No nits, dead or alive

Wednesday, Oct. 25, 2006

For more of your opinions, go to

Rita Rubin, Bethesda

My 7-year-old, a second-grader, was all dressed up one day earlier this month for her school picture. I’d fixed her shoulder-length brown hair in the ‘‘half ponytail” style she favors for special occasions. She looked pretty darn cute, if I do say so myself.

Well, she didn’t get the opportunity to have her school picture taken. In addition, she missed her first Spanish class of the year and her first after-school art class, which she’d been looking forward to for weeks.

The reason: She had dead nits in her hair.

I even had a signed note from my pediatrician saying that my daughter had been treated for head lice and that microscopic examination of the nits showed they were ‘‘not viable.” Therefore, the doctor wrote, she should be allowed to attend school. I might as well have had a note from the tooth fairy.

The acting principal for the day — our regular principal was ill — waved the county’s ‘‘no nits” policy in my face when I tried to show her the pediatrician’s note.

Nits, for the uninformed, are lice eggs. Lice are about the size of a sesame seed, their eggs, a poppy seed, if that. Dead or alive, nits stick to hair like bubble gum to the bottom of your kid’s tennis shoe. Neither brushing nor shampooing can pry them off.

Under the Montgomery County Schools’ antiquated ‘‘no nits” policy, children who have any nits, dead or alive, are banned from the classroom. The policy flies in the face of guidelines from the American Academy of Pediatrics and the National Association of School Nurses.

‘‘No healthy child should be excluded from or allowed to miss school time because of head lice,” concludes the pediatricians’ September 2002 guidance document. ‘‘‘No nit’ policies for return to school should be discouraged.”

And here’s what the school nurses’ July 2004 policy statement says: ‘‘Management of pediculosis (lice) should not disrupt the education process. Data does (sic) not support school exclusion for nits.”

Los Angeles, Charleston, W.Va., Newark, N.J., and Madison, Wisc., are among the school districts that have recently scrapped their ‘‘no nit” policies.

Clearly, Montgomery County, home of the National Institutes of Health, perhaps the most esteemed medical research institution in the world, has a lice policy based on fear and ignorance, not science.

My daughter had been ejected from class the previous Friday because of what a parent volunteer saw during the first lice check of the year. (‘‘Because of the lack of evidence of efficacy, classroom or schoolwide screening should be strongly discouraged,” the pediatricians advise.)

The lice check ran from about 1 to 1:45 or so. Dismissal isn’t until 3:05, but the suspect children were sent immediately to the school health tech, who called their parents and told them to pick their children up as soon as possible.

So much for privacy. Of course, the children’s classmates and the parent screeners knew why they were ejected from class. The health tech’s office adjoins the main school office, so the secretaries and anyone else who happened to be there at the time — namely, all the lice screeners — saw the children parade in to see the health tech.

Why don’t we just paint a big scarlet ‘‘L” on the kids’ foreheads?

The head nurse for the county schools tells me lice checks are not county policy but, rather, a relic from some previous administration and PTA at the school. Apparently, though, lice-aphobia is spreading in Bethesda. Another school principal sent an e-mail out recently on the school’s listserve seeking volunteers for an upcoming lice screening.

‘‘We used those screenings last year — once in the fall and once after winter break, and as a result, did not have the schoolwide lice problem we have had in previous years,” the principal wrote in her e-mail.

The American Academy of Pediatrics notes there is no evidence that schoolwide lice screenings do any good. That school just got lucky last year.

I’ve become somewhat of an expert on head lice, so I’d like to clear up some other misconceptions: They don’t carry disease, so even live adult lice (remember, my daughter had nits) are never a health emergency requiring immediate dismissal from school. They have nothing to do with poor hygiene (I’ve read they actually prefer clean heads). They can’t fly. They can’t even jump from head to head. I’ve read that it takes a louse about half a minute to crawl from one head to another, so just brushing by someone with lice isn’t enough to ‘‘catch” them. And they can’t live more than a day if they’re further than a quarter of an inch from a nice warm scalp.

I treated my daughter’s head with malathion. You might have heard of it: It’s a pesticide sprayed on crops to prevent mosquito infestation. It’s also the only relatively safe treatment that is virtually 100 percent effective in killing lice and nits. Some U.S. lice have developed resistance to over-the-counter treatments. Malathion, sold as Ovide for treating lice, is available only by prescription. It’s nasty stuff that reeks of garlic and gasoline.

Notice that I said malathion is effective for killing lice and nits. It is totally ineffective for removing them. After I shampooed the malathion out of my daughter’s hair, I used a cream rinse designed to help get the nits out. I also turned to vinegar, widely touted has having nit-loosening properties. And I tried several different styles of nit-picking combs, but none worked. Fully aware of the schools’ ‘‘no nits” policy, I probably spent a couple of hours trying to pluck the nits out of my daughter’s hair. Apparently, though, my middle-aged eyes had deceived me.

Instead of joining her classmates, my daughter sat with me in the health tech’s office or on a bench in the hall for most of the day. I made call after call, trying in vain to find some school official who would listen to reason, honor the pediatrician’s note and allow my daughter back in class. We left at 2 p.m., and only then because my cell phone battery was dead and I needed to retrieve some numbers at home.

Finally, the community superintendent for our cluster, called me back at around 5:30 p.m. He listened sympathetically and told me he was familiar with malathion’s effectiveness. He said he would try to reach the head nurse and confer with her about my daughter. I e-mailed him copies of the pediatrics’ academy’s and school nurses’ association’s lice policy statements.

At 8:45 a.m. the next morning, as my husband and I stood on our front porch in the morning sun, trying as best our we could to pull every last nit out of our incredibly patient daughter’s hair, the community superintendent called to say she could return to class.

I can just see some parents rolling their eyes at my efforts and at the community superintendent and head nurse’s decision. Just remember, my kids are lice-free now, knock wood. So, supposedly, schoolwide lice checks and the ‘‘no nit” policy are for their protection. But I know what a fallacy that is.