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Day care health risks

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Children in day care centers are more likely to catch an infection than kids who do not attend day care. Children who go to day care are often around other kids who may be sick. However, being around the large number of germs in day care may actually improve your child's immune system in the long run.

Infection is spread most often by children putting dirty toys in their mouth. So, check your day care's cleaning practices. Teach your child to wash their hands before eating and after using the toilet. Keep your own children at home if they are sick.

INFECTIONS AND GERMS

Diarrhea and gastroenteritis are common at day care centers. These infections cause vomiting, diarrhea, or both.

• The infection is spread easily from child-to-child or from caregiver-to-child. It is common among children because they are less likely to wash their hands after using the toilet.
• Children who are attending day care may also get giardiasis, which is caused by a parasite. This infection causes diarrhea, stomach cramps, and gas.

Ear infections, colds, coughs, sore throats, and runny noses are common in all children, especially in the day care setting.

Children attending day care are at risk of getting hepatitis A. Hepatitis A is irritation and swelling (inflammation) of the liver caused by the hepatitis A virus.

• It is spread by poor or no hand washing after using the toilet or changing a diaper, and then preparing food.
• In addition to good hand washing, day care staff and children should get the hepatitis A vaccine.

Bug infections, such as head lice and scabies, are other common health problems that occur in day care centers.

You can do a number of things to keep your child safe from infections. One is to keep your child up-to-date with routine vaccines (immunizations) to prevent both common and serious infections:

• To see the current recommendations, visit the Centers for Disease Control and Prevention (CDC) website -- www.cdc.gov/vaccines/. At every doctor visit, ask about the next recommended vaccines.
• Make sure your child has a flu shot every year after age 6 months.

Your child's day care center should have policies to help prevent the spread of germs and infections. Ask to see these policies before your child starts. Day care staff should be trained in how to follow these policies. In addition to proper hand washing throughout the day, important policies include:

• Preparing food and changing diapers in different areas
• Making sure day care staff and children who attend the day care have up-to-date immunizations
• Rules about when staff and children should stay home if they are sick and when it is safe to come back to day care

WHEN YOUR CHILD HAS A HEALTH PROBLEM

Staff may need to know:

• How to give medicines for conditions, such as asthma
• How to avoid allergy and asthma triggers
• How to take care of different skin conditions
• How to recognize when a chronic medical problem is getting worse
• Activities that may not be safe for the child
• How to contact your child's health care provider

You can help by creating an action plan with your provider and making sure your child's day care staff knows how to follow that plan.

References

American Academy of Pediatrics website. Reducing the spread of illness in child care. www.healthychildren.org/English/health-issues/conditions/prevention/Pages/Prevention-In-Child-Care-or-School.aspx. Updated November 21, 2018. Accessed November 29, 2022.

Sosinsky LS, Gillium WS. Childcare. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 29.

Vaughan AM, Coffin SE. Childcare and communicable diseases. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 199.

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Review Date: 10/31/2022  

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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