Managing Infection - If A Child Is Sick - Aussie Childcare Network

The following article describes the actions to take if you think a child or a staff member is sick or if a notifiable disease occurs in the education and care service; it includes information on Watching For Symptoms In Children, Identifying Severe Sickness, What To Do If A Child Seems Sick, Keeping Records and more.

Watching For Symptoms In Children

Because you care for the children in your group every day, you are familiar with the way each of them looks and behaves when they are well.

Watch for symptoms of sickness in every child in your care, especially if you know a family member or carer is sick. If you notice symptoms, consider these questions:

Does the child need medical attention immediately? If a child has any serious symptoms, call an ambulance (000) and the parent or carer. If a child has concerning symptoms that are severe or rapidly getting worse or has several concerning symptoms, consider calling an ambulance.
Does the child have symptoms that suggest they must go home or be separated from others immediately?
Does the child have symptoms that require medical attention to make a more specific diagnosis? Discuss all symptoms with the parent or carer and give them details that will help them decide about care and whether the child needs to see a doctor. Take care to tell the parent or carer if the symptoms are severe or if they developed rapidly.

Identifying Severe Sickness

Educators and other staff should understand the symptoms that suggest that a child may be very sick and need urgent medical attention. Remember that sickness in babies and infants can progress very quickly.

Serious Symptoms

If a child has any of the following serious symptoms, call an ambulance (000) immediately:

Breathing difficulty—the child may be breathing very quickly or noisily or look pale or blue around the mouth. The child may be working hard at breathing, with the muscles between the ribs or at the base of the neck being drawn in with each breath.
Drowsiness or unresponsiveness—the child is less alert, sleepier than normal, or difficult to wake from sleep, or they are not responding as they usually do (for example, making less eye contact than usual or less interested in their surroundings than usual).
Poor circulation—the child looks very pale, and their hands and feet feel cold or look blue.

Concerning Symptoms

Other symptoms may be concerning but do not necessarily mean that a child is severely sick. These symptoms may also occur in combination with the serious symptoms. The more of these concerning symptoms you see, the more likely it is that the child is severely ill.

If you see any of these symptoms, contact the child’s parent or carer and monitor the child carefully. Consider calling an ambulance (000) if:

any symptoms are severe
symptoms rapidly get worse
multiple symptoms develop

Concerning symptoms include:

Lethargy and decreased activity—the child wants to lie down or be held rather than participate in any activity, even activities that would normally interest them.
Fever—fever by itself is not necessarily an indicator of severe sickness. However, a fever (temperature more than 38.0 °C) in a child is usually a sign of infection and may need to be investigated. Children less than 3 months of age with a fever of more than 38.0 °C should see a doctor. Ensure you measure temperature accurately (see Taking your child’s temperature from Raisingchildren.net.au). See the Fever fact sheet for more information.
Poor feeding—the child has a reduced appetite and eats and drinks much less than usual.
Poor urine output—the child is going to the toilet less often or not at all; for babies, there are fewer wet nappies than usual.
Pain—a child may or may not tell you they are in pain. Facial expression is a good indicator of pain in small babies or children who do not talk. General irritability or reduced physical activity may also indicate pain in babies or infants.
A stiff neck, irritability (excessive or high-pitched crying), or sensitivity to light—this may indicate meningitis.
New red or purple rash—rashes may be caused by viral infections and other causes (for example, nappy rash). Rapidly developing rashes may be a symptom of more serious diseases. Monitor the child carefully if the rash develops rapidly or if it is combined with other concerning symptoms.

What To Do If A Child Seems Sick

If a child is not well enough to participate in activities, follow your service’s policy for contacting parents, carers or emergency contacts. Tell them that the child is sick and must be taken home. A child who is feeling sick is better off at home with close supervision from a parent or carer.

Separate the sick child from the other children until they can be collected by the parent or carer. For example, they could lie on a floor cushion or mat in a corner of the room where you can still comfort and supervise them.

Monitor the child to make sure their condition does not get worse. If a child develops any serious symptoms, call an ambulance (000).

Your education and care service may have a policy about giving children medication (such as paracetamol or ibuprofen) to relieve pain or fever. Check that the parent or carer has given permission before giving the child any medication.
When caring for a sick child, remember the main ways to break the chain of infection:

Remind a child who is coughing or sneezing to cough or sneeze into their elbow. If the child covers their mouth with their hands, ask them to do hand hygiene.
If you wipe a child’s nose, dispose of the tissue in a plastic-lined rubbish bin then do hand hygiene.
If you touch a child who might be sick, avoid touching other children until you have done hand hygiene.
Consider wearing a mask when caring for the child.

When the parent or carer picks up the child, talk with them about the child’s symptoms. Make sure you provide all the details that will help the parent or carer make decisions about care and whether the child needs to see a doctor. For example, describe the severity of the symptoms, how rapidly they developed and progressed, and how sick the child seemed. If appropriate, give them a fact sheet about the symptoms.

Keeping Records

Keep records of any sickness in children. Record information with as much detail as you can, such as:

symptoms you see
the time you first noticed each of the symptoms
action taken (for example, exclusion or review of nappy changing practices)
which area of the education and care service the child or staff member in for most of the day
doctor’s diagnosis, if there is one.

If the disease is one that the service must notify public health authorities about, record when and where the notification was sent and which staff member made the notification.

Keeping health records helps to identify outbreaks by showing any increase in illness among staff and children. It also helps to prevent the spread of infection—records show when your approach to infection control is working. Further, parents or carers and the child’s doctor may find written information on the child’s sickness useful. In some circumstances, the records may help identify the cause of an outbreak and how to control it.

Sick Policies In Early Childhood Services

Early childhood sick policies are regulated under the Education and Care Services National Regulations, which apply across all states and territories. Here are some key aspects:

Exclusion Criteria—Children with symptoms like fever, vomiting, diarrhea, or contagious illnesses must stay home until they recover. Regulations outline specific conditions that require exclusion from childcare settings.
Infectious Disease Management—Childcare centers must follow strict hygiene practices, including handwashing, sanitization, and vaccination recommendations, to prevent the spread of illnesses.
Medical Conditions Policy—Services must have policies for managing medical conditions, including risk minimization plans and communication strategies with families.
Notification Requirements—Parents must be informed of incidents, injuries, or illnesses affecting their child while in care. Serious incidents must be reported to regulatory authorities.
Staff Health Policies—Educators are encouraged to take leave when unwell to minimize transmission and maintain a safe learning environment.
Regulatory Compliance—Policies align with the National Quality Framework (NQF), ensuring services maintain high health standards. The Australian Government National Health and Medical Research Council provides guidelines on preventing infectious diseases in early childhood settings.