Illnesses in Child Care: How often is normal?

Illnesses in Child Care: How often is normal?

As a GP I see sick children all the time – I see well children too and parents who are absolutely terrified of their child contracting any type of illness. I understand this, I am a mother to a 3-year-old and seeing your child struggle with a fever, runny nose and cough is heart breaking –the added logistic of missing work because your child cannot attend childcare is an additional stressor. Lots of parents ask me about their child commencing childcare and whether or not they should wait until a certain age, “wean” their child into the program by starting one day a week and gradually increasing or avoid childcare altogether due to the risk of illness.


Here’s the truth – children get sick and viral illnesses like the common cold are just that, common. In the first few years of life children can get up to 12 viral infections per year; that number is considered normal. The tram track noses and annoying coughs however, are part and parcel of all young children building up their immunity to the community’s bugs.


12 infections a year – is this enough to exclude your child from childcare? That’s what I get asked and I think the best answer is it’s up to you- it’s a very personal decision. However, keeping your child at home does not mean they definitely won’t get sick. Our daughter went to childcare at 9 months of age – I did the risk benefit approach and sickness alone wasn’t enough for us keep her at home – we wanted her to get all the good stuff from childcare – the socialisation with other children and exposure to different caregivers so she could start building some resilience. I also wanted to gain a small part of me back and dip my toe back into my doctor life – and childcare allowed me to do that.


There are simple things you can do to reduce your child’s risk of illness – for instance, good hand hygiene (promoting hand washing before all meals for instance) and encouraging children to cover their mouth and noses when they cough and sneeze. A good diet high in fruit and vegetables and plenty of sleep are also beneficial for a good immune system. Keeping up to date with the childhood vaccinations on the schedule and considering additional ones (like meningococcal B vaccination which is currently only available privately in Australia) is also a great way to avoid illness. I commonly get asked if children need supplements or vitamins to help the immune system – the answer is that children who eat a varied diet (ie. eat all food groups with no significant restrictions) should not need any supplements or vitamins – they should be getting all the necessary nutrients from the food they eat. Children with malabsorption conditions (like coeliac disease) or dietary restrictions (vegetarian or vegan for instance) may need additional supplements, however.


During flu season an annual flu vaccine is also a great way to reduce your child’s risk of getting influenza (which can have serious complications in younger children including pneumonia). All children over 6 months of age are eligible to have the flu vaccine – for any child under 9 having the vaccine for the first time they do require 2 doses of the vaccine 4 weeks apart to mount an adequate immune response. In subsequent years however, they only require a single vaccine. The flu vaccine does need to be given annually as the effectiveness wears off after 3-4 months and the strains covered in the vaccine change yearly according to which strains are affecting the community at the time. My daughter has been having the flu vaccine since she was eligible – and it’s one of the greatest weapons I have to keep her well in Winter time.


I guess the short point is- yes, all children get sick and yes, they are potentially more likely to get sick when they are around other children who share literally everything with each other. However, it’s the sharing, communication and interaction that makes childcare a unique place for children and it’s why we opted for that over a nanny – we wanted our daughter to get to know a wide range of different people and experiences. Immunity builds up over time, and whilst 12 viral infections a year sounds like a lot – your child may not get all 12 (mine never did!) and your child may well get that number without attending childcare. Teach hand washing early, pack plenty of veggies and goodness into meals and allow plenty of sleep and rest – and that should be enough to survive the world of toddler infections. Good luck!


Written by Dr Preeya Alexander.

Dr. Preeya Alexander aka The Wholesome Doctor is a GP based in Melbourne. She is passionate about all things ‘prevention’ in medicine. You can follow her on Instagram @thewholesomedoctor or via her blog (www.thewholesomedoctor.com.au)

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