Knowing if a child is well enough to be at school - guidance for parents and caregivers - HE7037

About this guidance

Going to school every day is important for all school aged children. It helps build their confidence and social skills, and to achieve their education and life ambitions. This information helps you decide when it is okay to send your child to school, when you should keep your child at home and when you should contact a health professional for advice.

This resource was originally produced by Health New Zealand in partnership with the Ministry of Education in 2024.

For more information

An online version of this guidance is available at: Knowing if your child is well enough to go to school — guidance for parents and caregivers

Guidance for school leaders is available at: Knowing if a child is well enough to be at school — guidance for schools

When your child has symptoms but can still attend school

These mild symptoms can be caused by a condition or reaction rather than an infectious illness. A child with these symptoms is likely to still be able to attend school.

Mild respiratory symptoms

If your child tests negative for COVID-19 and they do not have any symptoms of concern (below), it is okay to send them to school if all of these apply:

• they have not had a fever for 24 hours
• they have not used medicine to reduce their fever for 24 hours, like paracetamol or ibuprofen
• they only have mild symptoms such as a mild cough, headache, or runny or blocked nose
• they appear well — they are happy, eating and drinking normally, and can easily focus on learning.

Even though your child may seem well enough to attend school, it is still possible they could have an infectious illness they could pass on. Remind them to cover coughs and wash their hands regularly to help reduce spreading germs to others.

If you are not sure if your child has COVID-19, check the information at: If you have COVID-19

Hay fever and allergy symptoms

If your child has a history of hay fever or allergies and they develop their usual symptoms — sneezing, runny or stuffy nose, coughing or an itchy face — they can go to school.

They should continue to take their usual allergy medication (antihistamines). If your child’s allergies are affecting them, let your child's teacher know.

If your child only has a runny nose after a change in air temperature, for example, moving from outdoors to indoors, or they only sneeze because of the sun or dust, they do not need to be kept home from school.

Skin problems that are not infectious

Most skin problems will get better on their own and do not require treatment.

You can send your child to school if they have insect bites, cuts, scratches, grazes or eczema as these conditions are not infectious.

The KidsHealth website has information about skin problems in children. This will help you identify and manage skin infections, and make decisions on when your child can return to school: How To Stop Skin Infections | KidsHealth New Zealand's Trusted Voice On Children's Health

When symptoms continue or get worse

If your child’s symptoms become worse or more frequent, consider if you need to keep them at home and whether they need health care.

If they have worsening respiratory symptoms, it is recommended they test for COVID-19 with a RAT.

If you ever feel worried about your child’s health, contact your doctor or healthcare provider. You can also call Healthline anytime, 24 hours a day, 7 days a week, for free health advice, treatment, and information about what to do next.

• Call Healthline: 0800 611 116
• Who to contact for health advice: Which health service should I use?

When to keep your child home to get well, and for how long

You should keep your child at home from school if they are too sick to learn and need time to rest and recover. You should also keep them at home if they have:

• any symptoms of concern (see below)
• tested positive for COVID-19
• another infectious illness and they have been told to stay home by their healthcare provider or public health service.

Who to contact for health advice

If you are worried about your child's health, or anyone else in your whānau, there are healthcare services and supports available.

Local healthcare providers

If you or someone in your whānau needs to see a doctor, contact your local healthcare provider to arrange an appointment. You can also contact or visit your local community pharmacy to ask for advice. Healthpoint has details of services and opening hours: Healthpoint • Find up-to-date information about providers, referral expectations, services offered and common treatments

Healthline

If you can’t access a doctor or you don’t have one, you can call Healthline on 0800 611 116 anytime 24/7 for free health advice, treatment and information about what to do next. Interpreter support is available.

In an emergency

In any critical or life-threatening emergency call 111 from any phone, or go to your nearest hospital emergency department (ED). This includes:

• heavy bleeding
• severe pain (particularly chest pain)
• difficulty with breathing
• severe headache
• sleepiness (hard to wake) or seeming floppy and confused
• severe allergic reactions
• bad burns
• mental health emergencies.

Symptoms of concern

Keep your child at home if they have any of these symptoms.

Fever

If your child has a fever, you should keep them home until all of these apply:

• their temperature has returned to normal (less than 38°C) without needing to use medicine to reduce it, like paracetamol or ibuprofen
• they are feeling well and happy within themselves again.

Most children with a fever can be cared for at home. However, if your child becomes more unwell or you are worried about them, get health advice urgently.

Symptoms to watch out for are:

• severe headache
• sleepiness (hard to wake), seeming floppy or confused
• a new rash
• your child is feeling very unwell, upset or unsettled.

Meningitis is a very rare but serious cause of fever in children. For more information visit: Meningococcal disease

The KidsHealth website also has more information on fever, and when to take your child to see a doctor: Fever In Children | KidsHealth New Zealand's Trusted Voice On Children's Health

Vomiting or diarrhoea

Gastro (also known as a tummy bug, rotavirus or norovirus) is an illness caused by an infection in the gut. Symptoms are nausea, vomiting, diarrhoea and fever.

Gastro can spread easily to others, so your child should stay home if they are vomiting or have diarrhoea.

If your child is drinking well, they probably will not need to see their healthcare provider.

Your child can return to school after 48 hours (2 days) have passed since the last time they vomited or had diarrhoea.

For more information on gastro, visit: Gastroenteritis In Children | KidsHealth New Zealand's Trusted Voice On Children's Health

Sore throat

You should keep your child at home if they need pain relief for their throat to feel comfortable. Pain relief includes paracetamol or ibuprofen. Make sure to give the correct dose for your child according to their weight or age.

If your child is suffering from a sore throat and is of Māori or Pacific ethnicity, contact your healthcare provider to arrange a throat swab or to be treated for possible strep throat. Māori and Pacific children in Aotearoa New Zealand are at greater risk of developing rare, but serious complications from strep throat, such as rheumatic fever or kidney disease.

More information on sore throats is available at: Sore Throats In Children & Young People | KidsHealth New Zealand's Trusted Voice On Children's Health

School sores and other skin infections

School sores (impetigo) is a common skin infection caused by bacteria. Symptoms are red sores or blisters, which burst to leave crusty, golden-brown patches. The sores can be itchy and affect the face and hands, but they can appear elsewhere.

Other skin infections can also show similar symptoms. If your child has sores that are red, swollen, oozing, weeping or blistered, or that feel hot to the touch, you should keep them at home.

As impetigo is very infectious, it is important any sores are kept covered until they are healed. For any skin infection, it is important you contact your healthcare provider for advice on whether your child needs antibiotics.

Your child can return to school:

• if their sores are covered and healing
• it has been 24 hours since they started antibiotics
• as directed in the guidance for infectious diseases: Infectious diseases

A new rash or itches

If your child develops a new rash, you may need to keep them at home from school.

Most of the time a child with a rash will not need to see a doctor. However, there are some rashes which are more serious and may need treatment to heal.

If your child gets a new rash and any of the following apply, you should get health advice urgently.

• They appear unwell — they have a fever, headache, are drowsy or appear to be very sick, upset or unsettled.
• They have been in contact with someone with measles or chickenpox, or have recently returned from overseas, especially if they are not fully immunised against these illnesses.

Meningitis is a rare but very serious cause of a new rash. A meningitis rash starts out looking like small pin pricks, but it can turn into red or purple bruise-like blotches. For more information on meningitis visit: Meningococcal disease

Head lice and scabies

Head lice (nits) are common in children because of how close they are together at school. Nits are small insects that lay their eggs on strands of hair. Scratching can be a sign that a child has them. Children with nits should stay at home from school until treatment has started.

More information on head lice is available at: Head lice (nits)

Scabies is a very itchy skin rash that is caused by a reaction to a tiny mite that burrows under your skin. Scabies is easily spread between people through close skin contact, shared bedding or clothing. This type of rash needs treatment to get better. If a child has scabies, they can go back to school 24 hours after their first treatment.

More information on scabies is available at: Scabies

For other skin problems in children, use the guidance on the KidsHealth website to help you identify and manage skin infections, and make decisions on when your child can return to school: How To Stop Skin Infections | KidsHealth New Zealand's Trusted Voice On Children's Health

Wheezing or difficulty breathing

Your child should not be at school if they are:

• wheezing or struggling to breathe (unless they can get quick relief with prescribed medicine, like an inhaler)
• coughing or sneezing frequently, and it is making it hard for them to concentrate and learn.

If your child is struggling to breathe, get urgent health advice.

Most coughs will get better on their own, but it can take many weeks for your child to fully recover. A child who has a lingering cough, but is otherwise well, can return to school.

More information on coughs in children is available at: Cough In Children | KidsHealth New Zealand's Trusted Voice On Children's Health

Infectious diseases that can spread easily at school

There are many infectious diseases that can spread easily at school where there are a lot of people together in crowded and confined spaces, like classrooms.

You should always keep your child at home if your healthcare provider or local public health service tells you to do so to prevent the spread of an infectious disease at school.

For more information visit this KidsHealth guide: Infectious Illnesses At A Glance | KidsHealth New Zealand's Trusted Voice On Children's Health

This helps you understand:

• how these illnesses spread
• the symptoms to look out for
• how long your child should stay home to prevent spreading the illness to others.

Sending your child back to school

As soon as your child is well enough to return to school, it is important that they attend to be with their peers and get back to learning. If your child cannot manage full days to begin with, discuss a transition plan with their school.

In general, a doctor’s certificate or clearance should not have to be provided for your child to go back to their school after being unwell.

Anxiety and school attendance

Anxiety is a normal response to situations that are new or stressful. Your child may feel anxious about school for a lot of different reasons.

For example: 

• feeling worried about something that is happening at school
• making friends or fitting in
• starting a new school
• returning to school after a long absence
• during exams
• finding relationships with peers or teachers difficult
• finding schoolwork or lessons confusing, or feeling pressured to learn in a certain way.

Sometimes going through difficult experiences outside of school, such as bereavement, an illness in the family, or being a young carer can also make it harder for a child to feel settled at school.

More information on anxiety in children is available at: Anxiety In Children | KidsHealth New Zealand's Trusted Voice On Children's Health

How to keep whānau healthy

There are simple things you and your whānau can do to stop the spread of infectious diseases and illnesses at home, school and work.

These include:

• immunise against infectious diseases
• keep hands clean
• stay at home when sick
• wear a face mask
• cover coughs and sneezes
• improve ventilation
• keep household surfaces clean.

For more information visit: Healthy habits to stop the spread of illnesses