How to keep your little ones healthy at nursery school

It’s the start of a new year, bringing with it exciting new beginnings. This may be the start of your little one’s daycare or crèche experience but along with all the positives of fun, excitement, stimulation and new friends, come the inevitable bouts of infections and illnesses. Sabine Warren explores why children get sick at daycare and what you can do to prevent this, or at least minimise the risks.

Going to crèche or nursery school should be an exciting chapter in your child’s life. However, this can be blurred by constantly fighting off viruses, trips to the doctor and trying to keep illness at bay in your up-until-now healthy child. 

Don’t be too quick to blame the new school for this because there’s a scientific explanation for it. Dr Terri Nunes, a paediatrician at Sunninghill Hospital, explains, “Babies are born with a passive immune system. Antibodies are acquired from their maternal side, crossing over from mother to baby through the placenta. For the first year or so, these antibodies mostly protect baby against getting sick, even when exposed to flu and other illnesses. These antibodies have a lifespan of about a year, and after that, there’s nothing to keep producing them.”

Dr Nunes continues, “‘Crèche syndrome’ as we call it, can be simplified by likening it to a computer. The toddlers have the hardware, there are mechanisms in place to make antibodies and they have white blood cells but they don’t have the software. Because the antibodies from the mother are no longer there to protect them by neutralising the viruses they’re exposed to, this is when they tend to start getting sick, from 12 to 18 months of age. Their antibodies first need to develop, which happens when a virus enters the body, makes them sick and the white blood cells come to the rescue and break it up. In this way, antibodies are produced against that virus. However, there are hundreds of viruses so every time they get a new virus, they first have to produce the antibodies to it to be protected from it. From 18 months to five years is the peak period for the development of antibodies in children. At this age, children notoriously get sick more frequently. And, if they now start being exposed to more people, say 30 kids, plus their accumulative 60 parents, this means more exposure to viruses.”

Upper respiratory tract infections are the most common. A cold at that age generally lasts three weeks. They produce mucus and wipe it on their hands, which is how it spreads. Children with allergies also tend to suffer more at daycare. They produce more mucus, resulting in more frequent and more severe illness.

Preventative strategies include cleaning toys and hands regularly. Good sleep habits certainly help too. And parents, please don’t send your sick toddler to school unless you really don’t have an alternative, since chances are, they’ll make another child sick. If they are on antibiotics, have a fever, or a tummy bug, keep them home. The first two days of an infection is when they are most infective.

Despite popular belief, Dr Nunes comments, “Vitamins have not been proven to work. A mature immune system is ultimately what is needed. And for that you need to feed your child a balanced diet.  Good forms of vegetables, proteins and carbohydrates are better building blocks to produce antibodies. A healthy body equals a healthy immune system. It is essential to minimise sugar and junk food. If, however, as can be the case in little ones, they don’t eat too well, then we will supplement with iron or multivitamins.”

Breastfeeding is another protective act. Parents with no option but to send their child to daycare at four months, should definitely try and breastfeed, as the milk has antibodies that can neutralise the germs in the gut.

Should you keep your little one at home a bit longer? “If you can, yes. Try to keep them home until they are two. Minimise exposure to keep them stronger for longer. Unfortunately, many people do not have the luxury of that option, as they have to go back to work,” adds Dr Nunes.

At the age of two, children interact with each other, and there is more chance of cross-contamination. Before two, they parallel play, so there’s less chance of sharing germs. A firstborn often stays home happily but chances are, the second child could be more socialised and want to go to crèche earlier.

“Another natural phenomenon causing illness in children aged 18 months to five years,” Dr Nunes adds, “is that they have small pipes – throat, ear and nasal passages. So, when they are sick and produce more mucus, it blocks these little pipes and sits around the tonsils and adenoids, which are relatively big for their little faces and act as obstructions in the passageways, often resulting in secondary infections.”

And lastly, “Ensure that inoculations are up to date and let them have the flu vaccine every year when they go to daycare. Babies can have the flu vaccine from the age of six months. As important, is that parents should be immunised. Your antibodies last forever if you have had an illness but the manmade antibodies and vaccinations have a lifespan, meaning that every 10 years, adults should have the Tdap (tetanus, diphtheria, pertussis) booster. And the flu vac every year for you, too, parents.”

Smoking

“And a little aside, but extremely important to parents who smoke: Stop! Smokers’ children definitely have more health problems. They get significantly sicker and more significant infections when they do get sick. Medical professionals can definitely see the difference with chest infections in cases where there’s parental smoking. Even if parents smoke outside, the tannin is on clothes and hands and irritates the nasal mucosa, which then produce more mucus. More mucus results in more infection.”

– Dr Terri Nunes, Paediatrician

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