Preschool and school illnesses: what to expect and how to handle them
By Dr. Roberto Albani, Pediatrician and Gastroenterologist
Getting sick helps build immunity
Over my many years working as a pediatrician, I’ve often encountered desperate parents—especially at the beginning of the school year—unsure of what to do with a child who seems to get sick every other day.
When a child starts attending daycare or preschool, colds, coughs, fevers, and runny noses seem to become a constant presence. But why does this happen?
The preschool years: messy noses, stronger immunity
The reason is simple and unavoidable. In a warm, enclosed environment where many children spend several hours together, viruses and infections spread more easily. So, contrary to popular belief, it’s not the cold weather that makes children sick, but the close contact with other children.
Children play together, touch each other, breathe near one another, sneeze—and, through no fault of their own, spread germs everywhere. These microbes not only make them sick, but also turn them into little carriers who bring infections home to their younger siblings, even infants who aren’t yet in any kind of group setting.
This is a process that has been happening for centuries, and it’s inevitable. Children haven’t yet developed all the antibodies needed to fight off infections, they build immunity by getting sick and recovering.
Fortunately, we now have effective medications that can help manage fevers, ear infections, and other illnesses. However, it’s still important not to underestimate the symptoms.
“School illnesses” are mainly viral respiratory infections: colds, coughs, pharyngitis, laryngitis. The classic runny nose and changing cough (starting dry, then becoming more productive with mucus) are experiences familiar to all parents.
And what about the cough that never seems to end? The one that appears to go away, only to come back just as strong? In reality, it’s not always the same infection: children can catch one cold after another, and consequently one cough after another, in a never-ending cycle that makes it feel like a single, recurring illness.
Let’s now make an important distinction:
- Viruses → mainly affect the respiratory tract and are transmitted through the air.
- Bacteria → are more commonly associated with skin infections or complications following a viral infection, such as ear infections (otitis), tonsillitis, or sinusitis. These often involve pus, higher fever, and localized pain.
When are antibiotics needed?
Antibiotics are not appropriate for common viral infections, but they become necessary when bacterial complications arise.
Your trusted pediatrician will decide, based on symptoms, whether antibiotics are truly needed.
There’s no need to fear antibiotics — they are incredibly useful — but they should only be used when necessary, and always under medical guidance.
Some children are more prone to these complications and may need antibiotics more frequently, but the golden rule remains: use antibiotics only when indicated.
Possible complications
In some children, especially those with a tendency toward respiratory allergies, frequent colds can lead to recurrent bronchitis, bronchospasms, or even pneumonia.
This doesn’t happen to everyone, and it’s crucial to consult your pediatrician if symptoms seem to deviate from the typical pattern.
Labored, noisy, or rapid breathing are symptoms that should be taken seriously to avoid more severe consequences.
Avoid self-diagnosis, and above all, do not send a sick child to school — out of respect for other children, and to better monitor the illness and its progression.
Can the immune system be strengthened?
The first step is to make sure children have received all the recommended vaccinations, including the flu shot. Vaccines help reduce the risk of more serious infections, though they don’t eliminate the common cold or cough.
To support the immune system, a healthy diet is key to keeping the body strong. Supplementing with vitamin C —especially through citrus fruits — doesn’t work miracles, but it certainly helps.
Unfortunately, immunity to many infections is only developed by going through the illness itself—which, in the vast majority of cases, is just a major inconvenience rather than a serious threat.
What about the poor parents?
Dear moms and dads, as you’ve probably realized by now, once your child starts school or daycare, you must come to terms with the inevitable: they will get sick often, especially during the first few years.
It has nothing to do with cold outdoor air: colds are caught in crowded indoor spaces, not outside.
So, what to do? Should you keep your child home to avoid illness? That approach often backfires. The first time your child is exposed to a group setting, they’ll be unprepared and may go through a rough patch all at once.
So: have patience, and remember—we were all snotty little kids once, too. Let’s allow our children to go through that phase as well.
The most important thing for parents to know is this:
This is a normal part of growing up.
Over time, your child’s immune system will strengthen, and the frequency of infections will decrease.