A sniffling, coughing, achy child can be a conundrum for parents. Where do you draw the line between keeping them at home (and, possibly, taking off work to take care of them) and sending them to school?  

The American Academy of Pediatrics says that some of it depends on the child. As long as they’re not contagious, some children may feel like they can still buckle down, concentrate and participate, others may be fatigued and require some extra TLC.

If they’re contagious, they should be at home so they don’t spread the germs to their classmates.
Other things to consider:

• Keep an eye on the thermometer. A temperature of 100 or above should warrant heavy consideration for bed patrol and plenty of fluids.
• Make sure they can keep down food and drinks. Vomiting and/or diarrhea can be telltale signs of the flu in children. The flu is highly contagious, and should be checked by a doctor as soon as symptoms appear.
• Watch their energy level. “Healthy children learn better,” says Amy Garcia, Executive Director of the National Association of School Nurses. Excessive tiredness, lack of appetite or achiness won’t make for an abundantly productive school day.
• Don’t load up on medicines. The FDA recently voted that no data supports the use of cough and cold medicines in children between the ages of two to six, and that these products should never be given to children under the age of two.

“The cough suppressants do not work to suppress cough; the decongestants do not work to reduce congestion,” says Dr. Michael Shannon, a pediatric emergency medicine physician and pharmacologist/toxicologist at Children's Hospital Boston. “The good news is that a cold will last three to four days and then their child will be fine.”

If your child has a fever or feels achy, Shannon recommends use of acetaminophen or ibuprofen, which are known to be safe and effective in children.

• Take sore throats seriously. A minor sore throat is common, but a severely sore throat could be a sign of strep throat, even if there is no fever. Be on the lookout for headaches and upset stomach, which can also be signs of strep. If you notice multiple symptoms, consult your doctor.
• Don’t ship them back to school too soon. Keep sick kids home until they’ve gone 24 hours without a fever (without medication). Returning to school too soon can hamper the recovery process and expose their classmates to germs.

Most people recover from the flu within a week, but may be left feeling exhausted for as long as three to four weeks.

• Know your company’s policies. You may need to consider telecommuting or finding a relative or sitter to stay with your sick child if you can’t take the time (or afford to take time) off work.
• Plan in advance: Before the cold and flu season hit, get flu shots for the whole family to help prevent unnecessary illness.

“It usually takes a couple of weeks from the time you get the shot to be fully protected," says Dr. Thomas Sandora, medical director of Infection Control at Children's Hospital Boston "but flu activity tends to continue through at least March.”