UNC Health Care

Seven Ways to Keep Kids Healthy in Child Care

Do your research to help ensure a safe transition.

If you are about to send your little one to day care or preschool, you may be worried about how to keep him or her safe and healthy while away from home. Ty G. Bristol, MD, MPH, medical director of UNC Pediatrics at Panther Creek, offered these seven tips for keeping your child healthy in child care.

  1. If possible, delay starting child care until after the first immunizations at age 6 to 8 weeks.

It’s not possible for many families, but if you can, Dr. Bristol advises keeping babies out of day care when they are really young.

“For very young children, the biggest concern is infectious diseases, because they don’t have the immune system to fight some of those infections,” he says.

These include respiratory infections such as coughs and colds, gastrointestinal infections that can cause diarrhea and vomiting, and the flu.

“A fever in a 1-month-old baby, for example, means the baby usually gets readmitted to the hospital to check for more serious infections” such as meningitis, Dr. Bristol says.

So try to avoid exposure as long as possible. If a parent or caregiver cannot be at home with a child, there are additional things you can do to keep your baby safe in a group child care setting.

  1. Stay up to date on shots.

It’s important that your child is up to date on immunizations before starting day care or preschool, Dr. Bristol says. The first doses of several vaccines can be given as early as 6 weeks old.

“If you know you’re starting day care at 2 months old, you might want to get the 2-month-old shots two weeks early, so at 6 weeks,” Dr. Bristol says.

Also, make sure all child care providers are up to date on their vaccinations. This includes in-home child care providers, babysitters and grandparents.

“Make sure the grandparents have their regular vaccines and vaccines for things like the whooping cough that they give to older teenagers and to adults,” Dr. Bristol says. “Definitely make sure the grandparents have had their flu shots.”

  1. Consider the size of the class or child care facility.

If you have the option, consider a smaller day care with fewer children or a place with smaller class sizes if it’s a larger day care.

“The setting is important because the more kids there are, the more chances there are of infection spreading,” Dr. Bristol says.

  1. Make sure surroundings are safe.

Accidents happen, so ask your child care provider how those are handled and communicated to you. Also, check the surroundings to make sure the provider is taking safety precautions; medicine cabinets should be locked and playground equipment shouldn’t be broken, for example.

Check to see what kind of surface the kids would be playing on outdoors. The National Safety Council offers advice for checking playground equipment for safety.

And make sure that all of the provider’s licenses are up to date, especially state or local government licensing. The National Database of Child Care Licensing Regulations includes contact information and websites for state licensing departments. You can choose your state and view, download and search the child care licensing regulations that apply to child care centers, family child care homes and other licensed child care programs.

“Visit the facility and drop in after your child is there to make sure everything is safe,” Dr. Bristol says.

  1. Ask about allergy prevention.

Ask your child care provider how they handle allergic reactions.

“If a child doesn’t have a known allergy but they’re exposed to something and a new allergy occurs at day care or preschool, that can be very scary,” Dr. Bristol says. “Be sure to ask them what they do if that happens.”

Ask the center staff how they introduce new foods to kids. And if your child has a food allergy, be sure the teachers have a treatment plan from your child’s doctor about what to do in case of a reaction.

  1. Wash hands and surfaces frequently.

Prevent the spread of germs by washing your hands and your child’s hands before and after day care or school. Remind your child to follow all of the steps of proper hand-washing.

“A lot of times for babies, infants and children get sick from touching and playing with each other,” Dr. Bristol says. “All of the runny nose, congestion, vomiting and diarrhea viruses can live on surfaces.”

Ask the staff how often they clean the surfaces, what their cleaning schedule is and whether a cleaning crew comes regularly.

If you have older children who are in day care, preschool or school, keep in mind that they can bring home an infection and pass it on to younger siblings.

“So there’s still precautions that have to happen even in the house, like hand-washing, that sometimes we forget about,” Dr. Bristol says.

  1. Remember that child care can boost your child’s immunity.

While most children will inevitably get sick at day care, this will help their immune systems grow stronger. That’s because when children are exposed to infection, it helps to boost their natural immunity.

“Thankfully, most of these are minor illnesses that kids can get over,” Dr. Bristol says. “We can treat these mild or minor infections, and your child will start having and developing a good immune system. So that’s a good side of it.”


If you’re concerned about your plans for child care, talk to your doctor. If you need a doctor, find one near you.

Editor’s Note: This post was updated on August 12, 2019.