I believe all parents with eczema children struggled with sending their children to daycare. I know I did, when I sent my baby girl Marcie to daycare when she’s 11 months old. Apart from worrying that daycare teachers can’t take care of her, given the constant scratching and attention required, I also worry that she will fall sick more often, resulting in asthma. Are these worries valid?
There is no conclusive research on daycare’s protection against nor causing allergy and asthma. As far as I gather, various studies’ conclusion are mixed as below:
1. A German study reviewed 3,097 children from birth to 6 years old and noted that children who attended daycare in the first two years also had more chances of eczema. This was from tracking children in East versus West Germany, as 52% of children attended daycare in the East versus only 6% in the West.
2. Another study showed that children who attended daycare early (between 6 to 12 months) had lower allergy antibodies, meaning less likely to develop food or nasal allergy. However, there was a higher incidence of respiratory tract infection, i.e. more wheezing.
3. Another study showed that children who attended daycare early were 75% less likely to develop asthma by 5 years old. However, if daycare was started after the child turned 2 years old, there were 3 times more allergy problems.
4. Another study showed that by 8 years old, daycare or no daycare had no impact on allergy/asthma.
How do we decide on daycare’s impact on allergic march when we still don’t know the cause? Based on the 4-part series, you’ll see that there is no one clear cause of eczema. If it’s the skin barrier, then you may decide to take care of your child yourself to make 100% sure that her skin is protected by moisturizing. If it’s the immune system, you may hope that sending your child to daycare will strengthen her immunity (though as you see above, there’s no conclusion). Moreover, eczema is a skin condition with multiple factors influencing the outcome, so it is hard to isolate a single cause to focus on.
So what do you base the daycare decision on? Personally, I don’t base it on impact on allergy/asthma. I base it on other factors, like whether she’s taken care of at the daycare, whether they pay attention to moisturizing and disinfecting her skin, whether I want or need to go back to work. The allergic march, which is the progression from eczema, to allergy and asthma, is also dependent on the severity of eczema (the more severe, the more likely to have allergy/asthma) and the whether the child has both eczema and allergy (then more likely to have asthma).
I know.. tough letting someone else take care of our eczema children, wondering if she scratches more, stresses more (which trigger more scratching) because someone else is taking care of them.