Daycares may put already-vulnerable kids at risk for serious complications from their illness, according to a new study.
The study involved children with a condition that results from premature birth, known as chronic lung disease of prematurity (CLDP), in which infants experience chronic respiratory problems such as coughing and wheezing.
Children with CLDP who attended daycare were nearly four times more likely to visit the emergency room over a one-year period than children with the condition who did not go to daycare. Kids in daycare with CLDP were also nearly three times more likely to have trouble breathing at least once a week, and twice as likely to need medications as non-daycare kids with CLDP.
Children at daycare are exposed to more germs than kids who stay home, and the resulting respiratory infections, which healthy children can typically handle, may be behind the findings, the researchers say. They advise health care professionals to inform parents of children with CLDP about the risks of daycare.
And they recommend children with the condition not attend daycare until they are at least 2 years old, to give their under-developed lungs a chance to grow and improve.
"We think that the physicians and the nurse practitioners and whoever cares for these children after they leave the hospital should educate the families on the possible risk of daycare exposure [for] the preterm infant and child with lung disease, particularly during the first couple years of life," said study researcher Dr. Sharon McGrath-Morrow, a lung specialist at Johns Hopkins Children's Center in Baltimore.
More than half a million babies born in the United States each year are premature, that is, born at 37 weeks of pregnancy or earlier. About 25 percent of babies born before 27 weeks develop CLDP, but it can show up in those born as late as 32 weeks. These infants are at increased risk for respiratory infections and have a higher rate of premature death and complications from infections. About a quarter continue to have lung problems as adults.
The researchers examined records of 111 children with CLDP ages 3 and under who, on average, were born after 26 weeks of pregnancy. Researchers asked their parents whether their children attended daycare, and whether they visited an emergency room, needed antibiotic or corticosteroid, had breathing problems and whether they were exposed to second hand smoke. (Corticosteroids are hormones sometimes given to children with CLPD to help them breathe.)
Parents of 22 of the children said their kids attended daycare. Of these, 37 percent had required a visit to the ER for their respiratory symptoms since their last doctor's visit, compared with 12 percent of the kids who didn't attend daycare. Half of the children in daycare needed antibiotics and 39 percent needed corticosteroids, while 26 percent and 19 percent of the non-daycare kids required these medications.
The researchers noted their results are based on the parents' reports, and parents may not always be able to recall this information accurately. The researchers also did not take into account environmental factors that may have influenced the results, such as whether the children were breastfed (breastfeeding may protect kids against respiratory illnesses).
Not a risk for healthy kids
It's possible that increased exposure to germs and the subsequent respiratory infections may put children with CLDP at risk for problems later in life, the researchers said.
The findings do not mean the daycare setting poses a risk to other premature infants, or to healthy children, the researchers said.
"Most healthy children tolerate respiratory infections and viruses without difficultly, and so daycare would not be considerate a problem for them," McGrath-Morrow told MyHealthNewsDaily.
The results are published in the October issue of the journal Pediatrics.
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