| A: The fact of colds and daycare is a bad news, perhaps good news state of affairs.
First, the bad news. Infections and daycare go together. Even without daycare, children under the age of 2 normally catch one cold after another-by some measures 6-10 per year. It’s just more for children in day care who experience an increased number of ear and intestinal infections as well.
Sneezing, coughing, and especially touching spread the cold virus. Transmission by hands occurs when day care staff are called upon to wipe several children’s runny noses and when children touch each other with virus-contaminated hands. The cold virus can also survive on toys and play surfaces only to take up residence in other children on contact.
The possible good news is that exposure to all these viruses may not be all bad. In fact, a recent study from Arizona published in the new England Journal of Medicine (August 24th, 2000) concluded that children, especially those under 2, who were exposed to other children at daycare or to older children at home were less likely to develop asthma and frequent wheezing episodes later in childhood.
This new information is added to the argument that frequent infections early in life serve to strengthen a child’s developing immune system. Please remember that these are just studies and still need long term confirmation of their conclusions.
What can be done to decrease infections?
- The most effective preventive measure is hand washing by childcare staff as well as children after toileting, before eating, following each diaper change and by staff after wiping a child’s nose. Hand washing should be to a count of 10, and rinsing to another count of 10 to be most effective.
In addition there are day care standards that have been developed jointly by the American Academy of Pediatrics and the American Public Health Association which include the above recommendations plus:
- Proper sanitation of changing surfaces after each use
- Wide separation of food areas and changing facilities
- Waterproof disposable diapers that fit snuggly
- Child-size flush toilets whenever possible
- Regular cleaning of toys and play surfaces
When just the hand washing standards are adhered to, this simple measure has been shown to significantly decrease the number of respiratory infections in the day care setting.
| -- Take Home Message -- |
| Daycare and infections go together. Although there may actually be some benefit of frequent infections in early life to a child’s immune system, measures to decrease risk of infections to infants and children are recommended. These measures should conform to national performance standards for day care programs. Parents should carefully review these practices, and the educational training provided to their staff in the selection of the best day care programs for their children. |
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