Should sick babies come to our playgroup?

We have a baby playgroup that meets once a week. In the past couple of months some of the babies have had colds.  It’s uncomfortable to tell other parents that they can't come to the group with a sick baby, but we also don't want the babies catching colds or other illnesses from each other. What can we do?

Once babies are out of a parent’s lap and playing (or just colliding) they begin to share more than toys.  Young children, especially crawling babies and toddlers, are particularly susceptible to colds and other illnesses because they pass toys around that they have placed in their mouths. The bacteria and viruses that are in everyone’s saliva and mucus pass from one child to another very quickly.  Since most viruses are contagious before a child acts sick, there is really no way to keep the babies in your playgroup from ever being exposed to illnesses.  However, you can develop guidelines for deciding which sick babies are most likely to infect other babies (or their mothers!). 

Here are some guidelines that are appropriate for infants in group child care (the standards for group care are the same as for any group of babies playing together, except that in group care there are fewer adults so there actually may be less chance of cross infection!)

• A baby who has had a fever should not be in group care until he has been without fever for 24 hours.  That means that if a baby has a fever at 7 p.m. on Monday, he should not be in care the next day, since a fever often will disappear in the morning and return in the afternoon.
• Babies who are not fully immunized can pass infections to babies who are only partially immunized.  Parents should agree about an immunization policy for the group.

• A baby who has had diarrhea or vomiting should not be in group care until he has been symptom-free for 24 hours.  

• A baby with a rash (except for diaper rash) should not be in group care.

• A baby who is too sick to be cared for by the childcare provider should not be in group care.

All of these guidelines would be appropriate for your play group to follow.  However, in group care it is usually not considered necessary to exclude babies or children with simple colds.   That's because the children are together every day, and they are exposing each other to the cold viruses even before their noses start to run.  (If every child with a runny nose were kept out of group care, it would be impossible for parents to get to work!)  In your weekly playgroup, on the other hand, the babies are not getting this continuous exposure.  It would be reasonable to ask moms whose babies are coughing, sneezing, or who have runny noses to stay home, especially if their babies are old enough to crawl or move about, touching other babies or toys that are shared.

You can also minimize illness among the group members by making sure that everyone washes hands after changing diapers and before serving food.  Hand sanitizers are just as good as soap and water if your hands are otherwise clean. It's best if each mother changes her own baby.  Toys should be washed after playtime and can be rinsed in a solution of 1/4 cup liquid bleach mixed into 1 gallon of water.  Try to meet in homes or parks that have ample space for your group--eight babies need a lot of room as they get more active.

Keep in mind that if you decide to ask moms to stay home from the group every time their babies are sick, you will sometimes be excluding a mom who really needs the support of the group.  This is particularly a problem if one mother has a baby who is often sick--she's the one who needs more time with other mothers, not less!  One solution to this problem would be for other mothers to visit the stay-at-home mom to take a walk while the babies are in strollers.  If that doesn't work, telephone calls or a visit later in the week if the baby is better will keep the mom from feeling too left out.

Expect mothers in the group to have different opinions and feelings about these guidelines.  It's often easier to discuss group business at an evening meeting when parents can relax--maybe without babies--so that everyone can feel as though they are a part of the decision-making process.