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Staying healthy at daycare

The question:
I work outside the home and my baby is at daycare during the day. So far, she's been sick almost constantly. For a lot of reasons, I cannot give up my job. How can I help her to be healthier? Do I need to take her out of daycare or will this resolve itself with time? - Cassandra in Las Vegas

The Physician Answers:

Many thoughts come to mind as you pose your question on keeping your baby healthier. It is important to know that you have no reason to feel guilty for needing to work outside the home. Many group daycare programs can offer some great advantages if properly managed and maintained.

Trained personnel can offer activities specifically designed to enhance your baby's development. Group daycare also allows one child to be stimulated by the other children in the center. Play and learning continues in a group setting which is extremely stimulating for children. These are some great advantages of group daycare. Also, in many communities, daycare centers need to be licensed by the state. This means that the licensing agency attempts to regulate safety and health measures within that region-this creates a safer, controlled environment.

As well as some advantages of a group setting are also some disadvantages. One must be extremely careful when shopping for a daycare program. Ask for references and check each one thoroughly. Find the provider to child ratio and find out about the turnover among the providers. Get a full history of the center and ask to speak to a few providers that have left the program. Call some area preschools and kindergartens to see if they are able to direct you to the better programs in your area. Look through the windows of the center to see what you may observe-of course ask the director to spend some time in the center so you can directly observe the happenings.

One of the greatest pitfalls with a group daycare setting is the increased passing of infection among the caregivers and children. This seems to be the major drawback with the program that your baby is involved with. I would want to be certain that strict health and sanitation rules are upheld. While some illness is expected in this setting, the frequency which you describe seems over the top. I would ask the daycare center to read their policy describing sanitation rules and regulations and compare that to what you actually observe. It will discuss immunizations, TB testing, handling sick children in the daycare setting, food preparation and feeding utensils. It should include diaper disposal, hand washing policies, and the frequency of sanitizing all toys and stuffed animals. I would also check with the local health department to determine if there have been any founded complaints or violations against the daycare center.

Lastly, the most important advice is to trust your mother's intuition regarding the place. Even if things seem to check out but you still have an uncomfortable feeling, please shop for a new center. Remember, if you are constantly home with your sick baby because of sloppiness at the daycare, you are losing ground at your workplace and unnecessarily having your baby exposed to many sick periods. In this case, neither mother nor baby is satisfied, which partially sacrifices each of you.

Dr Jane Forester
Family Physician
Glencoe, IL

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