In a perfect world, kids would never get sick, and they’d never miss a day of school. But it’s not a perfect world.

Kids get sick all the time, and they love to share their nasty little germs with everyone around them, especially this time of year.

It’s not uncommon for children to get viral illnesses 10 to 12 times per year, and these symptoms can last a week or more. When kids are sick, parents are faced with a difficult decision: Send the children to school or day care, or keep them home?

This can be such a tough decision because there are a lot of conflicting priorities to consider.

We all want our children to feel better and recover quickly, and we don’t want them to get other kids sick. But we also want them in school so that their education doesn’t suffer — and so that we don’t have to miss work or struggle to find last-minute child care.

It’s not always an easy call, but here are some things to consider from a medical perspective:

Some kids are sick enough — such as those with difficulty breathing, changes in consciousness or severe abdominal pain — that they clearly need medical attention.

Depending on the severity, that may mean a trip to your pediatrician’s office, an ER visit or even a hospital stay. In these cases, the decision tends to be pretty easy. School takes a back seat until things improve.

It’s the milder cases that are trickier: The child doesn’t necessarily need medical help, but a parent still isn’t sure whether the young one should stay home.

Kids go to school to learn. If your child is so uncomfortable, sleepy or otherwise distracted that he wouldn’t be able to get anything out of school, it may be better to keep him home.

In some cases, children are fine to sit in class, but may have trouble with gym or other demanding activities. In those cases, a note from your doctor asking for temporary accommodations may be helpful.

Sometimes a sick child requires more care than the teachers or staff can reasonably provide.

Sending her off probably wouldn’t be in her best interest and wouldn’t be fair to the other children.

That’s a good reason to keep a child at home.

And if so, how big a deal would that be?

The answer, even in mild cases, to the first question is probably yes, but it’s important to think about the second question, too.

While many childhood illnesses are contagious, they’re not all equally dangerous.

Sharing pinkeye or lice is a lot different from sharing measles or bacterial meningitis. Strict guidelines based on when the disease is contagious have been established for many of the more serious illnesses; in other cases, use your judgment or ask your pediatrician.

Even though children inevitably swap germs in the crowded indoor environment of school, we can do a few things to minimize the damage:

It doesn’t have to be antibacterial soap, and it doesn’t have to be hot water.

Teach your children how to wash properly: Scrub both sides of their hands and between their fingers for at least 20 seconds. Dry with a paper towel and use the towel to turn off the sink and open the door.

For certain medical conditions, very specific recommendations or requirements address whether a child should stay out of school.

Below is a list of some of these conditions, with guidance from specialists in pediatric infectious disease.

Please be aware that requirements vary among school districts.

There are other illnesses that require children to stay out of school, such as measles, mumps chickenpox and pertussis. Fortunately, these diseases are preventable with routine vaccines.

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