Early Daycare: More Airway Symptoms Early in Life, No Prevention of Asthma Symptoms or Atopy at 8 Years.

Daycare exposes young children to more infections early in life, and may thereby prevent the development of asthma and allergy. The objective was to prospectively study the effect of daycare on the development of asthma and allergic sensitisation during the first 8 years of life. In the PIAMA birth cohort 3963 newborn children were followed prospectively for 8 years. Daycare use and respiratory health were assessed yearly by questionnaires. At 8 years, sensitisation to airborne allergens and airway responsiveness were measured. Daycare was defined as early (age 0-2), late (age 2-4) or none (no daycare before age 4). Associations of daycare and/or older siblings with asthma symptoms (wheezing, shortness of breath, and inhaled steroids taken in the last year), airway responsiveness and allergic sensitisation were assessed in a longitudinal repeated-event analysis. The results demonstrated that children with early daycare had more wheezing in the first years of life, but less wheezing and steroid use between 4 and 8 years. At 8 years, early daycare was not protective for asthma symptoms (adjusted odds ratio, aOR 0.99, 95% CI 0.74-1.32), allergic sensitisation (aOR 0.86, 0.63-1.18) or airway hyperresponsiveness (aOR 0.80, 0.57-1.14). The transient reduction in airway symptoms between age 4 and 8 years was only observed in children without older siblings. The conclusions drawn were that Conclusion: eEarly daycare is associated with an increase in airway symptoms until the age of 4, and fewer symptoms between 4 and 8 years. WeThe researchers found no protection against asthma symptoms, hyperresponsiveness or allergic sensitizsation at the age of 8 years. Am J Respir Crit Care Med. 2009. doi:10.1164/rccm.200903-0327OC.