a first dose at home (rule 5180:2-12-25).
Sources
- Rule 5180:2-12-16: Emergency and health-related plans for a licensed child care center, Ohio Administrative Code (codes.ohio.gov). Checked November 3, 2026.
- Appendix A to rule 5180:2-12-16: Caring for Sick Children, Ohio Administrative Code (codes.ohio.gov). Checked November 3, 2026.
- Procedure Letter 34: 2025 Updates to the DCY 08087 Communicable Disease Chart, Ohio Department of Children and Youth. Checked November 3, 2026.
- When to Keep Your Child Home From Child Care, American Academy of Pediatrics (HealthyChildren.org). Checked November 3, 2026.
- Managing Infectious Diseases in Child Care and Schools, 7th Edition: A Quick Reference Guide, American Academy of Pediatrics. Checked November 3, 2026.
- Fever and Your Baby, American Academy of Pediatrics (HealthyChildren.org). Checked November 3, 2026.
- Fever: When to Call the Pediatrician, American Academy of Pediatrics (HealthyChildren.org). Checked November 3, 2026.
- Diarrhea in Children: What Parents Need to Know, American Academy of Pediatrics (HealthyChildren.org). Checked November 3, 2026.
- Norovirus: What to Do If Your Child Catches This Contagious Stomach Bug, American Academy of Pediatrics (HealthyChildren.org). Checked November 3, 2026.
- Urgent Care, ER or Pediatrician? A Parent Guide, American Academy of Pediatrics (HealthyChildren.org). Checked November 3, 2026.
- When to Call Emergency Medical Services (EMS) for Your Child, American Academy of Pediatrics (HealthyChildren.org). Checked November 3, 2026.
- Rule 5180:2-12-25: Medication administration, Ohio Administrative Code (codes.ohio.gov). Checked November 3, 2026.