When to Keep Your Baby Home from Daycare
The short answer
The AAP and CDC provide clear guidelines for when a child should stay home from daycare. The primary exclusion criteria are: fever of 101°F (38.3°C) or higher with behavioral changes, vomiting (2 or more episodes in the past 24 hours), diarrhea (stools that cannot be contained by a diaper), diagnosed contagious conditions during the infectious period (like strep throat until 24 hours on antibiotics, or chickenpox until all lesions have crusted), and any condition that prevents the child from participating in activities or that requires more care than staff can provide. A runny nose alone, even with colored mucus, is NOT a reason for exclusion. Most daycares require children to be fever-free for 24 hours without fever-reducing medication before returning.
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By Age
What to expect by age
0-6 months
Young infants in daycare may have lower thresholds for exclusion because they cannot communicate symptoms effectively. Any fever of 100.4°F (38°C) or higher in an infant under 3 months requires medical evaluation before return to daycare. For infants 3-6 months, a fever above 101°F with behavioral changes (poor feeding, excessive sleepiness, irritability beyond normal) warrants keeping home. Daycares may also exclude for excessive diarrhea or vomiting that could indicate a contagious gastroenteritis.
6-12 months
This age group is most prone to daycare-acquired infections. Standard exclusion criteria apply: fever over 101°F with behavior change, vomiting, uncontained diarrhea, or diagnosed contagious illness. Pink eye (conjunctivitis) policies vary — the AAP states that most bacterial conjunctivitis does not require exclusion unless the daycare policy requires it. Hand-foot-mouth disease does not require exclusion unless the child has open drooling blisters or fever, as it is contagious before symptoms appear.
12-18 months
Toddlers are better at fighting infections but still get sick frequently. Key exclusion situations include: persistent high fever, lethargy or inability to participate in activities, skin rashes that could be contagious (impetigo, scabies, undiagnosed rashes), and persistent cough with fever that could indicate pneumonia or pertussis. A mild cough or runny nose without fever is generally not grounds for exclusion, as toddlers may have respiratory symptoms for weeks during cold season.
18-24 months
Return-to-care timing matters: after a fever, wait 24 hours fever-free without medication. After vomiting or diarrhea, wait 24 hours after the last episode. After starting antibiotics for strep throat, wait 24 hours. After starting treatment for head lice, the child can usually return the next day. When in doubt, check your specific daycare's policy and consult your pediatrician.
What Should You Do?
When to take action
- A runny nose (even green or yellow mucus) without fever or behavioral changes — this is NOT a reason to stay home
- A mild cough without fever in an otherwise active, well-feeding child
- Residual symptoms after an illness (lingering cough, occasional loose stool) when the child is otherwise well
- Your daycare calling about a mild symptom that doesn't meet exclusion criteria — you can advocate for your child to stay
- Your child has been excluded from daycare repeatedly and you want guidance on when they can return
- You are unsure whether your child's symptoms are contagious
- Your daycare has stricter exclusion policies than AAP guidelines and it's causing frequent absences
- Your child has a chronic condition (asthma, eczema) that causes symptoms mimicking illness exclusion criteria
- Your child has a fever over 104°F (40°C), is lethargic, or has difficulty breathing
- Daycare reports your baby had a seizure, severe allergic reaction, or injury
- Your child develops a rash with fever and stiff neck, which could indicate meningitis
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
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Related Medical Concerns
Why Does My Baby Keep Getting Sick at Daycare?
It is completely normal for babies and toddlers in daycare to get 8-12 viral illnesses per year, and it can feel like they are sick constantly. This happens because young children have immature immune systems and are being exposed to many viruses for the first time. Each cold builds immunity, and studies show that children who attend daycare early have fewer illnesses when they start school (the illness burden shifts - you get them at daycare age or school age, but either way the total exposure is similar). While the frequency of illness is normal, it can be exhausting for families.
How Often Do Babies Get Sick? What's Normal
It is normal for babies and toddlers to get 6-8 upper respiratory infections (colds) per year, and children in daycare may have even more — up to 8-12 illnesses annually. According to the AAP, the average child will have experienced 80-100 viral infections by their 6th birthday. Babies in group childcare settings tend to get sick more frequently in their first 1-2 years (often called the "germ year") but research shows they have fewer infections in later childhood compared to children who were not in early group care, as their immune systems were exposed sooner. Each cold typically lasts 7-10 days, and with back-to-back infections, it can feel like your baby is sick continuously through the fall and winter months. This frequent illness, while exhausting for families, is a normal part of immune system development.
Baby Has a Cold - When to Worry
Babies can catch 8-10 colds per year, especially once in daycare. A typical cold lasts 7-10 days, with symptoms peaking around days 3-5. Most colds are caused by viruses and cannot be treated with antibiotics. Treatment focuses on comfort: saline drops, gentle nasal suctioning, humidifier, and keeping your baby hydrated. While most colds are harmless, certain warning signs - especially in babies under 3 months - require medical attention.
My Baby's Head Shape Looks Abnormal
Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.
Achondroplasia (Dwarfism) in Babies
Achondroplasia is the most common form of short-limbed dwarfism, affecting about 1 in 15,000 to 40,000 births. It is caused by a mutation in the FGFR3 gene and is usually apparent at birth with characteristic features including short limbs, a larger head, and a prominent forehead. Intelligence is normal. With monitoring for specific complications and supportive care, children with achondroplasia lead full, active, and independent lives.
Adenoid Hypertrophy and Breathing
Adenoids are lymphoid tissue located behind the nose that help fight infection in young children. When adenoids become enlarged (adenoid hypertrophy), they can block the nasal airway, causing chronic mouth breathing, snoring, nasal speech, and sleep-disordered breathing. Enlarged adenoids are most common between ages 2-7 and are a leading cause of obstructive sleep apnea in young children. Treatment ranges from watchful waiting and nasal steroids to surgical removal (adenoidectomy) if breathing or sleep is significantly affected.