NEW YORK (Reuters Health) - Results of a large Danish study confirm that young children who attend group childcare, especially those without siblings, are at increased risk for catching respiratory infections compared with their counterparts who are cared for at home.
The study, which included more than 135,000 children, also shows that the increased risk is most pronounced in children 0 to 2 years of age and is greatest soon after they begin daycare.
Dr. Mads Kamper-Jorgensen, from Statens Serum Institut, Copenhagen told Reuters Health: "Previous small studies have suggested that childcare affects younger children more than older children and that only-children are at greater risk when enrolled in childcare. With the present huge study, we have confirmed these hypotheses."
"We were pleasantly surprised," the researcher added, "to show that only the first year after enrollment into childcare is associated with increased risk of acute respiratory infection." Thereafter, it decreases and after 1 year in childcare the risk is equal to that of children being taken care of at home.
Kamper-Jorgensen and colleagues used Danish national registries to gauge the impact of childcare attendance on acute respiratory infections in all Danish children aged 0 to 5 years in the period from 1989 to 2004.
They report in the journal Pediatrics that 138,821 children were hospitalized for an acute respiratory infection during the study period.
In children younger than 1 year of age, the first 6 months of daycare attendance were associated with a 69-percent higher incidence of hospital admission for acute respiratory infection compared with children in home care.
For children aged 1, 2, and 3 years or older, the first half-year in daycare was associated with a 47-percent, 41-percent, and 8-percent higher incidence of hospitalizations, respectively.
"Our findings may suggest that it would be optimal to postpone enrollment into childcare until after 1 year of age," the authors write.
The incidence of hospitalization decreased after 6 months in daycare and after 1 year or more in daycare the incidence mirrored that of children in home care.
For 0- to 2-year-olds living in homes with no other children younger than 5 years, the excess incidence of hospitalization due to respiratory infection in the first 6 months of childcare attendance was 100 percent compared with 25 percent for children living with one sibling and 9 percent for those with two or more siblings.
Unlike most other countries, Danish parents are allowed a total of 52 weeks of maternity or paternity leave with benefits following the birth of a child. "We suggest that parents keep children at home as long as possible during the child's first year," Kamper-Jorgensen said.
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