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Why the American Association of Pediatrics (AAP) Recommends that Students with Lice be Allowed to Attend School

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Updated on July 19, 2020

You may be wondering why your childs school now allows children with head lice to attend. You are trying to protect your child and the school is allowing another student with an active case to be in the classroom. What’s going on at schools today with respect to head lice policies?

Since 2015, more and more schools have dropped their “no nit” school lice policies in accordance with the recommendations from the American Association of Pediatrics (AAP). Whereas, as recently as five years ago, the vast majority of schools were very strict about allowing children with any signs of nits (lice eggs) to attend school, now many schools allow children with live lice to remain in school until the end of the day. This represents a dramatic shift in school lice policy.

Below is an explanation of the reasons for the new guidelines as published

by the American Academy of Pediatrics in the May 2015 issue of Pediatrics (published online April 27):

“Most cases of head lice are acquired outside of school...a healthy child should not be restricted from attending school because of head lice or nits (eggs). Pediatricians are encouraged to educate schools and communities that no-nit policies are unjust and should be abandoned. Children can finish the school day, be treated, and return to school...

Once a family member is identified with head lice, all household members should be checked. The AAP does not recommend excessive environmental cleaning, such as home pesticides..While it is unlikely to prevent all cases of head lice, children should be taught not to share personal items such as combs, brushes, and hats. Regular observation by parents can also be an effective way to detect and quickly treat head lice infestations.”

In its report, the AAP suggests that by the time a case is diagnosed, the student has likely been in the classroom for several weeks, which suggests that it is arbitrary in timing to prohibit a child from attending school once a diagnosis is made. In other words, the child has already had ample opportunity to spread the case, if that were to be. Furthermore, most cases of head lice are spread through direct head-to-head contact and children sitting at desks are not in direct contact with other students. Schools as well as this organization believe that too many children were missing too much school for something that is a nuisance rather than an illness.

Organizations such as the National Pediculosis Association (NPA) in Newton, Massachusetts disagree with this policy. They believe that if a child has an active case of head lice, he or she is contagious and therefore should not be allowed in school. Furthermore, while the AAP makes the point that children with nits only are not contagious, the NPA counters with the argument that nits may hatch at any point and then you will have live bugs in the hair.

It is a complex issue weighing the importance of attending school against the possibility of increasing the number of children with head lice. There needs to be a study conducted to see if the incidence of head lice among children is increasing. The problem is that many children with head lice do not even report it to school and since nurses no longer do head checks in most schools, it is difficult to quantify. Unless, there is data showing that these new policies are contributing towards an increase in lice incidence, schools across the country will continue to adapt more lenient lice policies.

Source: American Academy of Pediatrics

For further reading, including expert opinions on managing head lice, check out this blog "No Nit" Policies Droping Like Flies or call 800-224-2537 for an appointment today.