DADvocate

Yesterday DrHelen posted concerning Daycare, Social Skills and Cognitive Development. From the post itself and the comments, it is clear that daycare can be better, worse or equal to home care with a parent depending on the parent and daycare staff and setting.

One aspect of daycare that didn't get touched upon is spread of disease. Generally, children in daycare are exposed to illnesses more often than those who stay at home. This article at personalMD points out some significant increases in illness in daycare children.

The investigators found that children in day care had an 89% higher rate of "nightly cough" and a 55% higher rate of nasal congestion compared with children cared for at home. Children in day care were also 21% more likely to catch a cold, and 48% more likely to contract an ear infection than were toddlers cared for in the home.

Risks for upper respiratory tract infections rose with earlier age of first enrollment in day care. The authors found that "the lifetime risk of doctor-diagnosed asthma was higher in children who started day care center attendance during the first 2 years of life" compared with children who started later in their development.

This report shows not only the spread of disease in daycare centers but also that the disease is spread to the child's family.

Day care centers bring together large groups of pre-school children in a setting that provides a fertile environment for the spread of communicable diseases and especially enterically transmitted infections. Outbreaks of hepatitis A, shigellosis, salmonellosis, giardiasis, and viral gastroenteritis have been increasingly reported to have occurred in day care centers in recent years. In addition to the morbidity to the children affected in these outbreaks, infection has often spread to the adults who take care of these children both within the center and at home.

Remember that the nurseries in health clubs, churches may be even more dangerous that a licensed daycare center. Staff is generally minimally trained or completely untrained and precautions may or may not be followed.

When my youngest daughter was 10 days old she contracted bacterial meningitis. She required 8 days of hospitalization. Twenty-one times they attempted a spinal tap in order to reach a definitive diagnosis via culture. Because she was so small they could not collect enough spinal fluid for culturing but the official diagnosis was bacterial meningitis. Spinal taps are performed without the benefit of any aneshtesia and are quite painful for the baby. The doctors also inserted a shunt in her chest so that the home health nurse could come by our house three times a day to administer antibiotics for 21 days after our daughter was discharged from the hospital.

The doctors' opinion was that our daughter probably contracted the bacteria from the changing table at the nursery of a health club that we went to. Our daughter had been cared for at home, no daycare. Needless to say our daughter never went to the health club nursery again until she was over 2 years old.

The possible effects of bacterial meningitis:

What are the effects of bacterial meningitis?
With early antibiotic treatment, the risk of bacterial meningitis being fatal is less than 15 percent, however, there is still a 10 to 15 percent chance of permanent brain damage. The level of damage depends on how much swelling and inflammation occurs near the brain. The stroke-like effects caused by the swelling can include:

• Hearing loss
  
• Mental retardation
  
• Organ damage
  
• Paralysis

Fortunately, the only remaining signs of our daughter's ordeal are two small pin head size scars from the shunt on her chest.