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Aseelah El-Amin is a self-proclaimed germaphobe. When the Atlanta mom was looking for daycare for her 18-month-old daughter, she visited many child-care centers, always asking the directors lots of questions. She asked how they kept toys clean, what the policy was about sick kids, and how they worked to fight germs.

"I knew that when children start daycare, they got sick a lot," she says, "so I was really picky."

She found a place near her home where germ fighting was a top priority. The staff had children take off their shoes in a small room before coming inside. Toys were cleaned every day with natural cleaning products. Parents were given a list of symptoms -- such as diarrhea and pinkeye -- that meant sick kids had to stay home.

Like El-Amin, you may be concerned about germs, hygiene, and sanitation when choosing a daycare center. Then your worries may surface again when cold and flu season starts. That's when you may notice kids with runny noses and coughs playing side by side with your child.

These concerns are valid, pediatricians say. With so many small kids together in a small place, daycare can be a festering ground for bacteria and viruses.

Questions to Ask About Germs

Sick kids and daycare may go hand in hand, but there's plenty you can do to make sure your child-care center is doing its best to keep the cold virus and flu virus -- as well as assorted bacteria -- under control. Start by asking some of these questions.

How often do employees wash hands?

The ideal center should require employees to wash their hands as often as a doctor does -- in between touching every child.

If your child-care center doesn't have a sink in every room, look for  bottles of hand sanitizer. If employees have to leave the room to clean their hands, they may be less likely to do it.

How clean are the toys?

Many centers have a policy that toys are cleaned and sanitized at least once a day. Guidelines from the American Academy of Pediatrics, however, suggest that every time a toy is placed in a child's mouth, it should be set aside until it can be cleaned and disinfected.

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