A new paper published in Clinical Microbiology Reviews explores why children often get sick when they start nursery and what this means for their health and immunity. The study was conducted by five researchers who are all parents of young children. They also work as clinicians or scientists at institutions including UCL, the University of Cambridge, Cornell University, and North Middlesex University Hospital. Their goal was to understand how often children fall ill in early childcare, why they are so vulnerable, and what parents can do to support their children’s health.
The researchers emphasize that vaccines remain the most effective way to protect children from serious illnesses. Co-author Dr. Lucy van Dorp, an infectious disease genomics researcher at the UCL Genetics Institute, explained that the study was inspired by the experiences of their own nine children. “We noticed how frequently our children caught infections when they started nursery. This led us to review the evidence on how often this happens and what parents can do to reduce the impact,” she said.
The review combines evidence from studies in epidemiology, immunology, and vaccination. It shows that repeated illness in young children attending nursery is very common and usually not a sign of poor care or hygiene. According to the findings, a one-year-old in nursery can get about 12 to 15 colds or chest infections in a year. They may also have diarrhea or vomiting two times. They can get one or two infections that cause rashes. These frequent illnesses can be hard for families. Parents may need to take time off work to care for their sick child.
Dr. Van Dorp noted that the evidence aligns with their experiences. “As parents, we’ve seen how nursery can quickly lead to children bringing home infections, sometimes serious enough to require medical attention. But this is part of normal childhood development,” she explained.
Dr. Charlotte Houldcroft, a virologist at the University of Cambridge and the study’s corresponding author, highlighted the importance of following guidelines when children are unwell. “Children should stay home while sick, and in some cases, for an additional day or two after symptoms improve, depending on the infection. Even though infections are common, parents can help reduce the spread by taking these steps,” she said.
The study also notes that children tend to get sick less often as they grow older. Respiratory infections are nearly monthly in the first year but gradually decrease in frequency over the following years. Older children are less likely to carry or show symptoms of viruses, which reduces the overall burden of illness on families. Dr. Van Dorp added, “Employers need to understand that parents of young children may need to take time off work regularly. Parents themselves are also at a higher risk of catching these infections, though this usually improves as children get older.”
One key factor in children’s susceptibility is their immature immune system. Dr. Leo Swadling from UCL’s Institute of Infection, Immunity & Transplantation explained, “Newborns receive some protection from maternal antibodies, but this protection fades during the first year. Infants, especially those starting nursery, are exposed to germs they’ve never encountered, which makes frequent infections normal. Nursery acts as a kind of ‘boot camp’ for their immune systems, helping build resilience for the future.”
The researchers found that children who start nursery at a young age experience more infections between ages one and five than children who remain at home. However, this pattern reverses when children start school. Those without early childcare become sick more. Early time in group childcare helps children build immunity. It helps protect them from common infections later in school. Vaccination is still crucial. It helps keep children safe and healthy in these settings.
The study highlights vaccines like the MMRV, which guards against measles, mumps, rubella, and chickenpox. “Keeping children up-to-date with recommended vaccines is one of the best ways to prevent serious infections in nursery and beyond,” Dr Swadling said.
