Premature Infants May Later Have Problems in Day Care
One of the health risks that very premature babies face is a condition known as chronic lung disease of prematurity, or CLDP. These children can be prone to respiratory infections and a recent study supported by the National Institutes of Health shows that kids with CLDP have an even greater increase in risk when placed in daycare.
Serious Respiratory Nearly Four Times as Likely
Normal gestation for humans is 40 weeks. Babies born at 38 weeks and less are considered premature. Chronic Lung Disease of Prematurity occurs in about one-fourth of babies born before 26 weeks of gestation, but can also develop in babies born as late as 32 weeks. Most children with CLDP improve with age as their lung mature, but about one-quarter continue to have respiratory problems even into adulthood.
Sharon McGrath-Morrow MD MBA of Johns Hopkins Children’s Center studied 111 children, aged 3 years and younger who had CLDP. Twenty-two of the children attended daycare. The parents were interviewed about infections, symptoms, emergency room visits, hospitalizations, and use of medications.
When placed in daycare, those children had a 3.7-fold increase of going to the emergency room with a serious respiratory infection over children not in daycare. Those children also were twice as likely to need corticosteroids and/or antibiotics. Children in daycare were also nearly three times more likely to have breathing problems at least once a week compared to those not attending daycare.
"Daycare can be a breeding ground for viruses and puts these already vulnerable children at risk for prolonged illness and serious complications from infections that are typically mild and short-lived in children with healthy lungs," said Dr. McGrath-Morrow says in a statement.
"Repeated infections in children with lung disease of prematurity can also put them on a fast track to lifelong respiratory problems and chronic lung damage, so prevention in early life is crucial."
Dr. McGrath-Morrow urges pediatricians to monitor prematurely-born patients, regardless of age, for signs of lung disease and make parents aware of daycare risks. She advises parents to either keep those children with CLDP at home for the first two years of life or in smaller, “healthier” daycare centers. They should also receive flu shots each year for added protection.
Sharon A. McGrath-Morrow, MD, Grace Lee, BA, Beth H. Stewart, MM, Brian M. McGinley, MD, Maureen A. Lefton-Greif, PhD, Sande O. Okelo, MD, J. Michael Collaco, MD.Day Care Increases the Risk of Respiratory Morbidity in Chronic Lung Disease of Prematurity. Pediatrics, September 27, 2010 DOI: 10.1542/peds.2010-0844