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How Daycare Families Can Thrive During the Fall Respiratory Season

Baby in daycare exposed to different illnesses
Baby crawling on a daycare floor mat.

The start of fall means it’s also the start of the fall respiratory season for parents with young kids and babies. Anyone with a child in daycare knows it’s only a matter of time before they see that first runny nose.

COVID-19, RSV & flu

The most common illnesses that begin to appear in the fall are rhinovirus or the common cold, COVID-19, RSV and influenza or the flu.

“Prior to the pandemic, RSV usually preceded influenza so RSV usually showed up in November or December. A typical influenza year starts in January or February. With the COVID pandemic, we’ve seen all kinds of different patterns, so it will be interesting this year to see if the previous pattern re-establishes itself,” said Thomas Murray, MD, PhD, associate medical director of Infection Prevention at Yale New Haven Children’s Hospital and professor of Pediatrics at Yale School of Medicine.

Dr. Murray adds that we have already seen some pediatric flu hospitalizations, so the peak of flu, RSV and COVID-19 may come earlier than expected.

The good news is this is the first year that we have vaccines and preventive treatments for the top three respiratory illnesses: COVID, RSV and flu. Kids 6 months and older should get their flu shot as soon as possible. Updated COVID boosters and the new RSV monoclonal antibody treatment are also recommended for eligible kids and babies.

Other common illnesses in kids & babies

It’s common for respiratory illnesses to result in symptoms that can include fever, runny nose and cough. However, babies and infants can also get croup, which is caused by several different viruses and is recognizable by the hoarse, barky cough that accompanies it.

Older kids may be susceptible to strep throat which can be highly contagious and caused by a bacteria. Symptoms include fever, sore throat without a cough and runny nose and treatment is required with an antibiotic such as penicillin.

Other common daycare illnesses can include hand, foot and mouth caused by a coxsackievirus, resulting in blisters on the hands, feet and inside of the mouth. Pink eye is also incredibly common and can be caused by respiratory viruses that survive on surfaces. It's then easy for a child to get it when they touch an infected toy and then their eye.

Treatments for respiratory illnesses

For most kids who get a mild respiratory illness, the best treatments will include plenty of rest and hydration, as well as Tylenol for a fever. For mild croup, cold air can be helpful and it’s important for parents to know that some mild symptoms like a cough can persist for up to two or three weeks. But any concerning symptom such as difficulty breathing with severe croup should prompt immediate attention as additional supportive care provided by the emergency department may be necessary.

“A parent should go to the emergency department anytime their child is seriously ill. Certainly, difficulty breathing with blue lips, difficulty eating, no wet diapers, if a baby is truly irritable and cannot be consoled, difficulty rousing, those are all reasons that you want to have your child seen at the emergency department,” said Dr. Murray.

Planning for respiratory season

The best way to prepare for respiratory season is to prevent as much illness as possible by getting vaccinated against flu, COVID and RSV if eligible. Hand washing, keeping kids home when they’re sick and wearing masks when appropriate can also help stop the spread of viruses. Even with the best prevention protocols, parents and caretakers should still prepare for sick days by creating a plan of action for their loved ones.

“It’s inevitable that your child is going to get some sort of illness between October and March,” said Dr. Murray. “Have backup childcare or make sure you’ve got a plan for when that happens. Scrambling to find childcare when you have to work, or you have somewhere you have to be, can be very challenging.”

It’s also a good idea to stock up on items like fluids with added electrolytes, disinfectant wipes and extra home COVID tests now, before the season reaches its peak.