Despite New Report, Local Nurse Advises "No to Nits"

Despite a recent report from the American Academy of Pediatrics that says children with head lice shouldn't be forced to miss school, township public health nurse Barbara Zigarelli believes, under certain circumstances, an important part of treatment is removing infected children from their peers.

"I think I would still stand with the 'no nits' policy," she said. "I can remember, we've had some terrible outbreaks where it has gone on for months and it can be hard to bring it in."

Zigarelli, who was aware of the study and its findings, said that decisions about removing a child from school should be based on the maturity level and age group of the child's classmates, suggesting that what might not be more than a social problem for older children could more severe for younger students.

"It all depends on how old the child is, what grade they're in and who they are exposed to," she said. "When they're young, they play with each other's hair, they share hats and that could spread it from one person to the next."

The report says that "no-nit" policies and other practices that pull children with lice from school do not benefit students, as nits, the dandruff-like white casings left behind by lice, are stuck firmly in hair and not likely to spread.

The report also said that over-the-top treatments of lice are unnecessary, as the insects die in environments that are too hot or too cold. The report warns that many lice treatments have not been researched or approved by the Food and Drug administration.

As a public health nurse, Zigarelli said that she usually directs parents back to a pediatrician rather than prescribing treatment herself.

"We usually refer treatment back to the family pediatrician," she said. "Sometimes we're called in for extra support or guidance."

In general, Zigarelli recommends a combination of over-the-counter drugs and strict observation until evidence of infection is gone.

"You want to treat them and re-treat them," she said. "Look through the child's hair in the morning and look through again in the evening. You've got to try and remove as many nits as you can find, both alive and dead, and spot check in the weeks after."

Health representatives from the Montville School district could not be reached, though Zigarelli believes that the district currently operates under a "no nit" policy. She feels such ordinances are still a sound course of action, especially in younger children.

"If they're just sitting next to each other, its not a concern," she said. "You have to look at the age group."