Day Care




Children in day care centers are often around other children who may be sick and are more likely to catch an infection that kids who do not attend day care. Respiratory infections, ear infections, and diarrhea are common at day care centers. Some research has linked asthma to day care.

However, keep in mind that being around the large number of germs in day care may actually IMPROVE your child's immune system in the long run.

Teach your child to wash his or her hands before eating and after using the toilet. Infection is spread most often by children putting dirty toys in their mouths, so check your day care's cleaning practices. Keep your own children home if they are sick.

The risk of infection in a day care center may also be reduced by:
  • Breastfeeding infants
  • Developing policies and training programs that help reduce the spread of bacteria and viruses at the day care center
  • Preparing food and changing diapers in different areas
  • Making sure day care staff and children have up-to-date immunizations
Ask about the child to staff ratio.

How many children are there for each staff member? The fewer children each staff member is responsible for, the better. The American Academy of Pediatrics recommends a ratio of one staff person for 3 to 5 small children and one staff member for 7 to 10 older children .
Are the younger and older children separated? Separating the older and younger children helps reduce the number of infections that are passed around.

Ask how the center cares for sick children.

How is medicine given?
How are parents told about illness among the children?
When must children stay home because of illness?
Does the center have a "sick room" for children with minor illnesses?
Is there a nurse or doctor to help with medical care?
Are children required to have vaccinations before coming to day care?
Is a physical exam required before admission?
Does the day care center keep a record of health-related problems, such as illnesses, injuries and accidents, for each child?

Ask about staff training.

What are the training requirements for staff members?
Are all staff members certified in basic first aid?
Are all staff members trained in child development?
Are all staff members trained in identification of abused children?
Are all staff members trained in preventing illness and injury?
Does the center have rules about careful and frequent hand-washing? This is key to reduce the spread of illness among the children. All staff members must wash their hands each time they diaper a child and before fixing meals or snacks.

Check building and playground safety.

Are poison control phone numbers and ambulance phone numbers clearly posted?
Does the playground have impact-absorbing surfaces, such as wood chips, under the swings and slides?
Are young children able to get to high places?
Are the children protected from strangers?
Are fire drills held at least every month?
Are there smoke alarms throughout the building?
Does the center use space heaters? If so, are they being used properly?
Are safety gates used in areas for small children?
Are electric outlets covered?
Are sharp corners of furniture covered?
Are the toys kept clean? Washable toys should be washed every day with a disinfectant cleaner, such as Lysol or a solution of water and bleach.
Does the day care staff regularly clean all surfaces with disinfectant?

What can I do to keep day care safe for my child?

Visit with the staff at the day care center. Go to meetings for family members and learn about the concerns of staff and other parents.
Suggest educational programs for parents and staff members. Helpful topics include child development, first aid, dental care, skin cancer prevention, general safety and recognizing abuse.
Help with cleaning and repairs at the day-care center. Many centers appreciate parents helping out as playground supervisors.
Ask your child every day about what happened at day care.

What are some signs that would tell me if there are problems?

The staff fails to answer your questions and address your concerns.
There is no way for parents to be involved in the day care practices.
Your child tells you about problems or is not happy with his or her day care experience.
Unexplained accidents happen more than once.
The staff changes often.
The management can't offer you a written copy of the day care policies.
Other parents tell you about problems or concerns with the day care center.
Credit: National Institute of Health.
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