More and more infants are being enrolled in daycare programs before the age of one, and as a result, we have seen an increased incidence of infections in our youngest daycare students—and yet we also know that the developmental benefits of being in a good daycare program outweigh the infectious risks. Yet how true are our concerns about infection—and if infections occur as a result in the first year of life, might that mean better immune protection as a child gets older? Hullegie et al. (10.1542/peds.2015-3356) share with us a longitudinal study involving a cohort of more than 2000 children followed for 6 years of which more than 1300 enrolled in daycare before a year of age.
These first year attendees were then compared with children enrolled after a year of age using medical records to study episodes of acute gastroenteritis over those 6 years. While first-year attendees in daycare had more gastroenteritis in their first year of life compared to those initially enrolled after a year of life, something interesting happened as these first year day care enrollees got older and stayed in day care--their incidence of gastroenteritis was less than other children who enrolled in daycare after age one.
The authors offer some rationale as to why this protection might occur and what the implications might be for other infections. We also wonder if this immune protection extends past 6 years of life which is when the data in this study stops. Hopefully the authors or others will continue to track this cohort or others to reaffirm the long-range implications of early daycare—which may help you convince parents of one year olds coming in with frequent common daycare infections that things will get better with fewer episodes likely as their child ages even if they stay in daycare. Go to the head of the class or at least the day care center near you and read this study to learn more.
