Child care and common communicable illnesses: results from the National Institute of Child Health and Human Development Study of Early Child Care.

OBJECTIVES

To examine the relationship between experiences in child care and communicable illnesses (gastrointestinal tract illness, upper respiratory tract infection, and ear infections or otitis media) throughout the first 3 years of life and to investigate whether increased frequency of these illnesses is related to language development, school readiness, and behavior problems.

DESIGN

Health, child care, family, and child developmental data were obtained from more than 1200 participants in the National Institute of Child Health and Human Development Study of Early Child Care, a 10-site prospective study that began at the participants' birth. Longitudinal logistic regression analyses were performed using each type of communicable illness as the outcome variable, with family, child, and child care variables as predictors in the model, and followed by a series of regression analyses with developmental measures as the outcome variables.

RESULTS

Rates of illness were higher in children in child care than for children reared exclusively at home during the first 2 years of life, but the differences were nonsignificant by age 3 years. Number of hours in child care per week during the first year and number of other children in the child care arrangement were related to the rates of illness. There was no evidence that increased rates of illness have a negative effect on school readiness or language competence. However, there was some evidence that increased illness was associated with behavior problems as reported by mothers, but not by child care providers.

CONCLUSIONS

Children in child care experience more bouts of illness in the first 2 years of life, but differences are negligible by age 3 years. The increased rates of illness bear little relation to other aspects of children's development, except, perhaps, for a small increase in behavior problems.