Health and Safety E-News for Caregivers and Teachers

Welcome to the April 2006 issue of the American Academy of Pediatrics Health and Safety E-News for caregivers and teachers.

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This issue includes information and action steps for you on the following topics:

Keeping Children Healthy by Preventing Infectious Diseases

Children who play in groups have an increased risk of infectious diseases. A child with a contagious illness has an infection that can be passed to another person. Below are things you can do today to keep the children in your care as healthy as possible.

  1. Use good handwashing practices. This is easier when there are sinks with warm water, soap, disposable towels, hand lotion, and easy-to-understand instructions in each room or near where the activities take place. Show children how you wash your own hands, and encourage them to wash their hands at the times listed below.
  2. Clean and disinfect surfaces available to the children including floors, equipment, toys, and objects that children might put in their mouths (thermometers, pacifiers, and teething toys).
  3. Children must have up-to-date immunizations for participation in the program. The health form that you keep on file should include immunizations given. Remind parents to ask the health care provider to update the form each time their child receives a "check-up". All staff members must have up-to-date immunizations because they can get sick too, or give these diseases to the kids.
  4. Tell mothers why breastfeeding is good for babies. Breastmilk both nourishes babies and protects them from getting sick. Encourage mothers to visit and nurse their baby during the day.
  5. Encourage healthy eating and nutrition, good handwashing skills and a safe, healthy place for children to play and learn. Talk to a health professional about things that you can do to prevent diseases. A child care health consultant can help you develop and carry out written policies for prevention and control of infectious diseases.

Deciding Whether Mildly Ill Children Can Attend Child Care

Knowing when a child is ill and deciding whether the child should attend child care can be difficult. Parents and child care providers may not agree about whether a child should attend child care or stay at home. Below are things you can do today to work with parents and make the right decision. Here are some things you can do:

  1. Talk to parents when they enroll their children in your program, and encourage them to plan ahead for when their child is ill and unable to attend. Explain why you might have to make a decision about whether their mildly ill child can attend child care.
  2. Know where to find information that can help you make a decision. Have a reference manual available, use a health hotline, and/or find a health consultant or other health professional who can offer advice when you have questions. Contact the local health department when you need help in managing a suspected outbreak and when a child, member of the child's family, or staff member has a reportable disease.
  3. When children are sick, think about how the illness will affect their day. If the illness prevents a child from participating comfortably in activities or if the child needs more care than you can provide, then the child should not attend child care. Children, caregivers, and program situations are all different. Sometimes mildly ill children can stay in child care if there's a place for them to relax or lie down where they can be watched carefully by someone they know. If this child requires a lot of additional attention, and you cannot properly care for the other children, it's best to send the child who is sick home.
  4. Consider whether the illness might spread an infection to other children. Most common infections are not dangerous. People can have diseases and be contagious without having symptoms. So, sending a child home may not significantly reduce the spread of an infection.
  5. Notify parents when their child becomes ill, and let them decide whether to take their child to the doctor.

Handwashing and Use of Hand Sanitizers

Good handwashing is the best way to reduce germs and infections in child care settings. Below are things you can do today to prevent and reduce the spread of infections.

  1. Wash your hands:
    • When you arrive for the day or when you move from one group of children to another
    • Before and after you eat or prepare or handle food
    • Before and after you feed an infant or give medicine
    • After you touch pets/animals, garbage, or sand in sand boxes
    • After you have been cleaning
    • After you change a diaper or help a child with toileting
    • After you wipe a nose or touch a mouth, sore, or any bodily fluids
    • When you leave for the day
  2. Help children to wash their hands:
    • Before and after they eat
    • After they touch pets/animals
    • After they play in the sand box, or a water table
    • After they have had their diaper changed or go to the bathroom
    • After they wipe their nose, or touch their mouths or any bodily fluids
  3. Use liquid soap, disposable towels, and warm water that is comfortable. Lather hands for 10 seconds and rinse hands until they are free of soap and dirt. Washing for a full 10 seconds is the hardest part; count "Bubble one, bubble two, etc", sing a song that lasts 10 seconds, or use a timer to make sure this happens. The warm water doesn't necessarily remove more germs, but it helps you to wash your hands longer. Dry hands with the clean, disposable paper or single use cloth towel.
  4. Know that gloves and/or hand sanitizers are not as effective as handwashing under running water. If you use gloves, you still need to wash your hands. Some germs get through tiny holes in the gloves. If you don't have running water, you can use wipes or hand sanitizers, but always follow-up with proper handwashing as soon as you can.
  5. Once your hands are clean, remember not to touch something that is not clean. Throw out diapers, put soiled clothing in bags, and toss the garbage before washing your hands. If the water does not shut off automatically, let it run while you dry your hands and then turn the taps off with a towel.


At first, it might seem like handwashing may take time away from activities. You can wash hands while singing songs, saying short poems or rhymes, or talking about the next activity. Handwashing keeps everyone healthy and able to attend child care, and it is well worth the time and effort it might take to work it into your program activities!

For resources on Infectious Diseases, visit the Resource Library.


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