A child who goes to a day care center will have more infections before 2½ years of age and fewer during their elementary/primary school period, Canadian researchers wrote in an article published in Archives of Pediatrics & Adolescent Medicine. Most typical illnesses include ear and respiratory infections.
The authors wrote:
- “Preschool children in group child care experience more frequent infections than do children cared for primarily at home, and the risk seems greater when children attend larger group child care (facilities). These findings have created concerns that group child care may compromise the health of young children and their community. However, few studies have examined the impact of group child care on infections beyond the preschool years.”
Sylvana M. Côté, Ph.D., of Ste-Justine Hospital and the University of Montreal, Quebec, Canada, and team assessed the data on 1,238 families who had a baby born in 1998. They asked the mothers whether their baby/child went to a large day care facility (up to 10 groups of 8-10 kids), a small facility (home-based with 3 to 8 kids), or whether they were cared for in their own home until elementary school age.
The investigators gathered data for a period of eight years on the children’s frequency of respiratory, ear and gastrointestinal infections before 2½ years of age, 3½ to 4½, 5 to 8 (early elementary school).
They found that:
- Those who started in large day care centers before 2½ years of age had higher rates of respiratory and ear infections than those cared for at home during early pre-school
- Those who started in large day care centers before 2½ years of age had the same rates of respiratory and ear infections as those cared for at home during late pre-school
- Those who started in large day care centers before 2½ years of age had lower rates of respiratory and ear infections than those cared for at home during early elementary school
Infection rates were the same for those cared for at home right up to elementary school age and those who started in small group child care places during early pre-school periods and never attended any large care settings.
The researchers also found that kids who started off at home, but during late pre-school went into any size day care place had a higher infection risk immediately after the change.
No difference in gastrointestinal infection risk was detected between the three groups of kids.
The authors wrote:
- “One possible mechanism that has received empirical support in the context of long-term protection against asthma involves an increased repeated stimulation of the immature immune system by early and mild infections. Future studies are necessary to investigate this and other mechanisms that may account for the results.(conclusion) This study provides reassuring evidence for parents that their choices regarding child care (group size and age at enrollment) should not have a major effect on the health of their children from a long-term (eight-year) perspective, at least regarding respiratory tract infections with fever, gastrointestinal tract infections and ear infections.
Children who initiate large-group child care early (i.e., before age 2 ½ years) may even gain protection against infections during the elementary school years, when absenteeism carries more important consequences for school adaptation and performance. Physicians may reassure parents whose children initiate large group child care early that their child’s experiencing infections is temporary and is likely to provide them with greater immunity during the elementary school years.”
Sylvana M. Côté, PhD; Amélie Petitclerc, PhD; Marie-France Raynault, MD; Qian Xu, MSc; Bruno Falissard, PhD; Michel Boivin, PhD; Richard E. Tremblay, PhD
Arch Pediatr Adolesc Med. 2010;164(12):1132-1137. doi:10.1001/archpediatrics.2010.216
Written by Christian Nordqvist