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Discussion

Chicken or the Egg?

How is it that so many school nurses are all of a sudden willing to let down the guard for head lice? Truth is there are also many others who aren't. Don't get the rationale for it really. What about basic hygiene? Leaving nits is leaving lice to hatch. ??!!

http://www.headlice.org/news/2006/050206_headliceWin.html

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If you are exclusing children for nits, you are denying them their right to a public education (FAPE). No nit policies are neither law nor recommended policy and practice by well established groups such as AAP, NASN and Harvard School of Public Health. According to the research, more than 30% of the children school nurses exclude for nits, do not have nits (they have other small white things in hair), and many of the other 2/3s of the children have hatched nits (following treatment) , not viable eggs.

Head lice do not pose a danger to students, and studies demonstrate that screening for head lice in schools does not decrease the incidence of head lice and is not cost effective.

NASN Position Statement is at

http://nasn.org/positions/2004pspediculosis.htm

Harvard School of Public Health information is at http://www.hsph.harvard.edu/headlice.html (and there's an excellent management chart for schools)

AAP Report is at http://www.aap.org/advocacy/archives/septlice.htm

*21 Surprising Things You Might Not Know About Head Lice*

School Nurse Perspectives

http://www.snp.homestead.com

Our school seems to have a policy somewhat in between. If there are live bugs in the hair- the kids stays home. If there were nits, and the kid still has two or three, but the parents are conscientiously combing them out, we'll let them come back if they're old enough. Kindergartners and preschoolers touch heads constantly- sixth graders not so much, and they can understand it if we say "Don't hug anyone, don't touch heads with anyone, don't share clothes." We've found that the anti-lice shampoo, plus lots and lots and lots of combing, works well.

All the lice cases I've diagnosed have been quite far-gone, with live bugs running around all over the place. If it goes from that to a couple of nits, as long as the parents are continuing treatment and the child is old enough to follow directions, they can come back. Yes, we technically have a "no-nit" policy, but our supervisor is changing it for next year, and has told us to perform exclusions on a case-by-case basis.

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