Barbara Finlay remembers 1986 as a difficult year for her family. Her 3-year-old son, Travis, who had just started preschool, always seemed to get sick.

The illnesses were not major, just the normal fevers and viruses children pick up. But Finlay and her husband both work, and last year they each took five days off to care for their sick son.

Neither parent is allowed to use sick leave for an ill child. Finlay, a benefits manager at Communications Satellite Corp., used vacation time. Her husband, Peter, an Army biological researcher at Walter Reed Army Institute of Research, took annual leave.

Yet there are times when Travis is sick and neither parent can stay home. Like most families, the Finlays must rely on friends, neighbors and relatives for help.

There are few options for working parents in this situation. Day care for a mildly ill child, one who is recovering from a cold or a case of the chicken pox but is still too sick for regular day care, is an alternative that communities and parents are just beginning to explore.

The average parent misses a minimum of three work days per year because of sick children, according to studies by Work Family Directions, a Massachusetts-based consulting firm that advises corporations on issues affecting work and family life.

Nationwide, 45 percent of women with children under age 6 have jobs outside the home. In the Washington area, 56 percent do, and that is among the highest rates in the nation, according to the Metropolitan Washington Council of Governments.

"Employers as a group are not very sympathetic to this problem," said Dr. Patricia Fosarelli, assistant professor of pediatrics at the Johns Hopkins Hospital in Baltimore. "Almost every child at some point gets sick, and working parents have difficulty with this."

Jan Pagliasotti, sick-care coordinator for Work Family Directions, estimates there are 70 to 80 programs nationwide that provide care for children with mild illnesses.

The programs vary widely. Some regular day care centers have separate rooms for sick children. In some cities, whole centers have been established for children with mild illnesses. In some hospitals, pediatric wards set aside space. And there are home programs, in which a person trained in child care comes to the home. "This is the option parents feel most comfortable with," Pagliasotti said.

Although none of these programs exists in the Washington area, several are in the planning stages.

Critics worry that children will become even more distraught if they are taken to strange surroundings when they are not feeling well, Johns Hopkins' Fosarelli said. "Some people might criticize this and say it is an emotional response, and I would agree because that is how the child is going to react."

Another problem is cost. A good center for sick children will have health professionals on the premises, Fosarelli said, and this escalates the expense. Depending on the program, costs can run up to $50 a day. In the winter, there is a greater need for services; staffing to meet this need gets expensive, said Work Family Directions' Pagliasotti. For a person to come to a family's home, costs can range from $6.50 to $7 an hour.

Programs in regular day care centers that set aside space for sick children tend to be the most cost effective, Pagliasotti said. But critics say this spreads germs to the healthy children.

A center for sick children needs to be run like an infirmary, with nurses and doctors and not child care people, said Dr. Jonathan B. Kotch, associate professor in the department of maternal and child health at the University of North Carolina School of Public Health.

Some sick care centers are affiliated with a place of employment. "One advantage," said Hopkins' Fosarelli, "is you can go and visit the child at lunch and on your break. This is a popular one, but employers are not eager to pick up on this because they worry about legal liability."

While most people agree that some form of sick child care would be useful, the logistics remain a problem. In Congress, a bill that would guarantee an employe unpaid time off for illness, maternity leave, adoption or the care of a sick child or parent is being considered. The bill would require employers to allow a 10-week unpaid leave period and assure that employes be reinstated in their old job or an equivalent position.

The bill would help workers who must take extended leaves. The situation of parents needing just a two-day absence, however, would remain a case-by-case problem.


Work Family Directions publishes a book, "A Little Bit Under the Weather: A Look at Care for Mildly Ill Children." Send $20 to Nine Galen St., Suite 230, Watertown, Mass. 02172.

Reston Children's Center sponsors a conference on "Day Care for the Sick Child." Oct. 23, 8:15 a.m. to 4 p.m. $95; students $85. Registration: 476-8150.