Lice at school? The big debate

A longtime policy of sending children home if they show any sign of lice or nits is gradually changing in Washington state and across the country, but not without resistance.

For decades, many schools have had a strict "no nits" policy, directing that a child with lice or lice eggs be sent home until the problem is completely corrected.

But health officials and educators worry that too much missed school may pose a greater harm.

Last year, the American Academy of Pediatrics (AAP) urged that if a child has head lice, a parent should be notified with a note or a phone call, and that, after treatment, the child should be allowed to return to school, even if the child still has nits.

"No healthy child should be excluded from or allowed to miss school time because of head lice. 'No nit' policies for return to school should be discouraged." said the AAP's Committee on School Health.

Seattle schools are moving in that direction, said Jill Lewis, head of the district's nursing department. "The real thing we need to change is this inclination to send kids home after they've been treated and still have eggs." At that point, she said, the nits are likely dead.

But this is a sensitive issue, particularly for parents of other children, Lewis said. "People don't want to have bugs on their bodies or on their children's bodies; and they don't want their home infested with them," she said.

Nationally, the AAP's position "has created something of a backlash and nurses are hearing about it," said Marilyn Fenn, Washington state's representative to the National Association of School Nurses. A task force of the nurses' group will be meeting with the AAP to find a common position on the issue, Fenn said.

"I think we need a middle ground," she said. "I think it is ridiculous to send a kid home with one nit or two nits ... but on the other hand, there are times when you need to say to a parent, 'You need to take care of this problem.' "

Fenn, school nurse for the Chehalis School District, is a veteran of the battle against lice. She's seen as many as two dozen live lice and a couple hundred nits on a single child's head. Fenn said nurses worry that a national policy allowing kids with lice to stay in school could send the wrong signal to parents, discouraging them from fighting the problem at home.

Jack Broom: 206-464-2222 or jbroom@seattletimes.com