Nursery Germs: Why Babies Get Ill So Often in Their First Term

9 min read

Quick answer: Babies get ill so often in their first term because there are hundreds of cold viruses and young children have no immunity to any of them yet. Children have 5 to 8 colds a year on average, and mixing in a group simply brings those colds closer together. Most colds get better within 2 weeks, though a cough often lingers after the cold itself has cleared.

What parents need to know

If your baby started nursery in September and has barely had a well week since, you're not imagining it. Here is what is usual, what needs a call, and how long each thing tends to take.

Why it feels relentless in the first term

There are hundreds of different cold viruses, and young children have no immunity to any of them because they've never met them before. Immunity builds gradually, and colds become less frequent over time.

Children have 5 to 8 colds a year on average. Put a group of them in one room and those colds arrive closer together, which is why a first term can feel like one long illness.

Most colds in younger children get better within 2 weeks. A cough often outstays the cold itself, because coughing is how the chest and throat clear mucus.

Realistic recovery timelines

These are the usual NHS and NICE timeframes. They help you judge whether something is running its normal course or drifting past it.

Illness	Usual course	Get advice if
Cold	Better within 2 weeks	Ask for an urgent GP appointment or call 111 if a cold is getting worse or you are worried
Cough with a cold	Can linger after the cold clears	See a GP if it lasts longer than 3 weeks
High temperature	Back to normal within 1 to 4 days	Call 111 if it lasts 5 days or more
Sore throat	Better on its own after a few days	See a GP if it lasts more than 3 days with a high temperature and they seem generally unwell; go to A&E or call 999 immediately if they are unable to swallow fluids or saliva, or have any difficulty breathing
Ear infection	Most settle within about 3 days	See a GP if earache does not start improving after 3 days
Bronchiolitis	Breathing and feeding improve within about 5 days; cough usually by around 3 weeks	Ask for an urgent GP appointment or call 111 if a cold is getting worse, or feeding drops well below normal

When to keep them at home

UKHSA guidance for nurseries, childminders and preschools is more practical than most parents expect. For respiratory infections, COVID-19 and RSV, children should stay away only if they have more than mild symptoms, for example a high temperature. A clear nose alone is not an exclusion.

Sickness bugs are stricter: stay away until 2 days after diarrhoea and vomiting have stopped. That applies to norovirus, rotavirus, food poisoning and general diarrhoea and vomiting.

If your child has a high temperature, NHS advice is to keep them at home while they recover.

Settings can refuse a child with a suspected or confirmed infectious illness if staff judge it necessary to protect others, so it's worth checking your nursery's own policy alongside the national one.

Chickenpox — Stay away until 5 days after the rash first appears.
Hand, foot and mouth, conjunctivitis, slapped cheek. No exclusion required.
Scarlet fever or group A strep — Stay away until 24 hours after starting antibiotics.
Impetigo — Stay away until all blisters have scabbed, or 2 days after starting antibiotics.
Flu — Stay away until better and no longer running a temperature.

When to get help

Call 111 if a high temperature has lasted 5 days or more, if there are other signs of illness such as a rash, if they are not their usual self and you are worried, or if there are signs of dehydration such as nappies that are not very wet, sunken eyes, or no tears when crying.

Ask for an urgent GP appointment or call 111 if a cold is getting worse, or if your child is feeding or eating much less than normal.

Call 999 or go to A&E immediately if your baby is under 3 months old with a temperature of 38°C or higher, or is 3 to 6 months old with a temperature of 39°C or higher (and has not had a vaccine in the past 2 days). Also call 999 immediately for a very low temperature (less than 36°C), feeling cold to touch or shivering, a weak, high-pitched or continuous cry, no pee or wet nappy in the past 12 hours, difficulty breathing, grunting noises or the tummy sucking in under the ribs, breathing very fast, pauses in breathing, being unable to swallow fluids or saliva, blue, grey, unusually pale or blotchy skin, lips or tongue, unusually cold hands and feet, a rash that does not fade under a glass, a stiff neck, being bothered by light, a first febrile seizure, being extremely agitated (not stopping crying) or confused, not responding like they normally do or not being interested in feeding or normal activities, being floppy and not waking up or staying awake, or if they are drowsy and hard to wake.

As a parent you may know when your child seems seriously unwell. Trust your own judgement, whatever a timeline says.

Caring for them at home

Most of this you can manage at home while the illness runs its course.

Fluids first — Offer plenty of fluids. If your baby is breastfed, continue as normal; smaller, more frequent feeds often work better when they are congested.
Pain and distress — Paracetamol or ibuprofen can help if they are distressed or uncomfortable. Do not give paracetamol under 2 months. Do not give ibuprofen under 3 months, under 5kg, with chickenpox, if dehydrated, or to children with asthma unless a doctor has recommended it; if your child has asthma, check with a pharmacist, GP or health visitor first. Do not alternate the two unless a health professional advises it.
Blocked noses. Saline nose drops can loosen dried snot and relieve a stuffy nose. Ask a pharmacist, GP or health visitor about them.
Do not cool them down — Do not undress your child or sponge them down. A high temperature is a natural and healthy response to infection.
Skip the cough medicine — Children under 6 should not have over-the-counter cough and cold remedies, including decongestants, unless a GP or pharmacist advises it.
Upright when awake — With bronchiolitis, keeping your child upright as much as possible while awake helps them breathe more easily.

What genuinely reduces the load

Handwashing is one of the easiest ways to protect against illnesses such as flu. Wash for around 20 seconds, the time it takes to sing Happy Birthday twice, and always after nappy changes, after blowing noses, coughing or sneezing, and before handling food. Encourage the whole family, not just the child at nursery.

Washing hands and toys often, wiping down surfaces, using disposable tissues and throwing them away straight after use all lower the chance of spreading the viruses behind bronchiolitis. Not smoking around your child matters too, as breathing in cigarette smoke raises the risk of severe bronchiolitis.

Keep vaccinations on schedule. The RSV vaccine is available on the NHS from 28 weeks of pregnancy and reduces the risk of severe RSV for your baby's first 6 months. The children's flu vaccine is offered every year from 2 to 15 years, and from 6 months for children with long-term health conditions. If you think a vaccine has been missed, your GP surgery can catch it up.

Frequently asked questions

Is eight colds in a year really normal?

Yes. Children have 5 to 8 colds a year on average, and they cluster when children mix in groups. Immunity builds gradually and colds become less frequent.

Why does the cough hang around after the cold has gone?

Coughing clears phlegm from the chest and mucus from the back of the throat, so it often lasts longer than the cold. See a GP if a cough lasts longer than 3 weeks, or if it's worse at night or brought on by running about, which can be a sign of asthma.

Should I keep my baby home for a runny nose?

For respiratory infections, the guidance is to stay away only with more than mild symptoms, such as a high temperature. A runny nose alone does not require exclusion, though your setting may have its own policy.

Are repeated ear infections a problem?

Ear infections often follow a cold and most get better by themselves, usually within about 3 days. Repeated middle ear infections may lead to glue ear, where sticky fluid builds up and can cause usually temporary hearing loss. See a GP if earache is not improving after 3 days, or if you think your child has hearing loss.

How worried should I be about bronchiolitis?

It is common in babies and children under 2 and a third of children have had it by their first birthday. It is usually mild and treated at home; about 3 in every 100 need hospital help with breathing and feeding. Symptoms are usually worst between days 3 and 5.

Does constant illness mean their immune system is weak?

No. Young children haven't met these viruses before, so they have no immunity to them. They build it up as they go, and get fewer colds over time.

Sources & further reading

General information, not individual medical advice. Speak to your GP, midwife or health visitor about your baby’s needs.