Health care experiences in infancy and subsequent frequent illness in 1-year-old children


Background: Parents of infants suffering from frequent episodes of illness demand more acknowledgement from general practice with regard to their observations of these illnesses, which is evident from their tendency to book multiple consultations. Aim: To identify factors relating to illness and health-care experiences in infancy that predict frequent episodes of illness in toddlers. Design of study: A retrospective questionnaire and a prospective diary study including 183 infants born in February 2001 in a district of the capital region of Denmark. Setting: Denmark, primary care. Methods: Infants were recruited from a birth cohort and experiences of illness from birth until the age of 11 months were collected using a questionnaire. Thereafter the infants were followed prospectively from the age of 11 to 14 months using diary cards. The diary data consisted of 1) selected symptoms, 2) doctor-contacts and 3) parent-rated illness severity, information used to form three aspects of a frequently ill child. The analyses explore associations from the infant data with the three indicators of frequent illness. Results: Experiences of restless sleep, earache, otitis media, penicillin usage and use of medicine associated with illness in infancy were highly associated with factors of excess illness during the follow up period. Disturbed sleep in infancy was the factor with the highest probability of frequent illness as a toddler—an unexpected finding. Experiences of acute otitis media (earache, frequent visits to the doctor and antibiotic treatment) were strongly related to frequent illnesses. Asthma or giving the child medicine correlated with a higher parent-rated frequency of illness later on. Conclusions: Sleep problems in infancy can predict frequent illness episodes later on. In clinical practice the GP may benefit from talking about sleep in the consultations in order to learn something more. The three different indicators of frequent illness applied to different aspects of being a frequently ill child.

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Ertmann, R. , Siersma, V. , Reventlow, S. and Söderström, M. (2013) Health care experiences in infancy and subsequent frequent illness in 1-year-old children. Health, 5, 259-266. doi: 10.4236/health.2013.52035.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Ertmann, R.K., Reventlow, S. and Soderstrom, M. (2011) Is my child sick? Parents’ management of signs of illness and experiences of the medical encounter: Parents of re currently sick children urge for more cooperation. Scan dinavian Journal of Primary Health Care, 29, 23-27.
[2] Helman, C.G. (1984) Culture, health and illness. Arnold, London.
[3] Jasenak, M., et al. (2011) Recurrent respiratory infections in children—Definition, diagnostic approach, treatment and prevention. Bronchitis. InTech, 119-148. _approach_treatment_and_prevention.pdf
[4] De, M.M. and Ballotti, S. (2007) The child with recurrent respiratory infections: Normal or not? Pediatric Allergy and Immunology, 18, 13-18. doi:10.1111/j.1399-3038.2007.00625.x
[5] Johnson, C.M. (2008) Children’s health: When to worry about frequent illness.
[6] Gannik, D.E. (1995) Situational disease. Family Practice, 12, 202-206. doi:10.1093/fampra/12.2.202
[7] Kleinman, A. (1988) The Illness Narratives: Suffering, healing & the human condition. Basic Books, New York.
[8] Janicke, D.M., Finney, J.W. and Riley, A.W. (2001) Children’s health care use: A prospective investigation of factors related to care-seeking. Medical Care, 39, 990-1001. doi:10.1097/00005650-200109000-00009
[9] Uijen, J.H., van Duijn, H.J., Kuyvenhoven, M.M., Schel levis, F.G. and van der Wouden, J.C. (2008) Characteris tics of children consulting for cough, sore throat, or ear ache. The British Journal of General Practice, 58, 248 254. doi:10.3399/bjgp08X279751
[10] Dingle, J.H., Badger, G.F. and Jordan, W.S. (1964) Illness in the home. A study of 25,000 illnesses in a group of cleveland families. Western Reserve University, Cleve land.
[11] S?derstr?m, M., Hovelius, B. and Prellner, K. (1991) Res piratory tract infections in children with recurrent episodes as preschoolers. Acta Paediatrica Scandinavia, 80, 688 695.
[12] Prellner, K., Kalm, O. and Harsten, G. (1992) Middle ear problems in childhood. Acta Otolaryngology, 493, 93-98.
[13] Douglas, R.M., Woodward, A., Miles, H., Buetow, S. and Morris, D. (1994) A prospective study of proneness to acute respiratory illness in the first two years of life. International Journal of Epidemiology, 23, 818-826.
[14] Andre, M., Hedin, K., Hakansson, A., Molstad, S., Rodhe, N. and Petersson, C. (2007) More physician consultations and antibiotic prescriptions in families with high concern about infectious illness—Adequate response to infec tion-prone child or self-fulfilling prophecy? Family Prac tice, 24, 302-307. doi:10.1093/fampra/cmm016
[15] Asmussen, L., Olson, L.M. and Sullivan, S.A. (1999) “You have to live it to understand it”: Family experiences with chronic otitis media in children. Ambul Child Health, 5, 303-312.
[16] von Linstow, M.L., Holst, K.K., Larsen, K., Koch, A., Andersen, P.K. and Hogh, B. (2008) Acute respiratory symptoms and general illness during the first year of life: A population-based birth cohort study. Pediatric Pulmo nology, 43, 584-593. doi:10.1002/ppul.20828
[17] Li, V.G., Malaponte, G., Bevelacqua, V., Messina, A., Bianca, S., Mazzarino, M.C., et al. (2003) Persistent high plasma levels of interleukins 18 and 4 in children with recurrent infections of the upper respiratory tract. Trans plantation Proceedings, 35, 2911-2915. doi:10.1016/j.transproceed.2003.10.024
[18] Saxena, S., Majeed, A. and Jones, M. (1999) Socioeco nomic differences in childhood consultation rates in gen eral practice in England and Wales: Prospective cohort study. British Medical Journal, 318, 642-646. doi:10.1136/bmj.318.7184.642
[19] Ertmann, R.K. (2007) What makes parents consult a physician? Ph.D. Thesis, Research Unit for General Practice in Copenhagen, Copenhagen.
[20] Ertmann, R.K., Siersma, V., Reventlow, S. and Soderstrom, M. (2011) Infants’ symptoms of illness assessed by parents: Impact and implications. Scandinavian Journal of Primary Health Care, 29, 67-74. doi:10.3109/02813432.2011.576863
[21] Saunders, N.R., Tennis, O., Jacobson, S., Gans, M. and Dick, P.T. (2003) Parents’ responses to symptoms of respiratory tract infection in their children. Canadian Medi cal Association Journal, 168, 25-30.
[22] M?lstad, S. (1990) Antibiotics usage and betalactamase production in respiratory tract bacteria. University of Lund, Lund.
[23] Getz, L., Kirkengen, A.L. and Ulvestad, E. (2011) The human biology—Saturated with experience. Tidsskrift for Den norske Legeforening, 131, 683-687.
[24] Steiger, A. (2002) Sleep and the hypothalamo-pituitary adrenocortical system. Sleep Medicine Reviews, 6, 125 138. doi:10.1053/smrv.2001.0159
[25] Raikkonen, K., Matthews, K.A., Pesonen, A.K., Pyhala, R., Paavonen, E.J., Feldt, K., et al. (2010) Poor sleep and altered hypothalamic-pituitary-adrenocortical and sympatho adrenal-medullary system activity in children. The Journal of Clinical Endocrinology & Metabolism, 95, 2254 2261. doi:10.1210/jc.2009-0943
[26] De, W.C., Zijl, R.H. and Buitelaar, J.K. (2003) Develop ment of cortisol circadian rhythm in infancy. Early Human Development, 73, 39-52. doi:10.1016/S0378-3782(03)00074-4
[27] Dijk, D.J. and Czeisler, C.A. (1995) Contribution of the circadian pacemaker and the sleep homeostat to sleep propensity, sleep structure, electroencephalographic slow waves, and sleep spindle activity in humans. The Journal of Neuroscience, 15, 3526-3538.
[28] Kirschbaum, C. and Hellhammer, D.H. (1989) Salivary cortisol in psychobiological research: An overview. Neu ropsychobiology, 22, 150-169. doi:10.1159/000118611
[29] Smith, A. (1992) Sleep, colds and performance. In: Brough ton, R. and Ogilvie, R.D., Eds., Sleep, Arousal, and Per formance, Birkhüser, Boston, 233-234.
[30] White, B.P., Gunnar, M.R., Larson, M.C., Donzella, B. and Barr, R.G. (2000) Behavioral and physiological re sponsivity, sleep, and patterns of daily cortisol production in infants with and without colic. Child Development, 71, 862-877. doi:10.1111/1467-8624.00196
[31] Caserta, M.T., O’Connor, T.G., Wyman, P.A., Wang, H., Moynihan, J., Cross, W., et al. (2008) The associations between psychosocial stress and the frequency of illness, and innate and adaptive immune function in children. Brain Behavior and Immunity, 22, 933-940. doi:10.1016/j.bbi.2008.01.007
[32] McEwen, B.S. (2000) Allostasis and allostatic load: Implications for neuropsychopharmacology. Neuropsycho pharmacology, 22, 108-124. doi:10.1016/S0893-133X(99)00129-3
[33] Nielsen, N.M., Hansen, A.V., Simonsen, J. and Hviid, A. (2012) Stressful life events in childhood and risk of infectious disease hospitalization. European Journal of Pediatrics, 171, 173-179. doi:10.1007/s00431-011-1498-2
[34] Lam, M.H., Zhang, J., Li, A.M. and Wing, Y.K. (2011) A community study of sleep bruxism in Hong Kong children: Association with comorbid sleep disorders and neu robehavioral consequences. Sleep Medicine, 12, 641-645.

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