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Head Lice in School

The new thinking about managing head lice in schools

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head lice in school

Conducting regular checks at home and at school is an important part of preventing and diagnosing head lice.

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How to manage cases of head lice in schools has been a contentious issue - as contentious as the issue of how to treat these annoying pests. Among the top points of debate has been whether or not schools should keep kids diagnosed with head lice or nits (lice eggs) out of school until they are completely nit- and lice-free, which has been the common practice in many school districts across the country.

The American Academy of Pediatrics (AAP) and the National Association of School Nurses both recommend that schools discontinue "no-nit" policies, which require that kids be free of nits before they can return to school.

Furthermore, the Centers for Disease Control and Prevention says that "students diagnosed with live head lice do not need to be sent home early from school; they can go home at the end of the day, be treated, and return to class after appropriate treatment has begun."

In other words, there is no reason for a massive panic once lice and/or nits have been spotted on a child’s head. Precautions need to be taken to ensure that the child does not share personal items or come into head-to-head contact with classmates. But lice do not jump from one person to another and do not pose a health risk, especially after treatment has begun to eradicate the problem.

What's Behind the New Recommendation

There are several reasons:

  • There has been no evidence that keeping kids with nits or lice out of school has lowered the rates of lice infestations.
  • Children who miss school can fall behind on coursework.
  • Misdiagnoses were common. In many cases, children who were thought to have lice after being examined by parents, school nurses and school volunteers -- and were thus sent home from school -- were found to actually have dandruff or harmless particles in the hair.
  • Lice do not cause illness and do not pose a health threat.

Who Is Responsible?

Parents often assume that schools are responsible for head lice infestations and should therefore be in charge of managing and eradicating lice. But while school-age children are at increased risk for getting head lice (an estimated 6 million to 12 million kids ages 3 to 11 get head lice every year), school is not the only place where a child might be exposed to lice. Kids can pick up lice anywhere they come into head-to-head contact or share certain items (bedding, combs, barrettes, towels, etc.) with someone who already has head lice, such as at camp or at a slumber party.

If your child has lice, your school and the school nurse may be excellent sources of information and assistance. You may also want to do your own research on treatments (both conventional and alternative) and talk to your child’s pediatrician about how to handle head lice.

What Families Can Do

  • Focus on solutions, not on blame. Remember: head lice can be picked up at sleepovers, camp, home and other places where children share close quarters and come into close contact with someone who already has lice. Be sure to check your child’s hair regularly, and especially before and after he attends a sleepover or other similar activity.

  • Tell your school to consider the new AAP guidelines. If your school insists that your child stay away until all the nits are gone, talk to administrators about the AAP guidelines. There is no medical reason for your child to stay out of school as long as she has begun treatment to eradicate the head lice.

  • Stay calm. Anxiety and guilt can be common reactions to the news that your child has head lice. But be assured that personal hygiene or cleanliness has nothing to do with a child getting lice. The fact is, while lice may be upsetting and a nuisance, they do not spread disease.

  • Do not self-treat without consulting an expert. If you think you spot nits but do not see any moving, living lice, consult your child’s school nurse or your pediatrician. Do not treat your child with medicated products without confirming that she does have head lice.

What Schools Can Do

  • Reconsider "no-nit" policies. Remember that cases of lice in school are not a threat to the health of the entire student population. Follow the AAP recommendations, take precautions to prevent the spread of lice and consider medical evidence rather than reacting with emotion.

  • Educate parents about lice. School nurses can send parents information on diagnosis and treatment, such as how to regularly check their child’s hair (as well as that of all family members) with a lice detection comb.

  • Conduct lice checks. School nurses who are trained to spot nits and lice can conduct periodic checks of students’ hair in school.

  • Be reassuring and informative with notices. If the school sends out alert letters when a case of head lice is discovered, make sure the notice includes facts about lice and information reassuring parents that lice are not a medical threat. Also, be sure the alert includes a reminder that not all itching is evidence of lice. Also be sure never to publicly name the child diagnosed with head lice.

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