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Advice for Patients
December 6, 2010

New Information About Group Child Care and Infection Rates

Arch Pediatr Adolesc Med. 2010;164(12):1179. doi:10.1001/archpediatrics.2010.237

Many parents place their children in child care settings, such as day care or preschool. “Group child care” settings are those that have 6 or more children in a classroom.

Parents sometimes worry that children who are in group child care will have more infections, such as colds or ear infections, compared with children who are cared for at home. Parents may worry that letting their child be exposed to viruses from other young children may not be healthy for their child.

Research about child care and infections

Research studies have found that children who are in group child care are more likely to have minor infections, such as the common cold, during the preschool years.

A recent study in this month's Archives shows several new research findings.

  • First, children generally developed more infections around the time that they started attending the group child care center.

  • Second, children who started group child care before they were 2½ years old had benefits of having fewer of those infections later on. Those children who were in group child care and had mild infections early had fewer infections with fever and ear infections later, during the elementary school years.

Why would early group child care lead to fewer infections during elementary school?

There are several ways in which being exposed to common viruses during the early years of a child's life may lead to fewer infections later on during elementary school. One possible reason is that young children who are in large child care settings (>6 kids) get an opportunity to be exposed to many different types of infections, which is a normal process of developing young children's immune systems so that they can fight infections later.

This study also found that there may be a sensitive period during the preschool years (before 2½ years of age) in which being exposed to large groups of children may be protective against future infections. Children who started large group child care after 2½ years of age did not benefit from this protection during their elementary school years.

Ways to keep your child healthy in child care settings

  • Make sure your child's vaccinations are up to date, including a yearly flu shot.

  • Stay on schedule with well-child visits to your pediatrician.

  • Teach your child to wash his or her hands often, especially before eating and after using the bathroom.

  • Choose your child care center carefully; spend some time there and get to know the center and the staff.

For more information

You can learn more about choosing a child care center at:


Inform yourself

To find this and other Advice for Patients articles, go to the Advice for Patients link on the Archives of Pediatrics & Adolescent Medicine Web site at http://www.archpediatrics.com.

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The Advice for Patients feature is a public service of Archives of Pediatrics & Adolescent Medicine. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your child's medical condition, Archives of Pediatrics & Adolescent Medicine suggests that you consult your child's physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

Source: American Academy of Pediatrics