JUANA SUMMERS, HOST:
Pediatricians and public health officials say lice is low on the threats - the list of threats to public health, but it can feel like a big deal to the school systems and parents struggling with the idea of keeping kids with lice in class. Blake Farmer of member station WPLN in Nashville reports.
BLAKE FARMER, BYLINE: A lice infestation is an ordeal, especially at a preschool.
UNIDENTIFIED CHILD: Hi.
EVELYN THOMPSON: Hey, girl. How's your hair? Feeling OK?
FARMER: Evelyn Thompson knows how to disarm 4-year-olds so they forget she's combing their hair looking for bloodsucking bugs the size of a sesame seed. Today, she's checking her work, methodically parting the hair of children she treated a week ago.
EVELYN THOMPSON: She was the first one we identified in the group, and I promised her she wouldn't be the only one.
TONYA BRYSON: And by the time we were finished, there were 13 children.
FARMER: Tonya Bryson owns the daycare Creative Youth Enrichment Center. When lice hit a third of her students, she knew the latest recommendations are to treat nits as a nuisance, not a public health threat, so they kept everyone in school and faced the dreaded four-letter word together.
BRYSON: It's not as bad as you think it is. I mean, yes, we had quite a few kids with it, and it went to parents and siblings, but it's manageable.
FARMER: If you grew up in the 1900s, no nits was the policy, and you were sent home until you had a clean bill of health. But 20 years ago, medical guidance shifted to let kids stay in school. At this point, when live lice are found, the recommendation is to simply notify parents. Cathryn Smith's the president-elect of the Tennessee Association of School Nurses.
CATHRYN SMITH: They can come back to school for their education the next day. It's more important that they're in school learning than it is for them to be out of school because of lice.
FARMER: After all, they're gross but essentially harmless. Lice don't carry disease. They don't jump or fly. So if little heads aren't touching, lice are usually staying put. Plus, it takes weeks to go from one bug on a kid's head to enough live lice to make them really itchy. Pediatrician Dawn Nolt, of Oregon Health and Science University, authored a widely cited paper in 2022 that spawned a flurry of schools revisiting their no-nit policies.
DAWN NOLT: Kicking them out on a Wednesday when they've been having it for the past four to six weeks is not going to do anything, but it's going to take that kid out of school and shame that kid and shame that family. And I just think that that's not acceptable.
FARMER: Inclusion is the priority, even if it may cause an inconvenience or even financial cost for others. Over-the-counter treatments like gels, creams and shampoos add up, and professional help can run into the hundreds of dollars since it could hit an entire household. Lice leniency is a tough sell, even for the experts.
NOLT: My child's best friend canceled a playdate because that person had lice. I was like, it's OK, just come. They were so embarrassed. And I said, OK, just get the treatment. We'll see you next week.
FARMER: For school districts that dropped their no-nit policies, second thoughts are going around. Parents in Massachusetts, Texas, Ohio and Georgia are petitioning for their schools to get strict on nits, and school boards are listening. The school board in Hernando County, Florida, is reverting to their old rules. Chair Shannon Rodriguez said she's seen families who treat their kids right away get lice again from the same outbreak because other families didn't act.
SHANNON RODRIGUEZ: What do you do as a parent, put them back in school with the same kids that have it? It's just a never-ending battle.
FARMER: Stephanie Buck teaches at the lively preschool in Nashville that's getting over an infestation. She's scarred.
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STEPHANIE BUCK: Because my daughter was really embarrassed when she found out that she was the first one who got checked and she had it. Man, it's hard. You want to protect your babies' hearts.
FARMER: But, she says, you also want to keep your babies lice-free, if you can. For NPR News, I'm Blake Farmer in Nashville.
SUMMERS: This story was produced in partnership with KFF Health News.
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