Day care attendance in the first year of life and illnesses of the upper and lower respiratory tract in children with a familial history of atopy

Objective. To examine the relationship between day care attendance and illn esses of the upper and lower respiratory tract in the first year of life. Study Design. Prospective birth cohort study. Methods. Children (N = 498) who had at least 1 parent with a history of all ergy or asthma were enrolled at birth and followed prospectively for the fi rst year of life. A home visit at 2 to 3 months of age and bimonthly teleph one questionnaires were used to obtain information on day care arrangements , home characteristics, respiratory symptoms, and physician-diagnosed illne sses of the upper and lower respiratory tract. Results. Day care attendance in the first year of life was associated with two or more doctor-diagnosed ear infections (OR: 2.4; 95% CI: 1.7-3.6), thr ee or more parental reports of runny or stuffed nose (OR: 3.2; 95% CI: 1.9- 5.5), a doctor's diagnosis of sinusitis (OR: 2.2; 95% CI: 1.1-4.2), and doc tor-diagnosed lower respiratory illnesses (croup, bronchitis, bronchiolitis , and pneumonia; OR: 1.6; 95% CI: 1.0-2.4). For children attending day care , exposure to pets in day care, the presence of a rug or carpet in the area where the child slept in day care, and a nonresidential setting for day ca re all were independent predictors of two or more doctor-diagnosed ear infe ctions. Conclusions. The results suggest that day care increases the risk of illnes ses of the upper and lower respiratory tract in the first year of life for children with a familial history of atopy. Specific environmental exposures within day care, such as the presence of pets or having a rug or carpet in the area where children sleep, may increase the risk of recurrent ear infe ctions in the first year of life among children with familial history of at opy who attend day care.