Keeping Kids Healthy at Daycare


What parent hasn’t experienced the dreaded childcare cold? Learn how to keep your child healthy without sequestering her from playmates.

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).

Children with Chronic Lung Disease: Any child who had serious respiratory problems as a newborn may be at increased risk for serious lung infections in the first 18 months or so after birth. Most often these infants are also prematurely born; however, some full-term infants with severe respiratory problems may also develop lung scarring. Any infant who required a ventilator for serious lung disease may also be at risk. Infants requiring supplemental oxygen for breathing are at particular risk. As these children grow and their lungs improve, their risk decreases. Again, it is important that you discuss this with your baby’s doctor and follow his or her advice.

Children with Weak Immunity: Some children are born with an inability to fight infections normally. These problems vary in severity and type. Check with your child’s physician to identify the best childcare option for you.

What You Can Do

Some cold and flu bugs are inevitable, but to help your child avoid serious illnesses, consider the following:

  • Keep Immunizations Current: Immunizations protect your child against infection. Make certain that your child receives the recommended immunizations on time. 

  • Know When to Say No: Most childcare facilities have a set of guidelines describing when children are too sick to attend daycare. Ask your provider for a copy of their specific guidelines but also trust your own instincts. You know your child better than anyone else does. Sending a sick child to childcare puts the other children and childcare providers at risk so, whenever possible, keep your sick child at home.

  • Sick Childcare Facilities: Some communities have special childcare centers for sick kids. These facilities allow children with moderate illness to receive the extra care they need outside of their own homes without exposing well children to illness. These facilities rarely make enough money to cover their expenses and are often subsidized by community agencies. Check with local agencies, children’s clinics, and hospitals for providers in your area.

Most children can safely be in childcare facilities without jeopardizing their health. Childcare facilities that develop and adhere to good policies for infection control minimize the risk of infections and ensure the safety of your child. Crucial to this policy are the criteria for when a sick child cannot be in the childcare facility—a policy you should know.


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