CDC’s Guidance to Reduce Spread of H1N1 Among Children in Early Learning Settings May Not Reach Millions of Children in Care

September 9, 2009

September 10, 2009

Arlington, VA – Last week, the Centers for Disease Control and Prevention (CDC) released additional guidance for child care and early childhood programs on how to respond to the H1N1 flu.  Children in early childhood settings present unique challenges for infection control due to the highly vulnerable population, close interpersonal contact, shared toys and other objects, and limited ability of young children to understand or practice good respiratory etiquette and hand hygiene.  And children under age 5 are at increased risk of complications from the flu with the greatest risk among children younger than age 2. 

Accordingly, the CDC recommends that children with flu-like symptoms remain at home for at least 24 hours after being fever free without the use of medication, which is usually between three and five days.  The CDC also recommends that children who live in a household where someone has flu-like symptoms remain home for five days from the day the first household member gets sick.

“The CDC is to be commended for its efforts to reduce the spread of H1N1 among children in early learning programs,” said Linda Smith, Executive Director of the National Association of Child Care Resource & Referral Agencies (NACCRRA).  “The agency is offering sound medical advice, but the fact remains that of the 11 million children under age 5 in child care every day, about half are not in regulated settings.  These settings have no oversight, providers have no training, and there is no formal communication with the health community. We must rely on the media and community efforts to reach these settings, and then hope that they do their part to reduce the likelihood of the spread of the illness.”

“There is much in the news about health care reform these days,” said Smith. “But, I believe our first health test will be whether or not we, as a nation, can reduce the spread of H1N1.  The fact is, even with all the information disseminated, which is helpful, it still comes down to parents making a choice. For parents without paid sick leave, this choice can be a difficult one.  Parents need to pay rent, buy groceries, and make ends meet. Taking time off without pay could place a lot of parents in a difficult financial situation. And, some could very well risk losing their jobs.”

To help reduce the potential stress on working families as well as keep sick children at home, NACCRRA recommends that President Obama look at using some of the $5.8 billion pandemic flu emergency fund, appropriated by Congress, to provide communities or states with funds to pay parents without sick leave to stay home for brief periods of time to care for their children.

“For parents without paid sick leave, taking time off to care for sick children is unrealistic,” said Smith.  “Despite the advice of medical experts, these parents just cannot afford to stay home.  If we really want to reduce the spread of H1N1, we need to offer parents the means to stay home.”

NACCRRA also recommends that parents, communities, states and the federal government examine how to potentially set up a backup child care system (should schools and child care settings close down) so that parents with healthy children can continue working without leaving children home alone or in informal settings that may not be safe. 

“By providing paid sick leave for families who need it and establishing a backup child care system in the event schools and child care programs close, we can encourage more parents to remain at home with sick children, ensure that children are safe, and prevent the spread of this potentially deadly flu.”



NACCRRA, the National Association of Child Care Resource & Referral Agencies, is our nation's leading voice for child care. We work with more than 800 state and local Child Care Resource and Referral agencies to ensure that families in every local community have access to high quality, affordable childcare. To achieve our mission, we lead projects that increase the quality and availability of child care professionals, undertake research, and advocate child care policies that positively impact the lives of children and families. To learn more about NACCRRA and how you can join us in ensuring access to high-quality child care for all families, visit us at