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Frequent early colds have both an upside and a downside

By JIM ROSS, Times Staff Writer
© St. Petersburg Times
published February 24, 2002

INVERNESS -- Kids are sniffling and sneezing, staying home from school, trying to recover from whatever ailment has knocked them down for the count.

No doubt about it, the sick season is here. But are some children more likely to get sick than others?

Consider a recent study published in Archives of Pediatrics and Adolescent Medicine. The study determined that, at age 2, children who attended large day care centers (six or more students) are almost twice as likely as children who stay home to have had frequent colds.

Between the ages of 6 and 11, however, the children from day care are less than half as likely as their stay-home counterparts to have suffered frequent colds.

The study's lead author, Dr. Thomas M. Ball, an associate professor of clinical pediatrics at the University of Arizona College of Medicine, drew the following conclusion: The early illnesses lead children from large care centers to develop immunity to many of the viruses responsible for the common cold.

By the time the children reach age 13, the study found, children from day care backgrounds and home backgrounds enjoyed the same degree of protection.

The study findings came as no surprise to Carol Byrum, an advanced registered nurse practitioner (ARNP) who specializes in pediatric care.

Byrum has examined countless patients during her 31 years on staff at the Citrus County Health Department. She often performs the general physical examinations that must be completed before a child may enroll in day care.

"I tell them (parents) to make sure that you have a backup (day care provider), because when your child goes into the day care, you are going to be in here every two weeks for the first six to 12 months," Byrum said.

That's an observation, not a scientific conclusion, Byrum emphasized.

Still, in her experience, it's true: Young children in day care get sick more often, and not just with colds; and kids cared for at home are more likely to fall ill once they start kindergarten and are around large groups of children.

For that matter, the theory applies to adults. Byrum said new employees at the health department's pediatric units often fall sick quite a bit until their immunities build up.

"I haven't been sick in 15 or 20 years," she said. (Advanced registered nurse practitioners like Byrum are trained at the master's degree level and have specialty training beyond their initial nursing training.)

Ball said the study should relieve parents who feel guilty for placing their children in day care.

"I would like to reassure parents of preschoolers that, when their child has colds, they should know the child's immune system is learning from this experience, and that will come back to protect them later," he was quoted as saying in an Associated Press story about the study.

That same story quoted from an editorial that Dr. Abraham Bergman of the University of Washington published in the medical journal. He said the study proved there was a "silver lining" to early viral illnesses.

"The benefit to colds in the toddler years is that kids miss less school later, when it counts," Bergman was quoted as writing.

Dr. Ira Fialko, a veteran Citrus County pediatrician, agreed that young children in day care tended to contract colds more often than their counterparts who are cared for at home.

He wasn't as certain about the second conclusion -- kids with no day care experience getting sicker between ages 6 and 11 -- but he didn't quarrel with the research findings.

Still, despite how the researchers framed their findings, Fialko said there are significant downsides to very young children contracting colds.

Younger children who contract a cold are far more likely than older children to develop ear infections, bronchitis and other complications that require medical assistance.

"The older you are, the better you handle a cold," the doctor said.

Ball and Anne Wright, a research professor of pediatrics at Arizona, studied more than 1,000 children who have been followed from birth as part of the Tucson Children's Respiratory Study, according to a university news release.

For the past 20 years, researchers at the Arizona Respiratory Center have collected information about children's health and their environment.

-- Jim Ross writes about medical news in Citrus County. Reach him at 860-7302 or

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