Advice Column, Education, Parenting, Toddler

Crèche Syndrome

  • Paarl Dietitians
  • Category Advice Column, Education, Parenting, Toddler

Parents whose children attend crèche or playgroups are very often faced with crèche syndrome. Crèche syndrome is not a condition you will read about in medical textbooks or medical research journals and literature. Yet crèche syndrome is probably the most common chronic condition seen by paediatricians in private practice.


Crèche syndrome refers to a phenomenon whereby young children come down with repeated episodes of infections that includes an ongoing cycle of colds, sniffles, excessive upper respiratory snottiness, wet coughs and in more serious cases lead to secondary ear infections, sinusitis, tonsillitis, bronchitis and even pneumonia.

Young children are very easily infected at a crèche or playgroup where they come into contact with other children on a daily basis. In a crèche environment, children engage with each other for several hours at time, in a very close proximity, and this exposes young children to whatever infections are doing the rounds. In winter time the children spend most of their time indoors, which is a breeding ground for illness.

Vulnerable age group

Babies and young children (under the age of 2 years) are most vulnerable to crèche syndrome. Their immune systems is immature and still developing, which mean they are more susceptible to viruses at a young age leading to frequent and more severe infections.

The vicious cycle…

It is all about continuous virus load – one after another – that wears down the children’s health. However, even though children need to build antibodies against various germs and infections, crèche syndrome doesn’t build enough resistance because of the unrelenting cycle of illness. By the time the virus has infected the first child and travelled through another 10 children at crèche, it reinfects the original child because its form has changed (mutated). After repeated infections a child’s immune system become compromised. Subsequently, these children can get as many as 10 upper airway infections per year. During each episode they could have 10-20 days of a runny nose and a cough as well as fever for the first 3 days (72hours).

The result

Crèche syndrome is exhausting! It involves a never-ending rollercoaster ride of illness, doctor visits, medication, time off work and very little sleep.

The good news

Crèche syndrome does not last forever. A young child’s immune system strengthens and becomes better at identifying and dealing with viruses. After the first two to three years you will notice that infections become fewer and often less severe.


Antibiotics are often prescribed too frequently to treat crèche syndrome and without justification. Antibiotics are rarely the solution because most infections are viral, for which they do not work. They will however kill good bacteria in our body. This disrupts the balance of bacteria present in the digestive system and in so doing compromise the immune system making the child even more susceptible to infections. This becomes a vicious cycle.

Recurrent use of antibiotics may also have a negative impact on long-term health. According to research, children exposed to oral antibiotics repeatedly as a baby or young child are more likely to develop allergic disease (eczema, asthma, allergic rhinitis), food allergies, irritable bowel syndrome, inflammatory bowel disease i.e. crohn’s disease and ulcerative colitis (IBD) as well as coeliac disease.

The wrong use of antibiotics may lead to the development of antibiotic resistance which is of increasing concern.  When it really becomes mandatory to use antibiotics, the may not be able to eradicate the offending bacteria.


The treatment of crèche syndrome is usually symptomatic and seldom addresses the cause – the underdeveloped immune system. Therefore, the best way to deal with crèche syndrome is to help support and strengthen the immune system to fight infections and thereby prevent the cycle of the condition.

Fight it with food

Good nutrition is essential in fighting crèche syndrome. It is very important to provide the essential vitamins and minerals much needed by the immune system but also to prevent nutrient deficiencies.

The problem is that many toddlers are fussy eaters and parents fall into the trap of feeding them something they know they’ll eat. Often processed meals e.g. pizza or 2-minute noodles instead of nutritious food. This means they miss out on very important nutrients and their immune systems as well as gut become impaired so they catch colds frequently. This can spiral into a vicious cycle of eating less and catching more infections. After repeated bouts of illness many children often battle to catch up the weight they lost making them even more susceptible.

Missing immune supportive nutrients

Nutrient deficiencies is a well-known cause of immune system malfunction and young children are very often deficient in immune supportive nutrients. An underlying iron, zinc or vitamin D deficiency are often present and can affect the immune system dramatically and increases a child’s vulnerability to an infection. If a child presents with recurring infections it is of value to have blood tests done to establish if there is any underlying nutrient deficiency present. These deficiencies can be easily corrected by means of supplementation.



If a child is a picky eater, multivitamin supplementation should be considered to help support the immune system. Daily supplementation ensure that the body is getting all of the building blocks for a healthy immune system. Look for a high quality broad spectrum multivitamin with vitamins A, B, C, D, E, and B12, zinc, selenium and magnesium. There are so many supplements available on the market that it can be confusing which to use. Paarl Dietitians would be able to advise you on the most appropriate supplement.

I usually suggest that children should rather drink a no.3 formula up to 3 years of age rather than cow’s milk that does not supply all the required nutrients for brain development and building a strong immune system. Important – Do not exceed 500ml of milk a day to reduce the risk of an iron deficiency.


Probiotics seem to be the new kid on the block with lots of evidence that a person’s microbiome plays a major role in regulating the immune system. Probiotics taken as a supplement aid in immunity by keeping the unfriendly bacteria under control & acting as soldiers.

It might be of benefit for children in crèches to take probiotics on a daily basis to help boost their immune systems since it has been clinically proven to reduce incidence, duration, intensity and symptoms of viral infections. Probiotics can decrease the incidence of upper respiratory tract infections by 85%.

It is important to note that not all probiotics address the immune system and you should be quite specific about your product choice. One example of a patented clinically proven formula for the prevention of viral infections is a combination containing Lactobacillus Plantarum HEAL9 and Lactobacillus Paracasei 8700:2. The STRAIN is key.  Also very important – all courses of antibiotics should be accompanied by a course of probiotics.

Omega-3 fatty acids

These healthy fats have been shown to improve immunity and decrease inflammation. Young children often struggle to eat sufficient amounts of omega-3 containing foods found in oily fish such as salmon, mackerel, herring, sardines, pilchards and trout as well as seeds and walnuts. Therefore, it would be advisable to make use of an omega-3 supplement to ensure adequate intake.


This is an important antioxidant that many are deficient in. A lack of zinc can lower immunity significantly. This mineral has a strong antiviral capacity and has been found to inhibit the common cold. A great tool is zinc lozenges, which dissolve in the mouth or zinc syrup. At the first sign of a cold, take a daily dose. Many clinical trials have shown that viral infections can be prevented and symptoms improved within just a few days on this treatment.


This is used to strengthen the immune system and to lower the risk of infection in persons with a weakened immune system such as young children. It is derived from colostral whey peptides and supports immune function by providing immunoglobulins and other immune factors.


Créches and playgroups are breeding grounds for germs and bacteria. Added to this are weather changes, constant activity from indoors to outdoors and close proximity to other children. Often repeated colds lead to weakened immune systems and secondary infections. Therefore young children’s immature immune systems need constant boosting, and it is vital that their little bodies are supported when they are not well.

Paarl dietitians would be able to look at your child’s diet and establish if there is any essential nutrients lacking. Blood tests can further be arranged to determine if there are any underlying nutrient deficiencies present which could compromise a young child’s immune system. Advice would then be provided on the most suitable dietary supplement, based on specific needs.

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