Fever policies are a primary concern for parents and providers, as clear health guidelines are essential in childcare environments. These policies are established to prevent the rapid spread of infectious diseases among young children, who are often in very close contact throughout the day. Standardized exclusion rules protect the entire daycare community, including other children, staff members, and their families, from unnecessary exposure to illness. A cohesive and consistently enforced policy ensures that all parties understand the conditions under which a child must remain home.
The Temperature Threshold for Mandatory Exclusion
The widely accepted temperature that defines a fever requiring immediate exclusion from a daycare setting is \(\text{100.4}^\circ\text{F}\) (\(\text{38}^\circ\text{C}\)). This specific number acts as a clear line for parents and staff to follow when a child shows signs of illness. The threshold is often based on guidelines from prominent health bodies, such as the American Academy of Pediatrics (AAP). Many state licensing agencies adopt this figure as the minimum standard for childcare facilities.
In certain circumstances, the specific temperature for exclusion may be slightly higher or lower, depending on the child’s age or the facility’s specific policy. For example, the AAP suggests that for children over two months of age, a temperature above \(\text{101}^\circ\text{F}\) (\(\text{38.3}^\circ\text{C}\)) is considered meaningfully elevated.
When Children Can Return After Fever
The policy for a child’s return to daycare after a fever is strictly defined and is a critical component of infection control. The standard requirement is a \(\text{24}\)-hour fever-free period before the child is readmitted to the facility. This window of time must be achieved without the assistance of any fever-reducing medications, known as antipyretics, such as acetaminophen or ibuprofen.
If a child is given medication to lower their temperature, the fever is merely being masked, and the infectious period may still be active. Daycare staff cannot accurately assess the child’s true health status until the medication has completely worn off. Therefore, the \(\text{24}\)-hour countdown begins only after the child’s temperature has naturally remained below the exclusion threshold. The child must also be well enough to participate comfortably in all normal activities upon return.
How Temperature Measurement Affects Policy
The method used to take a child’s temperature can influence the specific reading that triggers the exclusion policy. Rectal temperatures are generally considered the most accurate measure of core body temperature, but they are not practical or recommended for routine use in a group childcare setting. Most daycares instead rely on non-invasive methods, such as temporal (forehead) or axillary (armpit) readings, for practicality and safety.
Temporal artery thermometers, which scan the forehead, offer a quick and reasonably accurate alternative to rectal measurements. Axillary measurements, taken under the armpit, are often the least accurate but are commonly used for initial screening. Because of this difference in accuracy, a facility may set a lower exclusion temperature for an axillary reading, sometimes as low as \(\text{99}^\circ\text{F}\) (\(\text{37.2}^\circ\text{C}\)), compared to the \(\text{100.4}^\circ\text{F}\) standard used for temporal or oral methods.