When Should You Keep Your Child Off Nursery? UK Illness Guide

Every parent knows the feeling. Your child wakes up with a runny nose, a rash, or a slightly warm forehead, and you're left staring at the clock wondering whether nursery is off the cards. Send them in and you risk passing something round the whole room. Keep them home unnecessarily and you're missing work or childcare for no real reason.

The good news is that you don't need to guess. The NHS and UK government publish clear guidance for parents and childcare settings on exactly this question. This guide brings that advice together in one place, so you can make a quick, confident decision on a busy morning.

Why This Matters More at Nursery Than at Home

Nursery rooms are close, busy spaces. Young children share toys, cutlery, and cuddles, and they're not yet great at covering coughs or washing hands without reminders. That's part of why illnesses spread faster in group childcare settings than almost anywhere else.

It's also why nurseries follow set guidance rather than making a judgement call for every child individually. Staff aren't being overly cautious when they ask you to keep a child home with a fever or sickness bug. They're following the same rules that apply to every family, to protect babies, pregnant staff, and anyone with a weakened immune system in the setting.

The General Rule for Keeping a Child Off Nursery

As a starting point, a child should stay home from nursery if they have:

• A high temperature (38C or above)
• Diarrhoea or vomiting
• A condition that's still contagious in its early, most infectious stage
• Symptoms severe enough that they wouldn't cope with a normal nursery day

If none of these apply, most common childhood illnesses, including colds, mild coughs, and several rashes, don't require time off at all. Let's break each condition down so you know exactly where you stand.

Illnesses That Do Require Time Off

High Temperature

If your child has a temperature of 38C or higher, keep them off nursery until it clears completely. A high temperature on its own, without other symptoms, is often the first sign of an infection that's still spreading.

Diarrhoea and Vomiting

This is one of the clearest rules in UK childcare guidance. Children with diarrhoea or vomiting should stay away from nursery for 48 hours after their last episode of either symptom. Going back too soon is one of the most common ways stomach bugs sweep through a nursery room.

Chickenpox

Keep your child off nursery until every spot has crusted over. This usually takes around five days from when the rash first appears, though it varies from child to child.

Measles

Measles spreads very easily, so children need to stay off nursery for at least four days from when the rash first appears. Call your GP surgery before visiting in person, since staff will want to manage the appointment carefully to avoid exposing others in the waiting room.

Impetigo

This bacterial skin infection needs treatment from a pharmacist or GP, usually antibiotics. Keep your child home until every sore has crusted and healed, or for 48 hours after antibiotic treatment starts, whichever comes first.

Scarlet Fever

Scarlet fever needs antibiotic treatment from a GP. Your child can return to nursery 24 hours after starting the course. Without treatment, they can remain contagious for two to three weeks, so a GP visit is well worth it.

Ear Infections (with fever or severe pain)

If your child has an ear infection alongside a high temperature or severe earache, keep them home until they're feeling noticeably better or the temperature has gone.

COVID-19

A child with a high temperature or who doesn't feel well enough for normal activities should stay home and away from other people. Mild symptoms alone, such as a runny nose or slight cough, don't automatically rule out nursery as long as your child feels well.

Illnesses That Usually Don't Require Time Off

This list often surprises parents, since many of these conditions look far worse than they are.

• Coughs and colds. A runny nose, mild cough, or sore throat is fine for nursery, as long as there's no fever and your child is otherwise their normal self.
• Cold sores. No time off is needed. Just discourage touching the blister and sharing cups or towels.
• Conjunctivitis. Unless your child feels very unwell, they can attend nursery as normal. A pharmacist can recommend treatment, and regular hand washing helps stop it spreading further.
• Hand, foot and mouth disease. Despite the name, this common childhood illness doesn't require exclusion if your child seems well enough for their normal day.
• Head lice. No need to stay home. Treatment can happen alongside a normal nursery routine.
• Threadworms. These don't require time off either. A pharmacist can advise on treatment.
• Ringworm. Once treatment has started, your child can return to nursery as usual.
• Slapped cheek syndrome. By the time the rash appears, your child is no longer contagious, so the nursery is fine. It's still worth letting staff know, since the illness can pose a risk to pregnant women.
• Sore throat (without fever). A sore throat on its own doesn't need time off. Watch for a fever alongside it, which can be a sign of tonsillitis.

Quick Reference: How Long to Keep a Child Off Nursery

Illness

Time Off Needed

High temperature

Until it clears

Diarrhoea or vomiting

48 hours after last episode

Chickenpox

Until spots crust over (around 5 days)

Measles

At least 4 days from rash onset

Impetigo

Until crusted/healed, or 48 hours after antibiotics start

Scarlet fever

24 hours after antibiotics start

Cold sores

Not required

Conjunctivitis

Not required, unless very unwell

Hand, foot and mouth

Not required

Head lice

Not required

Coughs and colds (no fever)

Not required

What to Do If You Keep Your Child Off Nursery

1. Call the nursery first thing. Most settings, including Little Mowgli Nursery, ask parents to phone or message on the first morning of absence so staff know your child won't be in and why.
2. Tell them the specific illness. This helps staff watch for symptoms in other children and, where relevant, alert other families discreetly.
3. Keep an eye on the return date. Some illnesses have a clear number of days attached, while others depend on your child simply feeling better.
4. Ask about medication rules. If your child needs prescribed medicine during nursery hours, check the setting's policy on administering it before they return.
5. Watch for anxiety, not just illness. Occasional tummy aches or reluctance to attend can sometimes be worry rather than illness. If this becomes a pattern, a chat with staff or your GP can help work out what's going on.

How Little Mowgli Nursery Handles Illness

At Little Mowgli Nursery, a small, community-focused setting in Leyland, staff follow the same UK government and NHS guidance covered in this article when deciding whether a child is well enough to attend. This applies across both the Tiger Room, for children aged 0 to 2, and the Giraffe Room, for children aged 2 to 5.

If your child develops symptoms while at nursery, staff will contact you and, where needed, keep your child comfortable and away from others until you arrive. Little Mowgli Nursery also asks parents to give a clear reason for any absence, since this helps the team spot patterns and respond quickly if something more widespread, such as a stomach bug, starts to circulate in the setting.

Final Thoughts

Deciding whether to keep a child off nursery doesn't need to be a guessing game. A high temperature, sickness bug, or a handful of specific infections call for time at home, while many common rashes, coughs, and colds don't. Keeping a simple reference like this one on hand, alongside a quick call to your nursery, takes the stress out of those early-morning decisions and helps keep every child in the room a little safer.

Frequently Asked Questions

How long should a child stay off nursery after vomiting? 

UK guidance recommends keeping a child home for 48 hours after their last episode of vomiting or diarrhoea. This gives enough time for the infection to clear and reduces the chance of it spreading to other children and staff.

Can my child go to nursery with a cold? 

Yes, in most cases. A runny nose, mild cough, or sore throat doesn't require time off, as long as your child doesn't have a high temperature and feels well enough for their normal activities.

Does chickenpox always mean five days off nursery? 

Five days is the usual guide, but the real marker is whether every spot has crusted over. Some children take a little longer, so check the spots rather than counting days alone before sending them back.

What temperature counts as too high for nursery? 

A temperature of 38C or above counts as a high temperature under NHS guidance. Keep your child home until it has fully returned to normal, even if they seem otherwise cheerful and active.

Do I need to tell the nursery why my child is off sick? 

Yes, most settings ask for a reason. This helps staff watch for similar symptoms in other children and follow the correct return-to-nursery guidance for that particular illness.

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