According to the American Academy of Otolaryngology—Head and Neck Surgery (AAO—HNS), while in day care, the risk is greatest for viral upper respiratory infection, the common cold, ear infections and diarrhea. While some studies blame day care for spreading illnesses as severe as asthma, others claim that children’s immune systems are actually improved by that constant exposure to germs.

Most colds occur during the winter months, with the average child having 8 to 10 colds per year, lasting 10 to 14 days each. This means that your child could be sick for more than half of the winter, with or without daycare. However, children in day care are expected to have 3 to 10 episodes of otitis media (ear infection) annually, says the AAO—HNS, which is four times more than children who do not attend day care.

Although you cannot prevent your child from becoming sick while at day care, you can teach good habits like washing his or her hands before eating and after using the toilet. Have your child regularly examined by a physician and alert the day care manager if your child does get sick. Also, check your day care’s hygiene cleaning practices since most infection is spread by children putting dirty toys and hands in their mouths.