How to Care for Your Child with COVID-19 at Home

How do I know if my child has COVID-19?

Your child should be tested for COVID-19 if they have any of the following symptoms:

• Fever
• New sore throat
• New cough (not related to chronic illness)
• New shortness of breath or difficulty breathing
• New runny nose/nasal congestion
• New loss of taste or smell
• New muscle ache

Children with COVID-19 may also have abdominal (belly area) pain, diarrhea, nausea or vomiting, poor appetite or feeding, headache, joint pain or fatigue. These symptoms alone are not a reason to test unless your child has been exposed to someone with COVID-19.

Where can I get a COVID-19 test?

You can find a testing site and information about COVID-19 testing at the Massachusetts Department of Health’s website. Check the website before scheduling to make sure you know if the test is free, covered by your insurance or if you will need to pay. If you are not sure, call the testing site or your insurance company.

You can also use a home testing kit (often called antigen tests). Children recently exposed to COVID-19 without symptoms may test negative at first. Test again a second time in 1-2 days. Additional information on self-testing is available from the Centers for Disease Control and Prevention (CDC).

When should I call my doctor?

Children with mild symptoms (such as fever, mild sore throat, nasal congestion, mild cough, aches, and pains) can usually be taken care of at home without needing to see or call your health care provider.

You should call your doctor’s office if your child has any of the following:

• Fever, based on the following:
  • In babies under 12 weeks, a fever over 100.4F (38°C) (Do not give fever-reducing medication until you speak with your doctor or the nurse.)
  • In older children, a fever over 105°F (40.5°C)
• A fever over 102.4F (39.1°C ) that does not respond to fever medication or that lasts for more than 3 days
• Hard time breathing
• Wheezing (whistling noise when breathing)
• Not taking fluids
• In babies, no urine in diaper for 8 hours
• In children over age 3, no urine output in 10 hours
• Lethargy (extreme fatigue or tiredness) or sleeping excessively
• Ear pain
• Severe sore throat
• Develops a rash covering much of the body
• If your child has other medical problems as well as COVID-19
• Any time you are worried about your child’s condition

As always, call 911 or take your child to the emergency department if they have difficulty breathing or develop other serious symptoms.

How long can I expect my child to be sick?

Each child is different. Some children may not be very sick at all. Others may have high fevers and feel very sick. Your child may continue to have mild symptoms for up to 2 weeks.

How can I take care of my child at home?

The care for a child with COVID-19 is the same as for any child with the flu or a virus. These are the most important things to do for your child:

• Stay calm and comfort your child.
• Wear a mask when within 6 feet of your child when caring for or comforting them.
• If your child is younger than 12 weeks old, call your doctor’s office for any fever over 100.4F (38°C). Do not give your baby any fever-reducing medications without checking with your doctor or nurse.
• If your child is over 12 weeks old, use fever-reducing medications for a temperature over 102F (38.8°C) or if you think the fever is making your child uncomfortable. You can start with acetaminophen (Tylenol®). If that does not work and your baby is 6 months of age or older, switch to ibuprofen (Motrin®), unless your doctor has instructed you otherwise. Follow the dosing directions on the package.
• Encourage your child to drink fluids. Your child should drink almost as much fluid as they did before they were sick. If you are breastfeeding, you can continue to do so.
• If your child is congested or coughing, you can use a humidifier in their room.

Should other people in the home be tested?

We recommend that anyone exposed to a child with COVID-19 be tested. An exposure is defined as being within 6 feet of a person with COVID-19 for 15 minutes within 48 hours of their onset of symptoms or positive test (if asymptomatic, or not showing symptoms).

How can I protect others in the home from COVID-19?

• Wear a mask when within 6 feet of your child.
• Wash your hands every time you have close contact with your child.
• If your child is old enough, they should also wear a mask when within 6 feet of anyone in your home.
• If possible, your child should stay in a space separated from others and use a separate bathroom.
• Give your child their own set of household items, such as paper plates, cups or eating utensils. They should not share household items with other family members.
• Everyone in your home should wash their hands often with soap and water for 20 seconds and avoid touching their faces.

What is the difference between isolation and quarantine?

Isolation is for people who have tested positive for COVID-19 or who has symptoms of COVID-19. Quarantine is for people who have been exposed to someone with COVID-19. The CDC has more information here.

How long does my child need to isolate?

Note: The CDC guidelines change frequently, so you should check the CDC's website for any updates. This was the CDC guidance as of January 4, 2022.

Your child must stay at home for 5 days following the positive COVID-19 test or if they have COVID-19 symptoms. After 5 days, your child can leave the home (if they can wear a mask around others) and only if they meet both of the following:

• There are no symptoms or symptoms are resolving (getting better)
• They have not had a fever within the past 24 hours

Your child should continue to wear a mask around others for another 5 days. If your child cannot wear a mask around others, they should continue to isolate at home for another 5 days. Avoid people who are immunocompromised (when the immune system is not as strong or does not work as it should) or at high risk for severe disease. You should also avoid nursing homes and other high-risk settings until after at least 10 days. The hospital is considered a high-risk setting.

How long do other family members need to quarantine?

If your child is isolated, it is best for your child’s primary caretaker to quarantine at home. Household members who test positive should isolate.

Guidance around the need for quarantine with an exposure is changing. See the CDC, Massachusetts Department of Public Health or your state website for the most up-to-date guidance. Once your child’s isolation period is complete, household members should also wear a mask around others for 10 days.

Anyone outside of the household who has been exposed to your child should get tested 5 days after the exposure or sooner if symptoms develop. They should also wear a mask when around others for 10 days.

Once isolation and quarantine are completed, your child, family and other contacts should continue to follow local guidance on the prevention of COVID-19 spread in the community.

When can my child return to school and other activities?

• Check with your child’s school, daycare, activity coordinator or place of employment and follow their guidelines for returning to normal activities.
• If your child is sick, they should remain home.
• Your child does not need a doctor’s note to return to school.

Rev. 1/2022. Mass General for Children and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treat any medical conditions.