Nursery rules on illness, allergies and vaccination

Key rules

• Sick children: Nurseries send home children with fever, repeated vomiting or diarrhoea and contagious illnesses, and call you to collect them.
• Return note: No national law requires a medical certificate for a healthy child to return, but some centres or regions ask for one.
• Vaccination: Vaccination is not a legal condition for nursery admission, but many centres ask to see the record.
• Allergies: Give the nursery a medical report from the paediatrician or allergist for any allergy or intolerance.
• Paid leave: There is no general paid leave for ordinary child illness, so plan backup cover.

Expect your child to be sent home often

Nurseries exclude sick children, ask for allergy information and may ask for vaccination records. Young children in groups catch a lot of infections, so plan your working days to absorb frequent illness. No general paid leave exists for an ordinary illness.

When a nursery will not take your child

Most centres exclude a child with:

• fever, usually from 37.5–38°C depending on the centre
• repeated vomiting or diarrhoea
• purulent conjunctivitis, until treatment starts
• contagious rashes or skin infections such as impetigo
• contagious illnesses such as chickenpox, scarlet fever, whooping cough, measles, hand-foot-and-mouth disease, head lice, or Covid and flu with symptoms
• illness that stops them taking part, such as a severe cough, breathing difficulty or unusual lethargy

If symptoms start during the day, the nursery calls you to collect your child. Keep a phone reachable and name a backup person who can collect.

Going back after illness

A child can usually return once symptoms have gone: fever-free for 24 hours without medication, and no vomiting or diarrhoea for 24–48 hours. For conjunctivitis, lice or impetigo, they can return after treatment starts. Contagious diseases have set exclusion periods from regional health guidance. Chickenpox lasts until the lesions are crusted. Scarlet fever lasts until 24 hours after starting antibiotics.

No national law requires a medical certificate (alta médica) for a healthy child to return. Some centres or regions ask for a doctor's note after certain contagious illnesses. Ask your nursery before you need it.

Medicine at nursery

Staff are often reluctant to give medicine. Many centres do it only when it is essential and cannot be given at home. Expect to provide a signed written authorisation, the prescription or paediatrician's report with dose and times, and the medicine in its original labelled container with your child's name. For a chronic condition such as epilepsy or anaphylaxis, the centre sets up an individual health plan with you and the doctor.

Allergies and special diets

Tell the nursery about any allergy or intolerance at enrolment. You will normally need a medical report from the paediatrician or allergist, and you sign the centre's form. Most nurseries adapt menus for allergies and intolerances, and for choices such as no pork or vegetarian, if you ask. Centres must follow EU allergen information rules. Centres with their own kitchen usually adapt more easily. Some ask you to supply the food or charge a supplement, so ask about both.

Vaccination

Vaccination is not mandatory in Spain, and no national law requires it for nursery admission. Nurseries often ask for the vaccination record (cartilla de vacunación) or health card, and the health insurance card (tarjeta sanitaria, SIP). Regions differ on which health documents they ask for at enrolment. Check with the nursery or your regional education department. During an outbreak, unvaccinated children can be excluded temporarily on public-health advice.

Covering your working days

• 2 paid working days (up to 5 if you must travel) when a relative up to the second degree is hospitalised or has a serious illness or surgery needing rest
• up to 4 paid days for an unforeseen family emergency where your presence is essential, paid as your contract or collective agreement sets
• a reduced working day with proportional pay
• unpaid parental leave of up to 8 weeks until your child is 8
• for a child with cancer or another serious illness, a paid benefit if you cut your hours by at least half

Collective agreements often add more days, so check yours. Self-employed and public employees have separate rules. The timeline, documents and checklist below cover the details.

Choosing between options

Should you keep your sick child at home or send them to nursery?

• Keep them at home: Your child has a fever (usually 37.5 to 38°C or higher, depending on the centre), repeated vomiting or diarrhoea, purulent conjunctivitis before treatment, a contagious rash, head lice before treatment, or a contagious illness such as chickenpox.

• Ask the nursery first: Your nursery or region may want a doctor's note or paediatrician clearance. If your child has an allergy, bring the paediatrician's certificate so the menu can be adapted.

If your child has symptoms from the exclusion list, keep them home until they are symptom-free for the time that applies, then follow your nursery's rule on a doctor's note.

Timeline and deadlines

• Paid leave for an unforeseen family emergency where your immediate presence is essential: up to 4 days

Documents you need

• Vaccination record (cartilla de vacunación) or the child's health card, issued by your health service. Many centres ask for it at enrolment, but no national law makes it a condition of admission.

• Health insurance card (tarjeta sanitaria, SIP), issued by your regional health service. It is one of the usual enrolment documents.

• Medical certificate or report from the paediatrician or allergist, needed if your child has an allergy or intolerance and you want the menu adapted. The nursery's own form must be signed too.

• Doctor's note or paediatrician clearance to return after certain contagious illnesses. Only some centres or regions ask for it, and no national law requires an alta médica for a healthy child.

• Employer or collective agreement paperwork if you need leave for a hospitalised or seriously ill relative; hospital or doctor proof of the illness is the usual support.

Checklist

• Ask the nursery whether it wants a doctor's note before your child returns after a contagious illness.

• Bring your child's vaccination record (cartilla de vacunación) and health insurance card if the nursery asks for them.

• Ask for the nursery's medication protocol before you need it.

• Check your contract and collective agreement for paid leave days, since no general paid leave exists for ordinary illness.

Frequently asked questions

Does my child need a doctor's note to go back after being ill?

No, no national law requires a medical certificate (alta médica) for a healthy child to return to nursery. Some centres or regions ask for a doctor's note after certain contagious illnesses, so ask your nursery before the first sick day.

Can nursery staff give my child medicine?

Yes, but usually only when the medicine is essential and cannot be given at home, and only with your signed written authorisation.

Do I get paid leave when my child has an ordinary illness?

No, there is no general paid leave for ordinary illness in Spain. Paid days exist for a hospitalised or seriously ill relative (2 working days, up to 5 if you must travel) and up to 4 days for an unforeseen family emergency, and your collective agreement may give more.