"Parents want to make sure that their child is up to date on all their vaccines, including the flu vaccines," Altmann said.
Altmann advises parents to ask their day care provider what percentage of the children in their care are up to date on their vaccinations.
"We are seeing some of these infections that previously hadn't been around popping back up and emerging because parents aren't protecting their kids," she said.
Even if a child has had an immunization shot, Altmann said, they could still contract the illness, either because their shot was not effective or because they have not finished the series of shots necessary for immunity.
"They can still be at risk if the other children around them aren't vaccinated," Altmann said. "Even though it's a slight risk, it could still be there. Most of the very serious cases of whooping cough were in infants who were too young to get vaccinated or had only had the first dose in the series of the vaccine."
Other steps pediatricians recommend include basics, like making sure children eat healthy and get enough sleep, and, to prevent spreading illness, keeping toddlers home when they are ill.
Jana explained that keeping a child home for at least 24 hours after symptoms appear is a good rule of thumb, but parents still need to monitor their children, since the symptoms won't always tell the whole story.
If a child is symptom-free, but only because of medication, she said, he or she is probably not ready to go back to school.
On the other hand, she said, "If you have to chase a child around the park to take their temperature, chances are you don't need to do anything about it."
In addition to their own steps, pediatricians recommend that parents speak to day care providers on several issues to check the likelihood of their child getting sick.
These questions include seeing what additional measure they take to avoid spreading germs, finding out the policy for how long sick children must stay home, and determining how often the teachers clean the classroom surfaces and toys.
Keeping surfaces clean is no small matter. In 2004, a University of Arizona study concluded that over half of the surfaces and objects in homes and day care centers had strains of the influenza virus on them during the flu season.
"The toy-cleaning is not trivial," Jana said.
In the case of her day care, she said she knew her policies were being followed when one of her center's charges was found to have an undiagnosed case of salmonella for several weeks, but it had not spread to any of the workers or other children.
From changing diapers to serving food, Jana said she has policies to cover all of her day care operation, and parents should ensure that the place where they send their children has those types in place.
"I have more policies than you want to know about, but I believe in them," she said.