Improving child’s handwashing techniques for a pandemic

Before the age of COVID-19 handwashing for many children was largely fun and games. They just turned on the faucet and fooled around while their hands never got wet and soap remained untouched. No more. Correct handwashing has morphed into hand hygiene with long lists of fact-based do’s and don’ts.

Here’s what you should know:

1. While hands may be a significant route of transmission of OVID-19 it is far from the main route. So says the US Centers for Disease Control. The main route is via virus-containing droplets that infected individuals discharge into the air when they talk, sneeze and cough. Hand transmission results from touching surfaces that have viruses on them and then touching ones’ mouth, nose, or eyes. Not known is the precise proportion of spread via each route. Some experts speculate that among children, especially young children, the spread via hands may be more important than it is among adults. Children practice poor hand hygiene and have an affinity for touching objects and placing their fingers in their mouths and noses. A study of daycare centers shows that compliance with guidelines for hand hygiene is “low”, says the American Society of Infection Control.

2. Set up a child-friendly hand hygiene station appropriate for a child’s age. That involves a slip-resistant stepstool, and easily accessible and easy-to-use faucets, soap (preferably liquid, see below) and a child’s own towel. (Allow children to choose the color.) Label hot and cold faucets with appropriate pictures. Supervise as necessary. Most three-year-olds can manage acceptable hand washing.

3. Wash hands under running water. Washing in sinks or basins of standing water may re-contaminate hands. Turning faucets on and off between different phases of washing saves water and does not significantly contaminate faucets. Warm water is no more effective than cold water. Water sufficiently hot to kill disease-causing organisms is irritating to the skin.

4. Soap and vigorously rubbing hands together separates dirt and organisms from the skin. Rinsing washes the mess away. Completely cover hands with lather. Wash between fingers. Firmly rub hands together for at least 20 seconds, the time it takes to sing “Happy Birthday” twice. (Sing slowly.) Rinse well with running water until all lather is removed. Soaps marketed as “antibacterial” and “antimicrobial” are unnecessary for routine hand washing. Many researchers recommend avoiding products that contain triclosan. Widespread use may favor the buildup of organisms resistant to antibiotics.

5. Keep fingernails short to make it easier to clean them. Easy-to-grip, animal-shaped nail brushes that are fun to use are available. Brush daily.

6. Ideally, use liquid soap. Child-friendly dispensers are available. Many toddlers are not good at using bars of soap; the bars slip out of their hands. However, for everyday purposes, soap bars are just about as effective. While soap bars may retain some organisms from previous users, this is not a problem, especially if one rinses well.

7. When soap and water are unavailable, use hand sanitizers containing at least 60% alcohol. Such sanitizers are almost as good as soap and water. Cover all parts of the hands. Rub hands and fingers together as with soap. To be totally safe, rewash hands with soap and water at the earliest opportunity.

8. Approved sanitizers are safe for children. But they should not get sanitizers into their mouths. Accidentally licking fingers after a sanitizer is applied is not believed to be a problem; ingesting more is unhealthy. If that happens, call your Poison Control Center at 1-800 222 1222. (Rarely, teenagers drink sanitizers for their alcohol content.)

9. Moistened, packaged wipes are not substitutes for sanitizers. Ads claim that such wipes are great for kids’ skin: non-alcoholic, hypoallergenic, and kill 99%-plus of germs. However, all that wipes accomplish is getting rid of visible dirt, not disease-causing organism. If alcohol-containing sanitizers make hands feel dry and itchy, apply aloe-containing cream.

10. Improve hand drying techniques. Shaking hands in the air or wiping them against ones’ clothing may leave moisture on hands. This allows organisms to survive and multiply. Dry hands until they are entirely dry. Ideally, use single-use, disposable paper towels. Reusable cloth towels, especially when slightly moist from previous users, also help organisms to survive.

For additional information, see https://www.cdc.gov/handwashing/handwashing-family.html

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