EXCERPTS Children who start attending large child-care centres before age 2 1/2 seem to develop more respiratory and ear infections at that age, but fewer of the illnesses when they reach elementary school, a Canadian study finds. The study in Monday's Archives of Pediatrics & Adolescent Medicine looked at more than 1,200 Quebec families of children born in 1998. Sylvana Cote of Sainte-Justine Hospital and the University of Montreal her colleagues asked mothers what type of care their children had: A large child-care facility for up to 10 groups of eight to 12 children.A small child-care facility where a caregiver watched three to eight children or home. Unlike an earlier study that tracked cold infections in children just during the preschool years, Cote's team focused on how often the children had respiratory tract, ear and gastrointestinal infections up to age eight. Compared with children cared for at home, those who attended large child-care centres before age 2 1/2 had 1.61 times higher rates of respiratory tract infections and 1.62 times as many ear infections during the preschool period. But during the elementary school years, those who attended large child-care centres showed 0.79 times fewer respiratory tract infections and 0.57 times fewer ear infections than children previously cared for at home, the researchers found, based on interviews with mothers who recalled infections that occurred up three months before the interview. Infection protection "This study provides reassuring evidence for parents that their choices regarding child care (group size and age at enrollment) should not have a major effect on the health of their children from a long-term (eight-year) perspective, at least regarding respiratory tract infections with fever, gastrointestinal tract infections and ear infections," the study's authors concluded. Children who spend their early years in large-group care settings "may even gain protection against infections during the elementary school years, when absenteeism often carries stronger consequences in terms of adapting to school and performance," the authors added. The researchers took the mother's health and education, low birth weight, breastfeeding, ethnicity and family size into account. Children who were initially cared for at home but then went to any size of child-care facility during late preschool had a higher risk of ear infections at that time, but no other differences in infection risk. The study did not investigate possible reasons behind the long-term reduction in serious infections. But the timing of the findings suggest a role for developmental processes. Another possibility is that repeated stimulation of the immature immune system by early and mild infections may play a role, based on studies on long-term protection against asthma. ... - reprinted from CBC News