Your child wakes up with crusty eyes, red eyelids, or yellow-green gunk in the corner of their eye. Sound familiar? Conjunctivitis – commonly known as pinkeye – is extremely common in young children. But now you're left wondering: can my child go to childcare today? Or do I need to stay home and rearrange my work schedule? In this article, you'll learn exactly what the different causes are, how contagious it is, and most importantly: when you can bring your child back.
What exactly is conjunctivitis?
Conjunctivitis is an inflammation of the conjunctiva, the thin transparent layer that covers the eyeball and inner surface of the eyelids. It makes the eye red, irritated, and can cause unpleasant discharge. In babies and toddlers, you see it frequently because their immune system is still developing and they touch their face a lot.
There are three main causes, and these largely determine whether your child can attend childcare:
- Viral conjunctivitis: caused by a virus, often alongside a cold. The eye is red and watery, sometimes mildly irritated. This is the most common form.
- Bacterial conjunctivitis: recognizable by thick, yellow-green pus-like discharge that glues the eyes shut, especially overnight. It often starts in one eye and spreads to the other.
- Allergic conjunctivitis: itchy, red eyes with watery discharge, usually in both eyes at once. Caused by allergens such as pollen, dust mites, or pet dander.
How contagious is conjunctivitis?
This is where the causes differ. Viral and bacterial eye infections are contagious, especially through direct contact with hands, towels, or toys where infected fluid is present. Children rub their eyes and then grab everything – ideal for spreading at a daycare center (kinderdagverblijf/KDV) or after-school care (BSO).
Allergic conjunctivitis is not contagious. Your child can attend childcare as normal, although it may be uncomfortable if symptoms are severe.
An important point: with viral and bacterial forms, your child is often already contagious before the eyes become noticeably red. This makes it difficult to completely prevent outbreaks, even with strict hygiene in the group.
What does the RIVM say about eye infections and childcare?
The RIVM (Dutch National Institute for Public Health and the Environment) has specific guidelines for childcare regarding infectious diseases. For conjunctivitis, the following applies:
- Bacterial conjunctivitis: your child may return to childcare after treatment with antibiotic eye ointment or drops has started and your child's general condition is good. The pus production then decreases quickly. This is usually within 24 hours of starting treatment.
- Viral conjunctivitis: there is no specific treatment. Your child may attend childcare if they feel reasonably well and the heavy watery discharge has decreased. With severe symptoms or fever, keeping them home is sensible.
- Allergic conjunctivitis: no restrictions, unless your child is so uncomfortable that they cannot console themselves or get through the day.
Just like with chickenpox at childcare, the childcare worker doesn't just look at the diagnosis, but especially at how your child feels and whether they can handle the group dynamics without requiring extra one-on-one care.
When will childcare call you to pick up your child?
Childcare may ask you to pick up your child if:
- the eyes produce so much pus that it jeopardizes hygiene in the group
- your child is severely irritated and constantly touching their eyes, making spread likely
- there is accompanying fever or your child is clearly ill
- the childcare worker feels your child needs more rest and individual attention than is possible in the group
Every childcare location may apply its own house rules within the RIVM framework. Some daycare centers are stricter with bacterial eye infections and explicitly request a doctor's note or visible start of treatment. Check this in the illness policy of your childcare provider so you won't be caught off guard.
At home: what can you do yourself?
Whether your child can attend childcare or not, there's plenty you can do at home to make them more comfortable and limit spread:
- Clean the eyes with clean, lukewarm water and a fresh gauze pad or cotton pad. Work from the inside out and use a clean piece for each eye.
- Wash hands – yours and your child's – regularly and thoroughly, especially after touching the eyes.
- Don't use shared towels or washcloths during the eye infection.
- Keep your child from rubbing their eyes – easier said than done with toddlers, but important nonetheless.
- Don't use over-the-counter eye drops without consulting your GP, especially not for babies.
When should you call the doctor?
Call your GP if:
- your baby is under 3 months old and has an eye infection
- your child has severe eye pain or avoids bright light
- the eye infection doesn't improve after 2-3 days or gets worse
- there is blurred vision or your child complains about reduced sight
- the skin around the eye is also red and swollen
- your child wears contact lenses (even if it seems like child's play)
In babies, extra caution is needed because an eye infection is sometimes associated with a blocked tear duct, which requires a different approach than an infection.
How do you prevent the whole group from getting infected?
Strict hygiene rules apply at childcare, but as a parent you can also do your part. Always report the eye infection to the childcare worker, even if you think it's "just a bit red." This way, childcare can be extra alert with hygiene measures and inform other parents if an outbreak is imminent.
Similar to hand, foot, and mouth disease, early communication is essential to limit spread within the group. Childcare can then, for example, pay extra attention to hand washing and keeping shared toys clean.
What if your child frequently gets conjunctivitis?
Some children are prone to recurring eye infections. This can be due to:
- a chronically blocked tear duct (common in babies)
- allergic constitution
- nasal and sinus problems affecting the eyes
- an immune system still in full development
Discuss with your GP whether referral to an ENT specialist or ophthalmologist would be useful. For childcare, it's helpful if you report this, so they know there is no acute infection putting the group at risk.
Conclusion: how to practically handle conjunctivitis
Conjunctivitis is annoying, but usually harmless. The most important distinction lies in the cause: bacterial, viral, or allergic. The RIVM bases its guidelines on this, and childcare bases its policy on this. For bacterial eye infections, return is after starting antibiotic treatment; for viral, when symptoms decrease and your child feels reasonably well. Allergic conjunctivitis is not contagious and presents no barrier.
Yet there remains a gray area: sometimes your child feels unwell while the eyes are already less red, or vice versa. In that case: consult with your childcare provider and trust your parental instinct. An extra day at home is no disaster for anyone, but unnecessary absence isn't needed either.
Want to know how your childcare provider handles illness and hygiene? On Kiddie.nl you can easily compare locations in your neighborhood, including their illness policy and Municipal Health Service (GGD) inspection reports. This way, you choose a childcare provider that fits your family with confidence.
