Docs Nix "No-Nit" Lice Policy in Schools

Kids with head lice shouldn't be forced to miss school and "no nit" policies, like those of the Mill Valley School District, should be abandoned, according to a new report from the American Academy of Pediatrics.

The report appeared in the journal of Pediatrics, and is the first update to the academy's head lice guidelines since 2002. It emphasizes that "no-nit" policies, which require kids with lice to stay home as long as they have any evidence of an infestation. Nits are the empty casings left behind by lice once eggs hatch.

"No healthy child should be excluded from or allowed to miss school time because of head lice," authors Dr. Barbara Frankowski and Dr. Joseph A. Bocchini wrote. "No-nit policies for return to school should be abandoned."

The report could force many school districts to examine their head lice policies. The Mill Valley School District's policy states: "If live nits or lice are found, the student may be excluded from attendance and parents/guardians shall be informed about recommended treatment procedures and sources of further information."

"Excluded students may return to school when (1) they bring a note from the parent/guardian verifying treatment, and (2) reexamination by the nurse or designee shows no live nits or lice," the policy continues.

Mark Barmore, the district's director of students support services, had not yet seen the report when contacted, but said the prominence of the journal suggest that the report deserves a review.

"This is an issue that's near and dear to school districts everywhere and we will take a look at it and evaluate how it impacts our policies going forward," Barmore said.

Head lice affects up to 12 million kids in the United States every year, according to federal health officials, and as much as $1 billion is spent annually on treatment.

Adult lice are about the size of sesame seeds, but often hard to spot because they can move around the head quickly. Easier to spot are nits -- small, empty egg casings that look like they could be dandruff but are stuck on to the root of the hair.

But the presence of a few nits doesn't mean that a child has full-on infestation, the authors note. Instead of checking a whole class or school for lice, parents or a school nurse can check kids when they might be at a higher risk for getting lice, such as after a sleepover.

The report includes a number of additional positions, including urging pediatricians to take an active role in the management of lice because parents might not always know the best treatment, or if treatment is really necessary.