Early daycare infections protect kids later

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Clinicians can reassure parents that the many infections young children experience when they first start daycare are harmless and may actually help boost immunity later in life, data from a study published in the Archives of Pediatrics & Adolescent Medicine indicated.

Sylvana M. Côté, PhD, of Ste-Justine Hospital and the University of Montreal in Quebec, Canada, and colleagues from several international sites, analyzed the incidence of respiratory tract, ear and gastrointestinal tract infections in relation to group childcare attendance in a nationally representative sample that involved 1,238 families.

They followed this birth cohort from 5 months to eight years, performing yearly maternal questionnaires to determine how often children experienced these infections and whether the children attended a large group care setting (professional educators caring for up to 10 groups of eight to 12 children), a small child-care facility (home-based caretaker responsible for three to eight children), or were cared for at home.

Children who began attending large croup child care settings before the age of 2 ½ years had higher rates of respiratory (incidence rate ratio=1.61; 95% CI: 1.27-2.03) and ear infections (IRR=1.62; 95% CI: 1.19-2.20) during early preschool years compared with those who were cared for at home.

However, risk for infection during the late preschool period (ages 3 ½ to 4 ½) was the same in both groups, and during elementary school, those who attended large group childcare settings at younger ages had a lower risk of contracting either type of infection (respiratory, IRR= 0.79; 95% CI: 0.66-0.96; ear, IRR=0.57; 95% CI: 0.37-0.88).

Gastrointestinal infections were not associated with group child care at any developmental period.

“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,” the researchers wrote.

These findings are consistent with previous studies that have shown similar infection patterns with the common cold and are in line with the hypothesis that large group care environments expose children to a greater number of infectious agents, thus enabling broader immunity.

“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,” the researchers wrote.

They noted that future studies are necessary to confirm the exact mechanisms that account for the study findings.
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