When kids get lice, two of the most commonly asked questions parents ask are, 1) why wasn’t I notified that lice were found at my child’s school? And, 2) why aren’t kids with lice sent home from school until they are lice-free?
The majority of schools have moved away from ‘no-nit’ policies that require students to stay out of school until they are lice and nit free. The recommendation of the Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics (AAP) and the National Association of School Nurses (NASN) have all stated that no-nit policies should be discontinued.
The past decade has seen a significant shift in the medical and educational communities about how to deal with head lice. Doctors, nurses, and teachers now recognize that head lice do not represent a serious health threat and a case of head lice does not warrant missing valuable school time. Also, while some schools will notify the parents of children that are found with head lice, most schools don’t warn other families because of the panic and blame that often take place.
The policy changes are designed to help keep children from missing class, shield children with lice from embarrassment, and protect their privacy. The CDC lists the following reasons for the change in policy:
Many nits are more than ¼ inch from the scalp. Such nits are usually not viable and very unlikely to hatch to become crawling lice, or may, in fact, be empty shells, also known as ‘casings.’
Nits are cemented to hair shafts and are very unlikely to be transferred successfully to other people.
The burden of unnecessary absenteeism to the students, families, and communities far outweighs the risks associated with head lice.
Misdiagnosis of nits is very common during nit checks conducted by nonmedical personnel.
According to the AAP, “Most cases of head lice are acquired outside of school.” That’s why “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.”
The reality for most school districts is that the effort involved in keeping schools entirely lice-free would be a futile use of their limited resources. The CDC estimates that there are 6-12 million cases of head lice in children between the ages of 3-11. This means that at least 1 in 5 students have lice at any given time. In the early stages of a case of head lice, many children display no symptoms as nits, and adolescent lice, don’t bite and don’t cause the itching sensation that indicates the presence of head lice.
Keeping a school lice-free would require constant checks of the entire student body, which is unrealistic and unnecessary for a condition that is not considered a health problem. That’s the conclusion that the CDC, AAP, and NASN have come to, and many school districts are following these recommendations.
No-nit policies were developed because traditional lice treatments can take several weeks to be effective. The first treatment is designed to kill live lice but doesn’t kill eggs, or nits. Since nits can hatch over ensuing weeks, combing and nit-picking are required with traditional treatment.