In article <ASHWIN.93May2131021@leo.gatech.edu>, ashwin@[Agatech.edu (Ashwin Ram) writes: > Our 20-month son has started falling sick quite often every since he > started going to day care.  He was at home for the first year and he did > not fall sick even once.  Now it seems like he has some sort of cold or > flu pretty much once a month.  Most of the time the cold leads to an ear > infection as well, with the result that he ends up being on antibiotics > 3 weeks out of 4.  I know kids in day care fall sick more often, but we > are beginning to wonder how often "more often" really is, whether our > son is more susceptible or has lower immunity than average...  > Are there any studies that can help answer some of these questions?  When kids stayed in the home until kindergarden or 1st grade, infection  incidence was much lower because exposure was lower.  Some studies suggest  that early exposure to various infectious diseases is probably beneficial  because exposure as an adult carries much more risk of morbitity and  mortality(mumps, measles. etc.).  > -- How often do kids in their first, second and third years fall sick? > How often do they get colds, flus, ear infections?  Is there any data on > home care vs. day care?  Daycare will always carry a higher exposure risk than home care.  > -- Does being sick "build immunity" (leading to less illness later), > does it make kids "weaker" (leading to more illness later), or does it > not have any long term effect?  Exposure to infectious organisms does build immunity.  But many viruses  mutate and reexposure to the new strain requires another immune response( new antibody production).  In addition, antibody levels tend to decline  with time and re-innoculation is needed to keep the antibody levels high. Chronic overstimulation of the immune response can lead to immunosupression  but this is rare and very unlikely to occur in children.  > -- Does taking antibiotics on a regular basis have any negative long > term effects?  Yes, chronic use of antibiotics can have an adverse effect on the good  bacteria that are supposed to be present in and on the body.  Health effects  of this depletion of the good bacteria is a very hotly debated topic in the  medical community with most physicians seeming to discount any health effects  of chronic antibiotic use( a view that I do not support).   > -- How does one tell if a child is more susceptible to illness than > normal, and what does one do about it?  Chronic infection in an adult or a child needs to be worked up( in my  opinion).  But most physicians feel that chronic infection in a child is  normal because of both exposure and lack of prior immunity to many  infectious diseases.  I do not share this view and there are some  physicians who also suspect that diet plays a big role in infection  frequency and severity.  Exposure to an infectious agent does not have to  result in a severe infection.  A strong immune response can minimize the  length of time needed to deal with the infection as well as the symptoms  associated with the infection.  > -- Is there any way to build immunity and resistance?  There are five major nutrients that are responsible for a good strong  immune response to infectious agents.  They are: protein, vitamin C,  vitamin A, iron and zinc.  The American diet is not low in protein so this  is rarely a problem.  But vitamin A, vitamin C, iron and zinc are often low  and this lack of an adequate pool(nutrient reserve) can impair the immune  response.  Iron is know to be low in most kids(as is vitamin A).  There are  distinct biochemical tests that can be run to check the status of each of  these nutrients in a patient who is having a problem with chronic severe  infection.  Serum ferritin for iron status, dark adaptation for vitamin A  status, red blood cell zinc for zinc status and leckocyte ascorbate for  vitamin C status.  I have attempted to work up posts on these five  nutrients and their role in infection for this news group as well as the  others that I participate in.  I can e-mail you what I've worked up so far. But my best advice to you is to try to find a physician who recognizes the  critical role that diet plays in the human immune response.  You may also  be able to get help from a nutritionist.  Anyone can call themselves a  nutritionist so you have to be very carefull.  You want to find someone( like myself) who has had some formal training and education in nutrition. Many Ph.D. programs in the U.S. now offer degrees in Nutrition and that's  what you need to look for.  Some dieticians will also call themselves  nutritionists but most dieticians have not had the biochemical training  needed to run specialized nutritional assessment tests.  They are very good  for getting general dietary advice from however.  > Any data, information or advice relating to this would be much > appreciated.  Thanks a lot. >  > Ashwin.