Daycare Syndrome And Frequent Infections

Q. My daughter was in daycare from about 10 wks old till she was one. She was always sick so I took her out of daycare. However, she is now two and due to my schedule I have been forced to put her back into daycare. She has been back in daycare for 3 months and has been sick once a month since then. I feel like she is always sick, even the year she was out of daycare the illnesses subsided, but it still seemed like she was sick once every three months then. Should I be worried that she has some underlying illness that is causing this, or is it completely normal for a child who is in daycare to literally be sick once a month? Melanie, Pembroke Pines, FL

A. You are describing a very classic case of daycare syndrome.

Young children in daycare very often get frequent upper respiratory tract infections, including colds and secondary ear infections.

In fact, experts estimate that the average child gets 6 to 8 viral upper respiratory tract infections each year. And since that is average, that means some are getting more and some are getting less. It seems likely that it is the kids in daycare who are getting more infections.

They can also get 1 to 2 episodes of gastroenteritis, with vomiting and diarrhea, each year too.

Fortunately, the longer they are in daycare, the fewer infections they usually get. And by the time they start kindergarten, these children seem to get sick much less often than children who weren't in daycare and rarely got sick as a toddler or preschooler.

Daycare Syndrome vs Immune System Problem

Although parents and pediatricians often get frustrated when a child gets sick over and over, if the child is in daycare and is otherwise growing and developing normally, hasn't had any serious infections, like pneumonia, or other infections that required hospitalization, then it isn't very likely that she has any kind of problem with her immune system causing her frequent infections.

According to the Jeffrey Modell Foundation, warning signs of a primary immunodeficiency can include:

• eight or more new ear infections in one year
• two or more serious sinus infections in one year
• two or more months on antibiotics with little effect
• two or more pneumonias within one year
• failure of an infant to gain weight or grow normally
• recurrent, deep skin or organ abscesses
• recurrent thrush in mouth or elsewhere on skin, after age one
• need for intravenous antibiotics to clear infections
• two or more deep seated infections
• a family history of primary immunodeficiency

If you believe that your child does have a primary immunodeficiency, you might ask your Pediatrician about performing tests to look for immune system problems.

Avoiding Infections

Since keeping a child out of daycare isn't a practical option for most parents, some other things to consider to help your child stay as healthy as possible include:

• getting your kids a yearly flu vaccine and making sure your child's other vaccines are current
• avoiding other daycare type situations, such as a gym daycare or church daycare, so that your child isn't exposed to a lot of different groups of kids who might be sick
• discouraging thumbsucking or using a pacifier as your infant gets older, as a contaminated finger, thumb, or pacifier can be a good route for germs to make your child sick
• teaching your child to frequently wash her hands as she gets older

Most importantly, understand that frequent infections are very common in the first year or two of a child being in daycare.

_Sources:

_{American Academy of Pediatrics. Clinical Practice Guideline: Management of Sinusitis. Pediatrics. Vol. 108 No. 3 September 2001, pp. 798-808.}