Could day care protect your child's health?

Rosemary Behan reports on how interacting with other children may lower the risk of childhood leukaemia.

Powered by automated translation

Until last week, Charlotte De Lisle didn't worry about not putting her children in day care. The Khalidiya-based mother-of-two, who looks ­after her toddlers full-time, decided against pre-school education because she was worried that extensive professional childcare could damage their development. "I think it's mean to leave children with strangers all day long," Mrs De Lisle, who is from the United States, said. "And I sometimes think it's wrong. I have seen that children in day care can be more aggressive and difficult.­ I never thought it could actually be good for their health."

Mrs De Lisle is now reconsidering her choice to look after her son, Jamie, three, and daughter Samia, two, at home after research by the University of California showed that children who attend day care have a 30 per cent lower chance of developing leukaemia. A review of studies by the School of Public Health at Berkeley found that children who interact with ­other youngsters early in life have their immune systems primed against disease. Scientists believe that most types of childhood leukaemia are caused by a genetic mutation in the womb followed by a second trigger, such as an infection, during ­childhood.

The research was presented at the second Children With Leukaemia Causes and Prevention of ­Childhood Leukaemia conference in London last week and is thought to be the most comprehensive analysis of studies investigating the ­association between social contact and childhood leukaemia. "Our analysis concluded that children who attend day care or play groups had about a 30 per cent lower risk of developing leukaemia than those who did not. Combined results for studies of day care attendance specifically before the age of one or two showed a similarly reduced risk," said Dr Patricia Buffler, who led the study.

The most common form of childhood leukaemia is Acute ­Lymphoblastic Leukaemia (ALL), which accounts for three out of four cases. It can affect children at any age, but is most common in children aged one to four. It is more likely to affect boys than girls but some 75 per cent of cases are cured compared to just 20 per cent 40 years ago. Dr Buffler reviewed 14 published studies involving 6,108 children with leukaemia and 13,704 without the disease.

Parents were asked about whether their child attended day care or a playgroup, and about any other interaction with children. "We had 14 studies that we considered ­eligible," Dr Buffler said. "Twelve of them were protective while two of them showed no effect." The California study follows ­similar research released by the UK-based Leukaemia Research Fund in 2005. This involved over 6,000 children with cancer and some 3,000 without. Researchers found that increasing levels of social ­activity outside the home were linked to consistent reductions in Acute Lymphoblastic Leukaemia. The greatest reduction in risk - of 52 per cent - was seen in children who attended formal day care on a regular basis for the first three months of life.

The youngsters exposed to informal day care, such as that provided by friends and family, saw a 38 per cent drop in the risk of ALL, while those who had some social ­activity, but not day care, had a 27 per cent lower risk. While parents are often concerned about the easy spread of infections in environments where children are in close contact with each other, Dr Buffler encouraged parents not to isolate their children. Tamara Gabrielson, the vice principal of the Humpty Dumpty nursery in Al Bateen, Abu Dhabi, who has four children aged three, four, seven and thirteen, agreed.

"Parents do worry about this but I try to convince them that although it's tough on them this is one of the main reasons I put my own children in day care," she said. Mrs Gabrielson's first child attended day care from the age of six months, while the other three attended from the age of one. "At this age they are going through the process of building their immune system and I believe that being in an environment where there are other children helps to strengthen it. Whether it happens at the age of six or six months, it has to happen some time and for me, the earlier the better."

Mrs Gabrielson added: "It may mean a spate of illnesses at the ­beginning, but all my children now have very strong immune systems and are hardly ever ill." Mrs Gabrielson added that the mix of nationalities and cultures in Abu Dhabi schools was even better for ­children's immune systems and said too many parents were excessively concerned about the risks associated with day care and with maintaining an impossible standard of cleanliness.

"Obviously at the nursery we do maintain a good standard of hygiene but in a group environment contact will be made with other children. I try to convince parents that the children benefit from it." Dr Muhammad Faisal Khanani, a paediatric oncologist at the ­Tawam Hospital in Al Ain, agreed with the findings of the study. "There is ­certainly some truth in this. In ­India and Pakistan, where communities are very crowded and children ­suffer from a lot of water-borne and other diseases, the ­incidence of leukaemia is much lower than in ­developed countries", he said.

"I'm not convinced that full-time day care with both parents working is the best thing for children, but ­certainly they should be exposed to other children. It is like a vaccine - you have to expose the child to a small level of disease in order for them to develop antibodies against it." rbehan@thenational.ae