A runny nose shouldn’t keep a toddler home from the child care center, but a survey of child care center directors found many do not follow national guidelines and regularly send home a children with only a mild illness.

The study “Unnecessary Child Care Exclusions in a State That Endorses National Exclusion Guidelines” was published in Pediatrics and found that when surveyed, daycare directors excluded children from attendance more than half the time for mild or non-communicable illnesses.

Researchers surveyed 305 child care center directors in Milwaukee, Wis., and found directors would unnecessarily exclude 57 percent of children with mild illnesses. In a telephone survey, researchers read five vignettes that featured children with mild illness – a cold, conjunctivitis, gastroenteritis, fever and tinea capitis (a scalp infection) – and asked whether the child should be excluded. All of the vignettes described scenarios that should not warrant exclusion according to guidelines from the American Academy of Pediatrics and American Public Health Association.

Responses ranged from 8 percent of directors unnecessarily excluding a child with a cold, to 84 percent of directors unnecessarily excluding a child with tinea capitis.

Directors with greater child care experience and directors of larger centers made fewer unnecessary exclusion decisions.

Currently there are no formalized state training programs available for child care directors to learn about appropriate exclusion guidelines. Study authors suggest child care directors, especially inexperienced ones, may need ongoing, state-endorsed training regarding guidelines for exclusion.