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

Arch Pediatr Adolesc Med. 2001 Apr;155(4):481-8. doi: 10.1001/archpedi.155.4.481.


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.

Publication types

  • Multicenter Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Age Factors
  • Child Behavior Disorders / epidemiology
  • Child Behavior Disorders / etiology*
  • Child Care / statistics & numerical data*
  • Child, Preschool
  • Communicable Diseases / epidemiology*
  • Developmental Disabilities / epidemiology
  • Developmental Disabilities / etiology*
  • Ear Diseases / epidemiology
  • Female
  • Gastrointestinal Diseases / epidemiology
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Multivariate Analysis
  • Odds Ratio
  • Prospective Studies
  • Regression Analysis
  • Respiratory Tract Infections / epidemiology
  • Risk
  • Time Factors
  • United States / epidemiology