It’s all too common: A toddler starts attending day care or preschool and suddenly it seems like they always have a runny nose, a cough or worse.
Experts estimate that children contract six to eight upper respiratory infections on average each year. As a parent, you may feel helpless in what seems like an endless cycle.
Pediatricians explain why little kids tend to get sick frequently after starting day care or preschool, what parents should know about this phenomenon, and how they can help.
Why does this happen?
“These days, parents of toddlers are not used to having a sick child,” said Dr. Dyan Hes, medical director at Gramercy Pediatrics in New York City. “This is because many of their babies were born during a pandemic and these children have essentially spent their lives in a bubble.”
She noted that lockdowns, social distancing and masks have decreased children’s exposure to common pathogens over the past two years. And even before the pandemic, toddlers often didn’t come into contact with many of these pathogens until starting day care or preschool.
“Pre-pandemic, I would reassure parents that children get sick when they start day care because they are exposed to many forms of the common cold and other childhood illnesses,” Hes said. “Now, two years into the pandemic, I would multiple this by 100! This does not mean that a toddler getting sick is dangerous. It may just happen all at once instead of gradually.”
Preschool and day care generally involve groups of children in rooms together, so it’s inevitable that they will spread contagious illnesses to each other.
“Many children will bring viruses with them to preschool and share them with others as they play and explore together,” said Dr. Benjamin Levinson, a primary care physician at Nationwide Children’s Hospital. “Children with minimal symptoms, which may seem like allergies, can still spread the virus they carry to others. Thus, it is very common for children to get several viral illnesses shortly after beginning preschool as they will be exposed to many viral strains for the first time.”
Can parents prevent it?
“Really, the only way you can prevent getting a virus or other illness is not to be near someone else with a virus, and that’s very difficult if you’re going to attend any kind of school,” said Dr. Arthur Lavin, a pediatrician at Akron Children’s Hospital. “Hand-washing can help slow the spread of viruses like the stomach flu, but for viruses like the common cold that are spread through the air, it can be very difficult.”
Lavin recommends teaching your child to wash their hands before eating and after using the bathroom in order to slow the transmission of viruses or infections that spread via touch.
“If we really wanted to stop people from getting colds or other sicknesses, we’d have to be in a permanent lockdown,” Lavin added. “When we were in lockdown, that was the first time in recorded history we had no flu epidemic. While that was amazing, no one is willing to live like that, and I wouldn’t recommend it.”
What else can parents do to promote their toddlers’ health?
Parents can’t fully prevent the spread of germs in day care and preschool settings, but there are ways to reduce the risk of infection and promote your child’s overall health.
“Facilitate good sleep and healthy nutrition habits to help bolster their immune system,” Levinson advised. “Spend time interacting with your toddler in a positive manner to help reduce stress levels. Avoid any smoke exposure for your child as this can harm their lungs and make respiratory viruses more likely to cause significant illness. Ensure your child is taking medications appropriately (i.e., inhalers for asthma) if they are prescribed.”
He noted that since “immune-boosting” supplements aren’t well-regulated and generally haven’t been proven to work to a meaningful degree, it’s better to focus on providing a well-balanced diet for your child.
“Little ones are known to put their hands everywhere,” Hes said. “When hand-washing is not an option, I would recommend using hand sanitizer. I’m not a huge fan of hand sanitizer with little kids because it is very drying and contains alcohol, but it is better than not cleaning their hands at all. Also, teach your child to sneeze into their upper arm and not into their hands.”
She also emphasized the importance of physical activity, even in the winter, and advised making sure your toddler gets at least three hours of active playtime each day.
What should parents do when their kid is sick?
When your child has a contagious illness, it’s important for them to stay home. Of course, this is easier said than done for many parents, who might not be able to afford time away from work or at-home child care.
In general, common colds and infections are not a source of worry, Levinson noted. Still, he recommends getting in touch with a medical provider if your child is showing signs of difficulty breathing, are in significant pain, or have a temperature of more than 100.4 degrees Fahrenheit for five days in a row.
“In pediatrics we see many, many children with relatively frequent viral infections and very few are sick enough to need to stay in the hospital,” Levinson said. “Additionally, if children get sick repeatedly, but their body clears the infection such that they get back to normal prior to getting sick again, this implies they have a good immune system that is working well.”
Lavin urged parents to keep in mind that colds are different from COVID-19 and to get out of the pandemic-induced mindset that a viral infection means something terrible will happen.
“What’s important to keep in mind with colds and other childhood viruses and infections is that they don’t threaten your child’s health,” Lavin said. “It sounds like a funny thing to say about something that makes you sick, but most viruses and infections leave your child unharmed, which is good news because you really can’t stop these viruses from flowing.”