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School absence and a doctor's note

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 4 minutes read

All children get sick from time to time, and they may need time off school to recover. For certain illnesses, your child’s school may require them to take a set time period off. This is particularly true if they have something contagious, such as chickenpox, in order to protect other children, as well as letting them rest up and get better.

Schools can be strict on absences to avoid disrupting your child’s education. We’ve set out some guidance for instances that are acceptable and appropriate to keep your child away from the classroom, although do bear in mind that every school will lay out their own policy. It’s always important to be aware of the policies at your child's school.

As a general rule of thumb, if your child is unwell or feverish for whatever reason, they should stay at home to recover.

When should my child stay off school?

If your child has chickenpox, they should stay off school until all the lesions have crusted over. With impetigo, you must either wait until all the lesions have crusted over or 48 hours after starting antibiotics. Children with whooping cough can also return 48 hours after starting antibiotics.

Diarrhea and vomiting require returning to school 48 hours after the last episode, to reduce the risk of spread. With measles and rubella, your child can return to school 4 days after the rash appears, and with mumps, it’s 5 days after the beginning of the swelling.

If your child has scabies, they will need two treatments, a week apart, but they can return to school after the first treatment.

Children with scarlet fever can return 24 hours after starting antibiotics. With meningitis, your child can return once they have been treated and recovered. With tuberculosis, it’s 2 weeks after they started treatment.

These are intended as a guide, mostly to protect other children from catching these viruses or bacteria. If your child still feels unwell, they have fevers, they are in pain or uncomfortable, and they’re struggling to eat and drink, they need more time to recover so should stay at home.

You know your child, so trust your instincts on when they are well enough to return to their classmates, but you could also seek further guidance from your doctor, if needed.

When is my child fit for school?

Some conditions may be contagious, but illnesses are usually mild, so your child is expected to attend school even if it risks others catching their illness. But make sure they have no fever before they go back to school. These conditions include conjunctivitis, glandular fever, hand foot and mouth disease, slapped cheek syndrome, flu, head lice, threadworms and tonsillitis.

We would suggest informing the school of any of these conditions, so they can monitor for outbreaks.

For athlete’s foot, cold sores and ringworm, you usually do not need to inform the school nor keep your child at home, but bear in mind that these conditions are spread by direct contact, so measures should be taken to avoid the spread and/or treat the condition.

Will my child need a medical note?

In most cases, your child will not require a medical note from a doctor for being off school, especially if just for a few days. In very few circumstances the school may request one, if, for example, your child is unable to attend school or participate in certain activities or lessons for a prolonged period of time.

The school sometimes asks for verification if your child has had repeated absences throughout the year for a few days at a time. It’s best to discuss this with the school, as it’s hard for your doctor to provide a medical note if they haven’t seen the child for absences.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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