Early daycare linked to fewer infections later

NEW YORK (Reuters Health) - Although young children might get sick more often when they first start group daycare -- replete with its shared finger paints, building blocks and germs -- a new study hints at a possible future pay-off: fewer infections come kindergarten.

The researchers stop short of crediting childcare for the protection, however.

“Daycares have a reputation for being germ factories,” lead author Sylvana Cote of the University of Montreal, in Quebec, told Reuters Health.

That bad rap may be at least somewhat warranted, she said. Children going into daycare have been shown to get sick more often than children who stay at home. But earlier studies had not looked into daycare’s potential long-term effects on children’s health.

To see how the germ battle played out over time, Cote and her colleagues identified more than 1,200 families with a newborn in Quebec and followed them for the first 8 years of the child’s life.

On average, the children had about three respiratory infections, as well as one ear and one gastrointestinal infection every year. Of course, the rates varied widely.

The researchers found that kids under the age of two-and-a-half who spent at least 10 hours a week surrounded by at least seven other children in a daycare facility initially experienced around 60 percent more respiratory tract and ear infections than their homebound peers.

But these children appeared to be compensated for their suffering: they had 21 percent fewer respiratory tract infections and 43 percent fewer ear infections during the early elementary school years.

No differences were seen in the numbers of gastrointestinal infections, the authors report in the Archives of Pediatrics and Adolescent Medicine.

Further, kids who attended daycare with smaller groups of children, or who entered a large group daycare after the age of two-and-a-half, didn’t seem to enjoy the same later protection. (Children in smaller group daycare got sick about as much as those who stayed home, while those that entered large daycares late did experience an initial increase in ear infections.)

“When children start interacting with a large number of other kids, that’s when their rate of infection goes up,” noted Cote.

“It’s really a question of timing,” she added. “The children may have the same overall number of infections, but we argue that it’s better to experience these awful infections earlier. Missing daycare doesn’t carry the same implications as missing school in kindergarten or first grade, when children learn to read and write.”

The researchers caution that more studies are needed to confirm whether or not early daycare is responsible for staving off later infections and to pinpoint why a link might exist.

Cote suggests that being sick might help build a kid’s immunity, and that a child’s immune system may be particularly sensitive to such shaping during the early preschool years.

About one in three U.S. kids receives organized childcare before reaching kindergarten age, whether at a daycare center or a school.

While the science is being solidified, Cote softens some common fears: “Parents can be reassured that daycare is not leading to more infections overall. It may even be better to have those infections earlier.”

SOURCE: Archives of Pediatrics and Adolescent Medicine, online December 6, 2010.