Infectious Diseases in Day Care: Parallels Between Psychologically and Physically Healthy Care

A review of day care practices in the United States indicates a substantial increase since 1977 in out-of-home care for infants and toddlers, with a preponderance of care in un-licensed family day care homes. The effects of group care on infants and toddlers depend largely on the facility's success at meeting certain criteria for group size, staff-to-child ratio, and staff training. Parallels exist between providing psychologically healthy day care and minimizing the spread of infectious disease in day care facilities. Many of the same factors involvedin providing psychologically safe day care are also involvedin provid-ing disease-free care. Financial and regulatory obstacles to high-quality care are consider-able; however, supplementary child care for working parents is essential, and efforts to address such problems as infectious diseases must keep this perspective. One of the goals of workers who seek to provide ap-propriate supplementary care for children of work-ing parents should be the development of cost-effective and easy-to-implement strategies for con-trolling infectious disease in day care. We must b