Every year during the winter months, pediatricians begin to see a steady stream of children coming to their office with acute respiratory and/or GI illnesses. Many of these children are between the ages of 6 months and 3 years of age and are being cared for in daycare centers or facilities other than their own homes as their parents work. Although not a formal medical term, “daycare syndrome” has been used to describe the repetitive illnesses experienced by these children. Why is it that a child gets sick so frequently during these early years? What are the facts about the exposures to illnesses and resulting risks to children attending daycare? Here are some important facts and concepts that should address these questions.
With each exposure to an illness, our body’s immune system reacts in several ways to fight off that infection and to prevent future infections by the same illness. One of the most important ways our body fights off a viral infection is by producing an antibody directed specifically at that virus. Infants and young children have immature immune systems that have not been stimulated to produce these antibodies. When a young child is exposed to a viral illness, there is a high likelihood of getting sick. It is not unusual for a child from the age of 6 to 36 months to have 8 to10 viral illnesses in a year. Most of these illnesses are viral upper respiratory infections (URI) but one or two may be a GI illness with vomiting and/or diarrhea. They are clustered in the fall and winter months, making it seems as if the child is constantly sick.
There have been studies evaluating the number and type of infections experienced by children in this age range who attend daycare centers and those who are exclusively cared for at home. Children who attend daycare do experience a higher number of ear infections, URI, and GI illnesses during the first 2 years of life. However, by age 3 the rates of illnesses reported for children attending day care centers is the same as the rate in children who stay at home. There is no evidence that this increase in frequency of illnesses is associated with poorer language or school readiness skills. Other studies have shown that as a result of increased exposures to illnesses during the first two years of life, children in daycares have accelerated immune responses. This leads to a decrease in the number of illnesses experienced in kindergarten and first grade when compared to their counterparts who stayed at home. Simply stated, the number of illnesses experienced by the time a child reaches the age of 7 years is the same whether he or she attended daycare of not. Maybe we working mothers can find some solace in knowing that our children might be the healthiest in first grade.