My child is always sick since starting preschool

It is very common to hear parents complaining that their children fall sick very often after attending child care centres or kindergartens. One of my friend once said he had to take his child to see pediatrician once in two weeks in the first three months after his child attended a child care centre.

If you ask around, you will know that this is normal. In fact, a long-term study by a group of researchers at the University of Montreal from 1998 to 2006 found that toddlers in child care got sick more often than toddlers who stayed at home.

Why children get sick more often in preschools?

Preschools provide a good environment for the transmission of viruses. Many typical illness like common cold, stomach bugs, hand, foot and mouth diseases are caused by viruses. These viruses can spread out easily through direct and indirect contact between children.

​​Whenever children are together, there is a high chance of spreading viruses. This is because children are likely to use their hands to wipe their noses or rub their eyes and then handle toys, books or touch other children. These children then touch their noses and rub their eyes. In this way, the virus goes from one child to the next child.

Furthermore, many children have not learnt to cover their mouths with tissue paper or handkerchief when they cough or sneeze. Other children may get infected as they breathe in the virus. When they cough or sneeze, thousands of droplets, many which carry the viruses, are expelled from the throat to the air. Other children may get infected as they breathe in the viruses.

Lastly, children’s immunity system is still not mature. This make them more susceptible to infection when they are coming to contact with illness they have never had before.

How to prevent children from getting sickness in preschool?

1. Boost immunity

To prevent your child from getting sick in preschool, you can help to boost your child’s immune system.

You can help to boost your child’s immune system by providing a healthy diet that is high in fruits, vegetables. Carrots, green beans, oranges and broccoli are rich in immunity-boosting phytonutrients such as vitamin C and carotenoids. These Phytonutrients may increase the body's production of infection-fighting white blood cells and interferon, an antibody that coats cell surfaces, blocking out viruses.

Having enough sleep is also important in building a strong immune system. Parents needs to ensure their toddlers have at least 12 hours of sleep each day and preschoolers will need at least 10 hours of sleep each day. Sleep deprivation will reduce the number of natural killer cells in the body which could make your child more susceptible to illness.

Lastly, you can also help to boost your child’s immune system by exercising together with him or her. This is because exercises increase the number of killer cells.

2. Wash hand frequently

Good hand hygiene is the number one way to reduce the spread of illness, according to a pediatrician and chair of the American Academy of Pediatrics Section on Early Education and Child Care.

Parents can train their children to wash hand after using toilet, before and after food and after outdoor activity. Correct way of washing hands should also be taught to ensure the little hands are free viruses or bacterial after each wash.

Before you enroll your child in a child care centre, kindergarten, playgroup or day care centre, you should check with the principal about how often they will ask children to wash hands.  

Parents can also observe whether the daycare or preschool staff wash their hands frequently throughout the day, especially before feedings, after checking or changing diapers, after eating or using the toilet.

3. Understand the policy on sick children

In Singapore, staffs of preschools will check every child’s body temperature, any sign of hand, foot and mouth diseases (HFMD)every morning. If the child has fever or shows signs of HFMD, the child will have to go back home.

However, a child may not show fever although he is infected with a contagious illness like cough. If he coughs or sneezes often in the child care centre or kindergarten, other children may be infected.

Hence, it is important for parents to check child care centre or kindergarten‘s policy on this and find out if it is enforced.

4. Hygiene in preschool or daycare

To protect our children from falling sick often after attending child care centre or kindergarten, parent should make sure the preschool or daycare follow practice of good hygiene, parents can check the following:

(a)    Is there a sink in every room?

(b)    Are there separate sinks for preparing food and washing hands?

(c)     Is food handled in areas separate from the toilets and diaper-changing tables?

(d)    Are toilets and sinks clean and readily available for the children and staff?

(e)    Are toys sanitized ?

(f)      Are all doors and cabinet handles, drinking fountains, all surfaces in the toileting and diapering areas cleaned and disinfected at the end of every day?

(g)    Are all changing tables and any potty chairs cleaned and disinfected after each use?

5. Advocate regular health checkup of staff and vaccination for all children

In recent years, there were a few cases of tuberculosis involving childcare teachers in Singapore.

Do check with the preschool principal whether they require their teachers to do medical checkup regularly or not and how the preschools make sure the teachers are medically fit to take care of the children.

Parents may also want to ask how the preschool ensures that all children are fully immunized.

6. Ask about other standards of practices

To prevent our children from getting sick in preschool, it is also important for parents to understand other standards of practices at the preschool.

When there is a confirmed case of HFMD within the premises, different child care centres or kindergartens may react differently. It is important for parent to find out how the prospective preschools will respond to such incidence. Will the preschool engage a professional cleaning company immediately or a few days later to sanitize the premises? Will students of different classes still be allowed to play together? Will the teachers check for sign of HFMD more frequently?