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Tots Who Sneeze Have Last Laugh

Children who attend day-care centers build up resistance to colds

THURSDAY, Feb. 14, 2002 (HealthDayNews) -- Parents who feel guilty about subjecting their children to the gauntlet of colds that await them in day-care centers can take heart.

New research shows those same kids will likely suffer fewer sniffles later, when their peers who didn't attend day care are sneezing their way through elementary school.

Researchers with the University of Arizona's Arizona Respiratory Center tracked 1,246 children from birth for 20 years. They found that kids who were 2 and attended large day-care centers -- those with more than five children -- had nearly twice as many colds as children of the same age who were cared for at home. However, from the ages of 6 to 11, those who'd been in day care had only about a third the number of colds as children who had not been in day care.

By age 13, there was no difference between the two groups.

The study is the first comprehensive look at respiratory ailment trends among children of the day-care generation. It offers hard evidence for what most doctors have long suspected -- that exposure to colds in the early years lets children build immunities that will protect them in later years.

"This study gives credence to the theory that acquired immunity obtained in day care can protect a child from colds later in life," says lead author Dr. Thomas M. Ball, associate professor of clinical pediatrics at the University of Arizona. "But it also shows that regardless of whether that immunity is acquired at age 2 in day care, or at age 6 in elementary school, by the time children reach age 13, they are similarly protected from viruses."

The research appears in the February issue of Archives of Pediatric and Adolescent Medicine.

While both groups reach immune-system equality by puberty, there are some significant differences in colds experienced at age 2 or 3, compared with age 6 or 7.

For one thing, cold symptoms can be more exaggerated in younger children and chances of complications, such as bronchitis, are more common, says Dr. Stan Block, an associate clinical professor of pediatrics at the University of Louisville and University of Kentucky.

"A big caveat of this is respiratory infections do tend to be more severe when you're younger," he says.

Then there are those nasty ear infections.

Respiratory illnesses in toddlers are much more likely to lead to ear infections than they are in children over age 5. However, Block says parents shouldn't worry.

"Recent studies have shown that there are usually no long-term complications from repeated colds or ear infections that parents need to be concerned about," he says.

Still, parents who want to spare their children -- and themselves -- the misery of constant colds have a few options other than having to keep the kids at home.

For one thing, enrolling children in smaller day-care centers seems to reduce the numbers of colds, Ball says.

"The size of the center matters because there is simply more exposure to more viruses," he says.

In addition, since breast-feeding has been shown to have tremendous benefits in building children's immune systems, Ball advocates that mothers try to breast-feed for as long as they can. In addition, he urges day-care centers to offer breast-feeding support services, such as refrigerators where mother's milk can be stored.

However, washing your hands is still one of the best ways to battle the spread of bugs. "You can't beat the frequent washing of yours and your children's hands to fight the spread of germs," says Ball.

The National Center for Education Statistics reports that 59 percent of American children aged 3 to 5 were enrolled in child-care centers in 1999.

What To Do: Here's a helpful article from the American Academy of Pediatrics on caring for sick children in child care. The Centers for Disease Control and Prevention offers this article on ear infections in day-care settings.

Sources: Interviews with Thomas M. Ball, M.D., associate professor, clinical pediatrics, University of Arizona, Tucson; Stan Block, M.D., associate clinical professor, pediatrics, University of Louisville, Louisville, Ky., and University of Kentucky, Lexington, Ky.; February 2002 Archives of Pediatric and Adolescent Medicine
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