As parents, we worry about outbreaks of infectious diseases in childcare facilities. Any time children congregate—daycare, church, school, family reunions—it is likely they will exchange viruses and bacteria. The larger the number of children who are together, the more likely that someone will become ill from a virus or bacteria acquired from another child. Younger children are more apt to share their infections than are older children.
Review Your Childcare's Illness Policy
Your childcare provider should have a policy on how sick is too sick for childcare. Your child's (and your provider's) risk is lowered if the childcare provider's policy resembles the CDC's recommendations. Workers should be properly immunized and screened for health problems. Each childcare facility should have written criteria for excluding and readmitting children who are or have been ill. You should obtain a copy of these criteria from the childcare provider.
In addition, clean environments limit the spread of germs by frequent handwashing and weekly toy washing.
Who Is at Risk?
Children who don't have chronic illness or immune system defects should not have serious problems. It's crucial to keep your child's immunizations current, especially if the child is in daycare. It's true that children in childcare acquire more infections than those who stay at home; however, children are likely to acquire many of these infections when they start school anyway. Infants and children at increased risk of serious infection from childcare exposures should receive care in a facility that minimizes these risks. You might consider in-home childcare or small family childcare situations.
Premature Children: Some premature infants are more susceptible to respiratory infections than are infants born at term. Babies at greatest risk are those born at less than 32-weeks gestation (73,100 births or 1.9 percent of all births in 1995). What might be a simple cold in other children can become a serious lung infection in these children. This risk is usually higher in winter than in summer and during the first 18 months.
As these children grow and their immune systems mature, this risk decreases. Consult with your doctor about this risk if your child was born prematurely. Some babies may benefit from a special gamma globulin preparation that reduces the severity of a common viral infection, respiratory syncytial virus (RSV).