What measures can I take to prevent gastroenteritis in my daycare‑attending child?

Preventing Gastroenteritis in Daycare-Attending Children

The most effective prevention strategy combines ensuring your child receives rotavirus vaccination with rigorous hand hygiene practices, as these two interventions together provide the strongest protection against gastroenteritis in daycare settings. 1, 2, 3

Primary Prevention: Rotavirus Vaccination

Ensure your child completes the full rotavirus vaccine series, which should be administered between 6-32 weeks of age, with the first dose given between 6-12 weeks. 2 This vaccination is specifically indicated for preventing rotavirus gastroenteritis caused by the most common types (G1, G2, G3, G4, and G9). 2

• Rotavirus is the leading cause of severe gastroenteritis in daycare settings, accounting for up to 70% of hospitalizations during peak season in unvaccinated children. 1
• Outbreaks involving preschool children in institutional settings like daycare centers are commonly caused by rotavirus, adenovirus, calicivirus, or astrovirus. 1
• The combination of rotavirus vaccination with hand hygiene programs produces the largest reduction in gastroenteritis episodes. 3

Essential Hand Hygiene Measures

For Your Child at Home and Daycare

Hand sanitizer (alcohol-based) is more effective than soap and water alone for preventing gastroenteritis in daycare settings, particularly during winter months. 3

• Children who used hand sanitizer combined with educational measures and were vaccinated for rotavirus had significantly fewer gastroenteritis episodes compared to those using only soap and water. 3
• Hand hygiene programs including hand sanitizer were most effective during December and January when viral transmission peaks. 3
• Teach your child proper handwashing: rub all hand surfaces vigorously for at least 10 seconds with soap, then rinse thoroughly under running water. 1

Critical Handwashing Moments

Ensure your child washes hands:

• After using the toilet or having diapers changed 1
• Before eating or handling food 1
• After touching contaminated surfaces 1

What to Expect from Your Daycare Center

Protective Factors You Should Verify

Your daycare should implement these evidence-based practices:

• Daily cleaning of bed linens and toys 4
• Disinfecting surfaces and fomites with chlorine-based products 4
• Proper cleaning of vomit using paper towels WITH cleaner (not just paper towels alone) 4
• Separate nappy changing areas away from food preparation 4
• Exclusion policies requiring ill children to stay home for at least 2 days after symptom resolution 1
• Staff exclusion when symptomatic, especially food handlers 1

Risk Factors to Be Aware Of

Higher gastroenteritis risk occurs in daycares with:

• Large capacity and crowding 4
• Animals on premises 4
• Sandpits and paddling pools 4
• Staff mixing between child groups 4
• Cleaning potties in normal sinks 4

Stopping Daycare Attendance: Not Recommended

Completely stopping daycare is not necessary or practical for prevention. While daycare attendance does increase gastroenteritis risk, the combination of vaccination and proper hygiene provides adequate protection without requiring social isolation. 1, 3

• The risk can be effectively managed through vaccination and hygiene rather than avoiding daycare entirely. 3
• Most viral gastroenteritis outbreaks are self-limited, lasting less than one week. 1

When to Keep Your Child Home

Your child should stay home from daycare when:

• Experiencing active diarrhea or vomiting 1
• For at least 2 days after complete resolution of symptoms to prevent transmission 1
• If diagnosed with specific pathogens like E. coli O157:H7 or Shigella, follow public health guidance for return 1

Additional Protective Measures at Home

• Handle soiled laundry with minimal agitation, transport in plastic bags if wet, and machine wash at maximum cycle length with detergent. 1
• Clean bathroom surfaces routinely, especially after illness episodes. 1
• Avoid sharing utensils, cups, or food between family members during illness. 5
• Parents should practice rigorous hand hygiene, as transmission from children to parents occurs in approximately one of every three gastroenteritis episodes. 6

Common Pitfalls to Avoid

• Don't rely solely on soap and water when alcohol-based hand sanitizer is available - research shows hand sanitizer is more effective in daycare settings. 3
• Don't send your child back to daycare too early - the 2-day post-resolution period is critical for preventing outbreaks. 1
• Don't assume vaccination alone is sufficient - the combination of vaccination plus hand hygiene provides optimal protection. 3
• Don't overlook the importance of daycare staff compliance with hygiene protocols - staff are often the highest risk for disease transmission. 1