PORTLAND (AP) — Though Oregon has one of the nation’s most generous sick child leave laws, many working parents don’t use it.

Under the Oregon Family Leave Act, parents may stay home with a sick child — unpaid — without losing their job. And beginning Jan. 1, eligible workers may use their own paid sick leave for family leave, including caring for a sick child.

Small firms are exempt from the law, and other firms can require that workers use all accrued paid leave first. But many parents simply can’t afford to lose a day’s pay or are afraid to be seen as a problem employee.

“It’s gut-wrenching for parents,” says Judi Gilles, program manager at Fruit & Flower Childcare Center in Northwest Portland. “You feel like whatever decision you make, you let someone down, your boss, your co-workers or your child.”

By law, child care centers can’t accept a child with a 100-degree fever, diarrhea, vomiting, nausea, severe cough and other illness. Some of them, however, feel the pressure to accept sick children because they know the pressure parents are under.

Even a healthy child can affect a parent’s work. The American Academy of Pediatrics recommends seven well-baby checks the first year alone. As protection from their mother’s immune system diminishes, babies get sick twice as often as older children and adults.

When family leave was debated in the early 1990s, the issue focused almost exclusively on when a child was born or became deathly ill.

Then Mary Overgaard, the Oregon Bureau of Labor & Industry’s legal policy adviser at the time, learned of a woman who got fired after missing three days of work to care for children with chicken pox.

“It was stunning to me,” Overgaard said. “That’s when we started talking.” Overgaard and a bipartisan coalition led by then-Labor Commissioner Jack Roberts included the sick-child provision in the new law.

But many people don’t take advantage of it because either they don’t know about it, or they can’t afford to lose the pay. An Oregon bill to provide $250 a week for six weeks of family leave, similar to plans in Washington and California, failed last spring.

“The majority of our work force lives paycheck to paycheck; taking a day off is difficult and the fear of losing a job is huge,” said Leslie Hammer, a professor of psychology at Portland State University who is working on a study of how supervisors affect an employee’s health and ability to care for their families.

“The solution is not just about money, but a combination of training supervisors to support family-friendly policies and give employees control over their work time to solve problems themselves.”