Dear Dr Nina: My little boy keeps getting ill in crèche
Q I have a little boy in crèche and he is out sick more often than he is in. I understand that he is building up his immune system and all that, but there must be something I can do to boost it so that he doesn’t get sick so often. Would a multivitamin help? Also, the crèche has a rule that no one with a temp over 38°C can go in. Is this based on science?
Dr Nina replies: Many parents of crèche-aged children worry that there is something wrong with the child’s immune system but thankfully this is rarely the case.
Antibodies and protection to certain viruses are passed from the mother to the baby during pregnancy and at birth. Breastfed babies continue to benefit from some of their mother’s immunity that is transferred in breast milk.
Around the age of six months to a year, this passively-acquired immunity starts to wane. This leaves the baby’s immune system bare, with little memory for the over 200 bugs and viruses that it may be exposed to in the early years. This also often coincides with the start of crèche attendance.
Toddlers are unable to blow their nose, wash their hands or be aware of how germs are transferred. Enter any wobbler or toddler room and you will find them rolling and climbing over each other. Sharing toys, food and drool and generally interacting in close proximity on a prolonged basis.
Any virus or infection will pass easily form child to child in this environment. Those at home often become exposed to bugs brought home by older siblings and visitors. Pre-school children can expect to suffer from six to eight cold-like illnesses a year.
Vitamin C has long been thought to help keep coughs and colds at bay. This isn’t the case. Vitamin C intake may simply shorten the duration of a cough or cold in some people by maybe a day or so.
Vitamin D may be necessary or beneficial. Sunlight is our main source of this vitamin and as we are so far north, we do not get enough sunlight to boost this vitamin from the months of October through March.
All babies under a year should receive a daily vitamin D supplement. It is also advised in children up to five, those over 65 and anyone with dark skin living in northern latitudes.
If your child seems to be getting bugs but continues to develop normally, eats well, grows and gains weight then it is unlikely there is any serious underlying illness.
Signs to watch for are weight-loss, slowed growth or not reaching the same milestones as his peers. It is certainly worth checking out the hygiene and illness policy of your crèche. Children with contagious illness should be excluded form crèche until 24 hours after they have improved.
The policy of keeping a child out if they have had a fever the previous 24 hours may not necessarily be grounded in science but a young child with a febrile illness may be contagious so staying home for 24 to 48 hours make sense.
The best way to stay well is to lead a healthy lifestyle. For times when the pace of life means diet and lifestyle suffer, a short course of a general multivitamin may help fill the gap but it will not prevent disease.
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