Day care and baby’s immune system

A: From the infection standpoint, it is important to understand that most illnesses in the day care, preschool and early elementary years are caused by viruses. These germs cause colds, coughs, runny noses, ear infections, diarrhea, vomiting, fevers and rashes. All of us have seen and been infected with many, if not most, of these germs during our own early years. They are a normal part of growing up and developing one’s own healthy immune function, regardless of how disruptive, inconvenient and unpleasant they are to family, work and life. These infections help us develop our immune function and our ability to be healthy and well in our teen and adult years.

The infections that we want to prevent—and are fortunate enough to have the means to do so—are the serious bacterial and viral infections. They’re avoided with basic sanitation and vaccines. Many, if not most, of the serious infections (meningitis, measles, mumps, whooping cough and more) will be prevented with the routine childhood immunizations. Basic sanitation is also key.

Some things to look for when looking at day care centers include:

• A staff that is routinely updated and educated on infections and infection control.
• A dedicated and separate staff that cares for diapered children.
• A dedicated and separate staff that cares for nondiapered children.
• A staff that allows for no more than four infants per caretaker.
• Established and followed cleaning policies for common-use toys, mats and equipment.
• Separate food preparation and diapering spaces and sinks.
• Established and enforced policies on when sick children should not attend.
• Established and enforced policies for children who become sick while at the center.
• Health and vaccine requirements for caregivers.
• Health and vaccine requirements for attendees.
• Policies for animals and pets at the center.

We need to vaccinate our children against the most serious and life- threatening germs, and we have to live through the usual and many minor illnesses that all children have. We need to accept that infants and young children will have illnesses, but we also need to accept that these illnesses are milestones in normal growth and development. Back-up child care will make this part of the early years much easier!

—Leigh B. Grossman, MD, medical alumni professor of pediatric infectious disease at the University of Virginia School of Medicine and editor of The Parent’s Survival Guide to Daycare Infections