Head Lice School Policies Causing Heated Debates Across the U.S.

woman and man standing back to back, appearing to be in disagreement

Should children with head lice and or eggs (nits) be allowed to go to school? The topic is one facing school districts across the country. It is a lightning rod topic among parents, many of whom have dealt with the growing problem of head lice with their children and or fear that their children will contract a case of it from classmates. Parents whose kids have missed days of school due to head lice infestations are highly frustrated as are parents who have spent money and/or time eradicating lice only to have their child re-infested from a classmate.

Until recent years, almost every public school system had a "no nit" policy in place. This meant that if a child was discovered to have lice or nits, he or she was sent home from school. In April 2015, the American Association of Pediatrics (AAP) issued the following statement on head lice vis a vis school attendance policies

“Most cases of head lice are acquired outside of school. In the report, the AAP continues to recommend that 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.” (Source: A.A. of Pediatrics)

Since then schools, citing this recommendation, have become more lenient in terms of admitting students to school with nits. In the past 3 years, the number of schools dropping "no nit" policies has accelerated.

On one side of the debate are organizations and parents who want “no nit" policies. Their argument is that "no nit" policies help to contain the spread of head lice. The National Pediculosis Association (www.headlice.org), an advocacy organization that has been around for 35 years, is opposed to “no nit” policies. They plainly state on their web site:

The National Pediculosis Association, recommends the No Nit Policy as the public health standard intended to keep children lice free, nit free, and in school.They go on to say, “Opponents of No Nit Policies say that "overzealous" enforcement can lead to inappropriate exclusion of children with residual nits, but whose infestation has otherwise been "treated." Those who judge enforcement to be "overzealous" may not consider the broader public health values and preferences of the community. Few who oppose the No Nit Policies would accept infestations for themselves or for their own children. Without the No Nit Policy, communities are left with a hit-or-miss approach. Indifference about adopting a standardized management protocol permeates the attitudes of health professionals at every level. This in turn gives way to a maze of conflicting opinions and directives that are counterproductive”. (Source: NPA)

Those against "no nit" policies, like the AAP and the National Association of School Nurses, maintain that this policy is ineffective in preventing the spread of lice and that too many children are missing too much school due to lice.

LiceDoctors recommends

That schools maintain 'no nit' policies while applying the rule of reason. It is not reasonable for schools to allow students who are infested with bugs to return to school. No parent wants to send his or her children into a classroom where students are rife with lice, as lice are so contagious. Nits, on the other hand, are not contagious. When a child is treated for head lice by a reputable professional and put on a follow-up treatment plan, the child is at very low risk of being contagious even if a few nits remain on the hair. (Nits are not contagious—only mature bugs are). The reason that we support “no nit” policies is that you don’t know when those nits will hatch and bugs will emerge. Baby bugs are not contagious until they mature. If just a few nits remain in the hair, it is safe for child to return to school, assuming that she is doing some follow-up plan at home (caveat: chemical treatments are generally ineffective in eradicating nits and killing super lice). A child who is heavily infested with nits is just too at risk of transmitting lice when those nits hatch.

Some schools have tried abolishing “no nit” policies only to return to them as a better option. Given the prevalence of head lice in schools and the visceral reaction it causes among parents versus the number of missed days of school, it appears likely that this issue will continue to be debated for years to come.