If your child is exposed to lice, you have the right to know—but your school may not tell you. You can change that.

A brief history of lice and schools

Three simple steps for schools

Fact-checking common objections

The NASN’s misguided advice 

A brief history of lice and schools.

Schools used to be on the front lines in the battle against lice. Nurses routinely checked heads and enforced “no-nit policies”—in which a single nit or louse got a child sent home, unable to return until they passed a head-check. Health agencies now agree that these policies were too harsh, because they kept too many children home for too long and demanded too much time from school nurses.

In the 2000s and 2010s, schools began abandoning “no-nit policies” and routine head-checks. These were sensible changes, but many schools didn’t stop there—they proceeded to dismantle the entirety of their lice-prevention strategy.

  • Today, when a child has lice, many schools won’t even send a classroom notification like they send for strep or flu. This prevents families from taking control measures. And while nurses no longer conduct routine checks, many even refuse to conduct “targeted” checks (e.g. initiating checks in a classroom facing an outbreak).

    A reaction to one extreme (unnecessarily strict policies) has led to the opposite extreme (doing nothing). This fuels lice’s spread and leaves parents feeling alone as they face the significant expense, time, and stress involved in treating lice. Low-income families are hit the hardest by schools’ indifference; ironically, these are the families that schools often claimed they were protecting as they abandoned lice-control policies.

    This isn’t true for all schools, but it’s true for many. That’s because schools (especially public ones) follow guidance from the Centers for Disease Control (CDC), American Academy of Pediatrics (AAP), and National Association of School Nurses (NASN). These oversight bodies provide direction about lice that is confusing, conflicting, and sometimes outright false. (More on this below.)

There is a middle ground that keeps children in school and protects them from infestation.

Three Simple Steps for Schools:

Stop the spread with these simple, reasonable steps that comply with CDC and AAP guidance.

  1. Encourage parents to report cases of lice to their school, just as they would for flu, strep, etc.

  2. For each case of lice reported, send a classroom notification.

  3. Ensure all information shared with parents incorporates the latest evidence on lice’s resistance to common over-the-counter treatments. Learn more on our Treatment page.

We know from experience how schools may push back.

Respond with facts.

  • FACT CHECK: It is true that lice do not spread disease. A school is responsible, however, for making a child feel safe in school, physically and emotionally. Lice cause shame, anxiety and severe itching in children—all of which are detrimental to the learning environment.

    For families, lice are costly, stressful, and time-consuming to treat—which can undermine parents’ trust in a school that isn’t mitigating lice’s spread. Lower-income children are the most vulnerable because their families are least equipped to spend the time and money required to de-infest a household.

  • FACT CHECK: This may be true at middle- and high-schools, but it’s illogical to say that lice don’t spread in elementary schools where children as young as five have little concept of “personal space." Everything we know about lice suggests that they spread at schools. The CDC clearly states that 1) young children are most likely to have lice; 2) lice spread from head-to-head contact; and 3) this contact commonly occurs at school.

    Yet we’ve seen elementary schools insist that transmission primarily occurs at sleepovers, camps, and sporting activities. Lice surely spread there, too, but keep in mind that the youngest students (e.g. Kindergarten, 1st grade) are least likely to attend sleepovers, go to camp, and be involved in sports—yet they are caught up in any lice outbreak. This makes school a likely culprit.

  • FACT CHECK: If your school sends classroom health notifications for flu, strep, COVID, etc., then adding lice to the list shouldn’t be burdensome. The email can be a single template that is re-used with every new case.

    Classroom notifications are also anonymous, and not a breach of confidentiality. If your school allows students with lice to stay in school (as most US schools do), it’s impossible to identify the infested student. In other words, you couldn’t figure it out by asking your child, “Who wasn’t in school today?”

    Lice spread in the absence of communication and information—anonymous notifications are the easiest, most effective way to stop the spread. Above all, if there are lice in your child’s classroom, parents have the right to know.

  • FACT CHECK: If just one case of lice has been reported in a class, there are likely other cases that haven’t yet been identified (or won’t ever be reported by the parent). Waiting for three cases gives lice a free pass to keep spreading. It also denies parents an opportunity to take preventative measures, or to identify an infestation early on. It is simple to email parents but difficult to treat lice - there is no excuse for waiting until the case count reaches three.

    Lice spread in the absence of communication and information—anonymous notifications are the easiest, most effective way to stop the spread. Above all, if there are lice in your child’s classroom, parents have the right to know.

  • This is false. LiceToKnow.org knows of no state/federal policy or law that prohibits schools from sending the same notifications for lice that schools send for strep, flu, etc. In fact, the CDC encourages schools to inform parents of lice to best mitigate the spread.

    While the National Association of School Nurses does not support notifications, they are not an official governing body, and their guidance on lice contains multiple falsehoods (more on this below).

More on the NASN’s misguided advice

The National Association of School Nurses (NASN) downplays the impact that lice has on children, their families, and the learning environment. Its Position Statement on lice contains falsehoods that only fuel lice’s spread.

The NASN advocates for anonymous notifications to be discontinued. It falsely claims that notifications may be “a breach of confidentiality.”

Classroom notifications for lice are anonymous, just like notifications for any other illness. And because most schools allow students with lice to stay in school, it would be impossible to identify the infested student. (i.e. a parent couldn’t figure it out by asking their child, “Who wasn’t in school today?”). Lice spread in the absence of communication and information. Anonymous notifications are the easiest, most effective way to stop the spread. The NASN should be providing School Nurses with resources for sending lice notifications—not discouraging the practice entirely.

The NASN falsely states that the CDC and AAP advocate for classroom notifications to be discontinued.

The NASN states that both the AAP and CDC advocate for classroom notifications to be discontinued. This is false. Here is the truth:

  • The CDC promotes the value of notifications: “It is useful to share information with school nurses, teachers, parents of classmates, and others about contact with head lice to limit spread.” (Source)

  •  The AAP takes no stance on notification and supports schools that select a policy that works for their population: “Studies examining the efficacy of alert letters are not available; consequently, some schools choose to design guidelines that they believe best meet the needs of their student population.” (Source)