What temperature is too high for daycare?

Most licensed daycares use 100.4°F (38°C) as the fever exclusion threshold — the same threshold used by the American Academy of Pediatrics to define fever in young children. Some centers require a lower threshold of 99.5°F. Children must typically be fever-free for 24 hours without fever-reducing medication before returning to care.

Can a daycare refuse to give my child Tylenol to manage a fever?

In most states, daycares can administer over-the-counter medications only with written parental authorization. Centers cannot give medication without your written consent. However, centers are generally not required to administer medication — and many will still send a child home if they have a fever even if the parent authorizes Tylenol, because the underlying illness may be contagious regardless of whether the fever is managed.

What illnesses require exclusion from daycare?

Standard exclusion criteria at most licensed daycares include: fever above 100.4°F, vomiting (two or more times in 24 hours), diarrhea (three or more loose stools in 24 hours), undiagnosed rash, pink eye (until 24 hours of treatment), strep throat (until 24 hours on antibiotics), lice (until treated), and hand-foot-and-mouth disease (until fever-free and blisters have crusted over).

How many sick days should I budget for per year when my child is in daycare?

The CDC notes that children in group care settings average 8–12 respiratory illnesses per year in the first two years of attendance — compared to 3–5 for children cared for at home. Many of these are mild and resolve in 1–2 days, but during the first 6–12 months in group care, plan for more illness than you might expect. Most working parents in group care situations budget 10–15 sick days per year initially.

What should I look for in a daycare's sick policy before enrolling?

Ask for the written sick policy before you sign an enrollment contract. Specifically review: the fever threshold, the return-to-care requirements, the illness notification process (how quickly they call you and what they expect your response time to be), and whether they have a sick bay where a mildly ill child can rest while you arrange pickup. Centers that have a written policy and train staff on it consistently are much safer environments than those that handle illness informally.

Daycare Sick Policy: What Every Parent Should Know in 2026

April 25, 2026

Why Sick Policies Exist (and Why They Matter More Than You Think)

Young children in group care settings are exposed to a much wider range of pathogens than children cared for at home. A typical infant room may have 6–12 children who collectively attend multiple pediatric practices, have siblings in school, and interact with extended family — creating a substantial viral and bacterial exposure network. Sick policies exist to protect the most vulnerable children, particularly infants under 12 months who may not be fully vaccinated.

When reviewing a center's sick policy, you are evaluating two things: the quality of the written policy and the consistency with which it's enforced. A well-written policy enforced inconsistently is worse than a slightly looser policy that's enforced with integrity.

Standard Exclusion Criteria at Licensed Centers

The American Academy of Pediatrics and the American Public Health Association publish Caring for Our Children, the national health and safety performance standards for childcare. Most licensed centers model their sick policies on these standards. Standard exclusion criteria include:

Fever: Temperature at or above 100.4°F (38°C). Children must be fever-free for 24 hours without fever-reducing medication before return.
Vomiting: Two or more vomiting episodes in a 24-hour period at the center, or at home the night before.
Diarrhea: Three or more loose or watery stools in a 24-hour period beyond the child's normal baseline.
Rash: Any undiagnosed rash. Diagnosed rashes that are confirmed non-contagious (eczema, heat rash) do not require exclusion.
Eye discharge: Bacterial conjunctivitis (pink eye) requires 24 hours of antibiotic treatment before return. Viral conjunctivitis is often managed without exclusion after medical clearance.
Strep throat: Exclusion until 24 hours on appropriate antibiotics and fever-free.
Hand, foot, and mouth disease: Exclusion until fever-free and all blisters have crusted over (typically 5–7 days from onset).
Head lice: Exclusion until after the first treatment. Nit-free policies (requiring no remaining nits before return) are common but not universal.

What Happens When Your Child Gets Sick at Daycare

Quality centers have a written protocol for this. When a child develops symptoms at the center, staff should:

Separate the child from the group (most centers have a comfortable sick bay or quiet area)
Contact the parent or emergency contact — most centers require you to be reachable within 30–60 minutes
Document the symptoms and time of onset
Notify the group's parents if the illness is communicable (most states require this for reportable illnesses; some centers notify for common illnesses as well)

Ask the center: "What is your expected response time when you call me because my child is sick?" If the answer is "you need to pick up within 30 minutes," and your workplace is 45 minutes away, that's a practical conflict to address before enrollment.

The Sick-Child Reality for Working Parents

Children in group care settings average 8–12 respiratory illnesses in their first year of group care, per CDC data. Many of these are mild 1-2 day illnesses, but they still result in exclusion. For families where both parents work, this creates significant logistical pressure. Strategies working parents use:

Backup childcare arrangements: A trusted family member, a backup nanny, or a registered sick-child care service. Services like Care.com and Urban Sitter list caregivers available on short notice, typically at $15–$25/hour.
Flexible work agreements: Negotiate work-from-home days or flexible hours in advance, before the sick days accumulate.
Sick-child drop-in centers: Some metropolitan areas have licensed sick-child care centers that care for mildly ill children. These are not widely available, but worth researching in your city.
Pediatric telemedicine: Same-day telehealth visits can confirm whether your child needs to be excluded or can return to care faster — bypassing the in-person visit wait time that often extends sick days unnecessarily.

What to Ask About Before Enrolling

Request a copy of the center's written sick policy before signing an enrollment contract. Review specifically:

The exact fever threshold (100.4°F standard or different?)
The return-to-care window (24 fever-free hours is standard)
Medication administration policy — written consent requirements
Expected parent response time after a sick call
Communicable illness notification procedures

Browse licensed daycares near you: search by city and filter by age group and availability.

Frequently Asked Questions

What temperature is too high for daycare?: Most licensed daycares use 100.4°F (38°C) as the fever exclusion threshold — the same threshold used by the American Academy of Pediatrics to define fever in young children. Some centers require a lower threshold of 99.5°F. Children must typically be fever-free for 24 hours without fever-reducing medication before returning to care.
Can a daycare refuse to give my child Tylenol to manage a fever?: In most states, daycares can administer over-the-counter medications only with written parental authorization. Centers cannot give medication without your written consent. However, centers are generally not required to administer medication — and many will still send a child home if they have a fever even if the parent authorizes Tylenol, because the underlying illness may be contagious regardless of whether the fever is managed.
What illnesses require exclusion from daycare?: Standard exclusion criteria at most licensed daycares include: fever above 100.4°F, vomiting (two or more times in 24 hours), diarrhea (three or more loose stools in 24 hours), undiagnosed rash, pink eye (until 24 hours of treatment), strep throat (until 24 hours on antibiotics), lice (until treated), and hand-foot-and-mouth disease (until fever-free and blisters have crusted over).
How many sick days should I budget for per year when my child is in daycare?: The CDC notes that children in group care settings average 8–12 respiratory illnesses per year in the first two years of attendance — compared to 3–5 for children cared for at home. Many of these are mild and resolve in 1–2 days, but during the first 6–12 months in group care, plan for more illness than you might expect. Most working parents in group care situations budget 10–15 sick days per year initially.
What should I look for in a daycare's sick policy before enrolling?: Ask for the written sick policy before you sign an enrollment contract. Specifically review: the fever threshold, the return-to-care requirements, the illness notification process (how quickly they call you and what they expect your response time to be), and whether they have a sick bay where a mildly ill child can rest while you arrange pickup. Centers that have a written policy and train staff on it consistently are much safer environments than those that handle illness informally.