Twelve. That's the number of viral infections a healthy childcare-aged child will pick up in an average year, according to paediatrician Dr Golly. That’s roughly one a month. And given a viral cold runs seven to ten days with a cough that can linger up to three weeks, the maths is brutal: you're looking at a child who feels well for maybe a fortnight at a stretch.
If you've been wondering whether yours is sick more than other kids, they're not. They're just on the merry-go-round Dr Golly calls Childcare BINGO. It's the collection of viruses, bugs, and rashes your child is statistically guaranteed to collect once they start group care.
Here's what they are, how to spot them, and how long your child should be staying on the couch.
When can my child return to childcare after an illness?
| Illness | When your child can return to childcare |
|---|---|
| Gastro | 24 hours after the last vomit or loose bowel motion. Make it 48 hours if there’s an outbreak at the centre. |
| Common cold | There’s no formal exclusion, but if your child needs pain or fever relief to get through the day, they’re not ready. |
| RSV | Keep them home until their breathing has settled, they’re feeding normally, and they’re back to themselves. |
| Centre policy | Always follow your childcare centre’s policy if it’s stricter than this advice. |
How often do kids in childcare get sick?
In Dr Golly's words, it's normal for healthy children in a childcare setting to pick up around twelve viral infections a year. That's roughly one a month, and given a typical viral cold lasts seven to ten days with a cough that can linger up to three weeks, it's why so many parents feel like their child is sick more than they're well. They're not. They're just on the merry-go-round of lurgies, and as Dr Golly reassures, it doesn't last forever.
He's also a firm supporter of group care despite the bug exposure. The socialisation, the educators, the toilet and sleep training wins, they're real, and they're worth the snot.
1. Gastro in childcare: symptoms, exclusion, and when to worry
Gastro, or gastroenteritis, is inflammation of the stomach and intestines, usually caused by viruses like rotavirus, norovirus, or adenovirus, though bacteria and parasites can also be the culprit. It's the illness most likely to derail an entire family in a single weekend.
What to watch for
The two hallmark symptoms are diarrhoea (watery or loose stools) and vomiting. Children often also run a low-grade fever, lose their appetite, get crampy and tired, and become noticeably less themselves. Symptoms generally show up one to three days after exposure and run their course over a few days to a week.
The bit that catches families out
Dr Golly flags that even after the vomiting and diarrhoea stop, kids can struggle to process lactose for two to three weeks afterwards. This is called post-infectious lactose intolerance, and it's the reason your perfectly recovered child suddenly can't tolerate the yoghurt they usually live on. Go easy on dairy through the recovery window.
When to call the GP
signs of dehydration (dry mouth, sunken eyes, no tears, fewer wet nappies), bloody diarrhoea or vomit, persistent high fever above 38.5°C, severe abdominal pain, or being unable to keep any fluids down all warrant a review.
Verdict?
Keep them home until there's been no vomiting or loose bowel motion for 24 hours, or 48 hours in an outbreak.
2. Common cold in children: how long it lasts and when to keep them home
The common cold isn't a single illness. It's a catch-all for more than 200 different viruses, most often rhinoviruses, that infect the upper respiratory tract (nose, throat, ears, sinuses). It's the most frequent reason kids in care get sent home, and the one Dr Golly says young children are unusually prone to picking up.
What to watch for
It usually starts with a throat tickle or runny nose, and progresses to sneezing, cough, sore throat, low-grade fever, fatigue, irritability, watery eyes, and headaches. Symptoms generally peak at two to three days and resolve over seven to ten days.
The bit that catches families out
The cough often lingers long after the cold has gone, sometimes for up to three weeks in a child who is otherwise back to themselves. Dr Golly notes that this post-infectious cough in a happy, recovered child is harmless. It doesn't mean a new infection has set in.
When to call the GP
Babies under three months with a fever, a high fever (above 38.5°C) lasting more than a few days, breathing difficulty, wheezing or a persistent cough, signs of dehydration, ear pain, or no improvement after ten to fourteen days all warrant medical advice.
Verdict?
If they need paracetamol or ibuprofen to seem well enough for care, they're not well enough for care.
3. RSV: symptoms, exclusion, and recovery
RSV (respiratory syncytial virus) is so common that Dr Golly notes most children will have had an RSV infection by the time they turn two. In older children and adults it usually looks like a regular bad cold, but in infants and very young babies it can progress to bronchiolitis, an inflammation of the small airways in the lungs that's the leading cause of childcare-aged hospitalisation in Australian winters. It's most prevalent from late autumn to early spring.
What to watch for
RSV starts like a common cold, with a runny nose, cough, and sometimes a low-grade fever. As the infection progresses, look for wheezing (a high-pitched whistling on the breath), rapid breathing, difficulty breathing (chest pulling in with each breath, flaring nostrils, grunting), a persistent cough that often produces mucus, a decreased appetite, and unusual lethargy. Dr Golly describes the cough as "really distinctive, like a chain-smoker's raspy cough," and says he can pick it from his waiting room.
The bit that catches families out
RSV doesn't peak when you expect it to. The first few days look like a mild cold, then symptoms typically worsen around days five to seven before improving over the following week or two. Parents often relax on day three thinking they've got off lightly, and then things take a turn. Knowing that the back half is harder than the front half changes how you plan the week.
What to do
Vaccination is now available. Dr Golly flags this as one of the most significant recent developments in childhood illness. RSV immunisation is now offered to pregnant women (antibodies cross the placenta to protect the baby), and monoclonal antibodies are available to eligible infants after birth, with research showing a 90 per cent reduction in hospitalisations. If you have a baby under one or are pregnant, this is a conversation worth having with your GP or obstetrician.
When to call the GP
difficulty breathing or breathing very rapidly, blue lips or fingernails, being unusually drowsy or hard to wake, refusing to feed or drink or showing signs of dehydration, or any underlying health condition that raises the risk all warrant immediate medical care.
Verdict?
Keep them home until they're properly well, breathing easily, feeding normally, and back to themselves.
How to stop a childcare illness spreading through your family
Handwashing is your first line of defence for the whole family. A few of Dr Golly's most practical tips for keeping one child's bug from becoming everyone's:
- Wash hands with soap and water for 20 seconds, every time, before and after preparing or eating food, feeding a child, holding or cuddling a sick child, wiping noses, giving medication, changing a nappy, and using the toilet.
- Use hand sanitiser as a backup, not a substitute. It works when hands aren't visibly dirty, but soap and water is better.
- Cough and sneeze into a tissue or your elbow, not your hands.
- Wear disposable gloves when changing nappies or cleaning up vomit or diarrhoea during a suspected outbreak.
- Use paper towels rather than reusable cloths while there's illness in the house, and dispose of it straight after.
- Disinfect high-touch surfaces with hot soapy water followed by a bleach-based disinfectant. Think countertops, taps, toilet seats and flush handles, doorknobs, and light switches.
- Bag and seal contaminated tissues, paper towel, or fabric before they go in the bin.
Childcare illness: what educators need to know
If you're an educator reading this, a few things from Dr Golly's course are worth flagging for your team.
The early tell for RSV is breathing, not a rash. Watch for fast or laboured breathing, chest retractions (the skin pulling in around the ribs with each breath), nostril flaring, grunting sounds, or that distinctive raspy cough Dr Golly describes as chain-smoker-like. A child who was managing a runny nose in the morning and is working harder to breathe by the afternoon needs urgent escalation rather than a "let's see how she goes after lunch."
Bright green vomit, a non-blanching rash (one that doesn't fade when a clear glass is pressed against it), and significant lethargy all warrant immediate medical escalation across any of the big three, full stop.
For exclusion calls, Dr Golly's principle is the parent rule applied in reverse: a child who needs fever or pain medication to function isn't well enough to be in the room. That holds for gastro, colds, and RSV alike. And his reassurance for educators is the same one he gives to parents. Families should never feel awkward picking up a sick child, and a centre's clear, calm communication about why a child needs to go home is one of the most reassuring things a parent can hear.
Where to learn more about childhood illness
A dozen viruses a year is a lot to keep track of, and the difference between "ride it out" and "needs a GP" isn't always obvious in the moment. Dr Golly's NEW Family Illness course is a paediatrician-developed guide to the lot, designed for both parents trying to make sense of the merry-go-round and educators wanting clearer, more confident guidance on what to spot and how to handle it.
And if you're sorting out care for the season ahead, Care for Kids can help you find and compare childcare near you.
FAQ
What are the most common contagious illnesses in childcare in Australia?
According to paediatrician Dr Golly, the three most common contagious illnesses to come out of childcare are gastroenteritis (gastro), the common cold, and respiratory syncytial virus (RSV). All three are viral, all are highly contagious, and all generally resolve at home with rest, fluids, and time. It's normal for a healthy child in childcare to pick up around twelve viral infections a year.
How long should I keep my child home with gastro?
In a gastroenteritis outbreak, children should stay home until they've had no vomiting or loose bowel motion for 48 hours. Outside of an outbreak, 24 hours since the last episode is generally enough. Returning too early is the single most common reason gastro tears through a childcare centre.
When can my child go back to childcare after RSV?
According to paediatrician Dr Golly, children should remain home until they're properly well, meaning breathing has settled, feeding is back to normal, and they're behaving like themselves again. Unlike gastro, there's no specific exclusion window, but RSV symptoms typically peak around days five to seven before improving over the following week or two, so don't be surprised if the worst days come later than you'd expect.
Should I keep my child home with a cold?
There's no formal exclusion period for the common cold, but Dr Golly's clear rule is that if your child needs paracetamol or ibuprofen to feel well enough to be at childcare, they're not well enough to be there. Keep them home until they can manage a normal day without symptom relief.
How do I stop a childcare illness spreading through the rest of my family?
Dr Golly's first line of defence is handwashing with soap and water for at least 20 seconds, especially before food and after nappy changes, toileting, or contact with a sick child. Other essentials include coughing into elbows or tissues, wearing gloves during nappy changes when gastro is suspected, cleaning high-touch surfaces with a bleach-based disinfectant, and bagging contaminated tissues or fabric before binning.
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