Coping with young sick children.


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Content type
Family Matters article

April 1991


In addition to finding child care, a problem for mothers in the workforce is the care of children who are sick during the mother's usual hours of work. The Institute's Early Childhood Study provides information from 591 working mothers on: who cared for their children when they had been sick during working hours; their attitudes to sharing sick child care with fathers; mother's feelings about care arrangements; how the care of sick children could be made easier. Discussion of findings is followed by three case studies, which demonstrate the variety of child care arrangements in the preschool years, and the difficulties faced by some working mothers. The article includes brief information about care of sick children overseas, and concludes that 'the most comprehensive solution to the problem is some sort of official parental leave which does not jeopardise the employment situation of parents'.

AIFS Researchers Gay Ochiltree and Evelyn Greenblat present some key findings from Stage Two of the Institute's Early Childhood study

One of the most marked changes affecting children in the last decade has been the increasing numbers of mothers entering the workforce, particularly mothers of pre-school children. In June 1990 the rate of participation of mothers with children in the 0 - 4 age group reached 46 per cent, of which 27.9 were working part-time, 14.4 per cent full-time and 4.0 per cent were unemployed. Maternal workforce participation rates increase as children get older and in 1989 stood at 69.5 per cent for mothers of children in the 5 - 14 age group, with 34.9 per cent of mothers working part-time, 30.3 per cent full-time and 4.3 per cent unemployed (ABS 1990).

Women's workforce participation has become imperative in recent years as many families now need two incomes for living costs and to bring up their children. As a consequence, child care becomes a central concern. In Stage One of the Institute's Australian Early Childhood study it was found that the child care arrangements of mothers in the workforce in the child's pre- school years were varied, with more mothers using informal care than formal (Ochiltree and Edgar 1991). In the last few years the government has increased the number of places in formal child care (family daycare and centre-based care) but the need has far outstripped availability, particularly for infants and toddlers. Compromise, making-do and ingenuity have often been needed to make arrangements for the care of children, and frequently arrangements have changed over the years.

In addition to finding child care, a problem for mothers in the workforce is the care of children who are sick during the mother's usual hours of work. Australia has no mandated leave allowing parents to care for their sick children; working mothers have to solve the problem as best they can. Kahn and Kamerman (1987:190) referring to the United States (a country in a position similar to Australia's in regard to the care of sick children), sum up the situation:

Many parents, even when they manage to find an affordable, reliable, and satisfactory child care arrangement, still speak with a kind of horror when they describe their fears about a child getting sick on a work day. While most employers permit time off when an employee is ill, very few companies specifically allow the use of those same sick days to care for an ill child. Furthermore, many employees who would return to work after the acute phase of a child's illness is past cannot do so because they are unable to make arrangements for their child to be cared for while convalescing.

When a child presents symptoms, parents may find it difficult to decide if the child is really ill or if the illness is mild or severe. These decisions are particularly difficult for women in the workforce; they must decide if infants and toddlers are actually ill or whether symptoms are due to teething or a reaction to new foods. They must not only consider whether the illness is mild or serious but whether it is still developing or has progressed as far as it is going to. Mothers in the workforce must often make these decisions in a hurry when the child becomes sick in the night or has symptoms first thing in the morning.

The Institute's Early Childhood Study provided an opportunity to find how mothers in the workforce had coped with the care of their pre-school children (in their first year of school at the time of interview) when they were sick during working hours. Of the 728 mothers interviewed, 591 had been in the paid workforce at some time between the birth of the child and the time that child started school. Not all these mothers worked continuously or full-time; some were in the workforce for short times only.

Who Cared for Sick Children?

The 591 mothers were asked several questions about how they had usually cared for their children when they had been sick during working hours.

Almost 57 per cent of mothers usually took time off to care for their children if they were sick during their usual working hours. In only 7 per cent of cases was father the usual carer. Relatives, mostly grandmothers, usually cared for sick children in 17 per cent of cases, and about 15 per cent of children, mostly in informal care, remained in their normal child care arrangements. However, many of the mothers who usually took care of sick children themselves sometimes used other carers, including fathers. The decision about who should care for the child often depended on the perceived severity of the illness, whether other carers were available, and sometimes on the amount of personal leave due to the parents. While fathers played some part in the care of sick children, mothers took major responsibility, deciding how ill the child was, making arrangements accordingly and generally orchestrating the situation. (See Helen Glezer's article 'Juggling Work and Family Commitments' elsewhere in this issue.)

When mothers were the usual carers, they summed up their situation as follows:

'I'd always take time off to look after him, even if it meant loss of pay. Nanna sometimes helped if he was not too sick.'

'I would take them to work if it was a minor illness and put them in the back room and have them play under the big table and not move from there all day. If seriously ill, as when S had operations, then I took time off work.'

'One of us [husband or wife] would not go to work that day - generally me.'

'My husband and I took it in turns depending on who had sick leave owing. We still do that.'

When the usual carer was a relative, mothers responded as follows:

'When E was sick I had no choice - I had to get Mum or Dad down from the country. Doctors won't give you time off to look after your child. Or you have to take a "sickie". It's a really horrible situation but you've really got no choice.'

'My mother minded her. It depended how sick she was. If it was more than just a cough I would stay home.'

'His grandmothers would come - both lived nearby. I looked after him at first but I couldn't get any more time off work - I'd had six weeks off before July, and they intimated that it was either the job or the child. We had to make a compromise.'

Some children remained in the usual child care arrangement when they were sick. Mothers coped differently according to whether that arrangement was informal or formal care:

'If she was sick the babysitter would still take care of her.'

'Grandmother took care of R regardless of illness.'

'I gave her antibiotics and quickly tried to make her better and sent her to her care. I had little choice. It was very hard to get leave. The child was often ill and often caught things off other kids in care. I couldn't complain. I had nowhere else for my sick child.'

'In family daycare she wasn't sick. During her creche year they had a sick room.'

A few mothers (2 per cent) were able to care for their sick children themselves without taking time off work because of the flexibility of their working hours. These mothers were usually working part-time or casually or had some flexibility built into their working hours.

Attitudes to Sharing Sick Child Care

Mothers' attitudes to the sharing with fathers of the care of sick children was found to be largely at odds with what actually occurred when children were ill. Almost all mothers agreed with the statement: 'If a child gets sick and both parents are working, the man should be just as willing as his wife to stay home from work and take care of the child'.

A Canadian study (Northcott 1983:393) also found that while attitudes to sharing the care of sick children had changed, mother continued to be the the person who usually stayed home with the child:

The behavioural realities reflect a traditional division of labour. While people say that men and women should share equally in caring for children, in fact when a child is ill and when parents work it is the female parent who is by far the most likely to stay home from work to care for the sick child. This is true whether she works part- or full-time outside the home ... In terms of actual behaviour, a traditional division of labour is still much in evidence when trade-offs between paid employment and child care are necessary.

It is interesting to note the discrepancy between action and attitude. However, this discrepancy is likely to be as much to do with the workplace as with fathers' attitudes and willingness to care for sick children. As Kahn and Kamerman (1987) point out: 'For many parents, an ill child means that whichever parent has "the less important" job, or the more flexible job, or the more sympathetic boss or supervisor will stay home.' Fathers are more likely than mothers to be working full-time and to be earning higher wages, while mothers are more likely to be in part-time or in casual employment and earning less than their husbands; mothers therefore are more likely to be seen as having the 'less important job'and this will reinforce traditional sex role behaviour in caring for sick children. Furthermore, it is also likely that employers are more likely to accept mothers caring for sick children rather than fathers taking time off from work. (See Ilene Wolcott's summary of what employers say about workers with family responsibilities, elsewhere in this issue.

Mothers' Feelings About Care Arrangements 

Nevertheless, most mothers were happy about the arrangements they actually made to care for their children when sick. This may appear to be at odds with the difficulties many faced in making these arrangements, but most mothers felt that the main thing was that the child was safe and well cared for.

However, about 12 per cent of the mothers reported feeling guilty and tense over the arrangements they had made for the care of their sick children.

(When mother took time off) 'I felt awkward. I felt responsibilities to work and to the child - - "torn" is more the word. That's the big bug-bear of working if you have children, especially if they're not very ill. You take time off and half an hour later they're up and running around and you get annoyed with them. I think working mothers tend to send their kids back quicker than others. If they recover quickly when they do stay at home, next time you send them to care and then get a telephone call saying your child is sick. The problem is in the morning when the child says they are sick and you have only ten minutes to make a decision about what you're going to do.'

(When mother took time off) 'I was always the one taking time off from work with D being sick, so I was always under stress from the work area as well as being in a situation where I also had to look after my son. I was quite happy to look after my son but I always lost wages, so that was another hardship - especially if I lost wages and I'd utilised my sick pay.'

(When father took time off) 'I would worry. I'd ring up and check several times to see how he was.'

(When parents took own sick leave, uncertificated) I felt guilty about having to lie to employers, but happier that a parent instead of a stranger was caring for her.'

Almost 10 per cent of mothers felt they had made the best arrangements possible under the circumstances but that it had not been easy or always convenient.

(Sister or mother) 'Both my sister and my mother were superb with him, but in terms of inconvenience it was real hassle. I had to go out of my way before getting to work and that was after organising it. Neither of them were sitting at home waiting to look after him.'

(Usual carer) 'Not very happy at all. It's all I could do - hope for the best.'

(Grandparents) 'I was satisfied with grandparents' care, but I feel the workforce doesn't cater for children in any way at all. It caters for men. In the industry where my husband works there are no allowances whatsoever for anything to do with children - no on-site arrangements or anything.'

Making the Care of Sick Children Easier

Mothers were asked for suggestions that would make the care of sick children easier (they could make more than one suggestion). The greatest proportion of suggestions concerned the workplace: leave from work (41.2 per cent), more understanding, support from employers and flexibility in the workplace (25.1 per cent), and workplace care with facilities for sick children (7 per cent). The following suggestions related to the workplace:

'More flexible sick leave arrangements - additional leave for parents with young children.'

'It boils down to the employers. They must realise that mothers have to work and allow them to take off so much time each year to care for a sick family member - - say, four days special leave with pay. Where a longer time is needed, for chicken pox for example, mothers should be allowed to take time without pay for the period the doctor states.'

'Employers should be more understanding towards mothers with young children. Mothers and fathers should be able to take special sick leave, with or without pay, for when a child is sick.'

'Society views this from the wrong angle - they resent women taking maternity leave. They see it as giving women a paid time off instead of a scheme established to assist the child - it's for their sake. Similarly they should provide sick leave, not for the mother's sake but for the child's sake.'

'There should be a certain number of days per year for when you have a sick child. I don't know how people do it. I have friend who goes to work when she's sick so she can have her days free when her child is sick.'

'You should get time off. It should be exactly like sick leave for workers. It should be given as an extra on top of your own sickness entitlement, or else greater flexibility with holidays. The way my work was, I couldn't get leave without going through lots of people and virtually experiencing an inquisition. That shouldn't be. You should be able to just say "my kids are sick" and get leave without heaps of paper work.'

Although some mothers said they had no suggestions about ways to make it easier to care for sick children, their responses clearly reveal the belief that sick children should be with their mothers:

'I feel if a child is very sick he needs his mother to be with him.'

'I cannot make a suggestion but I reckon the family comes first. If ever I have a sick child I might skip work and attend to my child first.'

'I think that when you have a sick child you want to be at home with that child. I think that's something you and your partner have to come to terms with.'

There were also a number of other suggestions such as centres with special facilities for the care of sick children, work-based care, and workers who could care for children in their own homes; one mother suggested an 'adopt a granny' program.

Sick Children and Child Care in General 

Care of sick children during the pre-school years is not an isolated issue for employed mothers; rather it is one aspect of the difficulties often involved in arranging child care. The arrangements that are made for child care vary considerably depending on family income and the costs involved, the age and number of children, the availability of informal care by relatives or others, the availability of child care places in formal care, whether mother works part-time, full-time or does shift work, and mothers' beliefs about the care of young children.

The following case studies of three children aged six years, taken from the Institute's Early Childhood Study, give some of idea of the variety of child care arrangements in the pre-school years and the difficulties faced by some working mothers. These cases show how the care of sick children fits into the total child care picture, and they demonstrate the interplay of the factors mentioned above which affect child care arrangements, and the extent to which mothers have choices.


Peter's parents are European migrants who had been in Australia for 16 years. When they arrived mother was pregnant and all they owned was a suitcase and five dollars in cash. Peter was six years old at the time of the interview and his older brother was sixteen. His mother was a shop assistant who had returned to work full-time when he was nine months old and father was a plumber. Mother said she had returned to work because 'we were building here and I needed the money'. Peter was cared for first by a friend who had previously cared for his elder brother, and then by his grandmother when she arrived from Europe for six months. When she left he went to a local private creche.

When asked about care when he was sick, mother said: 'Sometimes my husband would take time off or I would take sick leave. If he just had a runny nose he would go to creche anyway, or infected ears - - go to creche.' However, she said: 'I sometimes felt awful sending him when he wasn't well. He had a lot of trouble with his ears.' She had no suggestions that would make it easier for mothers in the workforce when their children were sick other than 'not to work if they can afford it; it is best to stay with the kids'.

The family now owns a comfortable home and mother works part-time. She regrets that she had to spend so much time away from her son when he was younger. Peter has not been sick since he started school but mother will stay at home with him if this happens.



Mother has worked part-time in the local pharmacy since before six year-old Janine was born (Janine also has a five year-old sister). Mother worked part-time because if she had worked full-time the costs of child care for two children would have taken up most of her salary. Over the years Janine and her sister were cared for in the homes of several different family members, by friends, and by their own father at home; arrangements have depended on the availability of carers at the particular time. No costs have been involved but sometimes it has been difficult to make arrangements. At one stage another woman minded the children in their own home and their mother paid for this care by babysitting for the other woman.

If Janine was sick she was usually cared for by one of her grandmothers. Mother did not have any suggestions about making the care of sick children easier for mothers, saying 'there's no answer and no remedy'. Mother found that she herself had benefited from having the little bit of extra money, some independence and intellectual stimulation; however in the last couple of years she has worked shorter hours than she did when Janine was younger. Since Janine started school mother has mostly cared for her if she has been ill.




Mother returned to work full-time when Paul (aged six) was ten months old. She worked full-time because her employer would not allow her to work part-time. Paul was placed in family daycare because his parents did not like centre- based care with more than one carer and imposed routines. Nevertheless, Paul had five different carers before he went to school. Mother has had another child who was 18 months old at the time of the interview. During her time off work for the birth of the second child she was able to care for Paul herself but she has now returned to the workforce. When she first went back, a friend looked after both children until there were places for them in family daycare.

If Paul was sick during working hours both parents shared the care, but mother said that the split was: 'Probably 25 per cent husband, 75 per cent myself. We haven't a big problem here really as both of us have sick days, rostered time off and time owing. But I envy next door - - a couple who have grandparents for their children, who are younger in age and more physically able.' Paul's mother had nobody to fall back on in an emergency. Arrangements she had made when the boy was sick made her feel 'uneasy' as far as work was concerned. 'I remember the time the doctor put "fatigue" on my certificate. I wasn't sick but he had to give a reason. Admitting to fatigue is like admitting that you can't cope with your job. It rebounded. The chief executive came down to discuss my position, it was tantamount to getting the "push". You should be able to ask for time off for sick children and not be made to feel guilty.'

She thought the idea of family leave should be universal. 'This could be used for a multitude of problems - for example, to go to specialists. Dads should get it too.'


The majority of employed mothers in Stage Two of the Institute's Early Childhood Study wanted some change in the workplace or their working conditions which would make it easier to care for sick children. Many wanted either some special form of leave or the right officially to take their own sick leave, while others wanted employers to have more understanding of their situation.

The most straightforward solution would be a policy of mandated leave which could be taken by either parent. The average number of days taken by Swedish parents to care for sick children (about eight per year) indicates that there is not an enormous loss of work days through such a system, bearing in mind that many parents are already taking leave by various means.

Parental leave to care for sick children is also in keeping with International Labour Organisation (ILO) Convention 156, Workers with Family Responsibilities, ratified by Australia in March 1990, which states in Article 3:

With a view to creating effective equality of opportunity and treatment for men and women workers, each Member shall make it an aim of national policy to enable persons with family responsibilities who are engaged or wish to engage in employment to exercise their right to do so without being subject to discrimination and, to the extent possible without conflict between their employment and family responsibilities.

Present difficulties in the care of sick children where both parents are employed is clearly an instance of conflict between family responsibilities and employment.

Parental leave best suits the needs of sick children as well as the needs of parents. According to Fredericks and others (1986), care is best when provided by someone the child already knows, and when it is provided in a place the child already knows, where he/she feels comfortable. Recommendations by the European Childcare Network (which consists of 12 countries including the United Kingdom) for the Commission of the European Communities, is quoted by Phillips and Moss 1989:

There should be leave for family reasons, to enable parents to take time off work to undertake essential parental duties, including the care of sick children; taking children to medical appointments; settling children into new childcare arrangements ... [the report] proposes a period of ten days leave per parent per dependent child would be an appropriate period, with the possibility of transfer of entitlement between parents, and a double entitlement for lone parents.

Nevertheless, there are times when mothers require additional assistance for their sick children. Some mothers in the Institute's Early Childhood Study suggested emergency creche facilities for sick children and others suggested health care workers to care for children in their own homes. Both are available in other countries so that mildly ill children, convalescent children, and those whose parents cannot care for them themselves have alternatives available (Fredericks and others 1986).

In the United States there are a number of schemes catering for sick children, mostly paid for by parents. There may be some in existence in Australia also, although attempts to find any have so far proved fruitless. The schemes include: hospital care in a special section set up for the care of sick children on a daily basis; care integrated into the regular program at the child care centre stressing hygiene techniques to prevent cross infection; care in centres using a sick bay or a family daycare home specially set up for the care of sick children from a particular centre, or for mildly ill children from the general community; agency provision of specially trained staff who care for children in their own homes, or an aide who works in a particular centre who takes the sick child to his/her own home and cares for them there (Fredericks and others 1986). Before the parental leave scheme which now exists in Sweden some local councils employed 'samaritans' who looked after sick children in their own homes (Leijon 1968).

Sick children are a problem for many families where both parents are employed. Some parents have no-one to fall back on in an emergency, and if they cannot care for their children themselves must send them to their normal care although they are unwell. Even where available, care in special centres or by specially trained staff in the child's own home are all likely to cost money (sometimes in addition to the cost of usual care) and are likely to be outside the resources of many families. The most comprehensive solution to the problem is some form of official parental leave which does not jeodardise the employment situation of parents.


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