Daycare Does Not Reduce Asthma, Allergy Risk in Kids

by VR Sreeraman on Sep 9 2009 3:34 PM

Contrary to popular belief, taking children to day care might not make them immune to asthma and allergies, say researchers.

Children in daycare definitely get more illnesses and experience more respiratory symptoms as a result, any perceived protection these exposures afford against asthma and allergy seem to disappear by the time the child hits the age of eight.

"We found no evidence for a protective or harmful effect of daycare on the development of asthma symptoms, allergic sensitization, or airway hyper-responsiveness at the age of eight years," said lead researcher Dr Johan C de Jongste, of Erasmus University in the Netherlands.

"Early daycare was associated with more airway symptoms until the age of four years, and only in children without older siblings, with a transient decrease in symptoms between four and eight years," de Jongste added.

Over the course of the study, the researchers examined a cohort of nearly 4,000 Dutch children over the course of eight years in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) Study.

The daycare users were categorized in early attendees (first attendance before two years of age), late attendees (first attendance between two and four years of age) and non-attendees.

The study showed that children who started daycare early were twice as likely to experience wheezing in the first year of life compared to those who didn't go to daycare

However, as the children aged, there was a shift. By age five, there was a trend for less wheezing among early attendees: they were about 80 percent as likely as non-attendees to wheeze, but this was not statistically significant.

The shift reversed itself by age eight, when there was no association between early daycare attendance and wheezing at all.

Late daycare attendees had similar, but less pronounced and statistically nonsignificant effects. The effects of daycare on wheeze were not different between boys and girls, but were more marked in children with older siblings.

"Children with older siblings and early daycare had more than fourfold higher risk of frequent respiratory infections and more than twofold risk of wheezing in the first year compared to children without older siblings and daycare," said Dr. de Jongste.

"Importantly, children exposed to both early daycare and older siblings experienced most infections and symptoms in early childhood, without a protective effect on wheeze, inhaled steroid prescription or asthma symptoms until the age of eight years.

"Early daycare merely seems to shift the burden of respiratory morbidity to an earlier age where it is more troublesome than at a later age. [E]arly daycare should not be promoted for reasons of preventing asthma and allergy," de Jongste added.