A: Beth, it seems to be an unfortunate fact of life that children entering group care tend to get sick more their first year in the new setting. In fact, studies have shown that this illness pattern is similar whether children start childcare at 2 years old or have their first group experience in kindergarten. If it's any consolation, these illnesses help build children's immunity, and they generally stay much healthier in subsequent years.

It's also true that children in childcare bring these illnesses home and spread them to their parents and siblings. There are some things you can do to reduce the spread of illness in the family. You're right that hand-washing is most important. Here are a few other tips:

• Make sure that everyone in the family, even your 2-year-old, washes their hands after wiping their nose, diapering, and using the bathroom, and before meals and snacks.
• Keep alcohol-based hand sanitizer in the kitchen, bathroom, your car and your purse. When you're not able to wash your hands right away, use the sanitizer. A recent study showed that families of children in childcare who washed their hands and used hand sanitizer at home reduced by one-half the spread of gastrointestinal illness (vomiting and diarrhea) to family members.
• Teach everyone to cough and sneeze into their elbows. This keeps hands free of germs and reduces the spread to others.
• Wash the towels and disinfect the sink faucets, doorknobs, telephone and television remote control regularly. Remember that germs spread on objects that are frequently handled.
• Don't share food that has been in someone else's mouth. The saliva carries germs.
• Don't kiss your children on the mouth. Kissing on the forehead spreads fewer germs.
• Make sure your home is well ventilated. Fresh air helps blow away airborne germs that cause colds and flu. Also, be sure to take your children outdoors for fresh air every day.
• Make sure everyone stays up-to-date on immunizations. These can help prevent influenza (flu) and other serious illnesses.
• Talk with your daughter's child-care providers. Make sure they also follow good hygiene practices to reduce the spread of germs among the children and teachers.