Many young children spend a good portion of their lives in daycare. There are many benefits to day care. It can provide enriching educational and social experiences for the child. However, day care brings to the child a number of health and safety risks that are higher than those experienced in a child's own home. Parents must weigh the risks against the benefits in making the decision whether to use day care.
All young children are prone to acquiring infections, but children in day care face special risks. The group setting exposes a child to larger numbers of other children (and their infections) than the home setting.
What are some of the health risks for children in day care?
Because they are in a group setting, children in day care are exposed to many kinds of infectious diseases. Many of these are quite contagious. Children in day care tend to get more upper respiratory infections. They also have more frequent episodes of otitis (ear infections) which often come as a consequence of plugged up ears from colds.
Sometimes children in day care can be exposed to more serious respiratory infections. One of these is tuberculosis (TB). Although not as common as it once was, outbreaks of TB still occur. Infection of the intestinal tract, called gastroenteritis, is often caused by viruses. Gastroenteritis usually causes vomiting or diarrhea or both. These illnesses are very contagious, but rarely cause long-term problems.
Gastrointestinal infections are spread by the fecal-oral route. This means a person catches it by swallowing organisms found in feces. This type of infection is common among young children because they may not wash their hands carefully after using the toilet.
A less common intestinal disease sometimes found among children in day care is giardiasis. It is caused by a parasite called Giardia lamblia. The symptoms of giardiasis include diarrhea, stomach cramps, and gas. Young children can easily pass this disease to others.
Children in day care are also at greater risk of coming in contact with hepatitis A. This form of viral hepatitis is also spread by the fecal-oral route. Hepatitis A is commonly passed through contaminated food. Food can become tainted with the virus when a carrier of the disease handles food after using the toilet without washing his or her hands.
Other common, but less serious health problems occur in day care. These include head lice and scabies infestations, which involves mites infecting the skin. Effective treatments for these are available.
What are some of the safety issues for children in day care?
Safety issues can also be a concern for children in day care. The child's level of risk is related to the ratio of adult caretakers to children in the day care setting. Ideally, there should be 1 adult for every 4 children between the ages of 2 and 3. For children ages 3 to 6, the ratio should be 1 to 8.
Another safety concern is the location of the day care facility. A center on a busy street or in an unsafe part of town may pose safety risks for children. Parents should visit a day care facility unannounced before enrolling their child. This will enable them to assess the staff and the setting. Parents can also get a sense of the staff's attitude toward health and safety issues, and look for signs of child abuse. The staff should treat the children with warmth and gentleness. At the same time, they should provide enough supervision and structure to keep the child safe and comfortable.
What questions should parents ask?
Parents should verify that the center is licensed by the state and is operating within the limits of that license. They should also ask about guidelines for limiting the spread of illness. These provisions should include requiring staff to have up-to-date immunizations, including those for hepatitis A. Also, policies should restrict children with symptoms of infection from attending day care.