Minor infections are a normal part of childhood, but they can be puzzling and concerning for parents. If your child is in day care, the infections compound and can seem like an every day thing.
What infection symptoms should parents watch for in young children?
Dr. Leigh Grossman, a UVA Health System expert, provides tips for parents to navigate dealing with infections in young children.
Selected Podcast
How to Prevent, Identify and Treat Infections in Young Children
Featured Speaker:
Learn more about Dr. Leigh Grossman
Learn more about UVA Health System
Leigh B. Grossman, MD
Dr. Leigh Grossman is the medical alumni endowed professor of pediatric infectious disease, and the associate dean for international programs at the UVA School of Medicine. She has edited and authored five books; her newest book, The Parent’s Survival Guide to Daycare Infections, was released in October 2016.Learn more about Dr. Leigh Grossman
Learn more about UVA Health System
Transcription:
How to Prevent, Identify and Treat Infections in Young Children
Melanie Cole (Host): Minor infections are a normal part of childhood but they can be puzzling and concerning for parents. My guest today is Dr. Leigh Grossman. She's the Medical Alumni-endowed Professor of Pediatric Infectious Disease and Associate Dean for International Programs at the UVA School of Medicine. She's also edited and authored five books including her newest book, The Parent's Survival Guide to Daycare Infections. Welcome to the show, Dr. Grossman. So, a question that parents always seem to have is, “Does getting sick in daycare or school help kids build up those immunities”?
Dr. Leigh Grossman (Guest): That’s a great first question, Melanie, and I appreciate it because I think many people who send their children off to daycare, preschool, kindergarten, are very concerned that the health, not only of their child, but what they bring home, just ratchets up immediately. And it does, in fact, because they're exposed to germs of all varieties from all the other kids they are in close contact with. Having said that, each one of those infections endows them with immunity, or an ability to prevent future infections with that germ. So, this is an absolutely normal part of childhood, and whether you do this at two or you do it at four, whenever you enter the larger pool of germs, you're going to get sick, and you're going to get sick with organisms that you need to see in order to develop normal immunity.
Melanie: So, what are some of the most common infections that you see, that children in daycare have?
Dr. Grossman: Well, the classic colds, coughs, runny noses, ear infections, are the usual and customary that plague parents most of the way through the winter. And, if you accept that the normal, healthy child, with the normal robust immune system is going to have five to seven of these infections per year--that's an average; many have more, some have less--but the average is five to seven a year and most of those are clustered in the winter months when these kids are in close quarters. And so, that's every month, every other month? So, it is constant, and if you have two or three kids in the house that are bringing these bugs home, everybody is sick for prolonged periods of time during the winter months.
Melanie: Isn't that the truth?
Dr. Grossman: Yes. So, the other common infections are, obviously, is the stomach flus, the vomiting, diarrheal illnesses, and, additionally, common viral rashes. None of these infections are life-threatening in and of themselves, so they are just a huge toll on the family. Sleepless nights; can I take my child to daycare the next day? Can I go to work? Am I going to be sick with this germ? All of the above questions continue on a regular basis.
Melanie: So, then let's continue with that question, Dr. Grossman. When do you keep them home? What do you tell parents about the symptoms that they might see? Whether it's a stuffy nose or cough or watery eyes; when do you keep a child home and when do you say "Okay, they're all right to go to daycare" ?
Dr. Grossman: Great question. The real truth for me is whether that child can carry on normally. So, if they're well enough to continue with normal activities, whether they have a runny nose, or a mild rash, they acquired this infection at the daycare or the preschool and so to think that keeping them home is going to shelter the rest of the children from that infection--there's no way. They are all spreading around these germs in a normal fashion. However, at the point where a child has a fever, is too fatigued to participate in normal activities, has diarrhea that cannot be contained, is vomiting, has symptoms that do not allow them normal participation in the school activities, then they need to stay home. Above and beyond that is a child who has a fever above 101.
Melanie: So, what should you look for in a daycare center for your child in terms of infection prevention best practices? Are there certain things when you're walking around, looking at a daycare center, that you should be looking for?
Dr. Grossman: At the point where you're looking for a new daycare or a daycare for your child, it's a dicey time, and you can go in and you can look at colors on the wall and great school materials and pleasant environment and wonderful, nurturing people, but from an infection control standpoint, decreasing the risk of serious infectious disease, not the things we've been talking about previously, I am very interested in what they're doing for their infants, because that's a high-risk group, and so, I want to make sure that there are less than three or four per each caretaker in the infant spaces. Are there separate rooms and caregivers for diapered and non-diapered children? They should be different caregivers; they should not be all grouped together. Are food preparation and feeding areas separated from where you change diapers? Do you have proper hand washing facilities and procedures? There should be policies on bedding and toy and play equipment cleaning. They should have policies on when children must stay home and they must have policies on how parents are notified if they're children become ill at daycare. I want to know if they have a sick room for children who have minor illnesses or become sick at school until their parents can pick them up. I also want attendee policies. So, I want policies for children entering that daycare center that include a healthy child or documentation of what the child has that the daycare center needs to worry about, and what are the vaccine policies for each daycare center? In addition, the personnel or staffing policies are extremely important to know that the staff is healthy and does not have a communicable disease, and staff vaccines so that the staff are also immunized against the usual childhood illnesses so they're not further spreading around illnesses. And, lastly, you want pet policies, because some daycare centers encourage having animals and pets in the daycare center and you want policies to insure that they're not spreading a disease that can be prevented.
Melanie: So, how can one prevent infection in their children, if at all possible, and what do you think of the use of sanitizers all over the place? Do you want us teaching our children, of course, to wash our hands, Dr. Grossman, and to teach them proper hand washing, but what about using sanitizers after playing with communal toys or any of those kinds of tips? What do you think?
Dr. Grossman: Well, as we started, I have accepted that I am not going to prevent the usual and customary viral illnesses in this age group and I don't really want to, because I do want to boost their immunity with these illnesses, as unpleasant and difficult as they are to manage for the parents for this age child. Having said that, the organisms that I would like to decrease the spread of are things like strep throat, which we can treat with antibiotics, but if we could decrease the amount of that and that requires sanitizing the common use tables and using hand sanitizers after or before eating. You cannot stop a child from touching their eyes, their nose, their face in the way you might be able to educate adults. And so, I think the hand sanitizers in this setting would be before eating, and before and after using the bathroom.
Melanie: In just the last few minutes, tell us about your book, The Parent's Survival Guide to Daycare Infections.
Dr. Grossman: So, this is a book that was born out of a previous book that was written for pediatricians and public health care providers and nurse practitioners and daycare providers, and that book is in its eighth edition. And this current, new book was written because the professional guide was being picked up by parents and utilized, so we changed that book; I've edited this book with thirty-nine infectious disease authorities from around the country, on what to do with specific infections, how to choose a daycare center, what vaccinations are recommended, what policies are recommended for, let's say, a higher-risk child, such as an infant or a child with cardiac with disease or a child with cerebral palsy, so there might be other things that you would do for those children that we would recommend. So, it is a reference guide, hopefully user-friendly It's just out and so we don't have too much feedback, yet, but I'm looking forward to seeing parents' response to this new book.
Melanie: And, where can they find it?
Dr. Grossman: On the web, and it's The Parent's Survival Guide to Daycare Infections; Amazon has it on-line.
Melanie: Thank you so much for being with us today, Dr. Grossman. It's such great advice for parents and the book is called The Parent's Survival Guide to Daycare Infections, by Dr. Leigh Grossman. You're listening to UVA Health Systems Radio and for more information, you can go to www.uvahealth.com. That's www.uvahealth.com. This is Melanie Cole. Thanks so much for listening.
How to Prevent, Identify and Treat Infections in Young Children
Melanie Cole (Host): Minor infections are a normal part of childhood but they can be puzzling and concerning for parents. My guest today is Dr. Leigh Grossman. She's the Medical Alumni-endowed Professor of Pediatric Infectious Disease and Associate Dean for International Programs at the UVA School of Medicine. She's also edited and authored five books including her newest book, The Parent's Survival Guide to Daycare Infections. Welcome to the show, Dr. Grossman. So, a question that parents always seem to have is, “Does getting sick in daycare or school help kids build up those immunities”?
Dr. Leigh Grossman (Guest): That’s a great first question, Melanie, and I appreciate it because I think many people who send their children off to daycare, preschool, kindergarten, are very concerned that the health, not only of their child, but what they bring home, just ratchets up immediately. And it does, in fact, because they're exposed to germs of all varieties from all the other kids they are in close contact with. Having said that, each one of those infections endows them with immunity, or an ability to prevent future infections with that germ. So, this is an absolutely normal part of childhood, and whether you do this at two or you do it at four, whenever you enter the larger pool of germs, you're going to get sick, and you're going to get sick with organisms that you need to see in order to develop normal immunity.
Melanie: So, what are some of the most common infections that you see, that children in daycare have?
Dr. Grossman: Well, the classic colds, coughs, runny noses, ear infections, are the usual and customary that plague parents most of the way through the winter. And, if you accept that the normal, healthy child, with the normal robust immune system is going to have five to seven of these infections per year--that's an average; many have more, some have less--but the average is five to seven a year and most of those are clustered in the winter months when these kids are in close quarters. And so, that's every month, every other month? So, it is constant, and if you have two or three kids in the house that are bringing these bugs home, everybody is sick for prolonged periods of time during the winter months.
Melanie: Isn't that the truth?
Dr. Grossman: Yes. So, the other common infections are, obviously, is the stomach flus, the vomiting, diarrheal illnesses, and, additionally, common viral rashes. None of these infections are life-threatening in and of themselves, so they are just a huge toll on the family. Sleepless nights; can I take my child to daycare the next day? Can I go to work? Am I going to be sick with this germ? All of the above questions continue on a regular basis.
Melanie: So, then let's continue with that question, Dr. Grossman. When do you keep them home? What do you tell parents about the symptoms that they might see? Whether it's a stuffy nose or cough or watery eyes; when do you keep a child home and when do you say "Okay, they're all right to go to daycare" ?
Dr. Grossman: Great question. The real truth for me is whether that child can carry on normally. So, if they're well enough to continue with normal activities, whether they have a runny nose, or a mild rash, they acquired this infection at the daycare or the preschool and so to think that keeping them home is going to shelter the rest of the children from that infection--there's no way. They are all spreading around these germs in a normal fashion. However, at the point where a child has a fever, is too fatigued to participate in normal activities, has diarrhea that cannot be contained, is vomiting, has symptoms that do not allow them normal participation in the school activities, then they need to stay home. Above and beyond that is a child who has a fever above 101.
Melanie: So, what should you look for in a daycare center for your child in terms of infection prevention best practices? Are there certain things when you're walking around, looking at a daycare center, that you should be looking for?
Dr. Grossman: At the point where you're looking for a new daycare or a daycare for your child, it's a dicey time, and you can go in and you can look at colors on the wall and great school materials and pleasant environment and wonderful, nurturing people, but from an infection control standpoint, decreasing the risk of serious infectious disease, not the things we've been talking about previously, I am very interested in what they're doing for their infants, because that's a high-risk group, and so, I want to make sure that there are less than three or four per each caretaker in the infant spaces. Are there separate rooms and caregivers for diapered and non-diapered children? They should be different caregivers; they should not be all grouped together. Are food preparation and feeding areas separated from where you change diapers? Do you have proper hand washing facilities and procedures? There should be policies on bedding and toy and play equipment cleaning. They should have policies on when children must stay home and they must have policies on how parents are notified if they're children become ill at daycare. I want to know if they have a sick room for children who have minor illnesses or become sick at school until their parents can pick them up. I also want attendee policies. So, I want policies for children entering that daycare center that include a healthy child or documentation of what the child has that the daycare center needs to worry about, and what are the vaccine policies for each daycare center? In addition, the personnel or staffing policies are extremely important to know that the staff is healthy and does not have a communicable disease, and staff vaccines so that the staff are also immunized against the usual childhood illnesses so they're not further spreading around illnesses. And, lastly, you want pet policies, because some daycare centers encourage having animals and pets in the daycare center and you want policies to insure that they're not spreading a disease that can be prevented.
Melanie: So, how can one prevent infection in their children, if at all possible, and what do you think of the use of sanitizers all over the place? Do you want us teaching our children, of course, to wash our hands, Dr. Grossman, and to teach them proper hand washing, but what about using sanitizers after playing with communal toys or any of those kinds of tips? What do you think?
Dr. Grossman: Well, as we started, I have accepted that I am not going to prevent the usual and customary viral illnesses in this age group and I don't really want to, because I do want to boost their immunity with these illnesses, as unpleasant and difficult as they are to manage for the parents for this age child. Having said that, the organisms that I would like to decrease the spread of are things like strep throat, which we can treat with antibiotics, but if we could decrease the amount of that and that requires sanitizing the common use tables and using hand sanitizers after or before eating. You cannot stop a child from touching their eyes, their nose, their face in the way you might be able to educate adults. And so, I think the hand sanitizers in this setting would be before eating, and before and after using the bathroom.
Melanie: In just the last few minutes, tell us about your book, The Parent's Survival Guide to Daycare Infections.
Dr. Grossman: So, this is a book that was born out of a previous book that was written for pediatricians and public health care providers and nurse practitioners and daycare providers, and that book is in its eighth edition. And this current, new book was written because the professional guide was being picked up by parents and utilized, so we changed that book; I've edited this book with thirty-nine infectious disease authorities from around the country, on what to do with specific infections, how to choose a daycare center, what vaccinations are recommended, what policies are recommended for, let's say, a higher-risk child, such as an infant or a child with cardiac with disease or a child with cerebral palsy, so there might be other things that you would do for those children that we would recommend. So, it is a reference guide, hopefully user-friendly It's just out and so we don't have too much feedback, yet, but I'm looking forward to seeing parents' response to this new book.
Melanie: And, where can they find it?
Dr. Grossman: On the web, and it's The Parent's Survival Guide to Daycare Infections; Amazon has it on-line.
Melanie: Thank you so much for being with us today, Dr. Grossman. It's such great advice for parents and the book is called The Parent's Survival Guide to Daycare Infections, by Dr. Leigh Grossman. You're listening to UVA Health Systems Radio and for more information, you can go to www.uvahealth.com. That's www.uvahealth.com. This is Melanie Cole. Thanks so much for listening.