Child illness and exclusion periods

Last updated: April 2026

Knowing what to do when a child in your care is unwell is one of the most important parts of running your setting, and one of the most frequently asked about. This article covers your responsibilities, when to send a child home, exclusion periods for common illnesses, what to do when parents push back, and when you need to notify tiney.

Every tiney childminder must have a Sick Child Policy in place. This is a mandatory policy under the EYFS and must be uploaded to the tiney app as a PDF and shared with families before their child starts. You can use tiney's template policy from the resources section of the app as a starting point, and adapt it to reflect your setting.

Your Sick Child Policy sets the terms for your setting. When a situation arises involving an unwell child, your policy is what you and parents refer back to. Having it clear, up to date, and acknowledged by parents from the start puts you in a much stronger position when difficult conversations arise.

A child should not attend your setting if they:

As a general principle, if a child isn't well enough to be at your setting (whether because of their own comfort or the risk to other children) they shouldn't be there. You have both the right and the responsibility to enforce this.

The government's exclusion table for children in childcare settings is the definitive reference for how long children should stay away after specific illnesses. You should refer to this for any illness not covered here:

UK Government: Health protection in schools and other childcare facilities (exclusion table). Below are the most common scenarios childminders encounter.

Exclusion period: 48 hours from the last episode. This is one of the most important exclusion periods to know. The 48-hour rule applies even if the child appears to have fully recovered, and even if the vomiting or diarrhoea was a one-off episode with no other symptoms. The risk of spreading infection remains for 48 hours after the last episode. Example: a child vomits on Tuesday evening. They cannot return to your setting until Thursday morning at the earliest, provided there have been no further episodes since Tuesday.

Children with a fever should stay home until they've been fever-free for at least 24 hours without fever-reducing medication such as paracetamol or ibuprofen. Medication can mask a temperature, so a child who seems well because they've had Calpol may still be unwell and contagious.

There is no mandatory exclusion period for conjunctivitis alone. However, if the child is also generally unwell, the discharge is heavy and difficult to manage, or the infection is spreading, you can and should use your professional judgement and your Sick Child Policy to exclude the child until the condition has cleared. If a parent or their GP has prescribed antibiotic eye drops, it is generally considered safe for the child to return after 24 hours of treatment. Refer to the government guidance and your policy to confirm.

Exclude until all spots have crusted over, usually around 5 days after the spots first appeared. Remind parents of the risk to pregnant women and immunocompromised people who may be in contact with the child.

No formal exclusion period is required, unless the child is feeling unwell. Encourage good hygiene and be vigilant about managing any open sores.

Exclude until the sores have crusted over and healed, or until 48 hours after starting antibiotic treatment.

Exclude for 24 hours after starting antibiotic treatment.

No exclusion required once the rash has appeared. The child is no longer contagious at this stage. The infectious period is actually before the rash appears.

Follow current NHS and government guidance. As of the date of this article, there is no mandatory isolation period, but use your professional judgement about whether an unwell child is well enough to attend.

Yes. If a child arrives at your setting and you believe they are too unwell to be there (whether because of visible symptoms, a temperature, or your professional judgement) you have both the right and the responsibility to refuse care and ask the parent to take them home.

Being confident and clear about this is part of your duty of care, both to the unwell child and to the other children in your setting. Your Sick Child Policy supports you in doing this. It's not personal, it's professional.

Practical steps for refusing care or requesting collection:

This does come up, and it can be frustrating. Here's what helps.

Send a clear written message through the tiney app, restating your Sick Child Policy and confirming that children who are unwell cannot attend. Ask the parent to confirm in writing that they've read and understood the policy.

Document every incident: what you observed, when you contacted the parent, and what their response was. This record is important if the situation escalates.

Enforce your policy every time. Inconsistency makes it much harder to hold the line.

If a parent consistently disregards your policy, you may need to consider whether the placement is sustainable. Reach out to tiney for support if you're not sure how to handle a specific situation.

Children who have recently been vaccinated should not be excluded from your setting simply because they've been vaccinated. There's no medical reason to do this, and it can discourage families from keeping their children's vaccinations up to date.

You should only exclude a vaccinated child if they're showing symptoms covered by your Sick Child Policy, for example a fever, vomiting, or other signs of illness. The fact that those symptoms followed a vaccination doesn't change your policy obligations. You're not a health professional and are not in a position to determine whether any given symptom is vaccine-related or not. Apply your policy consistently.

This was clarified by the UK Health Security Agency (UKHSA) and communicated to early years settings in 2025.

For the majority of everyday childhood illnesses, you don't need to notify tiney. Your Sick Child Policy covers how you manage these situations in your setting.

However, there are specific circumstances where you are required to notify tiney under the EYFS.

If two or more children in your setting develop symptoms consistent with food poisoning, you must notify tiney as soon as is reasonably practicable, and in any event within 14 days of the incident. This is a legal requirement under EYFS paragraph 3.72. Failure to comply without reasonable excuse is an offence.

If a child in your care is diagnosed with a notifiable disease (for example, meningitis, measles, or whooping cough), notify tiney. You may also need to notify the UK Health Security Agency (UKHSA) directly. Your local health protection team can advise.

If any illness-related incident is serious enough that you're unsure whether to report it, contact tiney and we'll help you work out the right approach.

For a full list of what you are required to notify tiney about, see the Notifications to the CMA help centre article.

From September 2025, the EYFS requires you to record absences in your register, including the reason for absence. When a child is absent due to illness, log this in the tiney app register. This helps you and tiney to spot any patterns, for example if a child has frequent unexplained absences that may warrant a closer look from a safeguarding perspective.

If you're unsure how to handle a specific illness situation, or whether you need to notify tiney, reach out via the tiney app or call the safeguarding line. We're always happy to help you work through it.