Daycare Syndrome and Frequent Infections

Young children often get frequent upper respiratory tract infections, including colds and secondary ear infections. Getting sick a lot is expected, even if a child seems to get sick every two weeks, especially for young kids in daycare. In fact, experts estimate that the average child gets six to eight viral upper respiratory tract infections each year.

It's also very common for kids to get gastroenteritis—which can include vomiting and/or diarrhea, fever, and abdominal pain. Other common "daycare diseases" include pink eye, hand, foot, and mouth disease, and possibly even COVID-19.

Because these illnesses are contagious, it would follow that kids who are in daycare are more vulnerable to certain viruses and infections since they tend to be exposed to more people and more germs. Fortunately, the longer that kids are in daycare, the fewer infections they usually get.

And by the time they start kindergarten, children who were in daycare seem to get sick much less often than children who weren't in daycare. In other words, your child is likely to get sick a lot at some point in their early life—so if it doesn't happen during the daycare years, then it's likely to happen during kindergarten and first grade. Learn more about frequently getting sick in childhood and the so-called "daycare syndrome."

Distinguishing Daycare Syndrome From an Immune System Problem

Although parents and pediatricians often get frustrated when a child gets sick over and over, if the child is in daycare and is otherwise growing and developing normally, and if the child hasn't had any serious infections (like pneumonia or other infections that required hospitalization), then it isn't very likely that they have any kind of problem with their immune system.

According to the Jeffrey Modell Foundation, warning signs of a primary immunodeficiency can include:

• 8 or more new ear infections in one year
• 2 or more serious sinus infections in one year
• 2 or more months on antibiotics with little effect
• 2 or more cases of pneumonia within one year
• Failure of an infant to gain weight or grow normally
• Recurrent, deep skin or organ abscesses
• Recurrent thrush in the mouth or elsewhere on the skin after age one
• Need for intravenous antibiotics to clear infections
• 2 or more deep-seated infections
• A family history of primary immunodeficiency

If you believe that your child does have a primary immunodeficiency, ask your pediatrician about performing tests to look for immune system problems.

Tips for Avoiding Infections

Since keeping a child out of daycare isn't a practical option for many parents, some other things to consider to help your child stay as healthy as possible include:

• Getting your kid a yearly flu vaccination and making sure that your child's other vaccinations are up to date
• Making sure your child is getting the nutrition they need to help their immune system function normally. This means ensuring that they get enough protein, fiber, and micronutrients (vitamins and minerals) and minimizing sugar and processed foods
• Avoiding other daycare-type situations, such as a gym daycare or church daycare, so that your child isn't exposed to a lot of different groups of kids who might be sick
• Discouraging thumb sucking or using a pacifier as your infant gets older, as a contaminated finger, thumb, or pacifier can be a good route for germs 
• Teaching your child to frequently wash their hands as they get older

Most importantly, understand that frequent infections are very common in the first year or two of daycare and are usually not a cause for concern. If and when your child gets sick, call your pediatrician to figure out the best course of action. Also, try to maintain as much flexibility in your work schedule as possible and hang onto as many sick days as you can, since your child may have to stay home sick from daycare a lot.