My child is always sick! Should I be worried?

Little kids get sick a lot. Period.
Especially when they’re just over 6 months old, after they’re enrolled in day-care and especially during the winter season.
Many parents feel that they’re child is ill more than the other kids at their day-care, and tends to loses more school days than everyone else.
Does their child hold an underlying mystery illness or God forbid an immune deficiency?
Does it even make any sense for a child to be missing school/day-care half of the working days per months during the winter months?

If my child suffers from frequent episodes of febrile illnesses, then maybe there is a problem with his immune system?

Here are several important points regarding children who are healthy and have frequent episodes of febrile illnesses as opposed to children who suffer from a real problem in their immune system:
• Children with an immune deficiency (congenital or acquired) are children who have had to refer to urgent clinics or emergency rooms for most of their febrile illnesses or had to be admitted in order to receive treatment that was “stronger” than what they could have received by their primary care physician. These are children that need to be treated with intravenous antibiotics when they get pneumonia, for example, because oral antibiotics are inadequate in controlling their infection. These children are very ill! They don’t just get a viral illness or runny nose here and there and recover spontaneously. Read more about pneumonia in children here.
• Children who suffer from an immune deficiency usually express other abnormalities as well, like failure to thrive, chronic diarrhea and skin rashes.

Out of all the children I have seen along the years whose parents have complained that they get ill frequently, only a very small number (if any at all) turned out to actually have an immune deficiency.

Kids with frequent episodes of febrile illnesses are usually children that tend to catch viruses frequently, but do not have an immune deficiency. Sometimes the parents are right, and their kid is the sickest child at day care. But usually this isn’t medically concerning (despite it being very frustrating), as there is always that one kid who catches more viruses than all his/her peers and gets ill more than all the others.

I would like to cover a few additional important points:
The first kid at home is raised in a somewhat “sterile” house, without any older siblings. The second child grows up in a house with an older sibling who may be attending day-care and bringing back all the viruses home with him and sometimes he/she gets sick too. The third child is exposed to two older siblings and is usually expected to get ill the most.
Children who are enrolled in day-care, during the winter time, tend to get ill more than those who are enrolled during summer.
I don’t remember where I read this exactly – but on average children get sick between 9 -11 times per year in their first two years of life.

Can we boost are children’s immune system and make them “stronger”, so that they get ill less often?

We certainly can.
Breastfeeding – one of the benefits behind breast milk is the passive transfer of antibodies to the baby (read more here). Statistically speaking, infants who feed on breast milk will get ill less frequently than those who feed on formula. Mixed feeding is also helpful so if a mother’s breast milk is insufficient and she needs to combine breastfeeding with formula, the milk that her child does get is still protective.
Scheduled vaccines and seasonal vaccines – this is the reality of things. Following the vaccine schedule reduces the child’s risk of developing infections. Many of the routine vaccines provide protection against severe infections that we will probably never come across (rubella, tetanus, diphtheria and more) but some of them are especially relevant when it comes to young infants.
For example, Pertussis, Rotavirus and the vaccine against the streptococcus pneumonia (Prevnar).
Age of enrolment to day-care and its relevance to febrile illnesses – there are so many considerations when it comes to choosing the age at which the child is enrolled in day care, but I will just discuss the considerations that are related to infections.
Obviously, enrolling a child in day-care during the wintertime carries with it the risk of exposure to lots of infections. On the other hand, enrolment during summer is not completely virus-free either and winter will come eventually…
Obviously, enrolment of a 7-month-old is not the same as enrolment of a 1 year, 4 months old. The younger child will most probably get ill more often. Nonetheless, I do not recommend delaying enrolment of the child due to fear of infections. There are many other considerations that need to be taken: the child’s age, the season, the social background, the parents’ necessities, etc.
Obviously, the more caretakers there are at day-care, the less the transfer of infections.
Good hand hygiene maintained by staff at day-care – Enrolling your child in a day-care where vaccines are obligatory and sticking to the rules of return of child to day-care once their illness has resolved can make this period safer for everyone. But it does require a joint effort to be made by all parents.

Can I boost my child’s immune system using natural products?

There is an endless list of products that claim to “boost” children’s immune system. Usually children do not need any “boosters”. If the child has a specific deficiency, like iron deficiency, then I suggest he/she undergo proper diagnosis and management (read more about iron deficiency in children here). Most of the children do not need to boost their immune system and I wouldn’t waste my money on these supplements. I’ll just say this straight up – all those natural products out there being sold in an attempt to boost your child’s immune system are complete nonsense.

What about passive smoking?

This too, increases the risk for infection in children. Many times, I hear from parents who are smokers, that they do not smoke around their children. This is somewhat of a relief but if the parent smells like cigarettes, then their child is breathing in that smoke…

So, this entire post is not very comforting but let’s try and look on the bright side…
Nowadays there is evidence that children who tend to catch more mild viral illnesses, grow up to be healthier adults who suffer from less allergies…
So, maybe we can find some comfort in that as we watch them grow.