Your child can usually go back to daycare once they have gone 24 hours without a fever, without any Tylenol (acetaminophen) or Motrin (ibuprofen), and their other symptoms are getting better. That is the American Academy of Pediatrics guidance for a fever with cough, runny nose, or sore throat. A dose of fever medicine that morning resets the clock, because it hides the fever without ending the illness. Your daycare or state may have its own rule, so check the written policy.
What does 24 hours fever-free mean?
It means a full 24 hours with no fever while your child is not taking any fever-reducing medicine. Count from the last time the thermometer showed a fever, or from the last dose of medicine, whichever came later.
The AAP says children with a cough, runny nose, or sore throat and a fever should stay out of child care until the fever has been gone for at least 24 hours without fever-reducing medicine. The CDC's general advice for respiratory viruses is similar: symptoms improving and no fever for 24 hours without medicine.
- Fever Tuesday at 6 pm, no medicine after: earliest return is Wednesday at 6 pm, so most kids go back Thursday morning
- Fever broke Tuesday night but you gave Motrin at 7 am Wednesday: the clock starts at 7 am Wednesday
- No fever, but still miserable and can't join in: keep them home, even past 24 hours
Why doesn't giving Tylenol or Motrin before drop-off count?
Acetaminophen and ibuprofen usually bring a fever down. A lower number on the thermometer does not mean the infection is over. When the dose wears off, the fever can come back in the middle of the daycare day.
That is why the AAP and CDC rules say the 24 hours must be without fever-reducing medicine. Giving a dose before drop-off can also mean the daycare calls you to pick up a sick child a few hours later.
It is fine to give fever medicine at home to keep your child comfortable. Just count the 24 hours from the last dose. Check the label for your child's age and weight. MedlinePlus says not to give ibuprofen to babies 6 months or younger, not to give aspirin to children unless their doctor says to, and to call the doctor before giving any medicine to a baby 3 months or younger.
What temperature counts as a fever for daycare?
For babies, HealthyChildren.org (from the AAP) defines a fever as a rectal temperature of 100.4°F (38°C) or higher. Rectal readings are the most accurate for infants.
For deciding about child care, the AAP uses a fever above 101°F (38.3°C) by any method together with a change in behavior or other symptoms, like sore throat, rash, vomiting, or diarrhea. The AAP also says a child older than 4 months with a fever above 101°F and no other symptoms or behavior changes does not have to be kept home for the fever alone, unless they have not finished their recommended vaccines.
Many daycares are stricter than that and send kids home at 100.4°F or for any fever. Your program's rule is the one that decides whether your child can come in.
Does my daycare's rule override the AAP guidance?
For attendance, yes. Each child care program sets its own sick policy, and these can differ from the AAP guidance. The AAP tells families to follow their local school, district, or state guidance, which may differ.
Some programs want 24 hours fever-free. Some want longer, or a doctor's note after certain illnesses. Ask for the written policy, or check the parent handbook, so you know before the next fever.
- How many hours fever-free, and does the clock require no medicine?
- What temperature triggers a call home?
- Do they need a note from your child's doctor to come back?
- Is there a separate rule for vomiting or diarrhea?
When should you get care?
In an emergency, call 911Call your pediatrician right away if your baby is younger than 3 months (12 weeks) and has a temperature of 100.4°F (38°C) or higher, even if they seem fine otherwise. Do not give fever medicine first.
Call your pediatrician the same day if your child looks very ill, is unusually drowsy or very fussy, has repeated vomiting or diarrhea, has a fever that keeps going above 104°F (40°C), or has a new rash or bruises. Also call if a fever lasts more than 24 hours in a child under 2, or more than 3 days in a child 2 or older.
Watch for dehydration: fewer wet diapers or less pee, dry mouth, crying with few or no tears, sunken eyes, or unusual sleepiness or fussiness. Call the doctor if you see these.
Call 911 if your child has a seizure, has trouble breathing, has a stiff neck, is very hard to wake or cannot be woken, has blue, gray, or blotchy skin, or has a rash that does not fade when you press a glass against it.
How our AI doctor decides when to send you to care ›What if there is vomiting, diarrhea, or a rash too?
Other symptoms can keep a child home even after the fever is gone. The AAP lists these reasons to stay home from child care:
- Vomiting 2 or more times in the past 24 hours, unless it has a cause that is not an infection and your child is not at risk of dehydration
- Diarrhea that leaks out of the diaper, causes accidents in a potty-trained child, means more than 2 extra stools in 24 hours, or has blood or mucus in it
- A rash with fever or behavior changes, until a clinician says it is not contagious
- Strep throat, until at least 12 hours after antibiotics start
- Too sick to take part in normal activities, or needs more care than staff can give
Common questions
When can my kid go back to daycare after a fever?
Usually after 24 hours with no fever and no fever-reducing medicine, as long as other symptoms are improving and your child can join in normal activities. That is the AAP guidance for a fever with cold-like symptoms. Your daycare's written policy has the final say, and it may be stricter.
Can I give Tylenol and send my child to daycare?
Not to get around the fever rule. The 24 hours have to be without fever-reducing medicine, because the medicine hides the fever without ending the illness. You can give it at home for comfort and count the 24 hours from the last dose.
My child's fever broke overnight. Can they go today?
Usually not. If the fever was yesterday evening, 24 hours have not passed. Most children who had a fever one day go back on the second morning after it breaks, if they stay fever-free without medicine.
The fever is gone but my child still has a runny nose. Can they go?
Usually yes. The AAP says coughs and colds without fever, and runny noses of any color, are not reasons on their own to keep a child home. Your child should feel well enough to join in, and staff should be able to care for them without neglecting other kids.
Do I need a doctor's note to go back to daycare?
It depends on the program and the illness. The AAP guidance does not require a note for a simple fever, but some daycares and states do. Check your parent handbook or ask the director.
My baby is 2 months old and has a fever. Can I wait and see?
No. A baby younger than 3 months with a temperature of 100.4°F or higher needs a call to the pediatrician right away, even without other symptoms. Young babies can get serious infections that need to be checked quickly.
Pymander is not a replacement for a physician and does not provide medical advice, diagnosis, or treatment. Always seek the advice of a qualified health provider with questions about a medical condition. If you think you may have a medical emergency, call 911.