Can my child go to daycare with strep throat?
Not until antibiotics have started working: in Texas, a child with strep throat can go back 24 hours after the first dose, once they’ve also had no fever for 24 hours without fever-reducing medicine. The American Academy of Pediatrics and California’s health department say 12 hours after the first dose is enough.
Updated Oct 16, 2026. State rules and national guidance, not medical advice: if you’re unsure, call your child’s doctor.
Return to daycare: Texas, national (AAP) and California rules
| Texas centers | National standard (AAP) | California centers | |
|---|---|---|---|
| Stay home? | Yes. | Yes. | Up to the center. State guidance says at least 12 hours of antibiotics before going back; UCSF’s child care program says 24 hours. |
| Back when | 24 hours after starting antibiotics and 24 hours without fever or fever-reducing medicine. | 12 hours after the first antibiotic dose. | When the center’s policy allows. |
| Doctor’s note | Likely: a child a doctor diagnosed needs documentation that they’re no longer contagious. | No. | Only if the center’s policy asks for one. |
Texas: 25 TAC §97.7(a)(26), applied to centers by §746.3603; §746.3601(4). National: AAP quick-reference sheet; HealthyChildren.org. California: CDPH symptom guidance (2023); UCSF CCHP (Dec 2025). A Texas child sent home sick may also come back after 24 hours without symptoms or with a health professional’s statement (§746.3606). California leaves illness rules to each center’s written policy; its column is the state health department’s guidance.
How it spreads and how long it’s contagious
- Strep throat is most common from age 5 to 15 and rare under age 3. Toddlers with strep more often have a runny nose, fever and fussiness than a sore throat, and the AAP doesn’t recommend testing children under 3.
- Signs include a sudden sore throat, pain swallowing, fever, red swollen tonsils, white patches, tiny red spots on the roof of the mouth and swollen neck glands. A cough or runny nose points to a virus instead.
- Antibiotics quickly cut how contagious it is; the CDC says children can go back once well and at least 12 hours after starting them, and suggests 24 hours during an outbreak.
Sources: CDC: strep throat; CDC: clinical guidance.
When to call the doctor
- Heavy drooling, a muffled voice, trouble swallowing or trouble breathing: get care right away
- A severe sore throat with a rash
- A severe sore throat that lasts more than 24 hours
Sources: CDPH; AAP. Call 911 if your child is struggling to breathe, turns blue or is hard to wake.
What the center has to do
Both states have general rules on sending sick children home and on telling Licensing and parents about outbreaks, and a center’s own written illness policy can be stricter: ask for it at enrollment. The Texas and California rules →
What the state records show
No sick-child or outbreak citation at a Texas or California center licensed today names strep throat, and no California complaint does. See all sick-child citations in the sick-day guide.
Common questions
How long after antibiotics can a child go back to daycare with strep?
In Texas, 24 hours after the first dose and once they’ve had no fever for 24 hours without medicine (25 TAC §97.7). Under the AAP’s national guidance and California’s health department, 12 hours after the first dose.
Can toddlers get strep throat?
Rarely. The CDC says strep throat is uncommon under age 3, and the AAP generally doesn’t recommend testing children that young.
Does the daycare have to tell other parents about strep?
Not for a single case under Texas or California rules. In California, two or more children with strep are an outbreak the center must report to Licensing, the local health officer and parents (22 CCR §101212). Texas Licensing cites centers under its notice rules for not reporting an outbreak or not telling parents in writing. UCSF’s child care program recommends telling families even after one case.