By Alison Kopelman, M.D., I.B.C.L.C., F.A.A.P., F.M.A.A.P

How long is my child contagious? This is a question frequently asked by doctors, families, and daycare providers alike. Here’s the answer – for most illnesses, we don’t know because there is no definitive example.

For example, Respiratory Syncytial Virus (RSV) is most often contagious for 3 – 8 days, starting one to two days before symptom onset. However, some individuals can spread RSV for up to four weeks! Hand, Foot, and Mouth (HFM) can be contagious for weeks – well after symptoms end.

The way I approach this issue is by gauging the severity/risk of illness and time of peak contagiousness and then providing guidelines based on these factors.

Most viral colds, while making children miserable, do not endanger health in a meaningful way. Viral colds consist of runny noses, mild coughs, and low-grade fevers. General advice is that children are okay to be out and about, but do try to limit/clean up snot as much as possible. I encourage families to view these mild colds as opportunities to build immune systems.

More serious illnesses such as strep throat, HFM, and influenza are MOST contagious in the days right before symptom onset until 24 hours after fevers end. For this reason, I tell families that children should stay home until 24 hours after fevers end to limit the spread of more serious illness. This is not a guarantee that all illness will be stopped – but the illness spread will be minimized.

Stomach bugs or “flus” that cause vomiting and diarrhea also do not have a definitive timeline for contagion. Most of the viruses that cause these illnesses can be contagious from symptom onset to two weeks after symptom resolution. The time of peak contagion, however, is from symptom onset until 24 – 48 hours after the last episode of vomiting or diarrhea.

The holidays are fast approaching and as exciting as they can be for most, they can also bring up many emotions, especially for a child in care. Holidays are a time for families to be together, to celebrate traditions, exchange gifts, and eat delicious food. As a child who has been removed from their birth family and placed in a completely new environment, possibly experiencing new traditions, it can be overwhelming and bring up many mixed emotions. A child may feel sadness for not being in their home of origin or not experiencing traditions they’re used to. The child may feel guilt for feeling joy as they’re living with another family and not their birth parents. Certain behaviors may arise during this time, or the child may shut down and have trouble expressing how they are feeling.

It is important to validate the emotions that come to light, and to remember that even though some challenges may transpire, families can use this opportunity to make a child feel safe and loved. Holidays can be a chance for families to create new traditions with a child or highlight the special traditions they may have. There may be a special meal or treat to make together, a story to read, or a holiday movie to watch. There are many possibilities to ensure a child feels a part of the family, especially during the holiday season.
For families struggling with behaviors that may arise around this time, Adoptive and Foster Families of Maine, Inc. (AFFM) is available to offer support. AFFM has staff with lived experience, who are available to offer a listening ear and connect families with others who may be experiencing similar challenges around this topic. AFFM encourages families to attend a support group meeting in their area, (https://affm.net/support/cares/).

AFFM also offers a Holiday Gift Giving Program to children who are in care. The Holiday Gift Giving Program was designed to provide families who open their homes to children in care with a little extra support during the holiday season.