Before my daughter started daycare at 19 months, I could count on one hand the number of times she’d been sick. But after only two months in the daycare germ storm, I’d already lost count. It was a seemingly endless stream of runny noses, low-grade fevers, mysterious rashes and minor bouts of diarrhea. And from what I’ve gleaned from commiserating with other parents of toddlers over the years, we got off easy. A friend whose daughter had just started daycare had to cancel plans with us twice in one week: The first time because her daughter had contracted pink eye, and then again five days later because she’d caught hand, foot and mouth disease.
Henry Ukpeh, a paediatrician in Peterborough, Ont., confirms that it’s normal for toddlers starting group child care to get sick—developing as many as eight to 12 colds in the first 12 months. This is because daycares are “the perfect environment for the transmission of viruses,” he says.
Many of the typical illnesses found in daycare settings, including the common cold, stomach bugs, conjunctivitis (pink eye) and hand, foot and mouth disease, are caused by viruses. (Ear infections can be caused by either a virus or bacteria. The common cold can cause swelling and congestion in the nose and throat, and in a toddler’s tiny ear tubes, which is what causes the earache.) These bugs are easily spread through direct and indirect contact between toddlers in close proximity, who are likely wiping their noses, sneezing and coughing while sharing toys and food—no matter how many times the daycare workers clean the diaper-change station or disinfect toys that have been drooled on.
Other common outbreaks at daycares and schools can include gastroenteritis, lice, respiratory syncytial virus (RSV) and pinworms (sorry!).
Ukpeh’s best advice for keeping the whole family healthy is to make sure everyone is getting lots of rest and eating nutritious food. Always wash your toddler’s hands as soon as you get home from daycare, and before they eat or interact with siblings.
Children over the age of six months should get a yearly flu shot. The Canadian Paediatric Society also recommends flu shots for any adult caregivers living or working with kids under age five. If it’s the first time your child has ever had a flu shot, they’ll need two separate doses, four weeks apart. (The nasal flu vaccine is not available in Canada this year.)
Kate Mason,* an early childhood educator in Sudbury, Ont., works at a daycare and sends her two-and-a-half-year-old son, Max,* to another one. She knows how futile the war against germs can feel. “At work, we’re constantly disinfecting and cleaning and washing hands. When I come home, I change my clothes as soon as I walk in the door. Even so, when Max first started daycare and I went back to work, we were both sick all the time.” Mason also gets frustrated when moms and dads drop off kids who are sick, but she understands some parents (including herself) don’t always have much choice. “Yes, I grumble about the parents dropping off kids with diarrhea. But 30 minutes earlier I might have been telling my husband, ‘Don’t tell the daycare about the fever Max had last night!’”
Check your daycare’s parent handbook for their policies. Often, a child is not allowed to return to the centre until they’ve been fever-free (or diarrhea-free) for 24 hours. That means if a daycare worker notices your child is running a temperature at 3 p.m., they won’t be allowed to attend care the next day, even if the fever has vanished by morning. Most daycares will not give medications like Tylenol or Advil, either.
Michelle Richea, a Toronto naturopathic doctor and mom of one, says it isn’t realistic to expect even the healthiest kid to avoid getting sick when they start daycare. But there are some things parents can do to support a toddler’s immune system. In addition to serving foods that are rich in protein, zinc and vitamin C and free of refined sugar, parents should consider supplementing toddlers’ diets with immune-boosting vitamin D and probiotics, both of which are available in kid-friendly drops and chewable tablets. “It’s also important to remember that kids need to be exposed to viruses to build their immune systems,” says Richea.
A long-term study conducted by researchers at the University of Montreal from 1998 to 2006 found that toddlers in group child care get sick more often than those who stay at home. But it found that those same kids get sick less often than their peers during the elementary school years. In other words, your kids are going to get sick sooner or later. It’s reassuring to know that all the late nights and nose wiping now might mean fewer sick days in a couple of years.
* Names have been changed.