Adult helping child use hand sanitizer During a time when schools across the nation are making difficult decisions about whether to offer in-person classes this fall, many parents of younger children are faced with an equally challenging dilemma: Should children return to child care?

Whether your child attends daycare or is cared for at home by a nanny or relative, child care not only enables you to work but is also an important aspect of your child’s social and emotional development. But at the height of a global pandemic, how do you know if it’s safe?

To help answer this question, experts from across Children’s Hospital of Philadelphia (CHOP) — including our nationally-recognized PolicyLab — have compiled research-based guidelines that can help families make safe decisions regarding in- and out-of-home child care.

Five safety principles for child care centers

In general, all child care arrangements, including licensed family child care and center-based child care should follow five main principles of safety: symptom checks, hand hygiene, disinfection, distancing and masking. Many child care providers across the country have operated safely throughout the pandemic using these five principles. For more detailed guidance, review the CDC’s guidelines for returning to child care.

1. Symptom checks: Your child care center should provide screening for COVID-19 symptoms. Because your child may have a fever that is not related to COVID-19, fever alone is not a reliable indicator of infection in young children. In addition to fever, children and staff should be screened for chills, muscle aches, headaches, sore throat, new smell and taste disorders and at least one of the following symptoms: cough, shortness of breath and/or difficulty breathing.

In the event that a child or staff member is symptomatic or tests positive for COVID-19, your child care center is required to call the local public health department. A plan should also be in place for isolating the staff member or child with symptoms until they are able to go home. Attendance policies should prevent symptomatic children or staff members who have tested positive from returning to school for 10-14 days.

2. Hand hygiene: Hand hygiene is a key strategy for keeping children healthy. All staff at your child care center should be required to practice appropriate hand hygiene by washing hands or using hand sanitizer regularly. You can also help reduce possible transmission between your home and the child care setting by limiting drop-off and pickup duties to one caregiver and cleaning your hands before and after. Make sure your child washes their hands when they get home, too.

3. Disinfection: Sanitation and disinfection are essential practices for lowering the risk of COVID-19 spread. Many of these practices are already in place in child care settings. During the COVID-19 pandemic, however, the frequency of these procedures should increase. All frequently touched surfaces should be disinfected regularly. At a minimum, all shared toys should be wiped down at the beginning and end of the day, as well as during rest times and when visibly dirty or contaminated.

4. Distancing: For young children, social distancing is most important during meal times and nap times. Strategies such as positioning cribs or sleep spaces end-to-end and using clear barriers between seats at meal times can provide effective distancing. Child care providers should consider strategies to minimize risks during playtime, such as organizing activities that naturally distance children.

5. Masking: All staff members should wear cloth face coverings, with or without face shields. Make sure to wear a mask when you drop off and pick up your child, as well as when you are interacting with staff.

Some child care providers also require children to wear masks. Masks may be appropriate for children older than 2 who are mature enough and physically capable of wearing a mask and removing it in the event of an emergency. Remember that babies and children younger than 2 years old should NOT wear masks due to the risk of suffocation. If you need help getting your child to wear a mask, read these tips.

In-home care

If you choose to hire a babysitter or nanny to care for your children in your home, it’s important to remember that bringing a new person into your home introduces a new opportunity for COVID-19 transmission.

This is particularly relevant in multi-generational homes where older family members, such as grandparents, are typically at higher risk. It’s therefore important that your nanny also follow the main safety principles — symptom checks, hand hygiene, disinfection, distancing and masking — and limits their exposure to those outside of your home, as this will also help decrease your family’s risk.

An informed decision

The decision to return to child care is a personal one, based on your family’s individual needs. Talking with your child care provider about their health and safety plans will help you make an informed decision about the child care arrangement that best meets your family’s needs. Refer to this helpful checklist from CHOP’s PolicyLab to guide this important conversation.

If your child is immunocompromised, awaiting transplant or has a chronic medical condition, it’s important to consult your specialty physician for specific instructions prior to returning to child care.

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