Two-year-old Susie is always sick. At least that’s how it feels to her mother. In just four months, Susie had been to my office seven times for various symptoms: runny nose, fever, an occasional ear infection, and diarrhea—and a cough and congestion that lingers for weeks each time it shows up. Susie had been out of day care more than she was in it, and lost work was becoming a problem for mom.
Germs—the common name for microbes that can infect people and cause infection—include viruses (“flu”), bacteria (“strep”), fungi (yeast), and parasites (worms). They are everywhere—most are not harmful, and some, such as the bacteria in the large bowel, are even helpful. Thankfully, our immune system is well geared to combat these invaders, but it takes time to develop specific immunity. The close, crowded confines of a day care or school classroom become the perfect breeding ground for the germs to attack susceptible children.
Children younger than age six have one cold per month from September through April, with each one lasting an average of two weeks. Children in the first two years of day care have even more. They are quite literally “almost always sick.” Fortunately, there are ways to fight back and reduce the chance of germs gaining a foothold.
Practice proper handwashing & hygiene.
Both children and caregivers need good handwashing and hygiene habits.
Use soap and water. Antibacterial gels/foam are not considered a substitute, but are a good alternative when a sink is not available.
Practice proper handwashing technique. Young children should be taught, and older children reminded, about proper technique when washing hands: use warm water, lather for 10–20 seconds, leave the faucet running while you dry your hands with a paper towel, then use the paper towel to turn off the water and to open the bathroom door handle.
Remember when to wash your hands. Caregivers and children should be reminded to wash their hands first thing in the morning, upon leaving school, before and after eating, and after using the toilet, touching their nose or mouth, touching pets, or playing in sandboxes.
Don’t sneeze into your hand—
or on people. All children that are old enough should be taught to sneeze or cough either downward toward the floor (away from other people) or toward their own shoulder and not into their hand.
Keep things clean.
Clean up after children—often. At schools and day cares, there should be daily cleaning of tables, toys, and other objects touched by children. Potty chairs and diaper-changing areas should be cleaned after each use, and toilets should be cleaned at least daily.
Sanitize with bleach. There are a variety of “sanitizing” products on the market, but one of the least expensive and most effective sanitizers is a 1:64 freshly made bleach solution. Add one tablespoon of bleach into one quart of water. After spraying it on hard surfaces, let it sit for two minutes before wiping it off.
Share the love—but not all the toys and bedding. Fabric toys and naptime bedding should only be used by one child.
Encourage the sick to recover at home.
Make sure the school or day care your child attends has a documented exclusion policy if a child is ill. All parents should obey this policy and be prepared to quickly pick up their child if called by the school or day care. Routine colds and ear infections are not a reason for exclusion. Be aware that for many illnesses, the period of highest contagiousness is the day before symptoms are present.
Strengthen your child’s immune system.
If the germ does make it past this first phase, it is important to keep your child’s immunity at its peak. Make sure children get adequate sleep, proper nutrition, and are fully vaccinated. Breastfeeding your infant until at least one year of age also boosts immunity. And, as much as possible, work as a team: when parents, schools, and health-care providers cooperate, it helps minimize preventable illness.
Miles Landis, M.D., is the founder of Lake Mary Pediatrics in Florida. He has been married 31 years and has four grown children who survived years of classroom germs.
