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How can you prevent getting sick from daycare?

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    It's normal for toddlers to get sick quite often when they start daycare, contracting six to 12 viruses in the first year alone. This is because daycare and schools are ideal environments for the spread of viruses. Illnesses such as the common cold, stomach bugs and hand, foot and mouth disease are easily spread through direct and indirect contact with kids who are coughing, sneezing, rubbing their snotty noses, and sharing toys and food. As long as your toddler is just developing these typical viruses and not more serious bacterial infections like meningitis, there's no reason to be worried about his immune health—though having a sick kid all the time is likely to cause you some headaches.

    Preventing illnesses in infants or newborns can be a challenge, even more so if you have other school-age children in your home. So, how do you prevent infants or newborns from getting sick? Although you cannot completely control the germs that your children bring into your home from school or daycare, there are things that you can do to help. Frequent hand washing, disinfecting surfaces and doorknobs, and sanitising are all ways that can help.

    Why do children get sick from daycare/school?

    In child care centres and schools, germs can spread easily with kids playing near each other. Some of the main ways diseases can be spread are through the air when a sick child coughs or sneezes or through direct contact when an ill child touches infectious parts of their body then touches toys or other children, who may then touch their mouth, nose or eyes. Daycare centres and schools take precautions by encouraging children to practice good hygiene by keeping their hands clean and the toys they play with clean. They also keep kids showing signs of sickness away from other children and not allowing sick kids to attend.

    Most children will experience a mild cold or infection at some stage in their childhood. However, in some cases, a sick child may spread their illness to other children or adults if they attend child care or school while infectious. This is why it is important to keep your child at home or away from child care or school when they are sick and lookout for early signs and symptoms.

    What are the most common schoolyard illnesses?

    Many types of illnesses can go around child care centres and schools. Most are mild illnesses that will cause discomfort. However, some can be serious. A number of these diseases have vaccines that are included in the Immunisations Schedule Victoria, for example:

    • Chickenpox (varicella)
    • Whooping cough (pertussis)
    • Measles, Mumps, Rubella
    • Rotavirus
    • Tetanus
    • Influenza
    • Hepatitis B
    • Meningococcal ACWY

    Other mild illnesses children could get include:

    • Cold
    • Conjunctivitis
    • Ear infections
    • Hand Foot and Mouth disease
    • Gastro

    Illnesses like the common cold, conjunctivitis and hand foot and mouth disease do not have vaccinations. Although these illnesses rarely cause serious symptoms, children should still be kept home from child care or school until not infectious.

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    How Sick is Too Sick?

    When your child is ill, the first decision you need to make is whether they are too sick to send to child care. Many children with a mild illness, such as a cold, can attend child care without causing harm to themselves or the other children.

    However, you should always check your child care provider's policy on illness before you send your child off to child care for the day. Many providers have clear guidelines on sick children, which should be adhered to. A common example of this is: 'If your child's nose is running with green or yellow mucous, they should be kept home'.

    Nothing is more likely to cause friction between care providers and parents than when sick children are sent to care when they should be kept at home, so make sure you are very familiar with the policy and stick to it!

    It is sensible to have a sick day contingency plan ready for the day your child is too ill to send to child care.

    Make sure you are familiar with your child care provider's policy on sick children and never pressure your provider to accept your child if they are ill. Remember that it is the child care provider's responsibility to maintain a healthy environment for all the other children, staff, and families associated with the child care service, and they can't make exceptions. 

    Another good habit to get into is to notify your child care provider about any illness that occurred the night before. Many children go to bed with mild symptoms and wake up perfectly healthy after a good night's sleep. However, advising your service of any upsets the night before may make them more alert to any additional signs of sickness your child displays during the day.

    While it is sometimes okay to send your child off to care with a cold, there are many occasions when you should keep your little one at home. 

    When making your decision at the beginning of the day, ask yourself these three questions:

    1. Will my child be well enough to comfortably and happily participate in the activities of the day?
    2. Will my child's care provider be able to care for my child without it affecting their ability to look after the other children?
    3. Will my child pass the illness on to their playmates if I send them in today?

    In addition, if your child displays any of the following symptoms, you should always keep them at home until you have the all-clear from the doctor or until the symptoms lessen and the child seems well enough to return to care:

    • A temperature and fever are accompanied by a behaviour change and other signs of illness such as lethargy, persistent crying or breathing difficulties.
    • Signs of severe illness such as uncontrolled coughing, breathing difficulties, wheezing, persistent crying and lethargy.
    • A respiratory illness such as bronchitis or influenza.
    • Uncontrolled diarrhoea.
    • Vomiting, once a child has vomited, most doctors recommend that they should not return to child care for a minimum of 24 hours.
    • Any rash, especially when accompanied by a fever or behaviour change. Children with chickenpox can return to child care on the sixth day after their rash appears. Children with impetigo can return to care 24 hours for starting a course of antibiotics, and children with scabies can return to care after they've been treated.
    • Mouth sores that cause drooling.
    • Bacterial conjunctivitis and yellow discharge from the eye. Your child can return to child care 24 hours after starting a course of antibiotics.

    How To Prevent Or Reduce The Likelihood Of Illness

    It's unlikely that you can entirely prevent your child from getting sick – children are inevitably going to get coughs, colds and flu.

    The good news is that colds rarely cause serious harm. They make your child feel unwell. They will usually get better in 7-10 days – if not earlier, although a cough can last up to 3 weeks.

    Here are some things to help relieve your child's symptoms:

    • Keeping your child at home to rest can help fight the virus and help your child feel better.
    • Encourage your child to drink their usual amount of fluids.
    • Avoid exposure to cigarette smoke.

    Get your child to gargle warm salty water for sore throats, suck on ice or a throat lozenge. Pain relief medicines like paracetamol and ibuprofen can help ease the pain of a sore throat. Aspirin is not suitable for children.

    Prevention Is The Best Cure

    Preventing the spread of germs plays a huge part in avoiding the spread of illness. Your child care provider should have strict policies on how they encourage good hygiene in the centre. However, good hygiene starts in the home, and it is worth teaching your child good habits from as early as possible, such as:

    • Covering their mouths when sneezing or coughing.
    • Keeping their hands away from their eyes, nose and mouth.
    • Using tissues to blow their nose and throwing them in the bin after use.
    • Washing their hands with soap and running water.

    Does My Child Need Antibiotics?

    Although it might be tempting to ask your doctor for antibiotics when your child is sick, it is a misconception that they will speed up recovery or cure cold and flu viruses.

    Using antibiotics to treat your child's cold and flu symptoms contributes to antibiotic resistance. Because antibiotics only work on infections caused by bacteria, when they are used incorrectly, we are allowing the bacteria to become resistant – in your child and the wider community. Which, in the long run, will mean they no longer work when we need them to. Find out more about antibiotic resistance.

    However, it is important to talk to your doctor if your child's symptoms are not improving.

    The Tricky Issue Of Ear Infections

    My son had several ear infections during his first year of daycare. I found it difficult to know whether antibiotics would help as Dr Google had conflicting answers.

    The Royal Australian College of General Practitioners recommends that antibiotics be routinely used in children with ear infections between two and 12 years of age, as most ear infections will clear up within a couple of days.

    However, Aboriginal and Torres Strait Islander children are at higher risk of complications and should be treated early, so make sure you check in with your health professional.

    If symptoms are not improving, it is important to seek medical advice and take your child in for a check-up. In this instance, your doctor might prescribe a short course of antibiotics.

    Infants and Illnesses

    When we get sick, our body's immune system kicks in to fight off the illness as an adult. Unfortunately, infants have not developed a strong immune system to fight off illnesses on their own. One of the most common viruses that infants or newborns develop is Respiratory Syncytial Virus or RSV. Why is this virus so common among infants during cold and flu season? Older children or adults get RSV, often without symptoms. A simple cough or sneeze can transmit the virus to small babies.

    If your baby develops RSV, it can be confirmed through a simple nose swab at your child's pediatrician. Things to look out for in your infant are sneezing, green snot, congestion, coughing, rapid breathing (more than 60 breaths per minute), or having a hard time crying. Often infants will be admitted to the hospital to be monitored through the peak of the illness.

    What vaccinations does my child need before starting child care or school?

    Vaccinations provide the best possible defence against serious illness and disease. In Victoria, there are several recommended vaccinations children can receive for free through the Immunisation Schedule Victoria. These include the vaccines recommended in the National Immunisation Program.

    Check with your doctor or immunisation provider if you're unsure which vaccines your child needs or may have been missed.

    Some childcare centres require you to prove your child's immunisation status is up-to-date before you can enrol or attend an approved early childhood service. An immunisation history statement shows whether a child's immunisation status is up-to-date and can either be an official record issued by the Australian Immunisation Register or a letter from your GP or recognised immunisation provider.

    Prevention is Better than Cure

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    Preventing the spread of germs is a key part of avoiding the spread of illness. Your child care provider should have clear policies outlining the steps to encourage good hygiene among the children. However, good hygiene starts in the home, and it is worth teaching your child good habits as early as possible.

    Encouraging your child to adopt the good habits listed below will slow the spread of germs and hopefully reduce illness.

    • Wash your hands regularly: while most children are taught to wash their hands after going to the toilet, children should also be encouraged to wash their hands when they are dirty, before and after eating, after messy activities and when they do anything which puts them in contact with potentially germy objects such as animals.
    • Cover your mouth when coughing: uncontrolled coughing and sneezing quickly spread germs around an area. Children should be taught to cover their coughs with whatever they can. While a tissue might not be handy when the urge to cough comes on, children can cough into their hands and wash them or into the crook of their arm or sleeve.
    • Avoid close contact with sick people: when someone in the family is sick, make sure the above two rules are strictly applied to avoid germs within the family.

    A Note about Colds and Flu

    Children in child care are more susceptible to winter colds and flu because they regularly contact other children. So while it might be tempting to dose your little one up with the latest potion available at the pharmacy, it might be more effective to try cuddles, liquids and plenty of bed rest. Research conducted by an American think-tank, the Cochrane Library, has recently shown that many of the cold and flu remedies promoted as beneficial for children have little or no effect.

    The research included a review of devices that change the air in your child's room, such as dehumidifiers and vaporisers, and found no evidence to prove they work.

    The researchers also looked at cough medicines containing antihistamines and found no difference in the recovery rate of children treated with the medicine and those that weren't.

    The research concludes that winter colds and flu have to be put up with and that generally healthy children will recover of their own accord in a few days.

    The only way to prevent kids from getting sick is to wash their hands several times a day (or have their daycare provider help when you're not there) and to teach them healthy hand hygiene when they're old enough to catch on. 

    Teaching kids to "dab" or sneeze into their elbow is a good one to start with. Alcohol-based hand sanitisers can also fill in when they're at the park, and a sink is unavailable as for strengthening your child's immunity, getting plenty of sleep and physical activity, and eating a balanced diet are your best bets. Supplements or individual foods that claim to be immunity boosters don't live up to their claims.

    The good news is that once you get past this painful first year (more painful for parents, usually!), your child's immune system has been given a huge boost. A study by the University of Montreal found that toddlers in group child care get sick more often than toddlers who stay at home but found those same kids get sick less often than their peers during the primary school years. It might seem like a lifetime, but it's not forever. Good luck!

    Young children who are in daycare very often get frequent upper respiratory tract infections, including colds and secondary ear infections. In fact, experts estimate that the average child gets six to eight viral upper respiratory tract infections each year.

    Family day care is where a child is educated in a small group in a family style atmosphere at an educator's home, seeing the same educator or educators each day. ... The educator's children must be counted in those seven children if they are under 13 years and not being cared for by another adult at the premises.

    Immunity obtained in day care protects a child from colds later in life," he says. "But it also shows that whether children acquire immunity in preschool or elementary school, by the time they are 13, they seem to have similar levels of protection from viruses."

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