A Working Parent's Guide to Sick Kids

Marijean Jaggers cringes when she thinks about the time she strapped her vomiting 4-year-old daughter into the backseat of their car, gave her a towel and a bowl, and then drove 45 minutes to her office to pick up work she had to turn in that day.

"My husband was out of town, I'd been up all night, and my priorities were completely jumbled," recalls Jaggers, of St. Louis. Halfway there, she came to her senses, called the office, and asked them to e-mail the files to her at home instead. The message from the boss? "He said I needed to find backup child care when my kids got sick—and that I should get my 'a—into work.'"

Generally, it's not a big deal if either of Amy Williamson's two daughters gets sick. Williamson, a financial advisor in Raleigh, North Carolina, and her husband, Ray, a real-estate broker, take turns staying home. But last winter, both 9-year-old Ashley and 6-year-old Audrey came down with the flu at the same time -- the one week it was impossible for either parent to be out of the office. That's when they called in the reserves: "My mother lives four hours away," says Williamson. "She took two days off so that I didn't have to."

Wendi Jacob, the director of Lil' Critters Child Care in Hillsboro, Oregon, can tell a much more extreme story. She called the parents of one 14-month-old who started throwing up after naptime to ask them to come get their child. Neither could: The father had recently started a new job and was afraid he'd be fired. The mother had been home the previous week with the child's older sibling, and her boss told her she'd be docked pay if she left again. "So this mom stuck her finger down her throat and vomited all over her office carpet," says Jacob. "The boss sent her home sick, and she was able to pick up her child."

Sound over the top? Yes. But these situations illustrate the lengths working parents must go to when their carefully calibrated child-care arrangements fall apart. Many use all of their resources to get through a typical day and have little flexibility and no Plan B—no grandparent, friend, or neighbor to step in if a child is ill.

A Lack of Laws

Staying home to take care of a sick child is just not possible for many of the more than 40 million working people who don't have a single day of sick leave, paid or unpaid, for themselves or to care for a child. Some parents who are allowed time off fear that actually taking it will send a message that they're not serious about their work. And this May, a study published in Pediatrics found that in 57% of cases, child-care directors send children home unnecessarily because of mild illnesses, making the need for paid sick time even more evident.

"It's both puzzling and unacceptable that we trumpet the importance of family values as a society, yet we have fewer policies in place to aid working families than any other advanced industrial nation in the world," says Stephanie Coontz, director of research and public education for the Council on Contemporary Families.

Yes, we have the Family and Medical Leave Act (FMLA), which gives employees up to 12 weeks of unpaid, job-protected leave. It allows them to care for a newborn or a newly adopted child or a child recently placed in foster care. It also allows them to care for themselves or a child, a spouse, or a parent when they're very sick.

"Because the FMLA is meant to cover serious illness, it doesn't cover time off for more routine, short-term illnesses like strep throat or flu," explains Linda Meric, national director of 9to5 National Association of Working Women, which advocates for family-friendly workplace policies. What's more, to be eligible, your company must have 50 or more employees within a 75-mile radius, and you need to have worked there for at least a year—those guidelines alone rule out 40% of private-sector workplaces.

In the meantime, many other nations provide the kind of sick-care alternatives that most Americans can only dream about. A recent study of 190 countries by researchers at Harvard and McGill Universities found that 163 nations guarantee paid sick leave. The Netherlands offers two years. New moms in 177 countries are guaranteed paid leave; 74 countries offer it for new dads. Forty-nine nations guarantee paid time off to parents to care for sick children.

"Not only does the U.S. lag behind almost every developed nation when it comes to flexible leave policies and other family supports, it ranks well below many low- and middle-income countries too," says Jody Heymann, M.D., Ph.D., founding director of McGill University's Institute for Health and Social Policy and lead author of the study.

Many states have tried to pass or are considering bills requiring businesses to offer a certain number of paid sick days per year depending on how long an employee has worked. (Those states are Alabama, Alaska, Arizona, California, Colorado, Connecticut, Hawaii, Illinois, Iowa, Maine, Massachusetts, Minnesota, Montana, New Hampshire, New York, North Carolina, Pennsylvania, Rhode Island, and Vermont.) So far, only three cities (San Francisco, Washington, D.C., and Milwaukee) have actually passed such legislation. As a result, parents wind up taking a sick child to work with them if the boss allows, or they ask an older sibling to miss school and stay home, or they give a feverish child some acetaminophen, send them off to school, and hope the nurse doesn't call.

"No one should have to choose between their child and their livelihood," says Dr. Heymann, author of Raising the Global Floor. Parents who are high enough up the career ladder or fortunate to work for a family-friendly company often don't have to choose. But those in low-wage jobs (including child-care providers and restaurant and hotel workers, who typically have the least amount of flexibility) usually do. In a 2008 study by the University of Chicago's National Opinion Research Center, 16% said that they or a family member had been fired, suspended, punished, or threatened with firing if they missed work due to personal or family illness.

"This is an issue for all of us," says Dr. Heymann. "Even if you're able to stay home, you still have to worry about all the other parents who can't or won't." In May 2009, the late Senator Ted Kennedy (D-MA) and Representative Rosa DeLauro (D-CT) reintroduced the Healthy Families Act, which would establish for the first time that all employers with 15 or more employees provide one hour of paid sick time for every 30 hours worked. Workers can also use these days to care for a close relative (child, spouse, or parent), go to doctor appointments, or have medical tests. (At press time, it still hadn't been brought before Congress for a vote, but you can show your support for local campaigns and contact Congress at paidsickdays.org.) Meanwhile, working parents have to navigate their own path.

The Secrets to a Smart Backup Plan

"Many arrangements self-destruct because parents aren't prepared," says Michelle LaRowe, author of Working Mom's 411. "You'd be surprised how many people don't think about the what-ifs ahead of time." In an ideal world, you'd head straight to a center created especially for mildly ill kids (see "Sick-Child Day Care? Yes, It Exists!" below). But most parents will need to consider these strategies.

Create your own village. You may have more available connections than you realize. Ask family members or friends who have a part-time job or a flexible schedule if you can work out a reciprocal arrangement when a backup plan is needed. Chat up other parents at school drop-off, birthday parties, sports events, or church about organizing a backup co-op. And then get everyone together first, of course, to make sure you're comfortable with one another's parenting style and to hammer out specific requests and availability.

It's obviously not easy to ask a parent to care for your sick child—and thereby risk infecting themself and their own family. But if they've ever been in your shoes, they may be willing to help. Take the steps you can at home to help prevent the spread of illness: Have plenty of tissues and antibacterial gel on hand for your sitter; offer disinfectant sprays for germ-catchers like doorknobs, faucets, phones, and remote controls; urge your child to sneeze and cough into their elbow or wear a mask.

Instead of relying on other parent friends, many of whom also work full-time, Melinda Villagran, Ph.D., associate professor of communication at George Mason University in Fairfax, Virginia, took advantage of the perks of her college town. For her backup care, she hired four undergrads who share a dorm suite. "Our agreement is that one will show up when I call," says Dr. Villagran. "I use them regularly. They're all great, so I don't mind which one comes. They like the flexibility, and I have the coverage."

Barter. A single mom for many years, Cathy L. Greenberg, Ph.D., coauthor of What Happy Working Mothers Know, discovered that old-fashioned trading was her lifeline. Since she often traveled for business, on the days her daughter was ill she'd offer to switch sick-child pickup and care for Saturday carpooling to sports practice. "And one time, I even negotiated for dessert," says Dr. Greenberg. "One mother watched my daughter and I later picked up 24 cupcakes for her child's birthday party."

Do triage. At 7 a.m., when you and your spouse are scrambling to get to work, a conversation about who will stay home can easily slide into a confrontation. "Fathers often assume that mothers will be the ones to skip work," says Jessica DeGroot, founder of The ThirdPath Institute, a national organization based in Philadelphia that helps people find solutions to work/life conflicts.

Defuse a power struggle by discussing your concerns and restrictions ahead of time. Beth Brandt, the director of a small charitable foundation in Broomall, Pennsylvania, had a much more flexible schedule than her husband, Lee, an air-traffic controller. "When the kids were young, we'd try to make an educated decision the night before if we suspected that one of them wouldn't make it to school the next day," recalls Brandt.

"If Lee wasn't working the morning shift, he'd stay home. If he had to work, I'd hold meetings via conference calls." Can you and your partner split the day, with one of you going to work late and the other coming home early? Can either of you work over the weekend instead? What about telecommuting? If so, what equipment do you need?

Make your home work-friendly. If you've cleared it with your boss to occasionally conduct business from your house, be prepared for the challenges. "I can't just take the day off when one of my kids gets sick," says Josephine Geraci, a mother of three children, ages 4, 6, and 8, who works from her home in Huntington, New York.

Try her solution: She sets up an air mattress in her office and makes a cozy retreat for her kids. "I provide a stack of books and an activity box so whoever is sick can have an 'office' in the corner of my office," says Geraci. Stock a "surprise box" with new markers, books, puzzles, stickers, and more for your own stuck-at-home child.

Be ready with the details. When you're rushing to make last-minute arrangements, it's hard to recall all that goes into caring for your child. So keep an up-to-date file, including your child's daily routine and a list of prescription or OTC medications they take (with correct dosages), as well as a written medical-authorization release form. This allows a doctor to treat your child if you're not there. Laws vary from state to state, so check with your physician about proper wording.

Sick-Child Day Care? Yes, It Exists!

Get Well Place at Rainbow Station in Richmond, Virginia, a preschool and school-age recreation center for mildly ill kids, is a great Plan B for many working parents.

Founded 20 years ago by Gail Johnson, R.N., a former professor of nursing, Rainbow Station is now a franchise with nine facilities in Virginia, North Carolina, and Texas. The Get Well Place is staffed by a pediatric nurse, who dispenses medication and calls parents with updates during the day. Kids are cared for in separate rooms according to illness (respiratory ailments, such as flu; gastrointestinal illnesses; highly contagious diseases, such as pinkeye and strep throat; plus a room for kids recuperating from surgery). Each is equipped with a reverse ventilation system so no one has to worry that a child with, say, a broken leg, will catch the flu. Fees can range from $5 to $10 an hour depending on location.

Unfortunately, facilities like this are few and far between. Some are located in hospitals or medical centers (such as The Mayo Clinic in Rochester, Minnesota) for their employees only. Others, like Kid's Care at Northridge Hospital Children's Center, in California, are also open to the community. To find a backup-care center near you, contact your local or state social-service agency that licenses day-care centers, or call hospitals directly. "Some have these kinds of facilities but don't advertise them," says Johnson.

Make sure you've got important phone numbers and up-to-date medication information ready for last-minute caregivers.

Even with the Family and Medical Leave Act, parents of seriously ill kids, or those with disabilities that prevent them from being in school, face high hurdles. "Note that you don't have to take the 12 weeks all at once," explains 9to5's Linda Meric. "You can use them even in hour-long increments to take a child to a doctor's appointment. That, combined with short- or long-term disability coverage, may get you through."

Still, most of that time off is often unpaid, which is why the Healthy Families Act (HFA) is so critical, explains Katie Bethell, spokesperson for MomsRising.org, a grassroots organization that champions family-friendly policies. To show your support for HFA, log on to MomsRising.org, sign the petition, and write to your representative or senator. "Health care is such a major hot-button issue right now," says Bethell. "We're hoping this is the year that parents finally get what they deserve."

Originally published in the September 2010 issue of Parents magazine.

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