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Published on: August 7, 2017
Daycare attendance and respiratory tract infections: a prospective birth cohort study
Linnea Schuez-Havupalo1,2, Laura Toivonen1,2, Sinikka Karppinen1,2
1Department of Paediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland.
Insights
Starting daycare increases respiratory infections in young children, but symptoms decrease over time. Support for families during this transition is crucial for managing childhood illness.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Respiratory tract infections (RTIs) are common in young children.
- Daycare attendance is a significant factor influencing children's exposure to infections.
Purpose of the Study:
- To explore the impact of daycare initiation on the burden of RTIs in young children.
- To analyze the relationship between different types of daycare and RTI incidence.
Main Methods:
- A longitudinal prospective birth cohort study involving 1827 children followed until 24 months of age.
- Diary data on RTIs and daycare type (center-based, family day care, home care) were collected.
- Repeated measures variance analyses were used to assess symptoms, antibiotic use, and parental absence.
Main Results:
- A significant increase in respiratory infection symptoms, antibiotic use, and parental absence was observed after starting center-based daycare.
- Symptoms peaked at 2 months post-initiation, followed by a decline over 9 months.
- Family day care showed weaker effects compared to center-based care.
Conclusions:
- Daycare initiation leads to a rapid rise in RTIs, followed by adaptation and a decline in symptoms with continued attendance.
- Interventions and support are needed for families during the initial phase of daycare enrollment.
Objective:
We explored the burden of respiratory tract infections (RTIs) in young children with regard to day-care initiation.
Design:
Longitudinal prospective birth cohort study.
Setting And Methods:
We recruited 1827 children for follow-up until the age of 24 months collecting diary data on RTIs and daycare. Children with continuous daycare type and complete data were divided into groups of centre-based daycare (n=299), family day care (FDC) (n=245) and home care (n=350). Using repeated measures variance analyses, we analysed days per month with symptoms of respiratory tract infection, antibiotic treatments and parental absence from work for a period of 6 months prior to and 9 months after the start of daycare.
Results:
We documented a significant effect of time and type of daycare, as well as a significant interaction between them for all outcome measures. There was a rise in mean days with symptoms from 3.79 (95% CI 3.04 to 4.53) during the month preceding centre-based daycare to 10.57 (95% CI 9.35 to 11.79) at 2 months after the start of centre-based daycare, with a subsequent decrease within the following 9 months. Similar patterns with a rise and decline were observed in the use of antibiotics and parental absences. The start of FDC had weaker effects. Our findings were not changed when taking into account confounding factors.
Conclusions:
Our study shows the rapid increase in respiratory infections after start of daycare and a relatively fast decline in the course of time with continued daycare. It is important to support families around the beginning of daycare.
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