As the new school year begins, children trek off to school, returning in the evening with their artwork, stories about their day -- and possibly a few germs and viruses to share with the family.
"It's never too early to worry about your child picking up germs in day care," said Dr. Tanya Remer Altmann, a pediatrician with the Community Pediatric Medical Group in Westlake, Calif. "In fact, the first day of day care they can catch a cold."
"Typically, when kids start day care or preschool, within a few days to a week, we see them coming into our office with new colds they've picked up," she said. "With my own boys, I see this."
But while sicknesses may be ubiquitous among the playground set, parents who are sending their children to day care typically don't have the luxury of keeping them out.
Pediatricians say there are better ways to solve the germ problem than keeping children in a bubble. There are several steps parents can take, they say, to help cut down the number of germs and viruses a child picks up.
As a parent, pediatrician and the owner of a day care center, Dr. Laura Jana has seen the problem of children getting sick in day care from all angles.
"People send their children to child care in part to learn how to share, and it's just not just limited to their toys, they also share their germs," she said.
The only way to minimize the number of infections that are transmitted, she said, is to make reducing the infections part of the daily routine. That includes the prominent placement of sinks in the classrooms and having policies for regular handwashing and cleaning of toys.
"Germs are going to spread, but you can significantly lessen it," she explained. "If you try to tell people that it's a good idea ... and it's not part of the child care center's routines, it's as likely as not to be overlooked in the course of a busy day."
Regular handwashing, pediatricians agree, is one of, if not the most, important step in preventing the spread of germs. And that goes for day care providers as well.
"It's not just kids when you talk about the spread of infection in day care," said Jana.
She said staffers were also reminded to wash their hands after cleaning or changing a diaper.
And many adults could probably use the reminder for handwashing as well. A 2005 University of Minnesota study showed that 18 percent of adults in the U.S. do not wash their hands after using the restroom.
Having children wash their hands regularly, explained Jana, helps develop their lifelong routines.
Vaccinations are the other major step pediatricians say parents should take to keep their kids healthy.
In July, the CDC issued its recommendations for this flu season, saying that all children over the age of six months should be vaccinated against influenza.
Altmann recommended receiving a shot or, in children over two, FluMist -- a nasal spray comparable to the flu shot.
"Last year, the flu mist showed to be more effective in the children than the flu shot, at least in my part of the country," she said. "That's what I'm going to give my three year old this year.
"Once they're a little older, they often do prefer the flu mist. Sometimes, the fact that there's no needle involved gives an added benefit."
But Altmann also stresses that vaccines children should have go beyond the flu.