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How can baby avoid illness at daycare?
Q: My baby gets sick often. I will be putting him in daycare and would like to know best how to do this, since he already seems very susceptible to illness.
A: Gladys, it's very common for infants to be sick frequently. They can average a dozen illnesses a year between colds, ear infections, vomiting and diarrhea. In the first year of life, babies are exposed to many germs for the first time. But as they recover from each illness, they begin to build up immunity to protect them from that virus or bacteria. So when your baby is 2, he's likely to have about half as many illnesses. When he's between 3 and 5, he'll likely have half as many again.

Even though it's common for infants to be sick often, be sure to call your doctor when your baby is sick. The doctor will be able to check your baby and tell you whether he needs treatment, and whether he seems to have the normal amount of illnesses or if he might have a medical condition that's leading to the illnesses. Be sure to stay on schedule for your well-baby checks and immunizations at 2, 4, 6, 9, 12, 15, 18 and 24 months of age. Even if your child has a mild illness, he still can and should get his immunizations on schedule. These will help protect him from illnesses.

You're correct that childcare can affect the number of illnesses a child gets. Children in childcare are generally exposed to larger numbers of children and germs, and they average about two to three times as many colds, ear infections and episodes of diarrhea as children cared for at home.

If you need to go back to work or school and find childcare for your infant, consider a setting with smaller numbers of children to reduce your baby's exposure to illnesses. That would include the home of a friend, a relative, a caregiver who'll care for your child alone or with a couple other children, or a licensed family childcare home that cares for up to six children.

Above all, make sure the caregiver is well-trained and experienced, communicates well with you and provides your baby nurturing and individualized care, developmentally appropriate activities and a healthy and safe environment. In particular, make sure the caregiver washes her hands and your baby's frequently, especially after diapering and before meals.
Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician