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Published on: February 23, 2014
Child care and common communicable illnesses in children aged 37 to 54 months
1Center for Applied Studies in Education, University of Arkansas at Little Rock, 72204, USA. rhbradley@ualr.edu
Insights
Children in large child care groups (more than 6 children) had higher rates of communicable illnesses. Early child care experience before age 3 reduced illness risk compared to later entry, but rates remained higher than in smaller groups or home care.
Area of Science:
- Pediatric Health
- Infectious Diseases
- Child Development
Background:
- Child care settings are common for young children.
- Understanding illness transmission in child care is crucial for public health.
- Previous research indicates a link between child care and illness, but the impact of timing and group size needs further clarification.
Purpose of the Study:
- To investigate the association between child care experience and communicable illnesses (gastrointestinal, respiratory, otitis media) in children aged 37-54 months.
- To specifically assess the effect of entering child care after age 3 years on illness rates.
- To explore the influence of child care group size and prior enrollment on illness incidence.
Main Methods:
- Utilized data from over 1100 participants in the National Institute of Child Health and Human Development Study of Early Child Care.
- Employed longitudinal logistic regression analyses to model illness outcomes.
- Included family, child, and child care variables as predictors in the statistical models.
Main Results:
- Children in large child care groups (>6 children) had increased rates of upper respiratory tract, gastrointestinal, and ear infections.
- Children with prior large-group child care experience before age 3 had fewer illnesses than those starting after age 3.
- However, even with early entry, illness rates were higher than in small-group care or home-based care.
- Illness rates were higher in European American children compared to African American children.
Conclusions:
- Enrollment in large child care arrangements (more than 6 children) is associated with a higher incidence of upper respiratory tract infections in children aged 37-54 months.
- Early exposure to child care (before age 3) may offer some protection against illness compared to later entry, though risks remain elevated compared to less intensive care settings.
Objective:
To examine the relationship between experience in child care and communicable illnesses (gastrointestinal tract infection, upper respiratory tract infection, and otitis media) in children aged 37 months to 54 months with particular focus on the effect of entry into child care after age 3 years.
Design:
Health, child care, and family data were obtained from more than 1100 participants in the National Institute of Child Health and Human Development Study of Early Child Care, a 10-site prospective study that began at birth. Longitudinal logistic regression analyses were performed using each type of communicable illness as the outcome variable, with family, child, and child care variables as predictors in the model.
Results:
For children aged 37 to 54 months, rates of upper respiratory tract illness, gastrointestinal tract illness, and ear infections were higher in those enrolled in child care arrangements with more than 6 children. During this period, children with experience in large-group care prior to age 3 years were less likely to be ill than children who entered child care for the first time after age 3 years. Even so, their rates were still higher than for those in small-group care or who were cared for at home between the ages of 37 and 54 months. Reported rates of respiratory tract and gastrointestinal tract illnesses were higher for European American than African American children. Number of hours per week in child care was not a factor.
Conclusion:
Children in child care arrangements with more than 6 other children experience more bouts of upper respiratory tract illness between the ages of 37 and 54 months.
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