Daycare, nurseries do not protect against asthma

Frequent colds at the day nursery do not protect against asthma or allergy. Under the motto 'That's good for your resistance', many parents think that children benefit from being exposed to infections at a young age. Dutch researcher Daan Caudri has evidence to the contrary. He gained his doctorate on 3 December 2010 from Erasmus University Rotterdam for his research into asthma among young children.

Children who regularly go to a day nursery before their second birthday were found to suffer just as much from asthmatic symptoms or allergic hypersensitivity at eight years of age as children who stayed at home until their second birthday. However, Caudri's research revealed that the babies and toddlers who went to a day nursery were sick more often at a young age than their contemporaries who stayed at home.

At a very young age, children with a predisposition for asthma and allergy experience more severe symptoms during colds and infections. For example, they experience difficulties breathing and wheeze and cough a lot. Caudri therefore emphasises that parents must not feel obliged to send their children to a day nursery. It does not help against asthma, and if a child suffers from disproportionately severe symptoms during infections, it might be wiser not to send that child to a day nursery.

Although children who attend a day nursery experience more illnesses at a younger age than their contemporaries who stay at home, they are ill less often when they go to primary school. Infants who then come into contact with large groups of children for the first time are more frequently sick because all of the infections are 'new' for them. Therefore attending day nursery, shifts the occurrence of infections to a younger age.

Treating asthma

Respiratory problems and asthmatic symptoms are a frequently recurring problem in children. Nevertheless, doctors still find it difficult to determine the severity of the symptoms. Caudri discovered that many children between the ages of 2 and 8 years might not receive optimum treatment for their asthmatic complaints. Thirty percent of the eight-year-olds with severe asthmatic symptoms did not use inhaler medication. Yet about half of the children who had used inhaler medication for at least two years, said that they had not suffered from any wheezing during that period. It is therefore clear that both overtreatment and undertreatment occur.

To improve the detection and diagnosis of asthma, Caudri developed a test that allows eight different factors to be taken into consideration. Using this test, the risk of developing asthma can be well predicted from the moment that the child first presents with symptoms. This model could therefore be a useful tool for physicians.

Caudri's research is part of the large-scale PIAMA study, which is following almost 4000 children over a period of eight years. Daan Caudri carried out his research at the Department of Paediatrics/Respiratory Medicine of Erasmus MC – Sophia Children’s Hospital. His research was funded by the Netherlands Organisation for Scientific Research.

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