Common childhood illnesses and when children must stay home

Key rules

• Fever: A child with fever stays home until they have been without fever for 24 hours without medication.
• Centre rules: Your nursery or school can be stricter than regional guidance, so ask for its illness policy.
• Doctor's note: A doctor's note is usually not needed to return, but some centres ask for a parent's statement.
• Lice: Lice do not keep your child out, but treatment must start before the next day.

Who decides when your child must stay home

No single national law sets exclusion times. Regional health departments publish the guidance. Each nursery or school then applies it through its own internal rules (reglamento de régimen interno), and a centre can be stricter than the regional guide. Ask for the centre's illness policy when you enrol, and follow it if it differs from what you read here.

Some infectious diseases must be reported to public health. The centre or your doctor handles that, not you.

Fever, vomiting and diarrhoea

A child with fever stays home until they have been without fever for 24 hours without medication. A child with vomiting or diarrhoea stays home until the symptoms have stopped, usually 24 to 48 hours.

Common illnesses

• Flu: stay home until fever-free for 24 hours and feeling well.
• Chickenpox: stay home until all the spots have crusted over, usually about 5 to 7 days after the rash begins.
• Bacterial conjunctivitis: stay home until 24 hours after starting treatment. Viral conjunctivitis needs no exclusion if your child is well. Wash hands often and don't share towels.
• Lice: your child does not have to stay home, but treatment must start before the next day.
• Hand-foot-mouth disease: there is no mandatory exclusion. Your child can attend if they have no fever and can eat. Some centres ask you to keep them home while there is fever or many mouth blisters, so check with yours.

The timeline below sets these out in order.

Do you need a doctor's note to go back?

Usually not. Health authorities and paediatric societies advise against asking for medical certificates for minor illness, because they overload primary care. Some regions say outright that no certificate is needed. Some centres still ask for a short written statement from a parent, or a note for certain infectious diseases. Ask the centre what it wants.

What to do on the day

1. Tell the centre why your child is absent, especially if the illness is infectious such as chickenpox or lice, so other families can watch for signs.
2. Keep your child home for the full period, even if they seem cheerful.
3. Call your child's paediatrician at your health centre if you are unsure about the diagnosis or treatment.

The FAQ below covers notes, who sets the rules, and hand-foot-mouth disease.

Timeline and deadlines

• Start treatment for lice: Before the next day; no time off is needed

Frequently asked questions

Does my child need a doctor's note to go back to nursery after an illness?

Generally no, a doctor's note is not needed to return after common illnesses.

Who decides which illnesses keep my child out of nursery?

Regional public health departments set the guidance on which illnesses need exclusion and for how long. Each centre applies that guidance through its internal rules (reglamento de régimen interno) and can add stricter rules of its own. If your centre's rule seems stricter than the health guidance, ask the centre to explain it.

Can my child go to nursery with hand-foot-mouth disease?

Yes, usually, if your child has no fever and can eat, because there is no mandatory exclusion. Some centres ask children to stay home while there is fever or many mouth blisters. Check your centre's rules before you send your child in.