The University of Michigan C.S. Mott Children's Hospital National Poll on Children's Health recently asked parents who have children younger than six years old in child care about the impact of child care illness on their families.

In the poll, nearly two-thirds of parents of young children in child care say their children could not attend because of illness in the past year. Almost one-half of parents with young children in child care indicated that they've missed work in the last year to care for sick kids, and one-quarter missed work three or more times.

One-half of the parents of young children in child care said finding alternative or back-up care is difficult.

Along with the 33 percent of parents who were concerned about losing pay or jobs because of missing work for sick kids, 31 percent said they don't have enough paid leave to cover the days they need for sick children.

"The results of this poll clearly indicate that illnesses that lead to exclusions from child care are a substantial problem for working parents," says Andrew Hashikawa, M.D., clinical lecturer in pediatric emergency medicine at C.S. Mott Children's Hospital.

"Improving employee benefits related to paid sick leave appears to be important for many parents. More supportive sick leave policies would allow parents to care for their sick children at home or give parents the opportunity to go to their child's usual health care provider instead of the emergency room."

When asked about where to take a sick child for care, eight percent of parents in the poll say taking their sick children to the emergency room is more convenient than seeing a primary care doctor. "Parents may also feel that they don't have any other option but the emergency department if they want to have their children checked out after standard office hours and get them back to childcare the next day." says Hashikawa.

At this time of year, as the weather gets colder, there are more colds and runny noses. Many child care settings have policies that exclude sick children until they have a doctor's note, are taking antibiotics or their symptoms improve.

But according to guidelines from the American Academy of Pediatrics and American Public Health Association, not every well-appearing child with a runny nose or cold needs to be sent home from child care. Typically, colds are spread before the child has any symptoms, so exclusion from child care does not necessarily reduce the spread of illness.

"Training childcare providers to make safe and appropriate rules about when kids have to stay home could greatly reduce the burden on families," says Matthew M. Davis M.D., M.A.P.P., director of the C.S. Mott Children's Hospital National Poll on Children's Health.

"According to the National Partnership for Women and Families, an estimated 40 million workers in the United States lack paid sick leave benefits," says Davis, who is also associate professor of pediatrics and internal medicine at the U-M Medical School and associate professor of public policy at the Gerald R. Ford School of Public Policy. "We hope these latest poll results will spur national discussion about the importance of providing workers with the tools they need to be productive, but also care for their little ones when they are not feeling well," says Davis.

Full report: C.S. Mott Children's Hospital National Poll on Children's Health http://mottnpch.org/reports-surveys/sick-kids-struggling-parentsWebsite

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