Nursery: A Necessary Trial by Fire for Young Immune Systems
It’s a familiar scene for many Australian parents: the sniffles, the coughs, the fevers, and the dreaded call from daycare. For toddlers and pre-schoolers embarking on their first year of formal childcare, a barrage of illnesses is almost a certainty. New research suggests that children can expect to contract around 15 different bugs in their initial 12 months of nursery, leading to an average of 13 days off care. While this period can be challenging, with some youngsters even requiring hospitalisation, it ultimately equips them with a stronger defence against infections as they progress through school.
The study, a comprehensive review of existing data, highlights the crucial role of early childhood education settings as an “immune system boot camp.” By exposing young children to a variety of common pathogens, nurseries help their developing immune systems learn to identify and fight off these invaders, fostering long-term resilience.
The Toll of the First Year: What to Expect
Researchers have outlined a typical pattern of illness for children in their first year of nursery:
- Respiratory Infections: An estimated 12 episodes of coughs, colds, and other upper respiratory tract infections are common.
- Gastrointestinal Upset: Children may experience around two bouts of diarrhoea and/or vomiting.
- Rash-Inducing Illnesses: At least one illness involving a rash, such as scarlet fever, slapped cheek syndrome, or hand, foot, and mouth disease, is also anticipated.
This increased exposure to infections in group settings means that children attending nursery from a younger age tend to get sick more frequently between the ages of one and five compared to those who remain at home. However, this trend reverses once they commence primary school. Children who haven’t had prior exposure to a childcare environment often find themselves getting sick more often when they first start school. The early exposure in nurseries appears to confer a degree of protection for the early school years, likely due to the immunity built up against common infections.
Understanding the Vulnerability: Why Do They Get Sick So Often?
The authors of the study, a collaboration between experts from UCL, the University of Cambridge, Cornell University, and North Middlesex University Hospital, delved into immunology, infectious disease genomics, and epidemiology to understand this susceptibility.
Dr. Lucy van Dorp, an infectious disease genomics researcher at the UCL Genetics Institute and co-author, noted the personal experience that spurred the research: “As parents, we were all struck by how often our collective nine children became ill after starting nursery. So we came together to do the first review of how often a child starting nursery will get sick in their first year of attendance and what can be done about it.”
Newborns initially benefit from antibodies passed from their mothers, providing a degree of protection. However, this maternal immunity wanes within the first year, leaving infants, particularly those entering childcare, more vulnerable. Their immune systems are essentially encountering these bugs for the first time, leading to frequent illnesses.
The Benefits of the “Boot Camp”
Despite the immediate challenges, the long-term benefits of this early exposure are significant. The nursery environment acts as a crucial training ground for the immune system.
Dr. Leo Swadling, from the UCL Institute of Infection, Immunity and Transplantation and another co-author, explained: “It’s normal for children to get sick a lot because their immune systems have never seen these bugs before – but then nursery serves as a ‘boot camp’ for their immune systems, building up resilience for the years ahead.”
This acquired immunity from common infections provides a protective shield as children transition into the more structured environment of primary school, where they often face fewer new pathogens.
Supporting Parents and Mitigating Spread
The researchers also called for greater understanding and flexibility from employers regarding parental leave and sickness absence. They urged employers to adopt realistic expectations about the likelihood and frequency of both child and parental/caregiver sickness absence once parental leave concludes.
“Employers need realistic expectations about the likelihood and frequency of both child and parental/caregiver sickness absence following the end of parental leave,” the authors wrote in Clinical Microbiology Reviews. “Attendance at formal childcare may tip the balance in favour of infection now rather than later.”
While acknowledging the inevitability of infections, the study also stressed the importance of proactive measures to reduce their spread.
Dr. Charlotte Houldcroft, a virologist at the University of Cambridge and the study’s corresponding author, commented: “We all have experience of our children coming home from nursery with a bug that leaves them, and often us, feeling pretty poorly – even occasionally needing hospital care. But it’s important for parents to follow guidelines to keep children home from nursery while unwell – and potentially for another day or two after recovery, depending on the type of infection. While infections during nursery are normal and common, it’s important to do what we can to mitigate their spread.”
Key Protective Measures for Parents
Vaccination remains one of the most effective strategies parents can employ to safeguard their children against serious illnesses.
- Stay Up-to-Date with Vaccinations: Dr. Swadling strongly encourages parents to ensure their children are up-to-date with all recommended vaccinations, as they are a key defence against severe infections encountered in childcare.
- Follow Sickness Guidelines: Adhering to nursery guidelines for keeping unwell children at home is crucial. This not only allows the child to recover but also significantly helps in preventing the transmission of infections to other children and staff.
- Consider Additional Recovery Time: Depending on the specific infection, it may be advisable to keep a child home for an extra day or two after they appear to have recovered to ensure they are no longer contagious.
By understanding the natural progression of childhood illnesses and implementing preventative measures, Australian parents can navigate this challenging but ultimately beneficial period with greater confidence, knowing they are helping to build strong, resilient immune systems for their children’s future.
