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The Dirt on Daycares

Patrick Boshell
November 20, 2018



Daycare versus homecare is a tough decision most parents with young children face. One thing most parents do agree on is that daycares and preschools are germ hotspots and have a reputation as ‘germ factories.’


For children that attend daycare and preschools, there is up to a three-fold increase in the risk of respiratory infections, ear infections, and diarrheal disease (2).  Respiratory infections in children <5 years old are a major public health problem and the most frequent cause of excessive antibiotic prescriptions in the pediatric population (3).  According to research, children attending daycare centers typically have between six and ten respiratory infections annually (3).


Why are kids in daycares more prone to infections?


If you’ve ever spent time with a large group of kids, it’s easy to see why there is an increased risk for infections – especially when you change your perspective and view the experience as your child does. 


The first thing you’ll notice is the behavioural habits as kids touch everything and have lots of physical contact with each other and parents – increasing the risk for diseases to spread person to person. 


The second thing you’ll notice is a general lack of personal hygiene as kids are just learning and it seems that everything they touch goes in their mouths.  Its also important to note that young children have an immature immune system and even if they have completed their vaccination series, kids are more prone to new infections to which they have not been exposed (2).


Can hand hygiene help reduce the spread of infections in daycare centers?


We’ve all heard the hypothesis that exposure to germs (good or bad) as children helps develop our immune system – but all those runny noses and sore throats do ultimately lead to a lot of sick days for both kids and their families.  Absenteeism due to illness is a continuous trend for kids and its estimated that 164 million days are lost each year in the United States among students in kindergarten to grade 12 (1).


It is important to note that the infectious disease risk in daycare environments does decrease significantly when appropriate diapering, hand hygiene, and food safety initiatives are practiced (2).  Hand washing, in particular, is the most important and effective step in helping to prevent infection transmission (3).  One of the advantages of daycares is that children get to learn about the importance of hand hygiene at an early age and it helps them develop essential habits.



What about alcohol hand sanitizer, is it safe for children to use?


Alcohol hand sanitizers can provide significant infection rate reduction (30% to 50%) and are commonly used in elementary school settings as part of a hand hygiene program.  Alcohol hand sanitizers have also been used in daycare centers by staff and by children but only under strict direction from staff.  For children two years of age or younger, it is not appropriate to use alcohol hand sanitizers due to their underdeveloped skin barrier function (4). 


A recently published study concluded that hand hygiene programs in daycare centers that also include hand sanitizer and educational measures for staff, children and parents helped reduce absent days and respiratory infections in children.  This of course also contributed to a reduction in antibiotic prescriptions for these kids (3). 


Clean Hands, Stay Healthy















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